In the United States, healthcare and immigration law often intersect to create a complicated regulatory and statutory system that governs the admission and employment authorization of foreign medical professionals seeking to work here. Some medical professionals are given preference under our immigration laws (such as physicians, nurses, and physical therapists), while others are forced to navigate our antiquated immigration system. However, even with the differing levels of treatment under the law, there are still numerous options available for most medical professionals seeking employment opportunities in the United States, with or without sponsorship from a United States employer.
There are numerous options available for most medical professionals seeking employment opportunities in the United States, with or without sponsorship from a United States employer.
Many times, physicians with foreign medical degrees enter the United States with J-1 visas in order to complete their medical residencies here. Other times, such visa options as the H-1B (specialty occupation positions requiring at least a bachelor’s degree in a specific field) or O-1 (visas for individuals with “extraordinary” ability) are available to physicians who have received job offers from United States employers willing to sponsor their visa applications. These options can also be used to complete residency requirements and/or to work in the field after completing residency programs.
Physicians may also be eligible for permanent residency in the United States based upon their employment. Many physicians may be eligible through the PERM program, which tests the United States labor market in order to show the Department of Labor (DOL) that no willing and minimally qualified U.S. workers exist for the proffered position. The PERM process is long and extremely complicated; however, some physicians may also be eligible for what is called a National Interest Waiver. The National Interest Waiver is appealing for two reasons: (1) it allows the physician to skip the PERM process, meaning that no test of the United States labor market is necessary before filing for permanent residency; and (2) it also allows for physicians to “self-petition,” meaning that no job offer is needed in order to file for their green card. Physicians who can demonstrate that their achievements and future work will be in the “national interest” of the United States may be eligible for this classification.
Also, for physicians (and for all medical professionals) the EB-1immigrant visa category may be an option. This visa category is available for medical professionals of “extraordinary ability” who can demonstrate proven success in their field. This category is appealing as it allows for self-petitioning and the skipping of the labor market test. Applicants must demonstrate that they meet certain regulatory requirements and that they have “risen to the very top” of their fields.
PHYSICAL THERAPISTS AND NURSES
Nurses and Physical Therapists are unique in immigration law because there is a nationwide shortage of workers in both of these occupations. Certain requirements and restrictions still apply, but generally, a certified and licensed Registered Nurse and/or Physical Therapist should have to navigate through less red tape on their path to employment-sponsored permanent residency.
Both Nurses and Physical Therapists must ensure that they provide USCIS with a “VisaScreen” certification from an approved organization. This is to verify that they meet all the normal U.S. requirements for such a position (including training, licensing, education, and language capabilities).
Temporary work visas may also be eligible for nurses, physical therapists, and other medical professionals (such as the H-1B and TN category). The H-1B visa is for professionals with at least a four-year degree in a specific specialty seeking to work for a United States employer. There is an annual limit on the number of H-1B visas that USCIS will grant every year. Lastly, while the TN is similar to the H-1B in terms of educational requirements, it is only available for nationals of either Canada or Mexico. More so, it has no annual limit.
OTHER OPTIONS FOR MEDICAL AND HEALTHCARE PROFESSIONALS
Besides the immigration options listed above (EB-1, PERM, NIW, Schedule A, H-1B, TN, O-1) there are other lesser known visa categories which may be viable for medical entrepreneurs looking to start and run their own businesses in the United States. Specifically, the E-2 visa may be an option for nationals of certain countries who are willing to invest in starting and managing their own medical business and/or practice. There is no minimum amount of money that needs to be invested for the E-2 nonimmigrant category but the investor must present a comprehensive business plan accompanied by financial projections.
Representing foreign medical professionals and their employers is a technical and specialized area of immigration law; it is recommended that competent counsel be obtained before initiating any of the above mentioned visa applications with either USCIS or DOL.
If you have any questions regarding the information included in this bulletin, please contact: Dana R. Bucin at 860.240.6081 or email@example.com Michael J. Bonsignore at 860.240.6089 or firstname.lastname@example.org