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Form 4pgy - Certification of Approved Podiatric Postgraduate Training

  • Section I: Complete this section before forwarding it to the Director of Podiatric Medical Education at each hospital in which you completed approved post-graduate podiatric residency training.
  • Section II: The Director of Podiatric Medical Education must complete this section and return the form directly to the Department. Certification of approved postgraduate podiatric residency programs will be accepted only if they are signed no more than one month prior to the completion date of the residency training program and submitted to the Department directly from the Director of Podiatric Medical Education.

Please make as many copies of Form 4PGY as needed.

Electronic Verification of Experience

The Office of the Professions (OP) will accept experience forms directly from supervisors provided that:

  • OP can independently verify that the documentation is received directly from the supervisor
  • The applicant had no opportunity to directly alter the experience form before it is sent or transmitted.
  • Any experience documentation submissions should be made electronically to DPLSExperience@nysed.gov*.

*Do NOT use this email to submit a question, as we will be unable to provide a response. Submit a Contact Us Form for questions regarding specific applications or to check the status of a licensure application.