by Ulrike Streit, MD

To pursue a residency in California or work as a physician, one needs to obtain authorisation from the Medical board of California ( www.medbd.ca.gov/ ), in form of a PTAL( Postgraduate Training Authorisation Letter) or a license.

The Application material can be downloaded on the website:

http://www.medbd.ca.gov/applicant/application_international.pdf

Or an application package can be requested webmaster@mbc.ca.gov to be sent by mail.

It is a very lengthy (6-9 months) and expensive process (493$, non refundable fee), so the application should be send as early as possible. When applying for residency in September it is best to start applying at the beginning of the same year. Unfortunately most residency programs in California will not consider applications without it or at least a status report on the PTAL. Not having it will definitely slim the chances for interviews.

So during the ERAS application process definitely include the PTAL Status request as your fourth Letter of recommendation!  Also do not forget to request a USMLE transcript for the Medical Board on the ECFMG website.

Especially for international medical graduates meeting the requirements is tough. A detailed medical transcript is required, proving that 6 weeks of core clerkships in pediatrics, 4 weeks in psychiatry and 8 weeks in surgery, 8 weeks in medicine and 4 weeks in family medicine and 6 weeks in OB/GYN have been performed. If you have performed clerkships abroad, you will also have to fill out a form (L6) for each of the clerkships and obtain a signature from each head of that department with a hospital seal and that might not always be easy to obtain a year after. The Medical Board will not accept the general attendance certificates issued by the hospitals or university after having finished the clerkship / elective.

Another problem for IMG’s who do not possess a Green card, is obtaining a US social security number.  Without a working permit or special visa types like J1, a social security number will not be issued. Check out the website: http://www.ssa.gov/

The Medical Board of California website informs that all the documents and data sent to the Board have to be complete before they will start processing it, including the social security number. After calling the Board and speaking to multiple people there, I was assured that you are permitted to send the documents without filling in a SSN at first and will not be losing the 493$ fee or be charged a 100$ penalty fee as mentioned on the website The documents will be processed, but the PTAL will not be issued until you have a SSN, meaning a job offer and work authorisation. That might make starting residency in California difficult for the unfortunate mentioned above.  

There might still be a loophole, as I was told by the Medical Board. To obtain the SSN from the Social Security office with the simple indication, that having a SSN is a requirement for the PTAL might be possible. But the Social Security office could not verify that to me yet. Written confirmation from the Medical Board, however, will not be issued to support that case.

Something else that needs to be obtained for the License are the fingerprints for the background check. If you are in or visiting California for some reason, try to do it there. It is the easiest way, because they have a special electronic system only in this state that will allow fast processing. It will cost an additional 20$ -30 $. (You will still have to pay the fingerprint processing fee included in the 493 $ application fee.) It is a very simple and quick process. Find locations to take fingerprints here: http://www.ag.ca.gov/fingerprints/publications/contact.php

If you do not have the chance to go to California, your fingerprints have to be taken manually with ink. Cards for that will be sent to you by the Medical Board. Especially if taken outside the US, I suspect long processing times and maybe problems with the acceptance.

This is as much as I know at the moment. I will keep updating information.  Good luck!