Moonlighting

How to obtain your medical license/Moonlighting Privileges:

1. Register for Step 3 (if MD) or Level 3 (if DO - sorry don't have details on this process)

• Step 3:
  • http://www.fsmb.org/usmle_apply.html
  • Go to the link entitled “state-specific requirements” and select “Ohio”
  • Read it: note you cannot take the Ohio test until after 9 months of training
  • you can get your stuff together and you can mail in your identity verification (CID), but your program director can’t sign your post-graduation form officially until April 1st.
    • Note: if you wait to print forms until you register/pay, all the USMLE ID info, etc. will be pre-populated- don’t bother printing the ones at the bottom
  • Click on the giant button at the bottom that says “Begin the USMLE Step 3 Application.”
  • Fill it out
  • You will be asked to pay the fee. It’s $895.
  • Once everything is received and verified by the testing people, you will get a scheduling permit. Pick a location and time. (The closest testing center is Worthington.)
  • The test is two days. Plan your schedule accordingly.

2. Take/Pass Step 3 or Level 3

• For step 3: do practice questions, and do practice case simulations - You can do the ones on the test website (http://www.usmle.org/practice-materials/step-3/case-studies-feedback/), or you can purchase a commercial test prep (USMLE World, for example).

3. Fill out your FCVS (Federation Credentials Verification Service)

• http://www.fsmb.org/fcvs.html
• Click “Begin the online FCVS application.”
• Create an account. Write down your user name and password. You will forget.
• Fill out the forms.
  • Post-grad info:
    • Sponsoring Institution: Mount Carmel Hospital
    • 5500 North Meadows Suite 5900
    • Grove City, OH 43123
    • Recipient Designations: State Medical Board: OH- State
    • Medical Board of Ohio
    • Application Purpose: Full License
  • Pay the fee. It’s $448.
• Fill out the forms and send them in or complete electronically:
  • Affidavit and Release- you need a 2x2 photo, and it needs to be notarized. (Side note: you are going to need a bunch of 2x2 photos of yourself. So print a bunch. You can get passport-style photos printed, etc. Just know you will need a few of them.)
  • You need a copy of your medical school diploma to upload
  • You need a certified copy of your birth certificate. For Ohioians:
    • https://odhgateway.odh.ohio.gov/OrderBirthCertificates/
    • Use your mother's maiden name when searching for your birth certificate
    • It costs $21.50. They will mail it. Takes 2-3 weeks.
    • If you chose, you can mail your passport. It’s an additional fee (~$26). They are supposed to mail it back to you.
  • Once all the above is done, mail it to:
    • FCVS
    • 400 Fuller Wiser Road, Suite 300
    • Euless, TX 76039
• Fill out your UA (Uniform Application for State Licensure)
  • http://www.fsmb.org/ua.html
  • Use the same FCVS username and password
  • Type of License: "MD" or "DO"
  • State Medical Board: "State Medical Board of Ohio"
  • License Subtype: "Permanent"
  • Fill in all the different sections- basically identical to FCVS
    • For the section “Licensure & Employment”- be sure to add your training license number. The License type is “Training License” and the number will be 5x.xxxxxx (you have to renew it every year).
    • For address, be sure to have two addresses listed. One will be your personal address for the board to contact you if necessary. The second is a "public access" address, put the hospital address and phone for this section.
  • After filling in all the sections, print the forms. There are 3:
    • Affidavit and Authorization for Release of Information form (needs photo, notarized)
    • Licensure Verification (UA Form #1)- only fill out the top, part 1, the bottom is for the state board…
    • Ohio Addendum to Application.
    • Keep these however they are now all done online at eLicense.ohio.gov
    • Pay the fee: $60

4. Ohio License Application

• If you need help: https://www.med.ohio.gov/Apply/Physician-MD-DO
• Start the application at eLicense.ohio.gov.
  • Must have FBI and Ohio BCS background checks sent and AMA profile requested (See below)
• Pay fee: $305

5. Get Fingerprinted

• Find a facility that does both BCI and FBI
  • http://www.ohioattorneygeneral.gov/webcheck
  • Select a location close to you
  • Look at the hours- sometimes they have very limited hours, and you may need an appointment
  • Call the facility. Some only except cash vs. check vs. credit card vs. money order. They are very picky and every facility has different rules.
• Go to the facility
  • Bring a valid ID, and a blank check (or cash)- usually ~$60-$70
  • On the form, indicate reason for fingerprinting as “Required for licensure per ORC 4731.081.”
  • Request criminal records check be sent to:

State Medical Board of Ohio

30 East Broad Street, 3rd Floor

Columbus, OH 43215-6127

5. Request an AMA profile

• Go to: https://profiles.ama-assn.org/amaprofiles/
• Select the “Physicians Only” tab
• You may or may not be an AMA member
  • If you are, great- it will be free to send- select Ohio
  • If not, it will cost you ~$37
  • Side note: if you have recently changed your name, your profile may be under your maiden name or previous name. Call 1-800-665-2882 for instructions on sending your paperwork.

6. Wait

• You will have to wait for all the forms to get processed
• You will eventually get info via e-mail telling you about the status of your application and your license number. As long as everything is completed, you will get a hard copy license in the mail at some point.

7. Once you have received your state license, you can apply for your DEA number

• DEA Website
• Click on the New Applicants link
  • You want Form 224
  • From the “Select One Business Activity” menu, select “Practitioner”
  • It will cost you $731 for 3 years.
  • Have your DEA sent to your home address to avoid it being lost in hospital mail

8. After you get your DEA number, you can apply for Grove City Moonlighting Privileges.

• Start by contacting the following: (can be done simultaneously)
• Notify the Credential verification office (CVO) (#546-3540) that you would like to apply for moonlighting privileges. Carl Speckman (cspekman@mchs.com) is usually in charge of this unless on vacation.
  • He will send you the application to be printed and filled out for the credentialing office
  • Once the credentialing office has reviewed your application, they will contact Nichole Fischer (nfischer@mchs.com) who will present you with a contract to sign.
  • Once you have signed your contract ***YOU ARE NOT YET ALLOWED TO MOONLIGHT***
  • Once your contract is signed, your application will be reviewed by 3 committees for final approval of your privileges. They meet once a month to discuss the candidates, so make sure you get your stuff in BEFORE one of the meetings.
  • The board will send you a letter once your privileges are approved. At this point you are allowed to start moonlighting. To be placed on the schedule you must present this letter to the scheduling chief as well as the program coordinator.

RE-CREDENTIALING

• Every year you must complete re-credentialing paperwork for Mount Carmel. They will contact you 4 months before your privileges expire. If you fail to re-credential, and your privileges expire, you will not be allowed to moonlight.