H-1B, TN and O1 Visas for Physicians
H-1B Visa for Physicians
The application procedure for physicians seeking H-1B status is the same as for other professionals. Please refer to the general discussion of H-1Bs in the nonimmigrant section. However, there are several special considerations to keep in mind when filing H-1Bs for physicians.
A physician that will provide direct patient care must have passed all three steps of the United States Medical Licensure Examination (USMLE) in order to gain H-1B approval. This is true even where the position is for residency training. In addition, the physician must have a full and unrestricted license to practice medicine in the state in which the patient care will be performed. Finally, the physician must have ECFMG Certification.
A physician who will not provide direct patient care need not obtain ECFMG certification or state licensure, and does not have to take the USMLE. A physician may teach, perform research or act as an administrator in H-1B status without first complying with the onerous requirements attendant to clinical practitioners.
Physicians who completed their residency training in J-1 status must be approved for a J-1 Waiver before they can apply for a change of status to H-1B. For this purpose, the State Department Waiver Review Division's positive recommendation regarding the waiver is sufficient to gain approval of the change of status application from USCIS. If a former J-1 visa holder is seeking issuance of an H-1B visa from a U.S. embassy or consulate, the physician must have the final I-612 approval issued by USCIS. Embassies and consulates will not issue a visa based upon the State Department's waiver recommendation.
Under the North American Free Trade Agreement (NAFTA) Canadian and Mexican physicians with offers to teach or perform research in the United States may qualify for TN status. The physician must hold a state or provincial medical license and the position must strictly limit patient contact. Direct patient contact is permissible only to the degree necessary to perform instruction or research. The procedure for gaining admission in TN status for physicians is identical to the procedure that applies for other TN applicants. Please refer to the general discussion of TNs visa in the nonimmigrant section.
O-1 Visas for Physicians
The application procedure for physicians seeking O-1 status is the same as for other professionals. Please refer to the general discussion of O-1 in the nonimmigrant section.
However, for the physician who qualifies as an “extraordinary ability alien,” there are significant advantages to this type of visa. For instance, the O-1 visa can be used to avoid the two-year foreign residency requirement of the J-1 visa. Therefore, rather than being restricted to employers who will sponsor them for an IGA waiver, the extraordinary ability physician may work for any employer willing to sponsor him for the O-1 visa. However, the physician must eventually comply with the two-year foreign residency requirement or obtain a waiver, if s/he ever plans to become a permanent resident. Also, the O-1 visa may be used by the physician who has reached the six-year limitation period of the H-1B visa. In such a case, the physician can extend his employment indefinitely if his employer’s O-1 petition is approved.