Immigrant Visas (Greencard Options) for Physicians
A foreign national physician may obtain permanent residence through all of the channels available to people from other walks of life: employment, family relationships, and asylum. However, if a physician schooled outside of the United States or Canada seeks to obtain permanent resident status based upon work as a clinician, U.S. immigration law imposes additional requirements. In addition to showing eligibility for an immigrant visa (i.e., through labor certification or by obtaining a waiver of the labor certification requirement through a national interest waiver (see below), as a person of Extraordinary Ability or as an Outstanding Researcher).
National Interest Waivers for Physicians Working in Underserved Areas
Physicians who work in areas designated by the Department of Health and Human Services (DHHS) as "shortage areas" or in a Veteran Affairs (VA) hospital may qualify for a national interest waiver. A national interest waiver eliminates the requirement of obtaining a labor certification. The process of obtaining permanent residence, therefore, is less complex from a procedural perspective. However, as the following discussion explains, there are significant additional substantive requirements that make this option unattractive.
In general, an applicant for a national interest waiver under this category must serve five years in a shortage area. The required period of service begins to run the day the I-140 immigrant petition is approved. For former J-1 visa holders, the period of required service begins to run on the day that they commence work in H-1B status as per the terms of their J-1 visa waiver.
To prove eligibility for a national interest waiver under this category, the physician's employer must file Form I-140 along with a five-year employment contract dated within six months of the filing of the application. In addition, the application must include a letter from a State Department of Health, DHHS, the VA or another federal agency declaring that it has have reviewed the physician's qualifications and that the work is in the public interest.
The required five-year period of service need not be completed within the same shortage area. However, if a physician changes job sites or employers, he or she must file a new I-140 and demonstrate that the work remains in the public interest.
National interest waivers under this category are issued only to practitioners of general medicine, pediatrics, family medicine, internal medicine, obstetrics/gynecology, and psychiatry. Currently, physicians working at VA hospitals are not limited to primary care.
Former J-1 visa holders may apply for adjustment of status to permanent residence on Form I-485 upon receipt of approval of the I-140, but must remain in H-1B status throughout the full period of service required under the terms of the J-1 visa waiver. Other physicians need not remain in H-1B status, but rather may apply for employment authorization based upon the application for adjustment of status. All national interest waiver recipients must, at the close of the required period of service, provide U.S. Citizenship & Immigration Service (USCIS) with evidence that they have complied with all requirements. Upon receipt of this proof, USCIS will complete adjudication of the adjustment of status application.