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Your California Medical License Application
Physicians must have a state license to practice in California. Allowing sufficient time and providing a complete application with full documentation to the Medical Board can make a difference. Failure to do so may result in delay, denial or the filing of a Statement of Issues and an administrative hearing. Lately (2012) the process has been taking about seven or eight months.
The California Medical Board issues licenses (Physician's and Surgeon's Certificates). It can deny, offer probationary licenses, or allow a physician to withdraw an application. Without preparation the process can be daunting.
1. How Does the Medical Board Process A California Medical License Application?
When the Medical Board initially reviews a California medical license application, an analyst reads the application and supporting documents to ensure that basic qualifications have been met, including education, USMLE scores, board examinations, postgraduate training, and experience. The application also asks whether the applicant has any criminal convictions, pending criminal actions, terminations from training programs, or out-of-state discipline. For a criminal conviction to result in license denial, it must be “substantially related to the duties, functions or qualifications of a physician and surgeon”. This requirement has been broadly interpreted by the courts. For example, DUI convictions have so far been deemed substantially related to virtually all California licenses, as are tax violations and dishonest acts. Criminal assault or domestic violence may also be disqualifying. Omitting required information from your license application is often viewed by Medical Board staff as a dishonest act, and may result in denial or a probationary license offer of three or more years probation with terms and conditions including substantial community service and completion of an Ethics course. This can be economically devastating, since some large HMO organizations such as Blue Shield are known to exclude physicians while on probation.
When the Board intends to deny an application for a California physician license, it issues a letter advising the applicant and the reasons for denial. Denial usually follows prior informational requests or phone inquiries. The applicant is most often afforded an opportunity to provide information demonstrating that the deficiency or conviction cited is erroneous or mitigated. An exception may be a serious a criminal conviction or dishonesty in the application itself. In many instances of license denial the applicant is given the opportunity to withdraw. Withdrawal means there will be no record of denial. The board might also offer a probationary license if it appears the applicant might benefit from supervised education, counseling, additional training or monitoring.
2. How Long Does the California Medical License Process Take?
The Medical Board’s website previously claimed that applications would be reviewed within ninety days and the applicant then advised of any problems or requests for additional information, so that the process could be completed on a relatively timely basis. Those timelines, however, have changed drastically in recent years. Since 2008-2009, the Board has advised applicants to expect at least six to nine months to process a license application. When medical program appointments or job offers are at stake, these delays can be significant. It is best, therefore, to prepare for an extended process and, again, to make sure the initial submission is complete as well as accurate.
3. What If My California Physician License Application Is Denied?
If your application for a California medical license is denied and you decide not to withdraw or accept a probationary license if offered, you may request that a Statement of Issues be filed with the Office of Administrative Law and an administrative hearing held to determine whether the license should be issued. A Statement of Issues is a document prepared by a Deputy Attorney General. It describes the application, includes supporting documents, and alleges the reasons for denial. A hearing is scheduled before an Administrative Law Judge (ALJ). The ALJ will write a proposed decision that the Medical Board may adopt, modify or reject.
4. Common reasons for denial: Criminal record; criminal conviction or pending matter not reported on application (questions # 23 and 24); out of state disciplinary history; program or education deficiencies, including a medical degree from an institution not recognized by California's Board.
4. Can I Appeal After Losing at an Administrative Hearing?
Yes. The applicant may accept the Board’s final decision, or file a Writ of Mandate in Superior Court to overturn the decision. The applicant must demonstrate that the Board engaged in an “abuse of discretion” in denying the application—a relatively steep burden. If the court affirms the Board’s decision, an appeal can still be made to the California Courts of Appeal or even the State Supreme Court. However, the Board may also appeal an adverse Superior Court decision. Conclusion: A physician applicant should submit his or her license application to the California Medical Board as far in advance of any appointment or employment as possible. Completeness and accuracy help avoid inordinate delays. Even if everything is submitted on a thorough and timely basis, however, government bureaucracy can still make the process a long and difficult one. Many applicants find having licensing counsel helpful.