Postgraduate Training Authorization Letter PTAL Step by Step

Postgraduate Training Authorization Letter (PTAL) Step by Step Guide

Application information for a postgraduate training authorization letter (PTAL) • A PTAL allows you to seek and commence ACGME accredited training in California • To be eligible for a PTAL, applicants must have received all of their medical school education from and graduated from a medical school recognized or approved by the Medical Board of California (Board) • Some recognized medical schools that teach in their native language are opening English language medical school programs. The English language programs are not recognized unless specifically stated by the Board ü The Medical School’s name must exactly match the name on the Board’s list of recognized medical schools. ü Refer to the Board’s website to verify your medical school is recognized: http: //www. mbc. ca. gov/applicants/medical_schools/schools_recognized. aspx

PTAL Application Checklist 1) Application, fees and fingerprints Application fee $491 Application for Physician’s and Surgeon’s License, Forms L 1 A-L 1 F Fingerprints: Live Scan Form 2) Examination Documentation ECFMG Certification Status Report Official Examination Scores from the Federation of State Medical Boards (FSMB)

PTAL Application Checklist 3) Medical Education Documentation Certificate of Medical Education, Form L 2 Official Medical School Transcript Certified Copy of Medical School Diploma Certified English Translations (if applicable) Certificate of Clinical Training, Form L 5 Certificate of Individual Clinical Clerkship Training, Form L 6 (if applicable) 4) Other Items Curriculum Vitae (CV) Timeline of Activities

1) Application, fees and fingerprints

PTAL Application Fee 491. 00 Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Application for physician’s and surgeon’s license, Forms L 1 A-L 1 F ✓ Complete all fields, answer all questions and have the application notarized All six forms must be submitted together ✓ Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Application for physician’s and surgeon’s license, Forms L 1 A-L 1 F ✓ Complete all fields, answer all questions and have the application notarized All six forms must be submitted together Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Application for physician’s and surgeon’s license, Forms L 1 A-L 1 F ✓ ✓ USMLE Step 1 mm/dd/yy USMLE Step 2 CS mm/dd/yy USMLE Step 2 CK mm/dd/yy USMLE Step 3 mm/dd/yy Complete all fields, answer all questions and have the application notarized All six forms must be submitted together Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Application for physician’s and surgeon’s license, Forms L 1 A-L 1 F Complete all fields, answer all questions and have the application notarized All six forms must be submitted together Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Application for physician’s and surgeon’s license, Forms L 1 A-L 1 F ✓ Complete all fields, answer all questions and have the application notarized All six forms must be submitted together Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Application for physician’s and surgeon’s license, Forms L 1 A-L 1 F ✓ Complete all fields, answer all questions and have the application notarized All six forms must be submitted together ✓ Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Application for physician’s and surgeon’s license, Forms L 1 A-L 1 F ✓ Complete all fields, answer all questions and have the application notarized All six forms must be submitted together Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Application for physician’s and surgeon’s license, Forms L 1 A-L 1 F Complete all fields, answer all questions and have the application notarized All six forms must be submitted together Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Fingerprints: Live Scan Form • Criminal Records Check from both the California Department of Justice and The Federal Bureau of Investigation must be received prior to the issuance of a PTAL NOTE: If you have ever been convicted, the record of conviction will be reported to the Board as a result of your fingerprint inquiry. The Board receives results for all convictions: misdemeanors, felonies, infractions and citations. If in doubt, it’s better to answer “yes” on the L 1 E form and include an explanation • The “Request For Live Scan Service” form is required to have your fingerprints processed by Live Scan. This form must be completed in triplicate • Ensure that all personal data (name, AKA’s, date of birth, sex, height, weight, eye color, hair color, place of birth, Social Security Number or Individual Taxpayer Identification Number, California’s driver’s license number and home address) is provided on each of the three forms • The last section of the form requires information from the fingerprint agency; please ensure this information is completed or the forms will be void • It your responsibility to ensure that the person scanning the fingerprints submits TWO digital prints, one for the DOJ and one for the FBI Access the website http: //ag. ca. gov/fingerprints/publications/contact. html to obtain the names, location, and fees of approved fingerprint sites Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Fingerprints: Live Scan Form Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

