Postgraduate Training License (M.D.'s and D.O.'s)

A PTL will be required for all trainees participating in an ACGME accredited postgraduate training program in California in order to practice medicine as part of their training program. A PTL must be obtained within 180 days after enrollment in the program and will not be required to be renewed. An application should apply 6 months prior to the deadline the license is needed. 

Checklist

PTL Requirements for MBC (M.D.'s)

  • Application Fee - $674, Submit payment by credit card online on BreeZe.
  • PTL Application -  The board no longer accepts paper applications. You must apply online on BreeZe. Please do the following:
  • PTL Enrollment Form - GME Office will submit on your behalf. Please email ayin@llu.edu and state you have submitted your PTL Application.
  • Live Scan - Complete at a live scan agency within California and attach a photocopy of the completed live scan to the attachment section of your online PTL application.
  • Certificate of Completion of ACGME Postgraduate Training (if applicable) - If you have completed previous training, please request your previous program to fill out.
  • Certificate of Medical Education - Request from medical school once you submit your PTL application. GME can complete for LLU grads only. LLU grads can email ayin@llu.edu and state you have submitted your PTL Application.
  • Certified Medical School Diploma - Request from medical school once you submit your PTL application. GME can complete for LLU grads only. LLU grads can email ayin@llu.edu and state you have submitted your PTL Application
  • Certified Medical School Transcript - Request from medical school once you submit your PTL application. Paper version must be sent directly to MBC from the medical school. GME cannot complete this requirement for LLU grads.
  • USMLE Transcript (Proof of passing: Steps 1 and 2CK at minimum)
  • Updated CV or Timeline of Activities - Complete only if you've graduated over 6 months ago. Sign and date your updated CV or TOA Form.
  • ECFMG Certification Status Report - International graduates only

PTL Requirements for OMBC (D.O.'s)

  • Application Fee - $491, Submit a personal check if mailing the application or submit payment by credit card if submitting the application online on BreeZe.
  • PTL Application - Applicants with no middle name must apply by mail and cannot submit online on BreeZe.
  • PTL Enrollment Form - Please fill out the applicant information and sign the form and submit original form to the GME Office in person or by mail. GME Office will  automatically submit on your behalf after program signature.
  • Live Scan - Complete at a live scan agency and attach a photocopy of the completed live scan to your PTL application.
  • Certificate of Completion of AOA or ACGME Postgraduate Training (if applicable) - If you have completed previous training, please request your previous program to fill out.
  • Certified Medical School Transcript - Request from medical school once you submit your PTL application. Paper version must be sent directly to OMBC from the medical school.
  • Medical School Diploma - Attach a regular photocopy to your application 
  • COMLEX Transcript - Proof of passing: Levels 1 at minimum
  • Application requires three 2x2 passport like photos

Step by Step Guide for PTL

Transition from PTL to Physician's and Surgeon's License (M.D.'s and D.O.'s)

Trainees who hold a current PTL can apply to transition to a Physician and Surgeon License.  You should apply 6 months prior to when the PTL expires or deadline the license is needed.

Eligibility:

  • Complete 12 months of ACGME training for graduates of medical schools in the United States and Canada or 24 months of ACGME training for graduates of international medical schools
  • Proof of passing USMLE Step 3/COMLEX Level 3. However, you can still apply if passing score report is pending.
  • Demonstrate completion of 36 months of ACGME training, with at least 24 consecutive months in the same program, at the time of the first license renewal.

Checklist

Transition from a PTL to a Physician’s and Surgeon’s License Requirements for MBC (M.D.s)

Reduced Licensing Fee - $456.50, Submit payment by credit card online on BreeZe.

Application to Transition from a PTL to a Physician's and Surgeon's License (TF1-TF3) - The board no longer accepts paper applications. You must apply online on BreeZe. Please do the following:

  1. Answer the application questions.
  2. Pay the licensing fee.
  3. Explanation to Application Question (Form EXP), if applicable. Upload in the "Attachment" section 
  4. Timeline of Activities (Form TOA), if applicable. Upload in the "Attachment" section 

Certificate of Completion of ACGME Postgraduate Training (Form PTA/B) - GME Office will submit online on your behalf. Please email ayin@llu.edu and state you have submitted your PTL Application. 

