Postgraduate Training License (PTL)

Effective January 1, 2020, 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. 

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

Trainees who hold a current PTL and have successfully completed 36 months of ACGME training that includes four months of general medicine may apply for transition from a PTL to a physician's and surgeon's license in California.

Note: The PTL will be valid until 90 days after a trainee successfully completed 36 months of accredited training if the trainee is currently enrolled in an ACGME accredited training program in California.  

Physician's and Surgeon's License

Effective January 1, 2020, an applicant must successfully complete a minimum of 36 months of baord-approved postgraduate training, with at least 24 consecutive months in the same program, to be eligible for a physician's and surgeon's license in California.

An applicant 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.

An applicant who has completed 48 or more months of ACGME training outside of California must obtain a full unrestricted CA medical license prior to starting an ACGME training program in California.

PTL Resources

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

  • Application Fee - $491, If an incoming resident pays for the fee prior to the official start date, it will not be eligible for reimbursement using the Educational Fund benefit. 
  • PTL Application - The form is not compatible with Chrome Browser or Microsoft Edge for printing. Save the document prior to filling out, printing, and/or saving the information filled in. GME Office can notarize and submit on your behalf if you in the local area.
  • PTL Enrollment Form - GME Office will automatically submit on your behalf.
  • 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 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 graduate. GME can complete for LLU grads only.
  • Certified Medical School Diploma - Request from medical school once you graduate. GME can complete for LLU grads only.
  • Certified Medical School Transcript - Request from medical school once you graduate. Paper version must be sent directly to MBC.
  • USMLE Transcript (Proof of passing at minimum: Steps 1 and 2CK)
  • 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 - $540, If an incoming resident pays for the fee prior to the official start date, it will not be eligible for reimbursement using the Educational Fund benefit. 
  • PTL Application - GME Office can notarize and submit on your behalf if you in the local area.
  • 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 graduate. Paper version must be sent directly to OMBC.
  • Medical School Diploma (regular photocopy) 
  • COMLEX Transcript (Proof of passing at minimum: Levels 1, 2CE, 2PE)
  • Three 2x2 passport like real photos

FAQs

What will be the PTL application fee?

Medical Board of California: $491.00

Osteopathic Medical Board of California: $540.00

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.

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

You may start the PTL application priocess 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.

First year residents who enroll are enrolled in Transitional or Preliminary Year scheduled to complete on June 30, 2020

Current first year residents who are attending a transitional or preliminary year and are scheduled to complete the academic year on June 30, 2020 will not require a PTL. However, if the resident is accepted into an ACGME-accredited program in California starting on July 1, 2020, they will be required to obtain their PTL by March 31, 2021. 

Second year residents enrolled in a California residency program in July 2019

If a second year resident apply and are licensed prior to December 31, 2019, they will be issued a full license and not subject to the new PTL law.

If second year residents apply for licensure prior to December 31, 2019 but do not receive their license by December 31, 2019, they will be subject to the new law and they will be required to apply for the PTL. 

Residents who have completed 1-2 years of residency out of state, who are enrolled in a California postgraduate residency program after January 1, 2020

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.

Residents who have completed over 4 years of residency out of state, who are enrolled in a California postgraduate residency program after January 1, 2020

Anyone who has completed 48 or more months of ACGME training outside of California must obtain a full unrestricted CA medical license prior to starting an ACGME training program in California.

Note: 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 postgraduation applications will be accepted.

Is the Postgraduate Training License renewable?

No.

Residents continuing in an ACGME program for PGY-4: the PTL is valid for up to 39 months, which includes the 90 day grace period.

Residents in a 3 year program and not continuing in an ACGME program: the PTL is only valid for up to 36 months and must receive a full unrestriced CA medical license prior to practicing in California. There is no grace period.

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 reqirements are required after obtaining a CA 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 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