What is California Letter or PTAL?

Postgraduate Training Authorization Letter (PTAL) as commonly referred to the California Letter for residency or if applying later after residency to jobs in Cali,  then it is California License ( same process). Applying to any residency program or fellowship in California requires you to add the PTAL to your 3 LORs in the MyERAS to be eligible for interviews and hence to be ranked in the NRMP system by program directors.

How long it takes to process or issue a PTAL?

This will vary depending on how fast your medical school respond in the middle of the thing but the extreme average is 3 month to 1 year.

Is it difficult to get the PTAL?

Many of you don't apply to California programs just for one reason, you think getting a PTAL is difficult or impossible, no it is not, it needs some work from your side (and your medical school as well) but trust me if you follow the guidelines below you will get it. California has many IMG Friendly residency programs (Click to see more details) that are thirsty to invite you for interviews because they lack applicants, indeed. Many of the people who we help to match in California residencies every year tell us that programs there don't have much applicants as they are told by their PDs in comparison to other IMG friendly states.

How to use the PTAL?

The Postgraduate Training Authorization Letter or the PTAL as known as California Letter you need it to start a residency in California. It should be sent to ERAS as part of your application where it will stand instead of one of the 4 LORs you can send to each program. If you couldn't obtain at time of application, then you can send the "status report on the PTAL" generated for you by the Medical Board to use it temporary instead of PTAL.

Before starting my explanation, if you have any questions please don't hesitate to direct it to the Medical Board where they are very welling to help you in any step of the procedure:

By email address:

By mailing address:

2005 Evergreen Street, Suite 1200
Sacramento, CA 95815

By direct phone numbers:

800 633 2322
916 263 2382

By fax number:

916 2632487

How to get the PTAL?
PTAL made easy Applicant Guide!!

Before you start the steps below, make sure your medical school is listed in their recognized list:

Step 1

-Go to the MBC website

-then in the top middle of the Medical Board of California web site home page you will find the "Applicants" tab which will take you to

-(so as first time user don't click on "Check My Application")   

- Scroll down to the bottom of the page and click on "Continue" which will take you to this page

-then on the right upper part of the page click on the "Online Licensing Application Payment" button it will take you to "Professional Licensing Login" page where you will be either asked to upgrade your browser to be compatible with the application process or will start immediately applying as a new user where you will create a username and password.

-Follow the steps to complete your personal Information and do your payment [493$, non refundable fee, $442 (Application Fee) and $51 (Finger Print Processing Fee)], you will need your email and mailing address, date of birth, credit card and Social Security Number (SSN). Wait for the confirmation which you have to print it out for the Medical Board of California communications. Keep copies of it for your personal records. Alternatively, you can pay by sending money order, certified check or personal check and make it payable to "Medical Board of California" and enclose it with your application papers (however ApplicantGuide highly recommend doing this step online).

-Your Username and Password will be sent to your email which you will use it again to login and print your online receipt from as you will need to send it later with your application or other communications if needed.

Step 2


On the same above mentioned link there are two options "Live Scan Form" and
"Live Scan Locations", if you live in California print the first form and fill it (it will generate 3 copies) and go to one of the locations present in the second mentioned link "Live Scan Locations". There they will do the three forms for you, one you will mail it back to the board, one they will mail it to the FBI and DOJ and one you will keep it with you.

If you don't live in California, either take an appointment and fly there, or there is another option also mentioned inside the "Live Scan Form" called the fingerprints cards, instructions are also available there. In the other option which is also easy to do, the Board will mail to you two copies of the fingerprints cards (you have to request them by the above email address I mentioned initially) which you have to take it to any certified fingerprints service or to any police station that provide this service in the area where you live and get it done then mail them back to the board.

Now we come to the PTAL application itself, it consists of forms L1A through L1E (in addition to the other forms L2, L3, L4, L5 and L6 as needed, see below which is applicable to you).

So, on the "Applicants" page you will find a link on the left "International Medical Graduates". Click on it and it will take you to the PDF application (which contain the forms to be filled as discussed below).

You need to notarize L1E form.
You will need a recent 2" x 3" photo of your head and shoulders.

After finishing and sending the first 3 steps, the Medical Board of California should contact you in no more than 90 days to inform you that they received your initial application, however you have to finish all the steps to get the PTAL.

Go to the Federation of State Medical Boards website, specifically to the transcripts request page, . Click "Begin the online transcript request". Follow the instructions and pay $50 dollars. Select California Medical Board. Remember you will only do this step when you already have passed Step 1 and Step 2 (including CK and CS), otherwise you will need to pay again for any pending results.

NB: If you are in residency or post-residency and are applying to jobs in Cali we recommend you also apply to the FCVS and establish an account with them because they will send many of the documents required directly to the Cali Board (from your medical school or from ECFMG) and this will save you a lot of time. See this link which documents FCVS can help you to obtain without causing any headaches for you:

Documents your medical school has to send (fill them, except for L5 form they have to fill it):

1.- Form L2

•Complete your personal data (name, SSN, DOB) at the top of the form.
•Submit this form to your medical school for completion of all the information.
•The medical school official must affix his/her original signature and the seal of the medical school.
•This form must be mailed directly from the school.

