Temporary Employment and Permanent Residency for Foreign-born Physicians

Practicing medicine or researching and teaching in the U.S. requires special documents and authorizations. Beyond the basic information provided here about the process, let us answer your questions about completing necessary exams, filling out documents correctly and promptly filing petitions.

What foreign-born physicians can obtain an H-1B visa for temporary employment in the U.S?

Those that:

Have some form of authorization to practice medicine from the state in which they want to work AND

Have a license to practice medicine in a foreign country OR
Have graduated from a medical school in the U.S. or a foreign country.

There are different requirement for physicians who want to work with patients and physicians who want to primarily teach or research:

Physicians who want to treat patients must have passed a Health and Human Services-approved examination AND be competent in English (demonstrated by passing the English proficiency test given by the Educational Commission for Foreign Medical Graduates) or have graduated from a medical school accredited by the U.S. Department of Education.

Physicians who will be teaching or conducting research must do so for a public or nonprofit private educational or research institution. No patient care, other than that which is incidental to the teaching or research, can be performed.

Before international medical graduates (IMGs) can receive licenses from the state in which they want to practice, they must complete a residency program in the United States. Most do so by entering the country as a nonimmigrant exchange visitor under a J-1 visa. When their U.S. residency is complete, IMGs must return to their countries of citizenship or last residence for two years (although waivers can often be obtained) before returning to the U.S. as a temporary worker with an H or L visa or as a permanent resident.

How does a foreign-born physician obtain temporary working status through an H-1B visa?

Obtain a prevailing wage determination (PWD) for the area in which he or she will be practicing. By law, physicians with H-1B visas are required to be paid the higher of either the prevailing wage for physicians in the area or the actual wage paid by the employer to similarly-employed doctors. A PWD can be obtained through the State Workforce Agency of the state in which the physician will work.

File a Labor Condition Application (LCA) with the regional office of the Employment Training Administration of the U.S. Department of Labor. The physician’s employer must attest in the application to working conditions and must comply with state-approved standards for working conditions and disclosure.

Submit an H-1B petition with USCIS regional service center. The employer must show in the application that the employment and qualifications of the physician meet immigration law standards and that it can pay the appropriate wage. Documents pertaining to the physician’s education, licenses and compliance with examination requirements and regulations must accompany the petition.

When the physician is approved for an H-1B visa, his spouse and unmarried children under 21 are also granted H-1B visas.

How long is an H-1B visa valid?

The initial duration of an H-1B visa is three years, with one three-year extension possible. After those six years have passed, the physician must either have achieved permanent residence status or leave the U.S.

How does a foreign-born physician with an H-1B visa become a permanent resident?

A foreign-born physician can achieve permanent residence status if his employer can show that it is unable to find a U.S. physician to fill the job. The employer and physican can do so through the following process:

The employer must apply for alien labor certification from the U.S. Department of Labor. Usually, the employer must place a job ad in an appropriate national medical journal. After reviewing any applications that come in, the employer must demonstrate that there are no U.S. physicians qualified for the specific job of the foreign-born physician currently in the post. Physicians who intend to practice in medically underserved areas for at least five years can petition to bypass the labor certification requirement.

The employer must submit a visa petition to the USCIS, stating which category for permanent residency the physician qualifies under (most qualify for E-B2 visas as professionals holding advanced degrees) and that the physician’s salary and employment future are in good standing.

The physician must apply for permanent residency at a USCIS office AT THE SAME TIME THE VISA PETITION IS SUBMITTED. This is known as ‘adjustment of status.’ Applications for employment authorization and ‘advance parole’ (travel documents) for the physician and his family can also be filed at this time.

Durrani Law Firm can help you obtain your H-1B visa. We are available for consultations and can be contacted by email at info@durrani.com or phone at 1-866-DURRANI.