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H1B Visa
The H-1B visa for physicians
The H1B visa allows U.S. employers to hire foreigners in a “specialty occupation” – an occupation that usually requires a bachelor’s or higher degree in a specialized field of knowledge as a minimum for entry into the occupation.
The practice of medicine is a specialty occupation according to the U.S. government standards, but foreign national physicians also meet other H-1B visa criteria specific to them.
Many international medical graduates often desire to develop their careers in the United States. Since the H-1B is intended for highly-skilled workers, foreign workers seeking employment in specialty occupations within the U.S. after graduating at medical school aim to obtain the H-1B.
To make it clear from the start- there has been a trend of the high demand for this visa class in the past years, so having your application approved for an H-1B visa or getting an H-1B status is not always easy.
To avoid common delays and pitfalls and increase your chances of obtaining the H-1B it is essential to have right information and trustful immigration attorney by your side..
H1B Visa For Foreign Medical Graduates
Physicians and medical school graduates used to get the J-1 visa to work in the U.S., but this option had a two-year foreign residency requirement after they passed medical training programs.
Although this requirement could be waived by working for three years in a medically underserved area or in a health professional shortage area designated by the Department of Health and Human Services (Conrad 30 waiver), it was often hard to fulfill it, so many foreign professionals gave up applying for J-1.
Overview of H-1B Visa Requirements for Medical Professionals
- Have the sponsoring employer who will employ and file an H-1B petition on behalf of the visa seeker. The employment engagement can be working part-time for more than one hospital if each hospital petitions the medical professional.
- Being paid at least the actual or prevailing wage for a specialty occupation, defined by the Department of Labor’s (DOL) regulations.
- Demonstrate qualifications: a degree from an accredited medical school in the U.S. or have a foreign degree equivalent to an M.D. degree in the U.S.
- Demonstrate competency in written and oral English examinations.
- Passing all three parts of the United States Medical Licensing Examination (USMLE).
- Having an unrestricted license that allows petitioners to practice medicine in the state or have the authorization to practice medicine. Note: Every state has unique post-graduate medical training, educational, and licensing requirements.
- Obtain ECFMG certification before entering the U.S.
H-1B Requirements for Doctors and Physicians
The visa requirements ensure that the U.S. employer and foreign professionals comply with the Department of Labor standards.
Now, let’s get in more detail about requirements that the petitioners who want to obtain an H-1B visa have to meet.
Wage Requirements
Determining the prevailing wage is the first step of the process. U.S. immigration laws impose that employers pay their H-1B workers one of the following two options, whichever is higher for certain cases:
- The prevailing wage for other workers in the professional and the geographic area where they will be employed, or
- The actual wage paid to other similarly employed foreign nationals,
The Purpose of Using H1B visa
- To teach or conduct research at a public or nonprofit private educational institution.
- To participate in a residency program
- To work for a U.S. company that complies with the U.S. Citizenship and Immigration Services USCIS conditions and regulations as a doctor
- Teaching or conducting research at an educational or research institution or agency (public or nonprofit private);
- Providing direct patient care at this institution
- Working for a U.S. employer as a physician.
Can H1B Visa holders Bring their Dependents?
physicians can arrive in 6-8 months (Tennessee)
H-1B Visas and Research
Foreign medical workers coming to the U.S. to teach or perform research or practice medicine that involves only a small amount of patient care have to show that they have received medical education and are licensed to practice medicine in their home country.
Also, they must show that they have received an appropriate license from the state where the work will be conducted if they perform patient care.
Graduating at Medical school
If a foreign physician or a doctor did not graduate from U.S. accredited medical school but attended school in foreign language and has a foreign degree, they need to prove competence in written and oral English examination administered by the Educational Commission for Foreign Medical Graduates (ECFMG).
To do this, the petitioner has to pass the English proficiency test. Physicians with national or international renown are exempt from this requirement.
Appropriate State License
Also, the physician and doctors must meet the state medical license requirements in the state of intended practice if performing direct medical care.
