California Medical License: Everything you need to know

Obtaining a medical license in California is the first step for anyone seeking to practice medicine or other health-related professions within the state. California is unique because it maintains two separate licensing boards for Allopathic (MD) physicians and Osteopathic (DO) physicians. Each board has its own set of eligibility criteria and application procedures. So, you must understand the distinctions before getting started.

In this guide, we’ll walk you through the licensing process for physicians under the California Medical Board. By knowing the requirements ahead of time, you can avoid unnecessary delays, prevent costly mistakes, and reduce the risk of having to appear before the Board due to incomplete or incorrect submissions.

While the process may seem complex, especially with the licensing and documentation involved, the good news is that it doesn’t have to be overwhelming. Whether you're a new US graduate or an international medical graduate, this article will help you go through the licensing journey confidently and efficiently, increasing your chances of approval on the first try.

Let’s get started.

What is the importance of obtaining a medical license in California?

Apart from the fact that it’s a law that physicians have to abide by, obtaining a medical license will help you to make the most of your medical profession in California, gain trust, get the best job opportunities, and further your medical education.

Let’s discuss these in detail:

1. Legal authorization to practice

A medical license is mandatory by law for practicing medicine in California. Without a valid license, diagnosing, treating, prescribing, or even giving medical advice is considered illegal and punishable by fines or imprisonment.

2. Public trust and professional credibility

The license shows that the physician has met rigorous education, training, and examination standards. Patients, colleagues, and institutions can trust the physician to deliver quality healthcare based on their training. The license shows that the doctor is qualified and competent.

3. Eligibility for employment

Hospitals, clinics, and other healthcare facilities in California require a valid state medical license before offering employment or privileges. It also needs to be listed on insurance panels. 

Without a valid license, employment opportunities in California are slim and almost non-existent. This includes eligibility to provide telehealth services to California residents. Doctors must hold a California medical license, regardless of where they’re physically located.

4. Access to DEA registration

A California license is required to obtain a Drug Enforcement Administration (DEA) number, which allows physicians to prescribe controlled substances.
You must also register with the Controlled Substance Utilization Review and Evaluation System (CURES), the state’s prescription monitoring system.

5. Legal and financial protection

Licensed practitioners are eligible for malpractice insurance and can defend themselves in legal cases as recognized professionals. Unlicensed practice exposes individuals to lawsuits and financial penalties.

What are the eligibility requirements for getting a California medical license?

You must meet key eligibility requirements before applying for a Physician’s and Surgeon’s License. These include having the proper education, completing required postgraduate training, passing the necessary exams, undergoing background checks, and paying the required fees. 

Below is a detailed breakdown:

A. Proper Medical Education

To be eligible, you must have graduated from one of the following:

• A U.S. or Canadian medical school accredited by the Liaison Committee on Medical Education (LCME)
• A U.S. osteopathic medical school accredited by the Commission on Osteopathic College Accreditation (COCA)
• An international medical school that is approved by the Medical Board of California

Additionally:

• U.S. and Canadian graduates must complete at least 12 months of board-approved postgraduate training.
• International graduates (IMGs) must complete at least 24 months of board-approved postgraduate training.

B. Board-Approved Postgraduate Training

You must undergo postgraduate training at a facility accredited by:

• Accreditation Council for Graduate Medical Education (ACGME) if in the U.S.
• Royal College of Physicians and Surgeons of Canada (RCPSC) or College of Family Physicians of Canada (CFPC) if in Canada

If you completed 12 or 24 months of training in another U.S. state or in Canada and are accepted into a California ACGME-accredited program, you must apply for your full P&S license within 180 days of starting your California program.

If you don’t receive your license within those 180 days, you must immediately stop all clinical duties. Continuing to practice after this period will be considered unlicensed and could result in disciplinary action.

C. Examination Requirements

You must pass one of the following licensing examination series:

• USMLE Steps 1, 2 (CK), and 3
• COMLEX Levels 1, 2, and 3

Note: You are allowed a maximum of 4 attempts per exam step/level.

• Step 3 must also be passed within 4 attempts.
• All passing scores are valid for 10 years from the month you took the exam.

D. Background Check

You must undergo a criminal history check, including:

• Fingerprinting (Live Scan or FD-258 cards, depending on your location)
• Verification by both the California DOJ and the FBI

Complete this step early in the process, as it can significantly delay your application if done late.

E. Licensing Fees

The total fees for a full P&S license are:

• $442 application fee
• $635 initial license fee
• Total: $1,077

This does not include additional costs for fingerprinting, document certification, or credential verification services (e.g., FCVS).

What is the application process for the California medical license?

To begin your California medical license application, you’ll need to apply electronically through the BreEZe system, the state’s official licensing portal.

