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Unlike all other states, California requires a special authorization in order for medical

school graduates whether US or IMGs to practice medicine or to be enrolled in

residency programs.
The authorization to practice medicine is called California License.
The authorization to be enrolled in a residency program is
called Postgraduate Training Authorization Letter (PTAL) or commonly referred to
as California Letter.
Before talking about the steps on how to get the California letter it's important to
note down the contact information of the MedicalBoard of California (MBC). This
is going to be needed throughout the process.
California Medical Board Contact information
Email: which is unlike the they usually respond
promptly and give you courtesy.
Mailing Address:
2005 Evergreen Street, Suite 1200
Sacramento, CA 95815
800 6332322 or 916 263 2382
916 2632487
Now let's walk through the application process step by step:
First Step is the online application:
Go to
Click on applicants tab and in the resulting new page scroll down and click on
You'll be taken to this page
Click on "Online Licensing Application Payment" on the right upper corner
Then click on "Professional Licensing Log-in"
Which should take you to this page
and here's a screenshot of that page

click to enlarge

Of course you click on the first time users link

thereafter you choose a username and password, email, mailing address, SSN

(optional), and a credit card to be charged later on.

See this image to know what exactly should be checked while paying:

click to enlarge

The total amount that you have to pay is $493 broken down into $442 (Application
Fee) and $51 (Finger Print Processing Fee).
The page that you'll see when you finish the online application looks like this:

click to enlarge

You'll later receive an email confirmation from and they'll say in
it the following:
You have successfully registered with the State of California Online Professional
Licensing system.
You are registered as: FirstName LastName
Your User ID is: xxx
Please keep it for your records. You will need this User ID to login into the system or
to reset your password.
Thereafter you can go to
Log in with your username and password
print out the online receipt because you'll need this for the next steps.
Alternatively, if you don't like to pay online you can send money order or certified
check or personal check and make it payable to "Medical Board of California" and
enclose it with your application papers.
Next Step is to do the Finger Printing:
You can go to
and print out live scan forms (three copies)
then you can locate a live scan center here
or you can choose to send them a finger printing card instead if you don't reside in

California or you won't be visiting California. But in this case you have to contact
them in order they mail you the finger printing cards.
Note that usually you will be charged $25 when you go to the fingerprinting center,
this is another charge to be added to the $51 that you paid already. So your total so
far is 493+25= $518
Although you completed three copies but you will send only one copy to MBC to be
attached to L1A-L1E forms. The other two copies one will go to the FBI and DOJ and
the other can be kept with you.
The Next Step is to fill out and notarize forms L1A, L1B, L1C, L1D, and L1E:
These forms can be downloaded from this page
L1A: just answer the questions; Mention any of the exam scores that you have taken
so far. It's better you mention at least one exam though it is not mandatory.
L1B: not needed for IMGs; definitely we did not do any ACGME accredited
postgraduate training so far and we don't have a state license yet. So leave
questions 14 and 15 blank, just sign at the bottom and put your date of birth.
L1C and L1D: Leave ABMS certifications if you are applying for the PTAL and answer
all questions 17-38. (this is only required for the California license not the PTAL.
L1E: This form you have to sign in front of the Notary Public who should put his seal
and signature in addition to yours.
Now Your are considered an applicant:
Once you send the notarized L1A-L1E along with the application fees (Online Receipt
if you paid online, money order or check if you are not) and
the finger printing request document then you are considered an applicant and you
should receive a notice from the MBC within 90 days.
The letter looks like this
In which you can see that you now have application tracking system (ATS) number.
This number is very important because you will later on be able to follow your case
by entering it in this page
Once you get a number you will be assigned an application analyst. They have
people assigned to the first letter of your last name. For example if your last name is
James then the person in charge with the "J" letter will be in charge of your case.
Most of these clerks are friendly, supportive, and helpful. They will respond to your
emails and telephone contacts promptly and professionally.
Once you know who's your assigned clerk, keep his/her contact info handy as you
will frequently need to be in contact with him/her for various issues and most
importantly to expedite your letter should the match season starts and you don't
have it yet.

Although the complete list of required documents is more than what's mentioned so
far but the above steps are enough to get you into the process.
It's recommended that you complete the above steps early in April so that you enter
their system so that later on updating your case with exam scores and med school
papers get considerably shorter time to finish and you will be able to apply to
California programs in September.
Here's a screenshot of the latest required documents:

click to enlarge

The Next Step is to fill out and send L2, L3A, L3B, L4 and L5:
L3A and L3B and L4: these forms have to be filled when you finish your residency
and you want to apply for a California license (to practice). It's not needed when you
apply for PTAL.
L6: is needed if you have attended clinical training and clerkships outside your core
primary medical school training (a big example here is Caribbean medical schools
where they usually send their students for clerkships in US)
L2 Form should be completed and signed by your medical school
L5 Form should be completed and singed by you medical school
A very important point about L5 Form:
The most common reason of IMG rejection is the number of psychiatry hours during
your core medical curriculum, make sure to send them a total of at least 80 hours of
psychiatry rotations. If your medical school curriculum did not meet this requirement
then you have to top up your application with a certified psychiatry clerkship here in
the US in order to get it through.
Another big advice regarding from L5 is to try to find a colleague from your school
who has done it before and got accepted. This way you can adjust the number of
hours in lieu with what he/she has done, of course changing the dates as appropriate
if does not match yours.
The Next Step is to send them your exam scores:
for exam scores go here
You need to have passed both Step 1 and Step 2 CK before your are granted a
California letter. However, my advice is that you can start the application above (L1AL1E + Finger Printing + Fees) before you have passed these exams. This will buy you
sometime, so that then you can just update them with your exam scores which
should not take a long time. So for example start the application in February then
when your exam scores are ready in July or August you can update them with the

scores and your letter would be ready in September or October otherwise if you start
the application in July-August you may not get the letter until February or March next
year jeopardizing your potential match in a California program
The Next Step is to send them your Medical School Transcript and Degree
In their instructions they mention that your medical school should send to MBC
directly (not through you) certified copies of your transcript and degree. Certified
copies means that the photocopy should be stamped (true copy of original) and
sealed with the college stamp and signed by the authorized school official.
The previous paragraph is the ideal situation. However, if you are having difficulty
with your medical school sending the transcript and the degree (diploma) then the
alternative is that you yourself send them the original documents along with
translated copies (if they were not in English). In their official instructions they don't
mention that but in reality they do accept this method as I have experienced (and
several friends of mine) such a scenario with them.
What you can do if the letter is not yet out and you started applying for the
match in ERAS?
You can scan the receipt notice that you received and send to ECFMG for scanning.
This is considered equivalent to the original letter by most California programs.
However, they'll ask you to bring the final letter when you appear for the interview.
At the time of the interview you should have completed all the requirements.