Dos and Donts for re-entry
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Medicine is no longer a straight-line career path. Some doctors take time out to start a family; others try working in industry
for a while; still others find themselves coming out of retirement when their investments don't provide the financial cushion
they expected. Whatever the reason for the departure, more doctors are returning to practice after being away for years.
"Re-entry is a growing issue because the old patterns of medicine are breaking down," says Jesse Roberts, medical director
of the North Carolina Medical Board. "Doctors aren't as fixed in their location as they used to be, or fixed in medicine for
that matter. Increasing numbers of women have become physicians, and many take time off from practice to start families."
Getting back into the workplace after a hiatus entails planning, patience, and possibly putting yourself back into the role
of student for a while.
We asked some doctors who'd taken time off to tell us about their re-entry experiences. We also asked for advice from licensing
experts, state medical board representatives, and recruiters. Their major piece of advice is most helpful for those who are
planning a stint away from practice: Never let your license lapse; you may change your mind. "To reinstate a lapsed license, often you have to start the application process from scratch," says Jeffrey Sisk, president
of the Internet-based job site, PhysicianWork. "State boards vary on their requirements for skills training and timing because
there's no formalized national procedure, but in general the reinstatement process can be very lengthy." The licensure board
typically has to verify your information and check out disciplinary actions. As for you, there may be letters of recommendation
to provide, fees to pay, and numerous forms to fill out. It's also likely that you'll have to take one or more assessment
tests and attend a retraining program or proctorship.
To keep your license current, you'll pay, on average, a couple hundred dollars a year and will more likely than not have to
take CME courses, but it will probably be worth it if you want to return to practice.
The road back starts with the state board If you have let your license lapse, your first step in getting back into practice will be your state medical board. You'll find contact
information for each state board at the Federation of State Medical Boards' Web site, http://www.fsmb.org
Most state boards require that a license be updated or renewed within a certain period after you first applied—typically 10
years; otherwise, they require you to take the Special Purpose Examination (SPEX) to determine your current competence.
SPEX is a computerized test with 400 multiple-choice questions that focus on broad-based knowledge central to clinical encounters
and good practice. The content is organized by categories of clinical problems, not by specialty areas, and it emphasizes
an individual's ability to recognize frequently mishandled problems, drug interactions, ethics, and procedures. "It's a stripped
down version of the USMLE," says Dale Breaden, director of public affairs at the North Carolina Medical Board.
For a list of SPEX testing centers, see http://www.prometric.com. SPEX costs $800, and study guides can run from $500 to $2,000. For more information, call the Federation of State Medical
Boards, 817-868-4041.
Can the test be waived? In some states, yes, if you're certified by the American Board of Medical Specialties within your
state's time limit.
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