How to get licensed in a new state is a common question among physicians new to locum tenens. Although there’s no getting around the paperwork, there are ways to streamline the licensing process and make it both easier and faster. This guide walks you through the locum tenens licensing process, including how the Interstate Medical Licensure Compact (IMLC) works, licensing costs and timelines, and the nuances of working telehealth.
How locum tenens licensing works
Licensing is the same for locum tenens as it is for permanent positions. It starts with a state application and copies of your diploma, postgraduate training certificates, notarized forms, and background checks. From there, the state medical board requires primary source verification: exam scores, verification of any existing licenses, medical school and training verifications, and sometimes employment verifications, references, or board certifications. Once the board has the completed application and all verifications in hand, it moves into review, and the license is issued.
It’s more paperwork than most physicians expect the first time around, but it’s a one-time investment that pays off if you plan to continue working locums in other states.
Dr. Frank Mikell, a hospitalist with 12 state licenses, says he didn’t want to limit himself to one region to work locums. He admits the process is cumbersome—every state application asks about your last position and wants to speak with that program director—so he used the end of his permanent position as an opportunity to get the paperwork done while everything was still fresh. He got most of his 12 licenses on his own and now works with an agency to pursue additional ones.
Although acquiring licenses in other states can be time-consuming, many physicians use locums as a way to get paid to travel and find the trade-off worthwhile.
“I’ve been all over the country. Most Americans don’t travel as much as I do,” says Dr. Siamak Karimian, an interventional cardiologist who has worked full-time locums for more than 10 years. He now has more than 30 state licenses. “My favorite assignment was in Billings, Montana. The location was good, the hospital was magnificent, and the group was excellent.”
What the IMLC is and when you should use it
The Interstate Medical Licensure Compact (IMLC) is an agreement among participating states that provides a faster path to licensure across multiple states. Instead of starting from scratch with every state medical board, you complete one qualification process and use it to apply for licenses in any other member state.
Weatherby Healthcare senior locum tenens consultant Kaitlyn Krucynski explains that when you apply for the IMLC, you are issued a letter of qualification. There is an initial application fee of several hundred dollars, but then applying for another state license is as easy as logging into your account, selecting the state(s) you want a license for, with many of those licenses being issued within a week. She said, “I’ve never worked with or talked to a doctor who’s said it wasn’t worth it.”
The compact currently includes most U.S. states, plus Washington D.C. and Guam. Not every state has joined the compact, and which states are involved determines whether the IMLC is even an option for the assignment you’re considering. Membership is always expanding, so it’s best to check the IMLCC’s official site for the most updated information.
Dr. Gary Drizin, a pulmonologist, accepted a Michigan assignment on short notice through the IMLC’s expedited process. “Everybody said, ‘We’re good. We’ll get you the license within a week and you’ll be good.’ And it happened.”
The compact isn’t automatically the fastest or cheapest option for every physician, though. Before assuming the IMLC is the shortcut, it’s worth weighing the letter of qualification fee against what you’d pay applying to each state board directly, especially if you only need one or two additional states.
“For a while, I considered a multi-state license, but the way I practiced with assignments usually around 6 months to a year, it didn’t make sense for me.” says family medicine physician Dr. Viktoria Hasselhof.
Am I eligible for the IMLC
You are eligible if you hold a full, unrestricted medical license in a state that qualifies as your State of Principal License (SPL), have no history of discipline, and meet the compact’s other baseline requirements around board certification and a clean licensing history. Once your eligibility is verified, your SPL reviews your credentials and issues a Letter of Qualification (LOQ) to the Compact. You then use that LOQ to apply for a full license in the additional states where you want to practice. Each of those states still issues a separate license, but the LOQ allows them to skip re-verifying your credentials and speeds up the process.
Some member states, like Hawaii and Vermont, don’t currently qualify as SPLs. So you can’t qualify for the compact if that’s where you hold your primary license. You’d need to qualify through another member state first, after which the compact can issue you a Hawaii or Vermont license.
Locum tenens licensing costs by state
Costs vary widely by state, from around $35 in Pennsylvania and $1425 in Nevada. On top of the state application fee, the FCVS application, DEA registration, your state’s Controlled Substance Registration (renewed every few years), verification service fees, and incidentals like fingerprinting and postage also add to the cost. The provider is typically responsible for these costs, though locum tenens working with a reputable agency may have some of them covered.
FCVS
One way to cut down on repeat paperwork (and cost) across states is the Federal Credentials Verification Services (FCVS). Run by the Federation of State Medical Boards, it stores primary-source-verified education and training information that can be sent to multiple state medical boards at once. Fourteen state licensing boards require it, and every medical board accepts it as primary source verification, so it’s worth setting up even in states where it isn’t mandatory.
DEA registration
“Most locum tenens providers can expect to need a new DEA license to go with their new state license,” says Jessi Rawlins, a licensing manager for CompHealth. “Some boards require DEAs to stay in the state in order for a state-issued controlled substance permit to remain active.”
