Contact

Ann Dohn, MA

Director, Graduate Medical Education
Designated Institutional Official (DIO), ACGME
Training Program Liaison, ECFMG
Special Programs Coordinator, Medical Board of California
Institutional Official, NRMP

ADohn1@stanford.edu

650-723-5948 (office)

California Medical Licensure Exemptions

Special Programs with Medical Board of California

Notice

  • Section 2111, 2113, and 2168 (new, separation or renewals) must be sent to Ann Dohn (adohn1@stanford.edu) to process. She will see through the application process to the Medical Board of California (MBC). 
  • Do NOT send the form directly to MBC as they will not process without Ann Dohn.

Summary of Special Programs

Category Section 2111 Section 2113 Section 2168
Applicable For fellows/clinical instructors, not yet eligible for CA license full-time faculty, foreign trained MD, not yet eligible for CA license full-time faculty, foreign trained MD, not yet eligible for CA license
Application Requirements
  1. Initial application
  2. Renewal application (annual)
  3. Separation/Termination application
  1. Initial application
  2. Renewal application (annual)
  3. Separation/Termination application
  1. Initial application
  2. Separation/Termination application

Section 2111

Section 2111 can be used for fellows/clinical instructors who are not able to obtain a CA MD License for incidental patient contact under some circumstances.

Section 2113

Section 2113 can be used for full time faculty who are not able to obtain a CA MD License under some circumstances. It may not be used for physicians in advanced training.

When 2113 registrants apply for a full Physician & Surgeon’s (P&S) license, they must submit the items in the attached Checklist using the method of submission listed. Since they are requesting to enter into independent practice, copies of documents submitted with the 2113 registration cannot be used as part of their P&S application (i.e., diploma).

One main difference for these applicants is that instead of the Certificate of Completion of ACGME/RCPSC/CFPC Postgraduate Training (Form PTA-PTB), your institution must submit a letter to the Board from the Dean, which is commonly known as the Dean’s letter. The requirements of the letter have been modified to include the second bullet point; the full letter must include the following information:

  • Dates of participation in the 2113 program;
  • Summary of the duties performed during the program;
  • Specialty/Department;
  • Percentage of clinical and teaching duties; and,
  • Whether the registrant has demonstrated the knowledge, skills, and behaviors necessary to enter autonomous practice.
  • This letter can be sent directly to Williams, Miranda@MBC <Miranda.Williams@mbc.ca.gov>  via email and must use one of the following approved Electronic Signatures: DocuSign, DigiCert, IdenTrust, Entrust, and GlobalSign. The letter may also have an original, wet-ink signature and be mailed to my attention at the address listed in my email if an approved electronic signature is not used.
  • Miranda Williams, Special Programs & Fingerprints Analyst
    Medical Board of California - Licensing
    2005 Evergreen Street, Suite 1200
    Sacramento, CA 95815-5401
    (916) 561-8255 (desk)

Section 2168

Section 2168 is a faculty permit. As of January 1, 2010, permit holders and licensees are required to verify satisfactory completion of 50 hours of Category 1 continuing medical education credit hours at the time of renewal.

Apply, Renew, and Terminate Special Permit