Unpredictable life changes can alter the path you may have envisioned as a practicing physician. Although this may shift your expected journey, you can surely be open-minded while retaining your aptitude for optometric patient care.
My personal experience: Three optometric licenses
While at Nova Southeastern University in optometry school, I made arrangements and prepared to practice locally in Florida after graduation—well in advance, as one may expect.
However, due to the unforeseen conditions that COVID caused in healthcare and everyday life, it was not practical for me to do so. I stayed home in Georgia after my Zoom graduation, and I thought to myself, “I may as well work on adding a Georgia license” since things were so unstable worldwide.
In fact, the day after I received my Georgia license, there was a need for an emergency, temporary fill-in position at a private practice. I took it, and it was truly an unforgettable, meaningful experience. I gained so much knowledge and confidence in the perfect work environment with a great team.
When the time came, I moved back to Florida to be with my significant other, planning to retain both licenses. Eventually, after my husband finished his residency, we followed our passions to opportunities in private practices in Connecticut. This inevitably required another state license, which makes for three licenses that I now hold.
Steps to acquiring an optometry license
Optometry is a legislative healthcare profession—there are variations in physician requirements and scope of practice within each individual state of the US. When applying for a state optometry license, you have to meet certain criteria and/or pass the state’s law examination(s).
For example, Florida has minimum exam results needed for sections of National Board of Examiners in Optometry (NBEO) Part III, and Georgia requires up-to-date cardiopulmonary resuscitation (CPR) certification.
There are a multitude of differences among states, so you must research the particular state’s regulatory optometry board to complete the pertinent supporting documents appropriately. This guide is the perfect place to start if you are looking to register for a license to practice optometry in your state
When it comes to obtaining multiple licenses, some states have beneficial considerations called reciprocity. It allows for licenses to be granted with the understanding that requirements are similar or equivalent. My third license, which was for Connecticut, was simple and straightforward due to this endorsement feature.
Fees also differ from state to state. Florida is $555 (and $58 for the law exam); Georgia is $300 (and $165 for the law exam); and Connecticut is $565. Full optometry licensure cost totals can range from $25 to $1,300—which are Pennsylvania and Alaska, respectively.
Table 1 outlines the differences and similarities in optometry state license requirements between Florida, Georgia, and Connecticut.
| Requirement | Florida | Georgia | Connecticut |
|---|---|---|---|
| NBEO Part I, II, and II and TMOD | Minimum score of 75% on each skill in a single attempt including: biomicroscopy, binocular indirect ophthalmoscopy, dilated biomicroscopy, and non-contact fundus lens evaluation. Passing scores on all parts of the NBEO Florida Licensure Examination within the 3 years preceding or following the submission of the application are required. | X | X |
| Law examination | Minimum score of 84% or higher. | X | N/A |
| Online app and official transcripts sent directly to the Board | X | X | Photo required on online app. |
| Minimum total CE for renewal | 30 hours | 36 hours | 20 hours |
| Other | Have completed at least 1 year of supervised experience in differential diagnosis of eye disease/disorders as part of the optometric training or in a clinical setting as part of the optometric experience. | You are exempt from the 1 hour of Georgia laws and rules requirement if you're not practicing in Georgia. CPR certification is required. | N/A |
| Renewal period | Biennial | Biennial | Annual |
Table 1: Courtesy of Sasha Patel, OD.
CE considerations with multiple optometric licenses
Be sure to understand which continuing education (CE) courses are approved or would be accepted. Some need to be Council on Optometric Practitioner Education (COPE) approved courses, but some other great options that may apply are:
- Higher education institution courses
- State or local optometric-affiliated CE
- Medical association affiliated CE
Be attentive to details on any virtual CE or non-COPE-approved courses you take to ensure they will be accepted. Some emergency rules that came into effect during COVID-19 had allowed online interactive formats for a period of time.
Make sure you’re aware of your state’s current regulations around credits for online/interactive CE. The Eyes On Eyecare team offers free courses and events throughout the year—check out what is available here!
Keeping up with your CE
Along with using the state’s regulatory optometry board website, clinicians can utilize online tools to assist with CE requirements. The Association of Regulatory Boards of Optometry (ARBO) is a great resource to keep courses organized for multiple licensees, but CE Broker is specifically used for tracking Florida-approved courses.
ARBO and CE Broker will assist with managing options state by state. This is important for sorting required topics. For example, certain areas, such as pathology, may have minimum hours needed and practice management may have a maximum that cannot be exceeded in total.
Many states also allow a certain number of CE hours to be used from self-study online sources as well as CPR certification.
Insurance considerations for multiple optometric licenses
Keeping appropriate malpractice insurance coverage is critical for a healthcare provider. Request and save copies of your certificate of professional liability insurance. In addition, consider having tail-end coverage in case you run into work-related changes or have to relocate.
When it comes to vision and medical insurance, keep your credentialing team updated on any changes to locations you are practicing. Council of Affordable Quality Healthcare (CAQH) attestations also keep your provider information accurate and in sync for insurance panels and your employers.
Pitfalls to avoid with multiple optometric licenses
Steer clear of being overwhelmed
Use the resources mentioned in this article, but analyze your own CE requirements and additional state regulations. Also, be sure to keep records of your CE certificates—I like to keep them compiled in a folder on my professional email account.
Moreover, after the first one to two renewal periods, you will get a solidified idea of how to maintain your licenses. You will learn how to determine which CE courses are more valuable for your time (e.g., are they Transcript Quality (TQ) and/or COPE-approved?)
Stay organized with licensure requirements and mark your calendar to avoid missing important renewal deadlines. Ultimately, utilize your local and state associations for in-person CE opportunities and relevant optometric announcements.
Reminders for independent contractors
Depending on if you plan to conduct business as an independent contractor in a different state, you may need to register for a foreign LLC. Whether you have an LLC or S Corporation, be sure to have an understanding of how those business aspects change across state lines. Eyecare and corporation information can be found here.
Key takeaways
If you haven’t already, you will come to find that life has its own way of carving changes to how you anticipate your future. Some good and some not so great, but at the end of the day, it's important to identify and focus on what matters to you—that clears the way for your definition of success to become feasible.
Be goal-oriented and be honest with yourself. There are a plethora of career opportunities available. In fact, unique circumstances can ultimately lead to fulfilling, profound opportunities we may never have expected.
