California Medical License Requirements (2026): Fees, PTL, Exams and Timeline

For physicians, residents, medical directors and practice owners hiring in California. Updated October 22, 2026 · Prepared by Prospyr. To get a California medical license (a Physician's and Surgeon's License from the Medical Board of California), you need three things: a degree from a Board-recognized medical school, credit for 12 months of Board-approved postgraduate training (24 months if you graduated from a medical school outside the US and Canada), and passing scores on the required exams, which for most applicants means USMLE Steps 1, 2 and 3. You apply online through BreEZe, submit fingerprints, have your school, program and exam scores sent directly to the Board, and pay a $625 application and processing fee plus a $1,151 initial license fee (Business and Professions Code section 2435). The initial license fee rises to $1,255 on January 1, 2027. The Board asks applicants to apply at least six months before they need the license.

This guide covers MD licensure through the Medical Board of California. Osteopathic physicians (DOs) are licensed by the Osteopathic Medical Board of California, which has its own application. Every figure below comes from the Business and Professions Code or the Board's own pages, checked October 22, 2026. Fees, processing times and forms change, so confirm with the Board or a healthcare attorney before you rely on them. This is not legal advice.

California medical license requirements at a glance

Who needs a California medical license?

Anyone who practices medicine on a patient located in California. The Board's application page says, "All allopathic physicians must receive a license from the Board prior to practicing medicine in California, unless an exception applies." That includes telehealth: the patient's location, not the physician's, decides which state's license you need.

Practicing without a license is a crime in California. Under BPC 2052, it is punishable by a fine of up to $10,000, imprisonment, or both, and anyone who aids or abets it faces the same penalties.

The exceptions are narrow:

• Consultation. BPC 2060 lets a physician licensed elsewhere consult with a California-licensed practitioner, but the out-of-state physician "shall not open an office, appoint a place to meet patients, receive calls from patients within the limits of this state, give orders, or have ultimate authority over the care or primary diagnosis of a patient who is located within this state."
• Immediately life-threatening conditions. BPC 2052.5 allows telehealth care from an out-of-state physician in good standing, with no prior discipline, for an eligible patient with an immediately life-threatening disease, under conditions set out in the statute.
• Guest rotations. A resident in an ACGME-accredited program outside California may rotate in a California program for up to 90 days in total without a California training license (BPC 2065(c)).

Education and postgraduate training

Medical school. Schools accredited by a national accrediting agency approved by the Board and recognized by the US Department of Education are approved. A foreign medical school is recognized if ECFMG (or an ECFMG-authorized accreditor) has found it substantially equivalent to LCME, CACMS or COCA standards, or if it is listed in the World Directory of Medical Schools (BPC 2084).

Training. Before a license can be issued, you must have credit for at least 12 months of Board-approved postgraduate training if you graduated from a US or Canadian school, or 24 months if you graduated from another foreign school. The training must be accredited by the ACGME in the US, or by the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada (BPC 2096).

36 months by your first renewal. Twelve or 24 months is enough to be licensed, but not enough to keep the license. For licenses issued January 1, 2022 or later, the Board must receive verification at your first renewal that you have credit for 36 months of Board-approved postgraduate training, or that you are still enrolled in a California program. If you renew while enrolled, you need the 36 months by your second renewal. Your program submits Form ILR through the Board's DOCS portal (MBC renewal page). To allow time for that, licenses issued on or after January 1, 2024 are valid for 26 months at first; later renewals run 24 months.

Exams

The Board lists these pathways for a Physician's and Surgeon's License (MBC):

• The USMLE, LMCC or FLEX written examination, for applicants who hold no other license or have been licensed elsewhere for less than four years.
• Licensure in another state or Canadian province for four or more years.
• The NBME examination, for US or Canadian graduates.

You must pass all parts of USMLE Step 3 within no more than four attempts. Applicants who needed more attempts can still be considered if they qualify under the four-years-licensed pathways in BPC 2135 or 2135.5 (BPC 2177). Residents moving from a training license to a full license must have passed USMLE Step 3 within four attempts or Part I of the Medical Council of Canada Qualifying Examination (MBC transition page).

Licensed in another state for four years or more. BPC 2135 provides a pathway for physicians who have held an unrestricted license elsewhere for at least four years (time in training does not count), with no discipline and no pattern of negligence, and who have either one year of approved training plus ABMS board certification, two years of approved training, or one year plus a passing score on the clinical competency written examination.