Current Postgraduate Training Verification (Form CTV) - GME Office will submit online on your behalf. Please email ayin@llu.edu and state you have submitted your PTL Application.

USMLE Transcript - Proof of passing Step 3

Transition from a PTL to a Physician’s and Surgeon’s License Requirements for OMBC (D.O.s)

Application Fee (Part 1) - $200.00, Submit a personal check when mailing the Form OMB.1 application.

Licensing Fee (Part 2) - To be determined by the board. You will receive an invoice to pay a prorated fee because in most cases the license duration for the first cycle is less than two years and issued based on birth month. 

Application to Transition from a PTL to a Physician's and Surgeon's License

  • Application for Osteopathic Physician and Surgeon Certificate (Form OMB.1) - Complimentary notary is available at GME Office during business hours.
  • Certificate of Completion of ACGME Postgraduate Training (Form OMB.25) - Please fill out the applicant information and sign the form and submit original form to the GME Office in person or by mail. GME Office will mail to OMBC on your behalf after program signature.
  • COMLEX Transcript - Proof of passing Level 3
  • 3 passport quality photos 
    • Affix photo to Form OMB.1, Form OMB.25, and one photo loose with Form OMB.1

Initial Physician's and Surgeon's License (M.D.'s)

Applicants who does not hold a PTL can apply for a Physician and Surgeon License if the following are met:

  • Have completed at least 12 months of ACGME training for graduates of medical schools in the United States and Canada or 24 months of ACGME training for graduates of international medical schools
  • Proof of passing USMLE Step 3. However, you can still apply if passing score report is pending.
  • Demonstrate completion of 36 months of ACGME training, with at least 24 consecutive months in the same program, at the time of the first license renewal.

Initial Physician's and Surgeon's License (D.O.'s)

Applicants who does not hold a PTL can apply for a Physician and Surgeon License if the following are met:

  • Have completed at least 12 months of postgraduate training credit
  • Proof of passing COMLEX Level 3. However, you can still apply if passing score report is pending.
  • Demonstrate completion of 36 months of training, with at least 24 consecutive months in the same program, at the time of the first license renewal.

An applicant eligible for a full medical license has 90 days after beginning an ACGME training program in California to obtain a physician's and surgeon's license to practice medicine in California.  An applicant should apply 6 months prior to deadline the license is needed.

Checklist

Physician’s and Surgeon’s License Requirements for MBC (M.D.s) - Who Don't Hold a PTL and Coming From Out of State

Submit Application and Fees:

Application & Reduced Licensing Fee - $674.00 + $456.50 = $1,130.50, Submit a personal check if mailing the application or submit payment by credit card if submitting the application online on BreeZe.

Application for a Physician's and Surgeon's License (L1A-L1E) - We encourage you to apply online on BreeZe, please do the following:

  1. Answer the application questions.
  2. Pay all required fees.
  3. Attach copy of completed Request for Live Scan Service for electronic fingerprints, if you complete this in California. Upload in the "Attachment" section.
  4. Explanation to Application Question (Form EXP), if applicable. Upload in the "Attachment" section.
  5. Timeline of Activities (Form TOA), if applicable. Upload in the "Attachment" section.
  6. Attach supporting documents verifying request to expedite the licensing process, if applicable. Upload in the "Attachment" section.

Fingerprints:

  • Live Scan (CA only) - Complete at a live scan agency within California and attach a photocopy of the completed live scan to the attachment section of your online license application or mail to the board.
  • Two Fingerprint Cards (Outside of CA) - Submit two completed fingerprint cards to the board. You will need to request the fingerprint cards from the board. 

Examination Documentation:

  1. USMLE Transcript - Proof of passing Steps 1-3
  2. ECFMG Certification Status Report - International medical graduates only

Medical Education Documentation:

  1. Certificate of Medical Education (Form MED)
  2. Official Transcript
  3. Certified Copy of Diploma
  4. Official English Translation, if applicable

Postgraduate Training Documentation:

  1. Certificate of Completion of ACGME Postgraduate Training (Form PTA/B) - Request from all programs you have trained at. 
  2. Current Postgraduate Training Verification (Form CTV) - Request from your current program showing you are currently in training to qualify for the reduced license fee of $456.50, if applicable.
  3. Certificate of Completion of CODA Postgraduate Training (Form CODA1-CODA2), if applicable

Timeline of Acvtivities:

Updated CV or Timeline of Activities - Complete only if you've graduated over 6 months ago. Sign and date your updated CV or TOA Form.

