Physicians receive rigorous medical training for the better part of a decade. However, we emerge unprepared for the real-world job application process to which our friends in other professions are accustomed. One of these knowledge gaps is credentialing and verification for hospitals and clinics at which you intend to practice—a process that can take up to three months.
Solo and group practices, as well as university-affiliated hospitals, request a number of items during the credentialing process. I recommend that you keep the following documents, along with certification numbers, updated and stored together in a single place, so that they can be expeditiously sent to committees to complete credentialing:
- Driver's License: A passport or other government-issued identification is an acceptable alternative if you do not have a driver's license, but committees always request some kind of identification. A driver's license typically needs to be renewed every five years (around your birthday). A passport-sized professional photo is also sometimes requested for routine meetings with other hospital staff members.
- National Provider Identification (NPI) Number: The NPI number is associated with individual physicians, including solo and group practitioners, as well as those working at teaching hospitals. The NPI number is independent of records maintained by state licensing organizations and specialty boards. It is readily available on the web, and detailed information can be accessed online.
- Medical License: An active medical license is required for every state in which you are practicing or intend to practice medicine. A list of previous or inactive medical licenses may also be requested. Most medical licenses need to be renewed every 1-2 years.
- Board Certification (or Eligibility) Status: This information is required by every credentialing committee. Most physicians who have recently finished their residency training are waiting to take one or more exams to complete their board certification. In this case, a letter from the residency program director with the program completion date (i.e. graduation) will suffice. The same policies apply to subspecialty or additional board certifications. Board certification typically requires renewal every 10 years.
- Curriculum Vitae (CV): The CV is requested by every credentialing committee and should be updated monthly. Pay attention to the first few pages of your CV (and review template CVs for helpful examples), including the demographic data, education and licensure, awards and honors, practice history and hospital affiliations, peer-reviewed publications or presentations, and any press mentions.
- Peer Reference Information: It is helpful to have the contact information of close colleagues in your specialty that you can refer to for thorough and timely recommendations (requested by every committee). This list can include training program directors, or other clinical mentors and colleagues with whom you have worked with in recent years.
- Tuberculosis (TB) Testing: A recent skin PPD test or Quantiferon Gold blood assay is always requested and is must be repeated every year for healthcare employees. Positive testing suggests exposure and is usually followed by a chest radiograph to rule out latent TB.
- Immunizations: Information regarding Hepatitis B vaccination, as well as MMR (Measles, Mumps, Rubella) vaccination, is required with the initial credentialing application. You may also need to provide further information regarding boosters in a timely fashion. Similarly, annual documentation of your flu vaccine (or a waiver for the flu vaccine) is required.
- Adult and Pediatric Advanced Cardiac Life Support (ACLS, PALS): Every credentialing committee requires certification with wallet cards. Many hospitals offer subsidized in-house ACLS courses to ensure all housestaff officers and private physicians are well-versed in resuscitation protocols. Online courses for ACLS and PALS refreshers are also available. ACLS and PALS require renewal every two years.
- Malpractice Coverage: Most practices will request information about your current malpractice coverage, especially if it is not provided by your new practice. Insurers usually look at the frequency and severity of claims over the last 5-10 years of practice. In addition, you made need tail coverage by your previous employer to cover any claims filed after you have left the group. Pertinent information includes certificate number, occurrence- versus claims-made policy, maximum individual and aggregate limits, practice location, part- versus full-time status, dates of coverage, and any retroactive date of application.
- Medical School and Post-Graduate Training Diplomas: Credentialing committees occasionally request your diploma, along with a letter from your medical school Dean of Student Affairs.
- Privileges Request Form: Alongside any institution-specific application, most clinical practices representing procedure-heavy specialties will send a form outlining the required skill sets (with final approval required from the hospital committee).
In addition to the above items, there are some additional documents (which may or may not be required—you should ask your practice about submission):
Case Logs: Many credentialing committees request details about your case and patient load, including number and types of cases. Some groups will request that you provide a case log for procedures completed in the past year. Newly-graduated physicians should obtain a copy of their ACGME case logs and be ready to provide it to credentialing committees. Individual physicians are strongly encouraged to keep a spreadsheet of their own cases.
Drug Enforcement Agency (DEA) License: Your DEA license is required if you are in a specialty and practice where you or another healthcare practitioner is administering or prescribing narcotic medications. The DEA license must be renewed every three years.
Standardized Physician Credentialing Systems: Credentialing committees sometimes use common applications, which act as a single repository of information accessible to physicians, practice administrators, and health plans alike. Examples include California Participating Physician Application and the Council for Affordable Quality in Healthcare Universal Credentialing DataSource. These applications aggregate information regarding your training, licensure, practice and malpractice history, and any prior or pending actions on your medical license or clinical practice limitations.
Educational Commission For Foreign Medical Graduates (ECFMG) Certification: This documentation is only required for prospective residency and fellowship applications from outside the United States.
Aalap Shah, MD is a paid blog writer at Xenon Health; CEO of PRPmobile, LLC, and an independent quality improvement consultant for healthcare organizations in Southern California.