The following items are needed by all International Medical Graduate applicants:


  • 1. A current (within one year) Evaluation Status Letter from the Medical Board of California, indicating no training deficiencies, before beginning postgraduate training in any of our Family Practice Residency programs.
  • 2. A current ECFMG certificate is also required. Your application cannot be processed until these documents have been received by the Network Office. For further information, please contact the Medical Board of California (916) 263-2499. The evaluation status letter from the medical board can take as long as 90 days to obtain.

* Please note: If you have more than 36 months of post-graduate training in an accredited ACGME Program in the US, you must have a California Medical License to start a residency in California. 

Your application cannot be processed until these documents have been received by the Network Office. Keep in mind that it can take up to or greater than 90 days to obtain the PTAL Letter from the Medical Board of California. For further information, please contact the Medical Board of California (916) 263-2499 or visit their website For all other inquiries, please call (800) 792-9064 or e-mail:

I. Foreign Nationals - Graduates of Foreign Medical Schools (not U.S. Citizens or Permanent Residents)

A. Visa- A J-1 Visa under ECFMG sponsorship is required for admission to the U.S. for residency/fellowship training. ECFMG requires passage of the following written examination of medical knowledge and English language proficiency test: (Our Modesto program does NOT accept any Visas)

NOTE: UC Davis will not consider H-1B Visa sponsorship for international medical graduate postgraduate training.


  • 1. Prior to July 1984 - Visa Qualifying Exam (VQE).


  • 2. 1984 to 1993 - Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS*) or National Board Medical Examination (NBME).


  • 3. Current - U.S. Medical Licensing Exam (USMLE).

* FMGEMS not accepted in California.

NOTE: When the applicant has passed (1) one of the above examinations, (2) the Clinical Skills Assessment exam, and (3) the English exam, and the applicant’s medical education has been reviewed and approved, the applicant is then eligible for certification and sponsorship of a J-1 Visa through ECFMG. Visa sponsorship applications must be directed to ECFMG by the Graduate Medical Education Office. Please contact Kathe McDonald, Graduate Medical Education, (916) 734-4955 for information.

B. ECFMG Certification - All International Medical Graduates (IMGs) applying for postgraduate training must provide a copy of a current ECFMG Certificate in order to be eligible for licensure in California.

To obtain an ECFMG Certificate IMGs must meet the following examination and medical education credential requirements:

1. Pass one of the written exams listed above (FMGEMS not accepted in CA);

2. Pass Step 1 and Step 2 of USMLE. Step 2 exam has two separately administered components, the Clinical Knowledge (CK) component and the Clinical Skills (CS) component (as of 2005);

3. Pass the English exam.

4. Meet all educational requirements as specified by ECFMG.

ECFMG does not accept the Federal Licensing Examination (FLEX) for meeting exam requirements for ECFMG visa sponsorship. However, the FLEX exam, if taken prior to June, 1985, is accepted for certification by ECFMG. Applicants must obtain a score of 75 or higher on each of the three days of a single administration prior to June, 1985.

 C. Return to Home Country– Upon completion of residency/fellowship training, IMGs on J-1 Visas will be required to return to his/her home country for two years before applying for permanent residency or return to the U.S. for other purposes.

 II. Foreign Nationals - Graduates of U.S. Medical Schools

 A. Non-U.S. citizens who graduate from US Medical Schools and sponsored by an F-1 Visa, are not required to meet ECFMG requirements like International Medical Graduates. ECFMG will, however, sponsor these graduates for the J-1 Visa. No examinations are required for this sponsorship except the standard USMLE Steps.

 III. U.S. Citizens or Legal Immigrants (Permanent Residents) - International Medical Graduates A.  Visa - Not required for U.S. Citizens. Permanent residents must provide proof of resident alien status.

 A. ECFMG Certification - All individuals graduating from international medical schools must provide a copy of a current ECFMG certificate. U.S. Citizens or Permanent Residents will complete the requirements outlined in Section I, Part B.

 B. IMGs with pending applications for Permanent Residency will sometimes qualify for a Work Authorization permit (EAD). A copy of the current permit must be submitted along with a copy of the receipt for filing the I-485 (Application to Change Status to Permanent Resident).

 IV. Requirements for IMG Licensure in California - Foreign Nationals or U.S. Citizens


  • A. Current ECFMG Certification.


  • B. The following examinations and combinations of examinations are currently acceptable for licensing purposes in California:


  • USMLE Steps 1, 2, and 3 (Has phased out FLEX and NBME Exams)
  • NBME Parts I, II, and III (National Board Medical Examinations)
  • NBME Parts I, II, and Component 2 of FLEX
  • FLEX Components 1 and 2
  • MCCQE - Medical Council of Canada Qualifying Examination (Formerly called LMCC - Licentiate of the Medical Council of Canada)
  • Original FLEX (three day FLEX weighted average)


  • C. Two years of ACGME approved postgraduate training in any state in the U.S. If training is NOT in Family Medicine, Pediatrics, Internal Medicine or ObGyn, IMG must have 4 months of approved General Medicine postgraduate training OR current certification by a member board of the American Board of Medical Specialties or an ACGME approved specialty board.


  • D. All IMG's, with the exception of Canadian graduates will be expected to furnish a current "Postgraduate Training Authorization Letter (PTAL)" from the Medical Board of California (MBC) when submitting an application for postgraduate training at UC Davis. Fifth Pathway trainees will be expected to present a letter from the Medical Board stating that medical school training meets the requirements for licensure in the State of California. These letters will be provided by the Medical Board after a completed application to the Medical Board has been reviewed and evaluated. Possession of a Social Security number is necessary to receive this letter (PTAL).

• Applicants for Fellowship positions must be licensed prior to the training start date.


V. References - (addresses to contact for additional information)


  • A. J-1 Visa, USMLE and ECFMG certification information:

Educational Commission for Foreign Medical Graduates (ECFMG)
P.O. Box 828262
Philadelphia, PA 19182-8262
Telephone: (215) 823-2121 or 386-5900 (Sponsorship line)
FAX: (215) 386-9766


USMLE Secretariat
3750 Market Street
Philadelphia, PA 19104-3190
Telephone: (215) 590-9700
FAX: (215) 590-9457


  • B. California Licensing Information:

Medical Board of California Division of Licensing and Applications
1426 Howe Avenue
Sacramento, CA 95825
Telephone: (916) 263-2382