However, to use BreEZe, you must have a U.S. Social Security Number (SSN) or an Individual Taxpayer Identification Number (ITIN). These numbers are required to verify your identity and eligibility for licensure under California law.

If you do not yet have an SSN or ITIN, you won’t be able to use the online system. Instead, you’ll need to request a paper application by emailing the Medical Board at licensing.questions@mbc.ca.gov. In your message, be sure to mention that you do not have a U.S. SSN or ITIN and request that the Postgraduate Training License (PTL) application be mailed to you.

To avoid delays, it's recommended that you submit your application at least six months before your intended start date.

Here’s what else you should know:

• If you’re joining a non-ACGME program, your medical license must be active on your start date.
  
  
• If you have been previously licensed in California, you must submit a paper application along with the required fees and return your original California wall certificate. If your certificate is lost or destroyed, you must provide a notarized statement explaining the situation.

The Online Application Process:

Step One: Get your documents ready

Before you dive into the application form, gather the following essential details and documents:

• Full Legal Name: Ensure your name matches exactly as it appears on your identification documents (e.g., passport, birth certificate). Discrepancies here can cause delays.
  
  
• Social Security Number (SSN) or ITIN: This is crucial for identity verification and background checks. If you do not have an SSN or ITIN, you must email the California Medical Board’s webmaster requesting a paper application.
  
  
• Address of Record: This is the address where all official communication will be sent. It can be your home address or the address of your medical institution, but it must be consistent across all application forms and documents.
  

• Exams Taken: List all medical exams you've passed, such as USMLE, LMCC, or FLEX, including dates and scores. Be honest about any attempts, as California tracks your examination history.
  
  
• Medical School Details: Provide the name of the school, the dates you attended, the degree earned, and your graduation date. International graduates must submit additional verification, such as an ECFMG Certification.
  
  
• Postgraduate Training History: If you've completed any residency or fellowship programs, list the names of the training facilities, the dates of your training, and the specialties you trained in. California only accepts ACGME-accredited postgraduate training.
  
  
• Medical Licenses: List any current or past medical licenses held in other states or countries, including their status and expiration dates. If you’ve had any disciplinary actions against those licenses, they must also be disclosed.

Step Two: Pay the Application Fee

Once you have filled out your application, the next step is to pay the necessary fees. The total cost for the California Physician’s and Surgeon’s License application is $674, which includes a $49 fingerprint processing fee.

• Payment Methods: Payments can be made via the BreEZe system using a credit card or debit card. Make sure to save the payment receipt for your records.
  
  
• Non-Refundable: Be aware that this fee is non-refundable, regardless of whether your application is successful or not.

If you're a military spouse or domestic partner of an active-duty service member, you may be eligible for a fee waiver on the $625 portion of the application fee. However, the $49 fingerprint processing fee is still required.

Step Three: Submit Fingerprints for Background Checks

Fingerprints are required for background checks by the California Department of Justice (DOJ) and the FBI. This is a crucial part of the process, as it ensures the applicant has no criminal history that would prevent them from obtaining a medical license.

For California Residents:

• Use the Live Scan fingerprinting system.
  
  
• You will need to submit the Request for Live Scan Service form, which you can download from the BreEZe portal.
  
  
• Fingerprints can be taken at any certified Live Scan location (usually at police stations or private fingerprinting centers).

For Out-of-State Applicants:

• If you reside outside of California, you will need to send two fingerprint cards (FD-258) to the California Medical Board.
  
  
• You may also visit a California Live Scan facility if you are traveling to California during the application process.

Things to Watch Out For:

• Ensure that your fingerprints are clear and legible. Fingerprint errors are a common cause of delays (accounting for 26% of processing issues).
  
  
• If you're applying for a Temporary License, the fingerprint results must be received by the Board before the license can be issued.

Step Four: Submit Additional Supporting Documents

Depending on your situation, you may need to submit a variety of other supporting documents in addition to the application form, fingerprint results, and payment.

Key Documents Include:

• Name Change Notification: If your name has changed since your original medical records were issued (due to marriage, divorce, or legal name change), submit official documentation such as a marriage certificate.
  
  
• Explanation Form (Form EXP): If you answered “Yes” to any questions regarding past legal or disciplinary issues, you may need to explain. This form helps clarify the situation to the Board.
  
  
• Timeline of Activities (Form TOA): This form is required if there is a gap in your medical activity, such as time spent away from practicing medicine. If you had a break from medical practice, ensure you provide an accurate and detailed explanation. Missing details here could lead to delays.
  
  

• ECFMG Certification: If you graduated from a foreign medical school, you need to provide an ECFMG Certification Status Report to verify your education and training.

What is the typical processing time and what are the potential delays?

Getting your medical license in California is a lengthy process. On average, it can take 3 to 6 months for the Board to process your application, depending on your credentials. In fact, during the 2023/24 period, the average processing time for initial licenses was 106 days, and for reinstatements, it stretched to 168 days.