2) Examination Documentation

PTAL ECFMG Certification Status Report A Certification Status Report from the Educational Council for Foreign Medical Graduates (ECFMG) is required to verify your certification is valid The ECFMG must mail the Certification Status Report directly to the Board to be acceptable 1) Go to https: //cvsonline 2. ecfmg. org and log in as an International Medical Graduate 2) Click on “Go to CVS ON-LINE” 3) Log in using your USMLE/ECFMG Identification Number and Password

PTAL ECFMG Certification Status Report 4) Once you log in, make sure the information shown is correct 5) Check the box to confirm your information in correct 6) Make a Request ✓

PTAL ECFMG Certification Status Report 7) In Country select “USA” 8) In State/Province select "CA”. The Medical Board of California information will appear automatically 9) Select “Finish” 10) Select “Continue To Payment System” and complete the transaction. Your ECFMG Certification will be sent directly to The Medical Board of California

PTAL Official Examination Scores from the Federation of State Medical Boards (FSMB) • Go to: http: //www. fsmb. org/licensure/transcripts and create a new account • You will have to use your ECFMG number to proceed with the registration process • Once you do it, your FSMB account will be linked with your ECFMG and you will be able to request your official USMLE scores

PTAL Official Examination Scores from the Federation of State Medical Boards (FSMB) • Once you log in, make sure all the information shown is correct and click ”Continue” at the bottom of the page • Check the ”USMLE” box and select “Send to a Medical Licensing Authority” and then “Medical Board of California” • On the next screen click “Continue” • On the next screen check the box under “Terms & Conditions” and click on ”Checkout” • Pay the $70 fee and your Official Examination Scores will be sent directly to The Medical Board of California ✓

3) Medical Education Documentation

PTAL Certificate of Medical Education, Form L 2 • A Certificate of Medical Education, Form L 2, is required from each medical school attended ü Complete the applicant information at the top of the form and mail it to your medical school ü The form will need to be completed, signed and dated by the school official and affixed with the official medical school seal ü Any fields or questions left unanswered will require completion of a new form The form L 2 must be mailed directly from the medical school to the Board to be acceptable Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Certificate of Medical Education, Form L 2 ✓ Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Certificate of Medical Education, Form L 2 Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Official Medical School Transcript • An original medical school transcript, prepared on University letterhead affixed with the signature of the dean or registrar and the medical school seal, documenting all of the basic science and clinical courses completed during the medical curriculum is required • A transcript is required from each medical school attended • If the official language of instruction is in a language other than English, the official transcript will need to be translated The transcript must be mailed directly from the medical school to the Board to be acceptable Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Official Medical School Transcript Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Official Medical School Transcript fffffffffffffff Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Official Medical School Transcript Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Certified Copy of Medical School Diploma • A certified copy of your medical school diploma is required • The certified copy must have the original signature of the dean or registrar of the medical school, be affixed with the official medical school seal, and include a statement attesting that the copy is a true and correct copy of the original • If the official language of instruction is in a language other than English, the official medical school diploma will need to be translated The certified copy of your diploma must be mailed directly from the medical school to the Board to be acceptable Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Certified Copy of Medical School Diploma Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Certified English Translations (if applicable) • If the official language of instruction is in a language other than English, an official English translation will be required • Certified English translations are required for all academic documents that are not prepared in the English language • Refer to the Translation of International Academic Credentials for details regarding acceptable translations http: //www. mbc. ca. gov/Forms/Applicants/translation_int_academic. pdf The certified translation must be mailed directly to the Board to be acceptable Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Certificate of Clinical Training, Form L 5 • A Certificate of Clinical Training, Form L 5, is required to report all undergraduate clinical clerkships ü Complete the applicant information at the top of the form and mail it to your medical school ü The form will need to be completed, signed and dated by the school official and affixed with the official medical school seal ü You may print or copy as many forms as necessary to provide a compete breakdown of your undergraduate clinical training The form(s) L 5 must be mailed directly from the medical school to the Board to be acceptable Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Certificate of Clinical Training, Form L 5 • Report undergraduate clinical clerkships where you participated in DIRECT, HANDS-ON DIAGNOSIS OR TREATMENT OF PATIENTS IN A CLINICAL SETTING • - Minimal instruction in clinical courses is 72 weeks, with a minimum of: 8 weeks of Internal Medicine 8 weeks of Surgery 6 weeks of Pediatrics 6 weeks of OB/GYN 4 weeks of Psychiatry 4 weeks of Family Medicine There shall be an additional 4 weeks in one of the core clinical clerkship rotations You need to include the clinical clerkships completed during your 5 th year (internship year) Clinical clerkships completed in your 3 rd year do not count towards the 72 week requirement Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Certificate of Clinical Training, Form L 5 Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Explanation to Form L 5 • If your Official Medical School Transcripts do not show exactly the same information shown on your L 5, it’s better to ask you Medical School to include an official explanation with the breakdown of your clinical courses ü Doing so, you will avoid confusion and delays in your PTAL issuance L 5 Form Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Explanation to Form L 5 Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Certificate of Individual Clinical Clerkship, Form L 6 (if applicable) • Certificate of Individual Clinical Clerkship Training, Form L 6, is required for each undergraduate clinical clerkship completed outside of the primary teaching hospital of the medical school of attendance ü The form must be submitted to the hospital where the clerkship was completed and the current program or clinical instructor must verify completion of the clerkship The completed Form(s) L 6 must be submitted directly from the facility to the Board to be acceptable ü If the hospital where an undergraduate clinical rotation was completed is now closed, the medical school may provide a certified copy of the student evaluation form that was initially completed by the sponsorship hospital The copy must be affixed with the medical school seal and signature of the dean certifying it is a true copy of the original document and mailed directly to the Board

