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Regional Policies and Procedures

Resident and Fellow Policies and Procedures Manual

2024-2025 Policies & Procedures Manual

Licensing Requirements for MD and DO Residents


Changes effective January 1, 2024

Obtaining the appropriate California medical license is the responsibility of every physician. Failure to obtain the license will result in removal from clinical duties and participation in KP’s residency programs.

Postgraduate Training License (PTL)

  • A PTL must be obtained within 180 days from beginning a postgraduate training program in California, otherwise, the resident must cease all clinical service until PTL has been issued by the Board.
  • The PTL will be valid for 36 months for all United States, Canadian and International medical graduates, only while enrolled in a California ACGME-accredited postgraduate training program.
  • PTL Resources:

California Physician and Surgeon License

  • A PTL holder who receives either 12 months (US & Canadian graduates) or 24 months (international graduate) credit of Board-approved postgraduate training, taken and passed either USMLE Step 3 or COMLEX Level 3, may apply for a Physician & Surgeon’s license.
  • An incoming Fellow from out of State that has completed a residency training program, now have a total of 180 days from the date they begin their training program to obtain a P&S license.
  • P&S Resources:


California P&S License must be renewed every 24 months.
Upon first renewal, a trainee will need to provide evidence they have completed 24 months of training in a single ACGME training.

Additional Details

ACGME-International Training is not applicable for a California Medical License.
Deadlines for obtaining licenses are defined in the California statute and are not flexible. Failure to obtain a license by the indicated deadline will result in removal from clinical duties.
Visiting Trainees (Rotators) may work without a license in California for no more than 90 days.
For additional information please see the appropriate Medical Board websites:
Medical Board of California
Osteopathic Medical Board of California

Exam & Licensing Timelines

The timeline below is meant to be a guide. Actual tasks and responsibilities will vary by site and program.

Orientation & Onboarding

June – July

  • Complete regional, hospital and residency program orientation requirements.
  • Complete NCAL New Employee Orientation (NEO)*Mandatory*
  • Familiarize yourself with hospital, program and regional policies and procedures.
  • Meet with your program advisor/mentor to review, plan/outline your training curriculum to ensure you meet all program and specialty requirements.

California Medical License Application and/or Osteopathic Medical Board

Upon hire – June

  • Familiarize yourself with the California Medical Board (CMB) and/or Osteopathic Medical Board (OMB) requirements.
  • Begin gathering necessary documentation.
  • Confirm with residency program leadership before applying for Postgraduate Training License (PTL)
  • Monitor application status regularly

ACLS/BLS Certification


  • Ensure current Advanced Cardiovascular Life Support (ACLS) and Basic Life Support (BLS) certifications.
  • Varies by specialty, please confirm requirements with Residency Program Administrator.

USMLE Step 3 and/or COMLEX Level 3


  • Schedule and take the USMLE Step 3 or COMLEX Level 3 examination during PGY 1.
  • If scheduling a retake exam is needed, due so when allowed by the examination board.

Drug Enforcement Administration

Upon receipt of PTL

  • Confirm with residency program leadership before applying for DEA license

USMLE Step 3/COMLEX Level 3 Exam Completion


  • Schedule and pass the USMLE Step 3 and/or COMLEX Level 3 examination, if not already done.
  • Submit results to the California Medical Board and/or Osteopathic Medical Board.

Clinical Experience

  • Schedule a Formal Summative evaluation meeting with advisor/mentor.
  • Meet with your advisor/mentor to ensure compliance with residency program specialty requirements and board requirements.

California Medical License and/or Osteopathic Medical Board Application (Continued)

  • Complete and submit online via BreEZe the Physician & Surgeon’s License Application (upon passing USMLE Step 3/COMLEX Level 3 exam).
  • Monitor application status regularly

Residency Completion

  • Formal and Summative evaluation meeting with Program Director.
  • Meet with your program advisor/mentor to confirm you are on track for completion of all residency program and specialty requirements.
  • If pursuing fellowship training, ensure compliance with program requirements.
  • Ensure documentation of all required clinical experiences.

Board Certification


  • Review specialty board eligibility requirements and application for board certification (exam dates vary by specialty).

Physician & Surgeon’s License (P&S)


  • If applicable, apply for the permanent Physician & Surgeon’s (P&S) license in California.
  • Follow up with the California Medical License application monthly until license is obtained.
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