Physician’s and Surgeon’s License Requirements for OMBC (D.O.s) - Who Don't Hold a PTL and Coming From Out of State

Application Fee (Part 1) - $200.00, Submit a personal check when mailing the Form OMB.1 application.

Licensing Fee (Part 2) - To be determined by the board. You will receive an invoice to pay a prorated fee because in most cases the license duration for the first cycle is less than two years and issued based on birth month. 

Application for a Physician's and Surgeon's License

  • Application for Osteopathic Physician and Surgeon Certificate (Form OMB.1) - Make sure the application is notarized after completion date of PGY-1.
  • Certificate of Completion of ACGME Postgraduate Training (Form OMB.25) - Please fill out the applicant information and sign the form and give to your training program to complete. You must complete this form for each institution you have trained at, if more than one institution.
  • COMLEX Transcript - Proof of passing Level 1-3
  • Certified Medical School Transcript - Request from medical school once you submit your PTL application. Paper version must be sent directly to OMBC from the medical school.
  • Medical School Diploma - Attach a regular photocopy to your application 
  • Live Scan - Request a fingerprint card from OMBC if physically out of state or complete Live Scan form for fingerprint clearance in California.
  • License Verification - If you have/had a full unrestricted license in another state, you must request a license verification(s) by each state agency.
  • 3 passport quality photos 
    • Affix photo to Form OMB.1, Form OMB.25, and one photo loose with Form OMB.1

Step by Step Guide for Initial Medical License

FAQs

What will be the PTL application fee?

Medical Board of California: $674

Osteopathic Medical Board of California: $491

All fees are non-refundable.

Can I get reimbursed for the PTL application fee?

Reimbursement is eligible using your Educational Fund benefit if you pay for the application fee after your official start date with your Loma Linda residency program. We are not able to reimburse for expenses incurred prior to employment. Submit your reimbursement online on Concur for the fee after you've been charged.

Concur Login

Do I have to have an SSN or ITIN to apply for a PTL?

You may start the PTL application process without furnishing a Social Security Number (SSN).

Disclosure of a United States SSN or an Individual Taxpayer Identification Number (ITIN) is mandatory prior to the issuance of a PTL. 

First year residents who enroll in their residency program after January 1, 2020

These residents will be subject to the new law and be required to apply and be issued a PTL within 180 days of beginning their residency program.

Residents who have completed 1-2 years of residency out of state, who are enrolled in a California postgraduate residency program after January 1, 2022

These residents will be subject to the new law and be required to obtain a PTL from the Board within 180 days of beginning the California residency in order to practice medicine in their residency program. The duration of the PTL will depend on the length of their residency program.
 
If they have already completed one year of residency and they intend to complete the remaining two years of residency in California, then their PTL will last 24 months plus a 90 day grace period if they continue in an ACGME residency program.
 
If they have completed two years and are enrolled in a 1 year residency program in California for their third year, their PTL will last 12 months plus 90 days grace period if they continue in an ACGME residency program.

Residents who have completed 3 years of residency out of state, who are enrolled in a California postgraduate residency program after January 1, 2020

Anyone who has completed 36 months of ACGME training outside of California has 90 days after beginning an ACGME training program in California to obtain a full unrestricted CA medical license to practice medicine. 

Note: The 36 months of ACGME training must consist of at least 24-continuous months of training within the same program to qualify for the full unrestricted CA medical license.

When should an applicant apply for their Postgraduate Training License?

Medical Board of California: Applicants are not required to wait until they have begun their residency training to apply for a PTL, rather they may submit an application and all supporting documents required by the Board as soon as they have confirmation of acceptance into an ACGME program.

Osteopathic Medical Board of California: Applicants may apply for their Postgraduate Training License as soon as they have graduated from medical school, completed COMLEX Level 1 and 2 and received confirmation of acceptance into an AOA or ACGME accredited California program. The licensure process can take up to 6 months to complete. Applicants should not apply for a PTL prior to graduating from osteopathic medical school, only post graduation applications will be accepted.