PTAL Certificate of Individual Clinical Clerkship, Form L 6 (if applicable) Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

4) Other Items

PTAL: Curriculum Vitae (CV) Submit a signed and dated current CV with your Application Example Name, MD Address Contact Number E-mail • EDUCATION • CLINICAL EXPERIENCE • RESEARCH AND PUBLICATIONS • CO-CURRICULAR ACTIVITIES • COURSES AND CONFERENCES • REFERENCES Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Timeline of Activities Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL Timeline of Activities • A complete timeline from the graduation of medical school to present is required. • Provide the Board with a written chronological description of all your professional and non-professional activities with no gaps. • If you have completed any externships, observerships, or volunteers activities in California, please include a detailed description of your duties and responsibilities along with the location and name of the supervising physician. Mail your signed and dated timeline of Activities form directly to the Board Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL: Explanation to Application Questions (if applicable) Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

ADDITIONAL INFORMATION

PTAL: Additional Information • Once formally admitted to an ACGME-accredited postgraduate training program, you must complete and return the Postgraduate Training Registration Form which may be obtained from the Board’s website • The PTAL is valid for one year from the date of issuance ü You are required to update your file on a yearly basis by completing the Application, Forms L 1 A-F ü Check the update box at the top of the form and include your file number ü No additional fees are required ü You must mail in the Update Application along with a current Timeline of Activities form ü An Update Application may not be submitted using the Bree. EZe online application system Address: 2005 Evergreen, Suite 1200, Sacramento, CA 95815 -3831 Phone: (916) 263 -2382 or (800) 633 -2322 Fax: (916) 263 -2487 Website: www. mbc. ca. gov

PTAL: Additional Information • Begin the process ASAP ü Start gathering materials and dates now, whatever program you are in (A, B, C, D) ü The sooner you start collecting the necessary information and checking dates the better • Check and double check all dates and other information to ensure consistency across all documentation • Do not send blank forms to your medical school unless you are absolutely certain that they will be correctly completed ü Following the above instructions and sending a ”reference copy” electronically and/or physically will greatly reduce the likelihood of errors and unnecessary delays/questions

PTAL: Additional Information • Request a copy of your transcripts/grades/diploma for yourself to use as a reference ü Since your medical school will need to submit official copies directly to the Medical Board, you should ask for an additional copy so you can make sure the official dates and the dates on your PTAL correspond • Contact and stay in contact with your medical school – the sooner the better ü Call your medical school and identify the person who will complete the forms ü Ask 1) if they have completed a PTAL in the past specifically for the Medical Board of California, 2) how much the process will cost, and 3) a time estimate to submit the documentation once they receive it

Postgraduate Training Authorization Letter (PTAL) Step by Step Guide