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The Postgraduate Training Authorization Letter (PTAL) or California Letter is a document that allows International Medical Graduates (IMGs) to start their training in a residency program in California. IMGs must have this document to be eligible for a residency position in California. The process to obtain this document ranges from 3 months to more than one year.

Who Can Apply for a PTAL or California Letter?

International Medical Graduates (IMGs) or medical students from medical schools recognized by the Medical Board of California, otherwise do not waste your time. If your school is not recognized, you will not receive the PTAL. Note: If your medical school appears on the International Medical Education Directory (IMED), it does not mean that your school is recognized by the Medical Board of California.


  • Peruvian medical schools on IMED: 30
  • Peruvian medical schools recognized by the Medical Board of California: 7

Make sure your school is on the Medical Board of California's list of approved schools.

When to apply?

You have to apply as soon as you consider California as one of your top choices for a residency program. The PTAL is a document required by all residency programs in California to consider your ERAS application for the Match completed. Without the PTAL your chances to recieve receive invitations for residency interviews are almost zero. Note: To apply for the PTAL it does not matter if you have or not your USMLE scores. You can start your application even before taking your first USMLE test. Nonetheless, you will only get your PTAL until you pass all the USMLE tests and after you provide all the required documents.

Which Documents Do You Need?

You need the following documents:

  1. Documents you have to send:
    • Application forms L1A-L1E
    • Copy of Live Scan form
    • Copy of receipt of online payment
  2. Documents the Federation of State Medical Boards has to send:
    • Official Examination Scores
  3. Documents your medical school has to send:
    • Form L2
    • Official Medical school Transcript
    • Certified copy of medical degree
    • Form L5
    • Form L6 (if applicable)

Applying to the Postgraduate Training Authorization Letter (PTAL) is different than to apply for the ECFMG credential verification. You have to consider this a totally different and independent processs.

L5 Form - Certificate of Clinical Clerkship

  • What is a clerkship?

    It is any undergraduate course where you have hands-on clinical experience or direct practice with patients.
  • What is internship?

    For U.S. graduates the word internship is used for their first year of residency. While for international medical graduates the word internship (internado in Spanish) is used for the last year of medical school where you spend all your time at the hospital having hands-on clinical experience.
  • What is an undergraduate course?

    It is any course you took before getting your medical degree.
  • Do I need the L5 form?

    All international medical graduates are required the L5 form. However, it is your medical school who has to fill it out and send it back directly to the Medical Board of California.
  • Does the Medical Board of California will contact my medical school?

    No, you have to contact your medical school and send them the L5 form to be filled out by your dean very carefully. You may print or copy as many L5 forms as necessary.

    We recommend you to contact your medical school and tell them they will be getting lots of paperwork to fill out. Warn them ahead of time. Ask them if they have filled out a L5 form before.
  • What information should be included in the L5 form?

    Your medical school has to provide a complete breakdown of your undergraduate clinical training.
  • Should I include my internship?

    Your medical school has to include all undergraduate courses where you had hands-on clinical experience. If you did your internship before getting your medical degree your medical school can include it.
  • What else is required to be filled out?

    Your medical school has to document the exact beginning and ending dates of each clinical clerkship. The locations where the rotation took place have to be documented too.
  • What is a clinical week?

    The Medical Board of California considers one clinical week equal to 32 hours of clinical hours.

    Important: Candidate's medical school curriculum must satisfy mandatory clinical hours per clinical subject as outlined below:

    Total Instruction in clinical courses must be minimum of 72 weeks in length.

    Instruction in the core clinical courses of surgery, medicine, family medicine, pediatrics, obstetrics and gynecology, and psychiatry must total a minimum of 40 weeks in length. Minimum course length for the core clinical courses is outlined on the Core Clinical Course grid in accordance with Section 2089.5 of the Business and Professions Code.
    Minimum Weeks for Core Clinical Courses
    Core Clinical Subject Clinical Weeks / Hours
    Surgery 8 / 256
    Medicine 8 / 256
    Pediatrics 6 / 192
    Ob-Gyn 6 / 192
    Family Medicine 4 / 128
    Psychiatry 4 / 128
    Total 36 / 1152

    Please Note: These requirements are subject to change at any time by the Medical Board of California (MBC); visit the MBC website for updated information.
  • What is a Clinical Hour?

    One clinical hour is equal to one hour of practice (hands-on practice, direct contact with patients).

    Lecture or theory hours can not be applied to the clinical clerkship hours. Only hours of practice may be considered.

    Example 1:

    Medical Board requires 8 clinical weeks of Surgery.

    How many clinical hours is this?

    Answer: 8 x 32 = 256

    Eight clinical weeks equal 256 clinical hours.

    Example 2:

    Jose's Surgery course last 18 weeks. He had 3 hours of practice from Mondays to Fridays during this time. Does he fullfil the minimun clinical weeks required by the Medical Board of California?

    Answer: Yes.

    Number of weekly hours of practice: 3 x 5 = 15

    Number of clinical hours of practice: 18 x 15 = 270
  • Which are core clinical courses?

    Surgery, Medicine, Pediatrics, Ob-Gyn, Family Medicine and Psychiatry.

Additional Information

Updated January 2011