Postgraduate Training License (PTL)

If you are a resident in a California ACGME-accredited program and you do not yet have the 12 or 24 months of credit needed for a full license, you need a Postgraduate Training License. The rules, from BPC 2064.5 and the Board's PTL page:

• Deadline. Obtain the PTL within 180 days of starting your California program. If you don't, you must stop all clinical service until the Board issues it.
• Eligibility. A degree from a Board-recognized school, all required exams passed, enrollment in a California ACGME-accredited program, and ECFMG certification for international graduates.
• Term. A PTL is valid for 36 months and is not renewable. The Board can extend it only to give you time to earn the training credit required for a full license.
• Scope. You may practice only as part of your training program and its affiliated sites. Within that, you may diagnose and treat patients, prescribe (including controlled substances, with a DEA registration and CURES registration) and sign birth and death certificates without a cosigner.
• Transition. Once you have 12 or 24 months of credit, you apply through BreEZe to transition to a full license. The Board strongly encourages filing six months before you reach that credit. You may not practice on an expired PTL.

Already trained elsewhere? If you have 12 (or 24) months of credit from a program in another state or Canada and join a California program, you don't get a PTL. You must obtain the full Physician's and Surgeon's License within 180 days of starting the California program, or stop all clinical services at day 180 (BPC 2065(g)).

How much does a California medical license cost?

The fees are set in BPC 2435 and the Board's fee notice for 2027:

What you actually pay at checkout can be higher than the statutory fee. The Board's renewal fee page states the current renewal total is $1,206: the $1,151 renewal fee, a mandatory $25 fee for the Steven M. Thompson Physician Corps Loan Repayment Program and a mandatory $30 CURES fee. Likewise, the Board's 2024 PTL presentation lists a PTL "Application Fee - $674.00," which is $49 more than the statutory application and processing fee, and a transition license fee of $600.50, which is $25 more than half the initial license fee (MBC, January 2024). Check the amount BreEZe shows before you pay.

Figures of $491 for the application and $808 for the initial license still circulate online. They do not match the fees in the current statute.

How long does it take to get a California medical license?

The Board publishes processing times weekly on its processing times page. For applications reviewed October 9 to 15, 2026, the average time from receipt of the application and fees to the first review was:

After that first review:

• Deficiencies. If anything is missing, the Board emails a deficiency letter and lists it in BreEZe. Documents received after the initial review are reviewed within about two weeks of receipt.
• Quality assurance. Once the file is complete, it goes to a final quality assurance review, which averaged 1 to 3 days that week.
• Issuance. The license is then issued within 1 to 3 business days.

The Board's advice is to "apply at least six months prior to when they need their license." Most delays come from missing documents, so the date your school, program and exam scores reach the Board matters as much as your own application. Applicants can ask for priority review if they are honorably discharged veterans, have accepted a job in a designated underserved area, will provide abortions within their scope of practice, are military spouses or partners stationed in California, or were admitted as refugees, granted asylum or hold a Special Immigrant Visa (MBC).

Documents and fingerprints

According to the Board's PTL guidance, these documents are required and must reach the Board electronically, through its Direct Online Certification Submission (DOCS) portal or a Board-accepted third-party service:

• From you: the online application in BreEZe, a Timeline of Activities (Form TOA) with no gaps longer than three months since medical school, explanations for any application questions (Form EXP), and a copy of your Live Scan form.
• From your medical school: the Certificate of Medical Education (Form MED) and your official transcript.
• From your training program: the enrollment form (Form EF) for a PTL, and the Certificate of Completion of postgraduate training (Form PTA/PTB) where it applies, signed by the program director or designated institutional official listed with the ACGME.
• From the exam body: official USMLE or LMCC scores.
• From ECFMG (international graduates): the ECFMG Certification Status Report.

The Board may accept primary source documents held in your Federation Credentials Verification Service (FCVS) profile instead of separate copies of your passport, name-change records, ECFMG report, exam scores, Form MED, transcripts and Form PTA/PTB.

Fingerprints. In California, use Live Scan. Outside California, submit two fingerprint cards. You can find Live Scan sites through the California Department of Justice.

