Back in 2022, I once completed the entire credentialing process for a facility. When it came down to finalize my work schedule, I asked for certain days and weeks, expecting a normal back and forth. To me, this was a standard locums negotiation.
But this facility rarely used locum physicians, and they took it personally and thought I was being difficult. The medical director stopped responding. Just ghosted me. My recruiter really did try to make it work, but there was nothing she could do. Fully credentialed, ready to work, but no job.
The lesson? Credentialing gets you approved but it doesn’t mean your job is safe. Some facilities are evaluating you the entire time, and if they don't understand how locums works, even normal negotiations can kill a deal without anyone telling you why.
In today’s newsletter:
IMLC update: 42 states are in, but Michigan may be on the way out
How credentialing actually works (and why it takes so long)
The documents you need before your next recruiter call
What I’m Reading
The Interstate Medical Licensure Compact (IMLC) now covers 42 states, DC, and Guam, making it easier than ever to get licensed across state lines. But here's a wrinkle: Michigan is set to withdraw from the compact on March 28, 2026.
Not because they wanted to leave. The original legislation had a sunset clause that expired without renewal. There's a bill (SB 303) that passed the Senate last year, but it's still sitting in the House with less than two months to go.
If Michigan matters to you, keep an eye on this:
Working in Michigan? You can still get licensed through the IMLC until March 28.
Using Michigan as your state of principal license? Your LOQ may not be valid after the withdrawal.
Planning ahead? Consider establishing your SPL in another compact state if Michigan doesn't pass the fix in time.
Check the current IMLC map here.
Credentialing: What's Actually Happening
When people talk about "credentialing," they're usually lumping two things together: agency credentialing and hospital privileging. They're different processes, and you go through both.
Agency credentialing is the staffing agency verifying your documents, background, and references. This part is relatively quick, maybe 1-2 weeks if you're organized and responsive.
Hospital privileging is where things slow down. The facility's medical staff office reviews your file, checks references, and presents you to their credentialing committee. These committees often meet monthly. If you miss the cutoff, you wait another month.
Typical timeline from start to finish? Anywhere from 4-12 weeks depending on the facility. Be prepared for it to take longer than you think.
Why does it take so long?
Verification loops: med school, residency, every prior employer
State board processing times
Credentialing committees that meet once a month
Hospitals that are just disorganized
One thing that helps: having a "clean" file. No gaps in employment, no malpractice claims, no missing documents. If your file raises questions, expect delays.
The Reality Check
If a facility is vague about timelines, that's a red flag. Ask upfront: "When does your credentialing committee meet?" and "What's your average time from application to start date?"
If you're told "4-6 weeks" but they can't give you specifics, pad your expectations.
Some facilities are known for slow credentialing. Your recruiter will likely know this so feel free to ask them.
And on your end? Have all your files ready to go. The faster you respond to requests, the less you're the bottleneck.
The Practical Win: Build your credentialing packet now
🚀 Before your first recruiter call, have these ready to send within 24 hours:
CV (no gaps, explain any breaks)
Active medical licenses and DEA
Board certifications
Malpractice insurance history
Professional references (with current contact info)
NPDB self-query
This isn't an exhaustive list. I'm working on a full credentialing checklist PDF. Reply to this email if you want it when it's ready.
What’s Coming Next
Over the next few issues, I’ll cover:
Travel/housing systems
How to avoid burnout
Contract clauses and why they matter
Rate negotiations
Let me know what topics you would like covered in a future issue. Reply and let me know!