Is the Postgraduate Training License renewable?

No.

The Board will issue a PTL for up to 15 months (for U.S. or Canadian medical school graduates) or 27 months (for international medical school graduates) for PTL's issued on or after January 1, 2022.

Are there CME requirements while holding a PTL?

No, there are no CME requirements while in an accredited postgraduate training program on a PTL. CME requirements are required after obtaining a Physician and Surgeon license.

Can a holder of a PTL obtain an "X-License" or "Fluoroscopic Permit"?

No, the California Department of Public Health requires a full and unrestricted physician’s and surgeon’s license in order to obtain an “X-License” or “Fluoroscopic Permit.” For additional information, visit the California Department of Public Health website. 

PGY-1 to PGY-3 residents who do not hold a full and unrestricted physician's and surgeon's license will not be able to receive the California Fluoroscopy permits and thus will continue to need to be trained in radiation safety through our local process. They would then need to use fluoroscopy through the general supervision of an attending who holds the fluoroscopy permit.

Other Resources

Continuing Medical Education Requirement

Please view the medical board's website on Continuing Medical Education for full description of requirements. 

In summary:

  1. All licensees, regardless of status as a resident or a "real" doctor in the "real" world, must complete at least 50 hours of approved CME during each biennial (2-year) renewal cycle. They do not provide proof at renewal, they just sign the statement. But if audited later, they have to provide the paperwork for verification. The Board conducts random audits throughout the year.
  2. Residents and fellows are allowed six hours of Category 1 credit for each month of residency or fellowship, with a maximum of 72 hours each year. (So, in reality, a resident who does one year of training meets the whole 50 hour/2 year requirement)
  3. For general internists and family physicians who have 25% of their patients aged 65 or old ... they must complete at least 20% of the required CME in geriatric medicine or the care of the elderly. And don't forget about the Pain Management and End of Life Care (PM/ELC) requirements --- also CME, but separate from the above requirements. The legislation that enacted this mandate was specific - the PM/ELC hours must be a separate class specific to those topics. PG training does not count towards this requirement.
  4. Pain Management/End of Life Care CME is required of all licensees, regardless of status as a resident or a "real" doctor in the "real" world, and is required within the time frames listed below:
    • Physicians with an active license before January 1, 2002, will have until December 31, 2006, to obtain the 12 hours. 
    • Physicians licensed on or after January 1, 2002, must complete the 12 hours by their second license renewal date or within four years, whichever comes first. 
    • The 12 hours can be all in one subject, or split 11/1, 10/2, 9/3, etc. 
    • Radiologist and pathologists are exempt. 
    • The 12 hours for PM/ELC can be used towards the total 50 hours/2 year requirement.

Important Notes

  • There is now a training license in California.  A Postgraduate Training License (PTL) went into effect on January 1, 2020 under Senate Bill (SB) 798.
  • Years of residency refers to actual years of training rather than PGY.
  • Trainees entering non-ACGME programs must possess a valid CA Medical License before starting training.
  • There is a 90 day "grace" to obtain a CA MD license if a person has just completed 36 months of ACGME training in the U.S. and going into a training program in California as a PGY-4. 
  • Visiting residents who are a M.D. from outside California may participate in ACGME residencies as "visitors" for up to 90 days without a PTL or full medical license with the Medical Board of California.
  • Visiting residents who are a D.O. from outside California must obtain a postgraduate training license to participate in ACGME residencies as "visitors" with the Osteopathic Medical Board of California.

Reporting Misdemeanors and Felonies to Licensing Board

The reporting requirement is pursuant to Business and Professions Code (B&P) Section 802.1 which states:

802.1. (a) (1) A physician and surgeon, osteopathic physician and surgeon, and a doctor of pediatric medicine shall report either of the following to the entity that issued his or her license: (A) The bringing of an indictment or information charging a felony against the licensee. (B) The conviction of the licensee, including any verdict of guilty, or plea of guilty or no contest, of any felony or misdemeanor. (2) The report required by this subdivision shall be made in writing within 30 days of the date of the bringing of the indictment or information or of the conviction. (b) Failure to make a report required by this section shall be a public offense punishable by a fine not to exceed five thousand dollars ($5,000).

Please use the following reporting form from the Medical Board of California: Physician Reporting - Criminal Actions Form