1. Potential Problems
If you are expecting to return to the medical profession, you will need to start thinking about how to leave and how you wish to return as early as possible before beginning the formal process.
While there are differences from state to state, they share one common characteristic: the difficulty of re-entering the profession after a prolonged period away, especially if you have allowed your license to expire while on leave.
Of course, state medical boards have a duty to protect the public so, they demand that returning physicians demonstrate clinical competency through CME, interviews and board certifications. It is for exactly this reason that it is important to plan ahead.
2. Have a Plan
Investigate the specifics of your own state and specialty; research the state regulations and your medical specialty requirements carefully, but don’t rely on this information alone. Speak directly with your state board to discuss its policies with particular consideration given to your own individual specificities and identify any potential hurdles you might encounter.
Once you understand what is required to reinstate your medical profession after taking a break, you can begin to plan based upon your own goals and specialty. You’ll need to consider whether it makes financial sense to retain your license, how you will continue with CME and how you will demonstrate continued competency to the relevant boards prior to your return. If possible, begin with your expected return to work date and plan backwards from there. Keep in mind that, depending upon your state, you may need to share your re-entry plan with your state licensure board.
3. Giving Notice
We’ve already noted the importance of planning ahead to give yourself plenty of time to prepare for your break and your re-entry to the profession. It is also important to extend this time to prepare the other people involved. If you are employed and plan on returning to the same facility, you will need to liaise closely with your Human Resources department and medical staff leadership in order to understand the processes for leaving and returning.
There may be specific rules around timely notification for a leave of absence and certainly you will need to understand the possibilities and processes for maintaining or restoring hospital credentials.
Even if you aren’t planning to return to the same facility, communicate with Human Resources and the medical leadership teams as early as you can. Early notice doesn’t just make it easier for your employer to find a suitable replacement for you, it can help you ease your return to the field. You don’t want to burn bridges with people who can help you stay up-to-date with current practices and upon whom you will rely to provide references for you when you do return.
For physicians with their own practice, the issues are different, but still benefit from early action. You may need to seek legal counsel, depending upon the practice structure and legal arrangements. Make arrangements for the notification and transfer of your patients and their medical records to other physicians in the practice. Securing malpractice insurance tail coverage may be essential to cover you in case of malpractice claims being brought after a claims-made insurance policy is terminated.
Keeping good records of your professional activities before and during your leave of absence should help to smooth re-entry.
Before you leave, secure written references from senior colleagues, medical associates and practice or hospital managers.
Continue to keep records of CME and any clinical practice undertaken during the period of your career break.
Maintaining your license is the best way to ease your return to work. It can be significantly harder to regain a license once it has been allowed to expire. However, the financial implications of maintaining your license do need to be considered.
The financial impact of taking a break from the profession is significant enough. It can become a real burden if you need to add that to the cost of maintaining your license with the state licensure, board certification, credentialing, memberships of professional organizations and – potentially – insurance (either malpractice tail insurance, or for continuing your regular malpractice insurance if you plan to work part-time or on a voluntary basis occasionally to keep skills up to date).
If you are able to cover these costs, however, your ability to return to work will be considerably enhanced; it is a worthwhile investment if you can afford it.
6. Professional Memberships
National, state and local professional organizations can be a good way of keeping up to date with the medical profession, current clinical and procedural practice and your colleagues. The potential for networking and CME that your membership in these organizations affords you is often a good reason for maintaining your membership.
Some organizations offer reduced membership rates for clinically inactive members – so do inquire regarding what support your professional organizations can offer you.
7. Continuing Medical Education
Keep detailed records of all reading, online learning, training, volunteering and clinical practice you undertake during your leave of absence. Collecting references from colleagues whom you have worked alongside is a vital part of demonstrating your continued competence.
Reach out to your local medical school as it may be able to help you meet some of your CME requirements as well as providing networking and paid work opportunities.
Stay in touch with the profession by keeping your seat on any boards or committees or finding a professional who is happy to mentor you during your time off.
8. Work Part-time
Working part-time or on a locum or voluntary basis is the best way to keep up your skills. Continuing to work, even with a minimum schedule, will help you to demonstrate continuing competence when you are ready to return to full-time work.
In addition, the compensation may help to cover some of the costs of maintaining your license. Try to establish a good relationship with a good local locum tenens agency and ensure that you work with an agent who understands your priorities.
If you put in these hours out of state, or in a different country, make sure you keep records, get references, and seriously consider maintaining your state license in your home state as well. Of course, any clinical practice will be helpful but, if you can, aim to cover each aspect of the clinical practice to which you plan to return.
Nevertheless, however interested you are to secure continued clinical practice hours, don’t leave yourself exposed. Ensure that for every venture you meet your obligations in terms of license, certification, malpractice insurance and any necessary permissions or credentialing.
9. Physician Re-entry
It will be much easier for you to return to the profession if you keep your license current. While this may require considerable effort and expense, when compared against the effort and expense of not doing so, putting in the effort and expense for the full duration of your break is worth it (if you are in a position to do so).
Maintaining competency and connections will also help with your peace of mind and help sustain the confidence you will need to manage the return to work.
10. Adjust Your Plans
The need to plan ahead is fundamental to minimizing the hurdles you will face. However, it is likely that your plan will need to evolve over the course of your career break. As the American Medical Association (AMA) and Federation of State Medical Boards (FSMB) continue to press for a more cohesive and standardized approach to physician re-entry, it is likely that state requirements and policies will change. You will need to stay ahead of these changing expectations and adapt your return-to-work plan accordingly.
- Federation of State Medical Boards fsmb.org
Report 6 of the Council on Medical Education: Physician Re-entry,
American Medical Association ama-assn.org
Resources for Physicians Returning to Clinical Practice
, American Medical Association ama-assn.org/
If you are expecting to return to the medical profession, you will need to start thinking about how you wish to return as early as possible.