Renewal and continuing medical education (CME)

• Every two years. A California license expires at 11:59 p.m. on the last day of the month in which it was issued, every two years. The Board says, "There is no grace period. It is illegal to practice medicine with an expired license." It emails renewal notices starting 180 days before expiration (MBC renewal page).
• 50 hours of CME. You must complete at least 50 hours of approved CME in each two-year renewal cycle and certify it under penalty of perjury when you renew. Keep records of every course for at least four years in case of audit (MBC CME page, citing 16 CCR 1338(e)).
• Pain management. A one-time 12-hour course in pain management and the treatment of terminally ill and dying patients, within four years of your initial license or by your second renewal, whichever is first. For physicians licensed on or after January 1, 2019, it must also cover the risks of addiction associated with Schedule II drugs. Pathologists and radiologists are exempt (BPC 2190.5).
• Geriatrics. General internists and family physicians whose patient population is more than 25% aged 65 or older must complete at least 20% of their mandatory CME in geriatric medicine, dementia care or the care of older patients (BPC 2190.3).
• Late renewal. Renew more than 30 days late and you owe a delinquency fee; more than 90 days late, a penalty fee as well. If your license has been expired for more than five years, you must apply for a new license.

Where Prospyr fits

Once a physician is licensed, the practice still has to keep each provider's license and expiration dates straight, along with who can perform which treatments. Prospyr is practice software for med spas, plastic surgery and wellness practices, with online booking, charting, digital intake and consents, telehealth and e-prescribing. It does not issue or verify medical licenses. For practice-level rules, see our California med spa licensing guide.

Frequently asked questions

What are the requirements for a California medical license?

Graduation from a Board-recognized medical school, credit for 12 months of Board-approved postgraduate training (24 months for international graduates), passing scores on the required exams (usually USMLE Steps 1 to 3, with Step 3 passed within four attempts), ECFMG certification for international graduates, fingerprints and a BreEZe application with the required fees.

How long does it take to get a California medical license?

The Board's average time to the first review of a Physician's and Surgeon's License application was 60 days as of October 15, 2026, and it asks applicants to apply at least six months before they need the license. Total time depends mostly on how quickly your school, program and exam body send their documents and how fast you clear any deficiencies.

How much does a California medical license cost?

The statute sets a $625 application and processing fee and a $1,151 initial license fee, rising to $1,255 on January 1, 2027. Applicants enrolled in approved postgraduate training pay half the initial license fee. The total charged in BreEZe can include other mandatory amounts, so check it before you pay.

Do residents need a California medical license?

Residents in California ACGME-accredited programs need a Postgraduate Training License within 180 days of starting the program, or a full Physician's and Surgeon's License within 180 days if they already have 12 (or 24) months of training credit from elsewhere.

How often do doctors renew their license in California?

Every two years. The license expires on the last day of the month in which it was issued, there is no grace period, and you must complete 50 hours of CME in each cycle. Licenses issued on or after January 1, 2024 run 26 months before the first renewal.

Can I treat California patients by telehealth with a license from another state?

Generally no. The patient's location determines the license you need, so a physician treating a patient located in California needs a California license, apart from narrow exceptions such as consultation with a California-licensed practitioner (BPC 2060) and certain patients with immediately life-threatening conditions (BPC 2052.5).

Sources

• California Business and Professions Code section 2435: physician fees
• BPC section 2064.5: Postgraduate Training License
• BPC section 2065: practice during postgraduate training
• BPC section 2084: approved medical schools
• BPC section 2096: postgraduate training requirement
• BPC section 2135: applicants licensed in another state
• BPC section 2177: examination attempts
• BPC section 2190.3: geriatric CME
• BPC section 2190.5: pain management CME
• BPC section 2052: unlicensed practice
• BPC section 2052.5: out-of-state telehealth for life-threatening conditions
• BPC section 2060: out-of-state consultation
• Medical Board of California: applying for a Physician's and Surgeon's License
• Medical Board of California: Physician's and Surgeon's License eligibility
• Medical Board of California: Postgraduate Training License
• Medical Board of California: transition from PTL to a full license
• Medical Board of California: license application processing times
• Medical Board of California: licensing fee changes effective January 1, 2027 (PDF)
• Medical Board of California: changes to postgraduate training, January 2024 (PDF)
• Medical Board of California: license renewal
• Medical Board of California: current status renewal and initial renewal requirement
• Medical Board of California: renewal fees
• Medical Board of California: continuing medical education
• California Department of Justice: Live Scan locations
• Osteopathic Medical Board of California

Editorial method and corrections