Physicians

Overview

An immigrant is a foreign national who has been authorized to live and work permanently in the United States. If you want to become an immigrant based on the fact that you have a permanent employment opportunity in the United States, or if you are an employer that wants to sponsor someone for lawful permanent residency based on permanent employment in the United States, you must go through a multi-step process.

• First, foreign nationals and employers must determine if the foreign national is eligible for lawful permanent residency under one of USCIS' paths to lawful permanent residency.
• Second, most employment categories require that the U.S. employer complete a labor certification request (Form ETA 750) for the applicant, and submit it to the Department of Labor's Employment and Training Administration. Labor must either grant or deny the certification request. Qualified alien physicians who will practice medicine in an area of the United States which has been certified as underserved by the U.S. Department of Health and Human Services are relieved from this requirement.
• Third, USCIS must approve an immigrant visa petition, Form I-140, Petition for Alien Worker, for the person wishing to immigrate to the United States. The employer wishing to bring the applicant to the United States to work permanently files this petition. However, if a Department of Labor certification is needed the application can only be filed after the certification is granted. The employer acts as the sponsor (or petitioner) for the applicant (or beneficiary) who wants to live and work on a permanent basis in the United States.
• Fourth, the State Department must give the applicant an immigrant visa number, even if the applicant is already in the United States. When the applicant receives an immigrant visa number, it means that an immigrant visa has been assigned to the applicant. You can check the status of a visa number in the Department of State's Visa Bulletin.
• Fifth, if the applicant is already in the United States, he or she must apply to adjust to permanent resident status after a visa number becomes available.  If the applicant is outside the United States when an immigrant visa number becomes available, he or she will be notified and must complete the process at his or her local U.S. consulate office.  

EB-2 Professionals with advanced degrees or persons with exceptional ability 

•        Foreign nationals of exceptional ability in the sciences, arts or business
•        Foreign nationals that are advanced degree professionals
•        Qualified alien physicians who will practice medicine in an area of the U.S. which is underserved.

How to Apply

If you are an employer wishing to sponsor (or petition) for a foreign national to work in the United States on a permanent basis, you must file Form I-140, Petition for Alien Worker. Detailed information is provided in the instructions for Form I-140. Filing requirements differ for each of the five categories.

The Department of State is responsible for providing visa numbers to foreign nationals interested in immigrating to the United States. To find out more about the Department of State's visa process visit the Department of State website for specific information on how to get an immigrant visa number.

Immigration under the National Interest Waiver for Physicians in Underserved Areas

On September 6, 2000, the Immigration and Naturalization Service issued an interim rule regarding immigration under the National Interest Waiver for physicians in underserved areas.  USCIS subsequently issued a policy memorandum on January 23, 2007 that superseded certain provisions in the regulation.  The information provided below is meant to help people understand and comply with the regulations in light of the new policy memorandum.  A link to this memorandum can be found to the right on this page.

The national interest waiver for physicians in underserved areas relieves the petitioner only from the labor certification process.  If you are a petitioner requesting a national interest waiver on behalf of a qualified alien physician; or an alien physician self-petitioning for second preference classification based on medical service in a Health and Human Services Department (HHS)-designated underserved area or a Department of Veterans Affairs (VA) facility, you still must meet all eligibility requirements for this immigrant classification in order to be eligible for the national interest waiver.

Petition Document Requirements

The petitioner or self-petitioner must submit the following evidence with the Immigrant Petition for Alien worker, Form I-140, to support the request for a national interest waiver.  For physicians planning to divide the practice of full-time clinical medicine between more than one underserved areas, all of the applicable following evidence must be submitted for each area of intended practice:

1. If the physician will be an employee, a full-time employment contract (issued and dated within 6 months prior to the date the petition is filed) for the required period of clinical medical practice, or an employment commitment letter from a VA facility.

2. If the physician will establish his or her own practice, the physician’s sworn statement committing to the full-time practice of clinical medicine for the required period, and describing the steps the physician has taken or intends to actually take to establish the practice.

3. Evidence the physician will provide full-time clinical medical service in:

a. A geographical area or areas designated by the Secretary of HHS as having a shortage of health care professionals and in a medical specialty that is within the scope of the Secretary’s designation for the geographical area or areas; or
b.  A facility under the jurisdiction of the Secretary of VA.

4. A letter (issued and dated within 6 months prior to the date on which the petition is filed) from a Federal agency or the department of public health of a State (including territories of the United States and the District of Columbia) attesting that the alien physician’s work is or will be in the public interest.

a.  Any attestation from a Federal agency must reflect the agency’s knowledge of the alien’s qualifications and the agency’s background in making determinations on matters involving medical affairs so as to substantiate the finding that the alien’s work is or will be in the public interest.

b.  An attestation from the public health department of a State, United States territory, or the District of Columbia must reflect that the agency has jurisdiction over the place where the alien physician had practiced or intends to practice clinical medicine.  If the alien physician practiced or intends to practice clinical medicine in more than one underserved area, attestations from each intended area of practice must be included.  Attestations from the public health department of a State, United States territory, or the District of Columbia that does not have jurisdiction over the place in which the alien physician intends to practice clinical medicine will not be accepted.

5. Evidence that the alien physician meets the admissibility requirements established by section 212(a)(5)(B) of the Immigration and Nationality Act.  If applicable, evidence of the Service-issued waivers of the requirements of section 212(e) of the Immigration and Nationality Act, if the alien physician has been a J-1 nonimmigrant receiving medical training within the United States.

Counting of the aggregate 5 years of qualifying full-time clinical practice

A physician may request that any time served in qualifying capacity in shortage areas and in Veterans Affairs facilities prior to the approval of the Form I-140 to be credited towards the aggregate 5 years if: (1) the physician was in a lawful status (other than J-1 nonimmigrant status); and (2) the service meets the regulatory criteria established in 8 CFR §204.12(a).

Interim Evidence of Compliance 

A physician will be required to submit reports within 120 days after the 2nd and 6th anniversaries of the I-140 approval, evidencing that the physician has either completed or is in the process of completing the required years of qualifying medical service.  The list of acceptable evidence is provided in the January 23, 2007 policy memorandum.

Renewal Employment Authorization Document Adjudication

A physician seeking employment authorization based on a pending adjustment application may be served with an RFE, requesting evidence of meaningful progress toward completing the NIW employment obligation or of plans to use the EAD for the purpose of completing the medical service obligation.  The list of acceptable evidence is provided in the January 23, 2007 policy memorandum.

More information regarding immigration under the national interest waiver for physicians in underserved areas and eligibility for adjustment of status following completion of required serve may be found in sec. 203.12 and 245.18 of the Code of Federal Regulations.  Additionally, memoranda of the subject are available.  Open “National Interest Waivers for Second Preference Employment-Based Immigrant Physicians Serving in Medically Underserved Areas or at Veterans Affairs Facilities and Section 214(l)(2)(B) of the Code of Federal Regulations Immigration and Nationality Act” and “Interim Guidance for Adjudicating National Interest Waiver (NIW) Petitions and Related Adjustment Applications for Physicians Serving in Medically Underserved Areas in light of Schneider v. Chertoff, 450 F. 3d 944 (9th Cir. 2006)” for further information.

Policy and Procedural Memoranda on Immigrant Physicians

These are memoranda which have been issued by USCIS (and INS prior to the creation of USCIS) on this topic. You will need the free Adobe Reader software to view these files.

Guidance on Revisions to CDC's Technical Instructions for Civil Surgeons and Form I-693 (838KB PDF) - March, 2009