What Causes Delays?

The Board regularly receives applications with missing or incorrect information. The most common mistakes that slow down processing include:

• Incomplete documentation: Applicants often forget to submit important forms (e.g., Name Change Notification, Form TOA).
  
  
• Fingerprint issues: Incorrectly filled-out fingerprint forms or unclear prints.
  
  
• Name inconsistencies: Discrepancies between your application details and supporting documents.
  

To avoid delays, make sure all information is accurate and complete before submitting your application.

How do you renew your California medical license?

California licenses expire every two years on the last day of the month in which they were issued. The Board will notify you 180 days before your license is due for renewal.

If your license is still not renewed within 120 days, the Board will mail a paper Renewal Notice to your Address of Record. At this point, you can renew online via BreEZe or by submitting the paper renewal notice and payment through the mail.

To maintain an active California medical license, physicians are required to complete 50 hours of Continuing Medical Education (CME) which are AMA PRA Category 1 credits, during each renewal.

The standard renewal fee is $1206. Additional fees may apply for late renewals or other services.

How to Renew:

• You can renew your license online via BreEZe.
  
  
• You can also renew by mail using the paper renewal form if you prefer.

There is no grace period for renewing your license. If your license expires, you must submit a renewal application immediately. Additionally, the Board requires CME credits in pain management and treatment of terminally ill patients to maintain your license.

What are the licensing requirements for International Medical Graduates? 

To practice medicine in California as an International Medical Graduate (IMG), specific requirements must be fulfilled:

1. ECFMG Certification
   All IMGs must obtain certification from the Educational Commission for Foreign Medical Graduates (ECFMG), which ensures that their education meets U.S. standards. This includes passing the required examinations and submitting documentation as mandated by the ECFMG.
   
2. Form L5 (Certificate Status Report)
   IMGs must submit Form L5, a Certificate Status Report issued by the ECFMG, which verifies their certification status and summarizes their medical education credentials.
   
3. Minimum 36 Months of ACGME-Accredited Postgraduate Training
   California mandates that IMGs complete a minimum of 36 months of postgraduate training in a program accredited by the Accreditation Council for Graduate Medical Education (ACGME), and this training must be in the same specialty area.
   
4. Authenticated Copies of Medical School Diploma
   Applicants must provide authenticated, official copies of their medical school diplomas. These documents should be submitted directly from the issuing institution or through recognized credentialing services.
   
5. Official Translation of Medical Documents (If Applicable)
   If any medical documents are not in English, certified translations must be submitted along with the original documents. These translations must be done by approved translators to ensure accuracy.

Special Pathways for Licensure

California offers specific licensure pathways for particular applicant profiles:

1. Reciprocity/Endorsement

Unlike some states, California does not offer licensure by reciprocity or endorsement. All applicants must meet the state's complete licensure requirements.

2. Postgraduate Training Authorization Letter (PTAL)

IMGs are required before beginning ACGME-accredited training in California.
The PTAL process includes verification of medical education, credentialing, and assessing eligibility for postgraduate training.
Often referred to as the “California letter,” the PTAL must be obtained before starting any clinical training in the state.

3. Faculty Pathway

Designed for distinguished faculty members recruited by California medical schools. Applicants must hold a faculty appointment and meet criteria set by the Medical Board.
A separate application and documentation process is required for this pathway.

What are the key compliance requirements?

To remain in good standing, licensees must adhere to these ongoing responsibilities:

• Address Changes: All address changes must be reported to the Medical Board within 30 days of the change.
  
• Adverse Actions: Physicians must report any disciplinary or legal actions taken against them within 30 days.
  
• CURES Registration: DEA license holders must register with California’s Controlled Substance Utilization Review and Evaluation System (CURES) to monitor controlled substance prescriptions.
  
• Mandatory CME Topics: Specific CME hours must include content on pain management and the care of terminally ill patients. These are state-mandated and essential for license renewal.

Simplify the Licensing Process with Assured

The licensing process is complex and requires accuracy and constant monitoring to ensure that the license is obtained and renewed at the right time.

Thankfully, automating the process will ensure you go through the process with minimal effort. Assured is a licensing platform that handles everything from identifying state license requirements to application filling, status tracking, and auto-renewals.

The Assured team assesses your credentials against the California state's requirements to identify any potential issues before starting your application. 

The platform also collects your information and completes all required forms for your electronic signature. This way, you’re outsourcing your background checks, fingerprinting, and verifying all credentials as mandated by the licensing board.

Assured helps you get your approved license and implements automatic renewal tracking that alerts you and initiates the renewal process 60 days before expiration to ensure continuous practice authorization.

Book a demo and find out how Assured can help you with personalized licensing automation.