Questions about California residency/licensure requirements come up from time to time, I've been asked to post some general informations on these topics. Bear in mind that licensing laws change frequently. So please double check and confirm everything you hear from this forum with official sources.
For California, the Medical Board's website is:
www.medbd.ca.gov
CLINICAL:
We have affiliations in the following hospitals in California:
1) San Joaquin General Hospital in Stockton (90 miles east of San Francisco). We offer Medicine and Psych core rotations. Electives in medicine subspecialties are also available. Highly recommend our ICU rotation. There are talks of expanding our core rotations to other areas, but they are just talks now without any concrete plans. We have SGU grads in IM, FP, and Surgery residency programs in this hospital. Graduates who are in Surgery and FP sat out a year to wait for their California Letters (more on this later). Both chief residents in medicine this year are SGU grads (as well as last year's chief.) Housing is available on campus (Grand-Anse quality dormrooms), currently we charge $25 dollars per month including a in-house phone for local calls (and calling card OK) and utilities.
2) Highland General Hospital in Oakland. A busy county hospital with good teaching and patient diversity. It's in the Bay Area. Only Medicine core and medicine electives are available. You can do radiology elective here as well, but it will NOT be recorded as radiology elective (no radiology residency here), it will be recorded as medicine elective. We have SGU grads here in IM residency programs every year. Housing - you are on your own.
3) Kern County in Bakersfield. All cores are available here. You can potentially stay here your entire 2 years of clinicals. They only have limited spots here. Ross and AUC also rotate through here. They have minimum GPA/Step I score requirements. Don't know much about this place as it was not available when I was a student. They have SGU grads in medicine residency program. Housing -- don't know.
4) Children's Hospital of Orange County (CHOC) in City of Orange, next to Disneyland. Excellent pediatric core and electives, including critical care. Very good teaching. Unfortunately, they have virtually stopped taking our grads into their Pediatric residency programs in the past two years (the somewhat anti-IMG stance of the current program director). Housing -- on your own.
COLLECT L-6 FORMS FROM EVERY CLINCAL ROTATION YOU DO, including rotations in England. (See below for L-6 forms)
You will need to do 4 weeks of Family Practice rotation during medical school. This applies to both IMG's and USMG's.
RESIDENCY:
California is one of the states that do not trust ECFMG's ability to evaluate foreign medical education. They do their own individual evaluations of IMG's.
First of all, you need to attend (entire medical education, no transfers) and graduate from a California approved medical school. Currently only SGU, AUC, and Ross are approved from the Caribbeans. If you went to an unapproved med school, you will NOT be licensed in California, EVER. No loopholes. You can be a world famous board-certified chief of neurosurgery from an Ivy League hospital... if your med school is not approved by California, you still cannot be licensed. Board certification and/or licensure from other states do not get you around this rule. This rule applies to residency as well.
You will absolutely need to do all your rotations in hospitals that have ACGME-approved residency programs in the specialty of your rotation. Specifically, Family Practice residency CANNOT serve as the parent residency for other specialties except family practice.
In order to start residency in California, you need to have in your physical possession a "California Status Letter" (CA Letter) on Day 1 of your residency start date. Starting residency without the letter constitutes practicing medicine without a license and is a felony. To get this letter, you need to file and start your licensing process. You need to file paperwork and fulfill all licensing requirements except for Step III score and the two-year residency training requirement. It takes 60 days to get this letter... and your original diploma is required... so you don't have much time to play around.
For licensure/CA Letter, you will need to have:
1) Official transcripts from every school you attended since high school. Medical school transcript needs to show degree conferment. (So don't send it before you graduate -- see school paperwork below).
2) Completed licensing application.
3) L-6 Form from every single rotation you do. You can print this form from the CA board website. The form needs to be signed by DME of every hospital you rotate through for every rotation you do, and it needs to have either hospital seal or notary. COLLECT THESE AND HAVE THEM DONE AS YOU GO THROUGH YOUR CLINICALS. DON'T WAIT UNTIL YOU GRADUATE...
4) School certification. These are forms the school needs to fill out to certify your education. As of now, the school CANNOT fill these out before you officially graduate (meaning, the date on these forms cannot predate your official graduation date). Let Bay Shore (registrar's office) know that you are applying for California residency/licensure. School charges a fee, but will Fedex your paperwork, including transcript with degree conferment back to California medical board on the day of your official graduation date. This is very important. This is where SGU shines in terms of "customer service."
5) Official/original proof of US citizenship (birth certificate/passport), or letter of intent to become US citizen.
6) Fingerprint (2-sets) -- remember it takes 4-6 weeks to clear FBI. Don't know if CA Med Board is now set up to accept "Live Scan." If they are, submit prints via "Live Scan" (available in most local police stations) will save time.
7) Black and White, studio quality photo of specific size/dimension (NOT passport size photo). Spec's are on the application form.
8 ) Application Fee -- Around $520, give or take a few.
9) Original Medical School diploma -- yes, original. It's best to show it to them in person if at all possible. This way, they can inspect it in person, make a copy, and give it back to you on the spot.
10) I'm sure I'm missing something -- check the board's website for other details I might have missed.
AFTER TWO YEARS OF RESIDENCY --
Complete your licensing process by submitting Step III scores and Certificate of completion of 2 years of residency from your program. Pay initial licensing fee of $300, show original ECFMG certificate with indefinite validation stickers.... and become an officially licensed physician in California.
Final words and advices:
There are plenty of IM/FP residency programs that will take SGU grads right out of school, on your word that you will obtain the CA Letter in time to start residency program. Don't burn them -- keep up with your licensing process so that you get your letters in time. We have graduates in USC, various UCLA IM programs, Loma Linda, White Memorial, various Kaisers, and of course SJGH, Highland, and Kern... and few other places I can't remember off hand. FP is also doable in CA. Other specialties are hard to come by in California because most are UC-associated. Most UC programs will NOT interview IMG's without seeing the IMG's CA Letter first. So this means if you are interested in other specialty programs, you may have to sit out a year, get your CA Letter, before entering the match. This is how the SGU grad in our hospital (San Joaquin) got the surgical residency spot.
If you are interested in IM residency spots in one of our CA affiliated hospitals, it is very, very, very advisible to do rotations in these hospitals. Every SGU grad we have taken in our hospital (San Joaquin) has been a student here during med school.
Don't wait until you officially graduate to submit your California licensing application for your CA Letter. Start the process as soon as you know you have matched into a California program. Submit what you can as soon as you have them. Do the fingerprints ASAP to give them time to clear FBI, and above all, pay the application fee ASAP.
California allows IMG's to take Step III without any residency training. You can sit for Step III in California as soon as you graduate from medical school. You may be interested in doing so because you are at your best in terms of general medical knowledge... (I waited until I was almost two years into my residency, and I couldn't remember much Peds/OBGYN... )
Best Wishes, hope this helps,
Picard
edited to add FP requirement...