Wow this Cali approval topic is hot stuff!! Some of my own thoughts and recommendations as a 4 year english program grad:

1. As a student in Poland several years ago, I couldn't care less about the state of California. Wasn't from there, didn't want to go there. Now post residency, I had to pass up some pretty sweet jobs there b/c of my license ineligibility....so never assume an idea is useless because it does not suit you that moment.

2. California approval IS important because US states learn from each others mistakes and often adopt each others policies. It is shortsighted to ignore the issue b/c you plan to live and die in Schenectady NY. Quackery is abundant and the quickest fix to poor medicine is tightening up regulations concerning credentialling and medical practice. Many states and hospitals are now doing extensive criminal background checks on applicants, a recent trend which is quickly crossing state lines . Some state boards may not have the resources to develop elaborate credentialling guide lines. New Mexico for example has simply adopted California 's license eligiblity guidelines so hopefully those of us affected will have no need or desire to go there as well. You never know when New Jersey or Illinois might join the bandwagon no matter how unlikely you think the idea is.

3. Not having Cali. approval simply raises eyebrows. Not only with other state medical boards, but hospitals and juries should you have the misfortune of facing a keen malpractice attorney bashing your credentials in court. Not to Mention (although less important) your american grad friends will think of you as some kind of anomaly should you ever discuss opening a practice together on Malibu beach. I for one do not discuss my Cali ineligibility with anyone.

4. Regarding everyones comments on approved shools in Iraq and Afghanistan; I think the one point almost everyone fails to realize is that Cali approval really addresses the Legitimacy of your education and less the quality of your education which is why we are all so preturbed by the Cali board. These really are two separate things. Overseas English language programs regardless of location are exclusively for profit medical education ventures. Cali board just wants to make sure that your 4 year program in Poland or the carib is operating under the authority of the Ministry of health and not the people who brought you mickey mouse. Both Sadam U. and Kabul health science center believe it or not are official instituitions designed to train physicians for the health Benefit of their respective societies regardless how poor or wartorn these places are. The intentions of the people running medical schools in Iraq are not the same as the savy buisnessmen opening up schools in the carib and elsewhere. This is what scares the Cali board.
ECFMG measures your quality of training and your potential to practice medicine, not the California medical board.

4. Licensure in states like Cali, NY, TX and FL brings an odd low level type of prestige. People know you have been fully inspected and that you are legit.

5. Go to a Cali approved school if you can. By all means however, don't let the Cali board jeopardize a lifelong dream, you still can after all practice in the other 48 states. Just be well informed on your final destination before you start your studies. Push your administration to get approved if they're not. The application costs nothing. Someone just needs to fill out the 300 page questionaire.

6. Last and most importantly, do not apply for a Cali or New Mexico license if your school is not approved. Should they reject your application, you will have to explain why to every state medical board and hospital that you request privelages for the rest of your life. Sure you can sue the state of california ,but you will have to explain every detail of that for the rest of you life as well wether you win or lose. Obtaining a medical license and hospital privelages even for more liberal states can be a grueling process requiring documentation of your every bowel movement since the day you entered medical school. If you're going to take on any governing body, you better at least win.

This is based on my own recent experiences and those of colleagues of mine.

Regarding AsianTS's comments on physicians, many of us have seen the world through your eyes at one time or another. It is a normal function of youth to be liberal, broke and socialist. The majority of us are good people and responsible physicians just trying to survive in a health care system fraught with insurance, political and legal liabilities beyond belief. Don't worry, you seem pretty bright I am sure one day you will walk a mile in our shoes and look back at these posts a different person. Medicine by and large is a very conservative profession, once through the grinder, you will most likely become that way to.