Important information from the California Board

[SACTOBOY]

Hi everyone! Just wanted to let you know that I emailed Pat from the CA board and she responded to me with the following relevant and important information. Let's all give thanks to Pat for this.

It's true that students who leave a Philippine medical school after the fourth year of medical school are often deficient approximately 21 weeks of clinical training. If you stay in the Philippines and complete the fifth-year internship at a hospital affiliated with your medical school, as Philippine citizens do, you most likely would not be deficient in the medical school training required in California law. If you chose to attend a Philippine medical school and return to the U.S. after the fourth year, you'll need to allow time to remedy your clinical training deficiencies.

You used the term "externship in the USA." Be careful of "externships." After you graduate from medical school, California law prohibits you from engaging in any further clinical training in California until you enter a formal ACGME-accredited residency training program with your PTAL. The law allows only one exception, and that's for applicants who are remedying medical student-level clinical deficiencies who have staff's WRITTEN pre-approval to remedy a deficiency in a California hospital. Training in a California hospital without written permission from our staff is a misdemeanor criminal offense.

You cannot assume or anticipate that you'll have clinical training deficiencies and begin any training in California. You must have written pre-approval from our staff. If you independently begin remedial clinical training in another state without our staff's written approval, this training may not be found acceptable to remedy your deficiencies when you later apply in California.


If you plan to apply to residency training programs in California after graduation, you will need to apply for a Postgraduate Training Authorization Letter (PTAL). The PTAL tells California program directors that you have satisfied the minimum prerequisites of California law to begin a residency training program in California, and you can be considered for acceptance into a California program.

After you apply for a PTAL, our staff will review your application and notify you if your clinical training is deficient, the number of weeks, the clinical area(s) and what options you have to remedy your deficiencies.

NOTE: Again, you cannot complete any remedial clinical training in California until after you have our staff's written permission.

The following are 3 possible options for remedying deficient medical student training:

1) If you match to an ACGME-accredited residency training program OUTSIDE CALIFORNIA, we will simply take the first 21 weeks of the residency training you completed and apply it toward your elective training deficiency (see note below). You would still need to complete 24 more months of training to satisfy the routine postgraduate training requirement for licensure. There is no double-counting of training periods.

2) If you prefer to complete student-level clerkships after graduation in "Green Book" U.S. hospitals to remedy your 21-week deficiency, you MUST have written permission from one of our analysts BEFORE you commence this training. The training official needs to submit a detailed training proposal to our staff and wait to receive written approval before you begin the training. Training completed without written approval will not be accepted toward remedying your deficiency.

REMINDER: It is a criminal offense to complete such training in a California hospital without written permission from our staff.

3) You could also use the first 21 weeks of your routine ACGME-accredited residency training in California (in the event you apply to programs in California and gain admission), but again, this requires the Program Director to submit a written training proposal to our staff and wait for written approval before you begin training.

Most applicants with deficiencies prefer to remedy their deficiencies separate from and prior to residency training programs if they plan to apply to residency programs in California. Applicants with deficiencies are issued "Special" PTALs which state that the applicant must remedy the deficiency first before beginning routine residency training. With competition being so fierce for programs in California, applicants believe that Program Directors will rank a candidate with a clear PTAL over a candidate with a "special" PTAL. So they prefer to remedy their deficiency well before July 1st and qualify for a clear PTAL.

"NOTE: The above assumes that you end up with elective deficiencies only. Core clerkship deficiencies are generally harder to remedy, as many U.S. hospitals are only willing to offer clerkship training or remedial training in elective areas to foreign medical students or graduates. Also, if your deficiency is in a core area (for example, 4 weeks of psychiatry), and you're hoping to enter a pediatrics residency, you would not be able to use pediatrics residency training to remedy the psychiatry deficiency. You would need to complete the 4 weeks of psychiatry BEFORE you begin the three-year pediatrics residency. That requires good planning.


Sometimes "externship" is used to describe a rotation completed in a doctor's office by private arrangement. The trainee usually has already graduated from medical school. In California, this is illegal. Don't plan on any training of this type in California. California law does not permit medical school graduates to complete externships or clinical "observerships" or have any hands-on patient care in California, either paid or volunteer work, to gain or maintain clinical skills or earn Letters of Recommendation to enhance their eligibility for residency training in California.


The first step toward having our staff determine if you need to remedy any deficiencies is to file a licensing application. Please keep in mind that it may take up to 90 days before an analyst reviews your application and communicates with you. Staff reviews applications in date-received order, and their caseloads are very heavy. Also, our staff will not accept an application that's submitted any earlier than one year before the student expects to graduate.

If you have any further questions, please contact me again.

Pat Park, Foreign Schools Liaison, Medical Board of California

[SACTOBOY]

If you were to complete residency training in another state without first filing an application in California, then you could bypass California's application review process for a couple of years. When you were ready to apply to California for a license before you start your job search in California, our staff would review your medical school education and the ACGME-accredited residency training that you completed in another state. Hopefully, you would no longer have any clinical training deficiencies at that time, but there are no guarantees in life.

One further clarification about Philippine medical schools: It's come to our attention that some Philippine medical schools are offering an alternative "MBBS" degree. The California Board doesn't recognize that degree. We will expect Philippine medical school graduates to be issued the Manggagamot (i.e., Doctor of Medicine) diploma.

I hope this helps. Let me know if you or your friends have any more questions.

Pat Park, Medical Board of California

[trauma]

Only Indian nationals are allowed to enter MBBS programs in the Philippines. But this statement means THEY will have problems too.

[drmatty]

I Am A Current Usa Citizen, Planning To Attend Medical School In The Philippines At A Mbbs Program. Why Aren't The Programs Recognized By California? They Are Imed Approved And So Being One Can Get Ecfmg Certified And Take The Usmle Exams And Get A Usa Residency, So Why Aren't They Approved By California? And If Not How Would They Need To Go About Doing This?

Thanks For Your Help Guys.

[dt]

Originally Posted by drmatty

I Am A Current Usa Citizen, Planning To Attend Medical School In The Philippines At A Mbbs Program. Why Aren't The Programs Recognized By California? They Are Imed Approved And So Being One Can Get Ecfmg Certified And Take The Usmle Exams And Get A Usa Residency, So Why Aren't They Approved By California? And If Not How Would They Need To Go About Doing This?

Thanks For Your Help Guys.

individual state licensing boards trump imed listing.

[drmatty]

So your saying that even though they are IMED listed, that has no bearings on california, right? But what about other states, for other states its ok right? Would i still be able to get residency in california?

[dt]

Originally Posted by drmatty

So your saying that even though they are IMED listed, that has no bearings on california, right? But what about other states, for other states its ok right? Would i still be able to get residency in california?

imed listing is important.

go here for list of schools for California.

[mecbd]

Heloo Drmatty .

I would like to ask which university are you enrolling for MBBS and which agent are you working with. Please do reply. Thanks.

You may also PM me the details.

[SACTOBOY]

I wonder why you would enroll to the MBBS program instead of the MD program? What school are you attending if you dont mind?

[n|mzter]

whats a greenbook hospital? why are phil med graduates behind by 21 weeks? and why is everything about california? is it possible to prac somewhere else? like NY?