However, once an additional DEA license has been obtained, it’s typically easier to transfer these for future assignments without impacting a current assignment. “Obtaining a new DEA license can take twice as long as transferring an existing DEA from state to state,” Rawlins says. “This will help you to be ready for an assignment even quicker.”
How long does locum tenens licensing take?
Just like costs, timelines vary widely by state—from about a week in the fastest cases to as long as six months in others. A good rule of thumb is to apply 90 days ahead of an assignment.
“Most licensing boards post estimated timeframes on their website, or you can give them a call for an estimate. Licenses can take anywhere from one week to six months to be processed,” Rawlins says. “The time frame depends a lot on the board’s current processing speed, as well as the complexity of the individual application.”
The more questions a board processor has about your application, the longer it will take to issue, so it’s important to pay attention to the details.
Here are some common mistakes that can delay your application:
- Incomplete or inaccurate application details, particularly dates and gaps in employment history
- Failing to disclose past disciplinary actions, which causes complications if it surfaces
- Background-check snags, such as worn fingerprints from experienced surgeons
“Each medical board is working hard to license providers as efficiently as possible, while holding to the laws and statutes of their states,” Rawlins says. “Keep in mind that medical boards are far busier during the holidays and residency season—delays during residency season can begin as early as April, and holiday delays typically begin in November.”
Telehealth licensing for locum tenens
If you’re interested in telehealth locum tenens jobs, licensing gets a little more complicated: You generally need a license in both the state you’re practicing from and the state where your patient is located, not just one or the other.
Want to practice virtually? A physician’s guide to telehealth locum tenens
When to renewing or let a license lapse
Renewing a license is quicker and simpler than reapplying after one lapses. You’ll still pay renewal fees, but the process is shorter and less involved. However, not every license is worth the cost and paperwork to keep active. If you’re not planning to work in a state again, it can make more sense to let that license lapse, especially once you factor in CME requirements and renewal fees.
For states with high renewal fees but a straightforward path to reacquiring a license, letting it expire is often reasonable if you’re not likely to need it again soon. Some states also let you switch a license from “active” to “inactive,” which exempts you from CME requirements but not renewal fees. Controlled substance registrations can typically lapse independently of your medical license and be renewed quickly if you need them again.
Licensing vs. credentialing: What’s the difference?
Licensing and credentialing are often confused, but they’re two different processes: licensing is permission from a state medical board to practice medicine there, while credentialing is a healthcare facility or agency verifying your qualifications before you can see patients at that specific site.
For the full breakdown: A guide to locum tenens credentialing.
Get licensing help
If obtaining a new license sounds like a lot of work, remember you don’t have to manage it all alone. Locum agencies like CompHealth and Weatherby Healthcare have dedicated licensing staff who handle much of the process—application fees, verification fees, delivery to the licensing board—and may even cover the costs of additional licenses for future assignments. Agencies who have been around for a while also tend to have established relationships with medical boards, which can smooth the process along.
In short, help is available. “If you’re working with an agency, ask the licensing expert or your recruiter questions,” Rawlins says. “If you’re not working with an agency, don’t be shy about reaching out to a medical board directly with your questions.”
Frequently asked questions
What is the IMLC (Interstate Medical Licensure Compact)?
The IMLC is an agreement among participating states that lets physicians who qualify use one streamlined process to get licensed in any other member state, instead of applying from scratch to each one.
How much does it cost to get a locum tenens medical license?
Costs vary widely by state—as low as around $35 in Pennsylvania and $1425 in Nevada—before adding FCVS, DEA, and verification fees.
How long does locum tenens licensing take?
Generally, one week to six months, depending on the state and how complete your application is. A good rule of thumb is to apply 90 days ahead of an assignment.
What is FCVS, and do I need it?
FCVS (Federation Credentials Verification Service) is a centralized, verified record of your medical education, training, and licensing history that you can send to multiple state boards instead of re-verifying everything each time. Fourteen states require it, and every state board accepts it.
Is medical licensing the same as credentialing?
No. Licensing is permission from a state medical board to practice. Credentialing is a facility or agency verifying your qualifications before you can see patients there.
Most reputable agencies will help you with the licensing process. Check out our agency comparison tool to learn more.
Hear from physicians who’ve done it
Listen to The Locumstory Podcast for stories from physicians who’ve taken the leap into locums and can answer questions you didn’t even know you had:
- Episode 81: Locum tenens consultant Kaitlyn Kruczynski discusses the IMLC
- Episode 79: Dr. Hasselhof shares her experience working across states and internationally
- Episode 61: Dr. Rhodes offers advice for weighing your options
- Episode 53: Dr. Drizin on navigating the IMLC for locums
- Episode 48: Locum tenens consultation Gregg Crowe explains telehealth licensing