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Licensure for H-1B Physicians

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This section is for physician employees with patient care responsibilities only. If the employee is not a physician with patient care responsibilities, please put N/A in the box on the checklist to indicate that the section is not applicable.

  • H-1 regulations include stringent provisions for physicians who have patient care responsibilities. In order for Stanford to sponsor H-1 physician faculty with patient care responsibilities, it must be demonstrated that either 1) patient care does not comprise more than 20% of the physician's effort, or 2) that the physician earned the MD degree in the US, OR has passed all three parts of the US Medical Licensing Exam.
  • E-3 physicians whose offer of employment includes patient care must have a license for the jurisdiction in which the employment will take place, or possess an exemption therefrom with evidence that the applicant is eligible to take the necessary examinations or other steps needed to attain licensure, and that such exams or steps will be taken within a reasonable period of time subsequent to entry. 
  • TN physicians are limited to "teaching and research only" by the language of the treaty. No patient care is permitted.

Special H-1 Provisions

All prospective H1B physicians with patient care responsibilities must provide evidence, issued by the California Medical Board, that they hold one of the documents listed below:

  • a valid California Medical license.
  • a certificate of registration under section 2113 (temporary exemption from licensure).
  • a "but for" letter pertinent to the section 2113 exemption (the letter states that the physician will be registered under section 2113 after arrival in the US and after obtaining the Social Security number).
  • a "but for" letter pertinent to licensure, if the physician is a Canadian Medical School graduate not yet in the US (the letter states that the California Medical license will be issued after arrival in the US and after obtaining the Social Security number).

Cover Letter

In the cover letter for your clinical faculty, please include information as to where the physician earned the MD degree/equivalent; the FTE that will be dedicated to patient care; if patient care FTE is greater than 20%, whether they have passed all three parts of the US Medical Licensing Exams (MLEs) OR are graduated from a US medical school;  and whether they hold a California license or an exemption from licensure. If the physician has a provisional letter from the California Medical Board, you will need to reference that fact. If the physician will be placed in more than one location, you will need to stipulate an itinerary. If the physician will be placed in a location that is not owned by Stanford or does not have a Stanford marquee, you will also need an end-client letter.