Medical Fellowship in the USA
Medical Licensing
Medical Licensing
Medical Licensing in the USA is determine on a state-by-state basis. Interestingly, some programs, usually if more heavily research focused, do not require taste medical licensing or grant hospital privileges directly without requiring a state license. Check with your program directly regarding this prior to the start of your fellowship.
Drug Enforcement Agency (DEA) License
Several programs will require you to prescribe controlled substances, which requires obtaining a DEA License. Of note, you typically need a valid state license in order to have a DEA License. See: https://www.deadiversion.usdoj.gov/online_forms_apps.html
BLS/ACLS Certification
This may be a requirement for your medical licensing. Most fellowship programs will offer you to do this at no cost once you have started their program, but I would check with your program and your state licensing board to see whether this is current.
National Provider Identifier (NPI)
A National Provider Identifier (NPI) is a unique 10-digit number assigned to healthcare providers in the United States. It is used to identify providers in healthcare transactions, such as billing and electronic health records. NPIs are issued by the Centers for Medicare & Medicaid Services (CMS) and are required for all healthcare providers who conduct transactions covered under the Health Insurance Portability and Accountability Act (HIPAA). If you are a Canadian physician practicing in the U.S. under a J-1 visa, you will likely need an NPI for billing and credentialing purposes. Ensure you have your state license and other relevant documentation before applying. There is typically an option to apply without having your Social Security Number, in which case you would typically need to provide:
1. Two proofs of identification (e.g., passport, driver's license, Birth Certificate). Check on the NPI website which forms are acceptable and translation requirements when applicable. https://nppes.cms.hhs.gov
2. Letter explaining why you need an NPI prior to obtaining your SSN.
Medicaid Licensing
This is typically required in order to bill for Medicaid Patients and requires first having obtained an SSN (this will take some time and your program should expect this).
Liability Insurance
This is frequently arranged by your individual fellowship program, so I would check with them. Of note, check with your Canadian Liability Insurance (e.g., CMPA) whether you can "freeze" your Canadian liability insurance while in the USA to avoid paying for it needlessly. You can typically reactivate it later when/if you return to Canada.
Some words of wisdom
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Try to start as much of this process before the start of your fellowship, but if you did what you could and you are still not fully licensed on your start, most programs are understanding of this (or at least should be) given the intricacies of the process.
