Application & Instructions for Initial Licensure - Short-Term Residency

Log in to LaMED DashBoard to begin a new online initial application, complete a previously started (and saved) online initial application or to check the status of your completed online initial application.

The items listed below MUST be completed and mailed to the LSBME as part of the initial application process.

The board may issue a temporary permit for the purpose of participating in a short-term residency   program sponsored by an accredited medical educational institution in Louisiana. The board must approve the program prior to the applicant’s participation. Contact the LSBME to see if the program is approved.

Oath or Affirmation
This form must be notarized. All yes answers must be accompanied by a sworn affidavit. A sworn affidavit is an explanation (in applicant’s own words) that must be typed and notarized. Note: If criminal history is found that was not disclosed, you will be required to submit a new Oath or Affirmation, a notarized affidavit as to why you did not disclose the information and a new processing fee equal to the initial licensure fee. It is important that you answer question 3 accurately and truthfully. Do not take the advice of friends, lawyer, etc.

Third Party Authorization
This form must be notarized. It authorizes LSBME to obtain information concerning the applicant from third parties.

Background Check - NOTE: If you are a physician on a current LSBME training permit, you do not need to do another background check when applying for full licensure. LSBME conducts background checks as part of the application process. Instructions and forms can be found at the link above.

Definitions

For the purpose of this rule

  1. An accredited medical educational institution for this purpose is defined as a medical school or other medical institution that sponsors one or more educational programs in the relevant subject area that is approved by the Accreditation Council of Graduate Medical Education

  2. The term short term residency includes preceptorships, fellowships and similar terms.

  3. A short term residency for this purpose is defined as an educational program that lasts for less  than 90 days

Qualifications for Permit

  1. Must be at least 21 years of age and of good moral character

  2. Be a citizen of the United States or possess valid and current legal authority to reside and work in the United States duly issued by the commissioner of the Immigration and Naturalization service.

  3. Possess a doctor of medicine or doctor of osteopathic medicine degree duly issued by a medical school approved by the board.

  4. Hold an unrestricted license to practice medicine or hold a training permit issued by another state and be enrolled and in good standing in an accredited training program

Checklist

  1. An application form

  2. A copy of the  applicant’s medical license issued by another state

  3. Oath or Affirmation relating to professional background which must be notarized

  4. Third party authorization for release of information

  5. Application Fee. Credit/Debit card only. Fee is non refundable

In addition there must be a written commitment from an accredited medical institution in Louisiana from the physician under whom the preceptorship or short-term residency describing the capacity in which the applicant will be serving and the inclusive dates of service. This letter must be signed by the director of the program and must be mailed directly to the LSBME.

Please note

  1. LSBME will obtain verifications of licensure and training and conduct required background checks

  2. A copy of the temporary permit when approved will be faxed to the applicant with an original mailed by regular mail service unless requested otherwise

  3. Work may not begin until the permit has been approved

Additional Requirements

Fees
Fee must be paid via credit/debit card (Visa, MasterCard or Discover only) .
Fee is non-refundable.

·     Permit - $100.00

Birth Certificate/Valid Visa

·       U.S. citizen - submit a notarized or certified copy of your birth certificate.

·       U.S. citizen not born in the U.S. - submit a notarized copy of your certificate of citizenship, consular report of birth abroad or certificate of naturalization.

·       Non-U.S. citizen - submit a notarized copy of current proof of citizenship.  Acceptable forms of citizenship are an H1B Visa, J1 Visa, O1 Visa, TN Visa, Permanent Resident card or Employment Authorization card.

·       Louisiana law (LA RS: 37.12) requires a valid permit to live and work in the United States to practice medicine.

·       J1 Visas are structured for training and educational purposes only.  The typical sponsor for a Medical Doctor’s J1 Visa is the ECFMG.  A J1 visa is not for employment outside of a formal training program.

·       H1B Visas are intended for those who are performing a specialized service or occupation.  These Visas are usually sponsored by hospitals or a particular employer.

·       The LSBME works with the United States INS to grant interlocking letters to obtain an effective date for the H1B Visa.  The effective date of the Visa will be the effective date of the Louisiana license or permit issued by the LSBME.

·       The applicant’s employer usually needs a valid LSBME license to complete the credentialing process for hospitals, insurance companies, and professional liability insurers.  Therefore, the licensure applicant should work with the United States INS Visa sponsor to set the effective date for the Visa. 

Other Information

Verification of Application/Licensure Status - Visit our website at www.lsbme.la.gov and log on to your account to verify the progress/status of your application.

Communication with the Board
Mailing Address - LSBME, 630 Camp Street, New Orleans, LA 70130
Questions - Contact our licensing department at licensing@lsbme.la.gov. To find the analyst directly assigned to your application, click on Contact Us.