NB: L3A,L3B and L4: these forms have to be filled when you finish your residency and you want to apply for a California license (to practice). It's not needed when you apply for PTAL.
L6: is needed if you have attended clinical training and clerkships outside your core primary medical school training (for example Caribbean medical schools where they usually send their students for clerkships in US)

2.- Official Medical school Transcript

•An original official medical school transcript must have the following:
•Prepared on university letterhead.
•Affixed with the signature of the dean/registrar.
•The medical school seal.
•Document all of the basic science and clinical courses completed during the medical curriculum.
•A transcript will need to be provided directly from each institution of attendance and submitted directly to the Medical Board of California.
•If prepared in language other than English will need to be accompanied by an original, official translation.
•This form must be mailed directly from the school.

3.- Certified copy of medical degree

•Submitted DIRECTLY from the medical school.
•To be acceptable shall contain:
•A statement on the reverse side of the copy indicating that it is a true copy of the original degree.
•An original signature of the dean or registrar immediately following the statement verifying authenticity of the copy.
•An official medical school seal affixed to the copy.
•If prepared in language other than English will need to be accompanied by an original, official translation.
•This form must be mailed directly from the school.

4.- Form L5

•You have to submit the Form L5 to your medical school for completion of all the information.
•You may print or copy as many L5 forms as necessary to provide a complete breakdown of your undergraduate clinical training.
•Include each and all clinical clerkships.
•Your medical school official must affix his/her original signature and the seal of the medical school.
•Your medical School has to send the forms back to the Medical Board of California.

Some international schools complete their family medicine clerkships (rotations) within community medicine clerkship. If this is the case with your school, you must attach a letter from your medical school stating this. The document must state your name, institution name with proper letterhead, and the amount of hours completed in family medicine. This should be signed, sealed, and mailed to the MBC, preferably with forms L2 and L5.
Tip: finding a colleague from your school who has completed the requirement for a PTAL can make this step easier.
If your medical school curriculum does not meet the family medicine or psychiatry clerkships, you must find ACGME certified clerkships in the U.S. to complete them.

NB:If you have done any rotations outside of your main medical college teaching hospital you need to fill out form L6. Otherwise it is not needed. Forms L3 and L4 are not required for the PTAL. They are used when you apply for a Licence.

Rotations required: Minimum of 40 weeks of undergraduate clinical rotations plus: minimum of 8 weeks in surgery, 8 weeks in medicine, 6 weeks in pediatrics, 6 weeks obgyn, 4 weeks in family medicine (or community medicine) and 4 weeks in psychiatry. You will find this information also in the PDF application you will get form the links above. This means the L5 forms the medical school will send should document minimum of 72 weeks of clinical rotations as the above breakdown outlined.

Sample on how to fill the L5 form of the PTAL:

Sending the PTAL to ECFMG/ERAS as a part of the application for the match, the following is from the ECFMG website:
Postgraduate Training Authorization Letter (PTAL) or “California Letter”
If you apply to programs in California, you must submit a Postgraduate Training Authorization Letter (PTAL) issued by the Medical Board of California with your residency applications. The PTAL was known formerly as the California Applicant Status Letter and may also be referred to simply as the “California Letter.”

IMPORTANT NOTE: The Medical Board of California will require several months to issue the PTAL. You should contact the Medical Board of California for information and apply for the PTAL well in advance of program deadlines.

You must include the PTAL as one of your LoRs in your applications to programs in California. As a result, you can assign up to three LoRs and the PTAL to any program in California. List the letter as one of your LoRs by entering “California Letter” instead of a letter writer’s name, and checking the box that indicates “This is a California Applicant Status Letter.” Then send to ERAS Support Services a copy of the letter, identified with your AAMC Identification Number and accompanied by a completed DSF.

If you do not yet have your PTAL, you need to let programs in California know that you are working to obtain one. To do this, list the letter as one of your LoRs, as described above, and submit a temporary document, such as the receipt issued by the Medical Board of California or the “Originals Returned” letter that accompanied your returned originals, with a completed DSF. When you receive the final PTAL, send a copy to ERAS Support Services at ECFMG with a completed DSF requesting that it replace the temporary document.

IMPORTANT NOTE: Please list “California Letter” only once in MyERAS. Do not create a second letter entry for your final letter. There should be only one slot designated for the “California Letter.”

Obtaining a PTAL (“California Letter”)

Please contact:

Medical Board of California
2005 Evergreen Street, Suite 1200
Sacramento, CA 95815
Tel: (916) 263-2382

Information and application materials are also available by visiting or sending e-mail to

How to renew a PTAL:

1. No fees to renew (check for any changes in the CA board website).

2. You need to mail L1A-L1E forms again to CA board after being notarized.

3. PTAL needs to be renewed every year this way until you get the license (early 3rd year). The deadline will be the date PTAL is issued.

4. If you matched this year, send the registration form ASAP to CA board. This form was mailed to you with the PTAL. IF you cannot find it, go to CA board website to download.

5. Always call your agent to ask. There is the number and name of the person's who takes care of your file at the end of the PTAL.

Do renew it even you matched, because you need it to get licensed or apply for fellowship later in CA.

How to get SSN, please follow these two links

If you have any questions regarding USMLE, ERAS, Observerships, NRMP match and SOAP contact us at

NB: we are not affiliated to California board by any means. We are an independent bloggers helping IMGs with their residency seeking.