Application & Instructions for Initial Licensure - Short-Term IMG

 

CLICK HERE TO BEGIN THE ONLINE APPLICATION PROCESS

     Click HERE to complete a previously started (and saved) online initial application.
     Click HERE to check the status of your completed online initial application.

To access a paper application, click HERE (available for a limited time)

 

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

 

The board may issue an institutional temporary permit for the purpose of participating in a short-term residency or other post graduate training 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.

 

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. The applicant has not held any permit issued under this chapter within one year prior to the date of application
  2. Must be at least 21 years of age and of good moral character
  3. 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.
  4. Possess a doctor of medicine or doctor of osteopathic medicine degree duly issued by a medical school approved by the board. 

 

Application

  1. An application form
  2. Oath or Affirmation relating to professional background which must be notarized
  3. Third party authorization for release of information 
  4. $ 100 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

 

 

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 Sandra Broussard at (504) 568-7688 or sbroussard@lsbme.la.gov.