Texas Medical Licensing Instructions

**WARNING** This will take about 3 - 6 months to complete and is not cheap.  However, you do not have to wait until you are finished with intern year to get this started.
 
USMLE STEP 3

• You must have this in order to get licensed, and you must have a license to moonlight. Many people take this during intern year (anesthesia, US, tox rotations give plenty of time to study)
• Information:  www.usmle.org
• Application:  www.fsmb.org
• Cost: approximately $845 in 2017
• Take as soon as possible

 
TX State License Application

• You will need a copy of your birth certificate.  This is probably the only free part of the whole process.
• After getting Step 3 results, go to the Texas Medical Board website (you can start this before completing intern year)  http://www.tmb.state.tx.us/page/full-medical-license then click on the link to the left to complete the online application.  This will give you access to the LIST (License Inquiry System of Texas) website, which you will use to follow the status of your application online.
• There is a choice to use FCVS (Federal Credentialing Verification Service).  Rumor has it this is best for those who plan on applying to multiple states when done with residency. Check here for FAQs regarding FCVS to decide if this is right for you: http://www.fsmb.org/licensure/fcvs/ .  Most of us did not do this – it takes longer to get licensed and if you think you are going to stay in Texas, you don’t need it.  Only some states actually require FCVS, many will accept it but it is not required.
• Forms must be submitted to your med school and to your residency director, which then go to TSBME.
  o    Form D goes to your medical school
  o    Form L goes to Dr. Velez
• Forms that go to TMB can be mailed by USPS or private company (UPS, FedEx, etc). TMB recommends private company, but some have used USPS without issues, just make sure to follow the directions carefully. You will not get e-mail confirmation from TMB, your LIST checklist will simply be updated.
• USMLE transcript request, online (cost $70).  Info at http://www.fsmb.org/licensure/transcripts/overview . Sign in to request your transcript and have it sent electronically to TMB.
• Online inquiry to National Practitioner Data Bank (cost $4) at https://www.npdb.hrsa.gov/ and choose “Start a Self-Query” on the right.  You should receive both electronic and a hard copy of the results.
• Fingerprinting: see below
• Jurisprudence test: see below
• TSBME cost $835 to apply for your license; you will later have the opportunity to pay for your license (see below).  Nice.
• License registration is approximately $284 for 12 months, due 90 days after your permanent license is issued.
• They’ll give you regular updates regarding what you still need to complete your application via the LIST website.  Again, once you start the application process, you will gain access to the LIST site and everything becomes infinitely clearer. (Select Applications tab on the site, then click link for “Full License” to see your check list of what is completed)

 
Fingerprinting

• Must be done for Texas and the FBI, but can be done at the same time/place.
• Go to http://www.tmb.state.tx.us/page/get-fingerprints for information (follow instructions on Live Scan Fingerprinting). Schedule an appointment with your assigned ID on https://uenroll.identogo.com/workflows/11G62J
• Fill out the online forms and bring the appropriate documents to your appointment
• Cost: $41.45

 
Jurisprudence Test

• You’ll get your scheduling permit on the LIST site.  Check your Message Center tab on LIST (you have to actually click on the “Inbox” link to see your messages)
• Computerized at Pearson VUE (similar to Prometric) like USMLE
• More info: http://www.tmb.state.tx.us/page/physician-jurisprudence-examination
• Study guide (book) can be purchased at bookstore (approx $80 and about 350 pages) or just borrow it from the lounge.  For most, just reading the questions and answers is enough. (There is also a short study guide floating around, ask an R3 for the PDF, and there are flashcards online at http://www.cram.com/flashcards/jurisprudence-exam-for-texas-medical-board-836632 )
• Study time should be no more than 2-3 days at the most.
• Test cost: $58

             
TSBME temporary license

• After passing JP test, the Texas Medical Board (TMB) will contact you about applying for a temporary license. (They will not e-mail you, it will be in your LIST mailbox)
• A temporary license will only be issued if you request one.  It is good from the date your license is complete until the regular licenses are next issued, usually two weeks or less.  A temporary license is free, but must be requested using the Temporary License link
• A temporary license will enable you to initiate applications for DPS and DEA certificates while the TMB reviews your application for permanent licensure.  Depending upon your situation, this may allow you to start moonlighting a couple of weeks sooner.

 
DPS certificate (Texas) – No longer required
 
DEA number (Federal)

• Apply after you have received your DPS number.
• This is the final document you need in order to moonlight.
• Online:  www.deadiversion.usdoj.gov
• Choose “New Application” in the menu on the right
• Cost: $731

 
Apply at the places you want to work

• Opportunities are generally passed on via word-of-mouth from the people who have gone before you.
• Usual places: Texas Institute of Surgery, Sunnyvale, Care Now, outlying Presby facilities.  Single and double coverage opportunities available as well as doc-in-the-box.  Many places give referral bonuses, which referrers generally split with referees.

Total Cost:
USMLE                 845
Transcript              70
NPDB                     4      
Application           835
Registration          284
Fingerprint             41.45
JP test                     58
DEA                       731  
                                = $2870 -- This is approximately 4 moonlighting shifts!
 
Other things you need to know and may be able to work on now (will need these to apply at places you want to work):

• Be sure your procedure logs are updated and your conference attendance is maximal--you need to request permission from the residency to moonlight (form on MedHub).  Additionally, those who are not up-to-date cannot go to ACEP
• Gather BLS, ACLS, PALS, ATLS cards and see what needs renewal (BLS/ACLS/PALS every 2 years, ATLS every 3 years)
• BLS, ACLS, and PALS renewal—see Health Stream for dates and times; free through Parkland (ACLS is an online course with in-person Mega Code testing; PALS is a full day in-person renewal course)
• Update CV
• Get plenty of passport-sized photos

Costs are high.  Most of the expenses are payable by credit card.  Some R2s apply for a 0% interest credit card until “year 20XX” to defer large payments until the moonlighting money starts coming in.  Be aware of credit card timelines (must be paid in full by certain month).
 
This was passed on from previous classes and adjusted accordingly based on changes in fees.  Please pass on the love to those who follow in your footsteps.
 
Most recent update: February 2017