After doing significant research and speaking with the OCG and SGU Deans, below are some state licensing forms that you may be required to complete in case you’d ever like to practice medicine in certain states.
States and their required licensing forms
California: California-L6-Form (please ensure you download the L6 form with the current governor on it – its in the top right corner of the form). Due to recent changes, ALL L6 forms now need to be completed by the hospital and mailed from the hospital to California.
Illinois: AF-MED Form – the hospital needs to complete the AF-MED form. SGU will need to send a letter on your behalf including your evaluations, affiliation agreements, and official transcript for your core rotations.
Massachusetts: E1 and E2 Form
Oklahoma: Verification of Clinical Clerkship Form – has to be filled out for each rotation.
Texas: Form J Clerkship Form – Per SGU, if you are applying prior to becoming board certified, you will need to complete a J form and list all your rotations as well as their ACGME numbers. SGU would also need to send a letter on your behalf including all your rotations. These do not apply if you are already board certified and applying for Texas. If you are applying after becoming board certified, you don’t need to list your rotations on the J form (but the J form still needs to be completed).
Thanks to Brent Bohlig for his hard work updating this section.