Healthcare Resource Center
Foreign health care workers play a major role in the health care industry in the United States. Berardi Immigration Law represents many reputable health care organizations, as well as physicians, nurses, researchers, and other health care workers.
Our attorneys evaluate each client’s options and tailor a customized immigration approach. There are a variety of visa options available, depending on the client’s situation and circumstances.
Nonimmigrant Visa Options
Our firm considers the following visas for foreign health care workers:
H-1B specialty occupation visas, and analyzing for cap-exempt filing opportunities
The H-1B category is designated for temporary professionals to work in the U.S. in a “specialty occupation.” This is generally defined as a position that requires at least a Bachelor’s degree or the equivalent. Many foreign nationals who come to work as physicians in the United States do so pursuant to H1B status. Candidates must usually be counted against the H-1B cap before the individual is eligible to work in H1B status, unless the institution is:
- an accredited, nonprofit institution of higher education;
- a nonprofit entity that is related to or affiliated with a qualifying institution of higher education; or
- a nonprofit research organization or a governmental research organization.
J-1 visas and J-1 waivers
The Exchange Visitor (J) non-immigrant visa category is for individuals approved to participate in work-and study-based exchange visitor programs. Many international medical graduates (IMGs) pursuing graduate medical studies opt to use this visa. IMGs in the United States on J-1 visas are subject to a two year residency requirement. This requirement holds that a J-1 visa holder must be present in their home country or country or permanent residency for two years prior to applying for another non-immigrant visa category (H1-B) or permanent residency in the United States. Waivers can be applied for in order to bypass this requirement. There are five circumstances which make a J-1 visa holder eligible for a waiver:
- the visa holder receives a no objection statement from the host government;
- an interested U.S. Government agency requests a waiver on the visa holder’s behalf;
- the visa holder would be persecuted upon return to the country of residence;
- the residency requirement would cause exceptional hardship to a U.S. citizen or a permanent resident spouse or child; or,
- a designated State health agency or its equivalent requests a waiver.
O-1A visas for individuals with extraordinary ability in science
The O-1A visa is for individuals with an extraordinary ability in the sciences, education, business, or athletics. “Extraordinary Ability” means a level of expertise indicating that the person is one of the small percentage who has risen to the very top of the field of endeavor. This is a category to consider for well-published researchers, accomplished clinical physicians, and other highly-skilled and achieved health care professionals. The O-1 category is also an exception to the J-1 two-year home residency requirement.
TN category for Canadians and Mexicans in the health care industry
The TN Visa category was created under the North American Free Trade Agreement (NAFTA), which created special economic and trade relationships for the U.S., Canada, and Mexico. Canadians and Mexicans may be eligible to work in the U.S. as a nonimmigrant NAFTA professional if they meet certain conditions. Generally, each profession listed under this category requires the applicant to possess a Bachelor’s degree as an entry-level requirement. In some professions, an alternative to a Bachelor’s degree is listed, such as related experience or special licensing.
USCIS considers the following medical professionals for the TN category: dentist; dietitian; medical laboratory technologist; medical technologist; nutritionist; occupational therapist; pharmacist; physician; physiotherapist; physical therapist; psychologist; recreational therapist; registered nurse; and veterinarian. It is important to note that only physicians in research or teaching roles are eligible for the TN visa.
E-2 Investor Visas, where appropriate
The E-2 Treaty Investor visa exists for citizens of countries that maintain a treaty of commerce and navigation with the United States. It enables an individual to be admitted to the U.S. when investing a substantial amount of capital in a U.S. business. This classification can be utilized by foreign nationals of treaty countries in the medical profession to establish and open their own practice in the States.
Green Card Applications
Our attorneys are also adept at analyzing green card options for health care professionals. U.S. immigration law provides foreign nationals with a variety of ways to become lawful permanent residents through employment in the United States:
PERM Labor Certifications
Labor certification is the standard route for obtaining an employment-based green card. U.S. employers must demonstrate that there are no minimally qualified U.S. workers for a given position. The Department of Labor (DOL) must certify this application in order for an employer to be able to apply for a green card for a foreign employee.
Applications are processed under a program called Program Electronic Review Management (PERM). Labor certification applications under PERM require a full-time employee, a permanent job offer, reasonable job requirements, and pay of the prevailing wage or higher for the job’s occupational classification.
EB-1 extraordinary ability applications
EB-1 visas are available to foreign nationals that can demonstrate exceptional abilities in their field. This category is of primary preference. EB-1A and EB-1B visas are most relevant to those in the medical field. EB-1A visas are for those who can demonstrate extraordinary ability in designated fields, including the sciences. A major asset of the EB-1A category is that applicants may self-petition and do not need an offer of employment to apply. EB-1B visas are designated for outstanding researchers and professors.
While a major benefit of these categories is their relatively broad nature, USCIS sets out stringent guidelines and evidentiary criteria that must be met.
EB-2 National Interest Waivers
EB-2 visas are of secondary preference after the EB-1 category. Generally this category requires an offer of employment and PERM Labor Certification; however, some individuals may qualify for a National Interest Waiver (NIW). The NIW allows an EB-2 visa without an offer of employment or PERM Labor Certification. To obtain an NIW, an applicant bears the burden of demonstrating that the United States would gain a greater benefit from waiving the EB-2 requirements than enforcing them.
Although the jobs that qualify for a national interest waiver are not defined by statute, national interest waivers are usually granted to those who have exceptional ability and whose employment in the United States would greatly benefit the nation. Physicians meet a specific set of criteria:
- an applicant must be a J-1 physician in pediatrics, internal medicine, obstetrics, psychiatry, or family medicine;
- an applicant must sign an agreement to work for at least 5 years in one of the above practices;
- an applicant must to work in one of the following areas:
- Health Professional Shortage Area
- Mental Health Professional Area
- Medically Underserved Area
- Veterans Affair facility; and,
- an applicant must have a statement from a government agency or the state department of health stating that the applicant’s qualifications demonstrate the benefit to the public interest.
Schedule A Green Card Applications
Schedule A green cards provide an accelerated option for professional nurses and physical therapists looking to reside permanently in the United States. Currently, this application applies only to these two professions. To qualify for this accelerated processing, a professional nurse must have either passed the Commission on Graduates in Foreign Nursing Schools (CGFNS) examination or must hold a full and unrestricted license to practice professional nursing in the state of intended employment. A physical therapist must possess all the qualifications necessary to take the physical therapist licensing examination in the state in which he or she proposes to practice physical therapy. The major benefit of this option is a green card can be obtained without going through the entire labor certification process, which cuts down the processing time significantly.
Berardi Immigration Law represents numerous clients in the medical field and provides an individualized approach for each client. If you study or work in the medical field and are considering immigration to the United States, please contact our office to schedule a consultation with one of our attorneys today!