In most U.S. states, a foreign physician will need to prove the passage of the United States Medical Licensing Examination (USMLE) (or an equivalent examination, such as the Federation Licensing Examination (FLEX)). The doctor must have an unrestricted state license in the state of practicing medicine or an authorization to practice medicine.
Residency Program in the U.S.
The H-1B visa holders have to obtain a medical state license, but from the state where they will practice medicine. International medical graduates who didn’t obtain their degree from US medical school must complete medical residency in the U.S. before a state issues a medical license.
Most foreign workers enter the U.S. with J-1 “exchange visitor” visa status for graduate medical training and to complete a U.S. residency program. When medical residents with J-1 visa status want to transfer status from J-1 to H-1B visa, they first must return to their home country or country last residence for two years. Upon this period expires, they may file the petition, or they may apply for permanent residency.
When international medical graduate receives a J-1 waiver and a state medical license and want to get a new work authorized status for U.S. employment, in most cases it will be an H-1B visa.
Many foreign medical workers obtain H-1B visas to pursue U.S. medical residence. Those who complete medical residency program without getting J-1 status can find a private employer and permanent residence who will file sponsor their H-1B petition. In other words, they do not have to obtain a J-1 waiver before seeking employment as a physician.
Examinations for Physicians
To obtain H1B visa a foreign physician needs to have passed one of the required medical examinations:
- Federation Licensing Examination (parts I and II), or an “equivalent examination as determined by the Secretary of Health and Human Services”;
- National Board of Medical Examiners (Parts I, II, and III) or
- The U.S. Medical Licensing Examination (Steps 1, 2 and 3)
H1B Visa Application Process
The H-1B application process comprises three steps:
1. Submitting a labor condition application to the Office of Foreign Labor Certification.
2. Submitting a certified LCA and the “Petition for Nonimmigrant Worker,” Form I-129 to the USCIS.
3. Obtaining the visa from the Department of State (DOS). If the foreign worker is already in the U.S., USCIS will provide an I-797 approval notice that acts as employment authorization allowing the individual to work under the approved H-1B petition.
The sponsoring employer must also make attestations and submit a labor condition statement to the Wage and Hour Division (WHD).
Labor Condition Application (“LCA”)
The sponsoring employer must file the Labor Condition Application LCA with the U.S. Department of Labor (DOL). The LCA requires that an employer make attestation that:
- The doctor’s or physician’s working conditions will not adversely affect currently employed U.S. physicians.
- There is no strike or lockout of medical workers at the facility;
- The employer notified its employees that an LCA had been filed. A prospective employee has to get one copy of the LCA.
The DOL may investigate an employer to determine whether it complies with provided statements, and if conclude that the employer misrepresented any material, they may impose severe penalties.
H-1B Petition
Once the LCA is approved, the employer can file the H-1B petition, establishing that the job offer and the foreign worker meet the immigration law standards. The employer also must demonstrate the ability to pay the appropriate wage, as we mentioned above. The petition must include documents proving that the physician’s or doctor’s education, licenses, and compliance with the English and the medical examination requirements. The petitioner may begin working in the U.S. once the application is approved and either changed the visa status to H-1B or has obtained an H-1B visa and entered the U.S. in that status.
regular (non Physician) H-1B visa process
Once you have been selected to apply for the H-1B visa, your employer can begin the process by filing a petition on your behalf.
To do this, your employer will need to submit a Labor Condition Application (LCA) to the Department of Labor (DOL) for Certification. The purpose of the LCA is to confirm that your employer will pay you the same wage as other similarly qualified workers in the same geographic area and that your working conditions will not affect other employees.
Once the LCA has been certified by the DOL, your employer will have to complete Form I-129, Petition for a Nonimmigrant Worker, and file both the LCA and the I-129 to USCIS, along with any fees and additional documentation. These other documents may include evidence of your education, any training certificates or professional membership documents if relevant, your resume, a confirmation letter of employment, a letter of support, and any necessary fees.
If your Form I-129 is approved, then there are two options for you, depending on whether you are in the United States already or not.
If you are within the United States on a different visa category, you must wait until your H-1B visa status becomes active in order for you to start working.
If you are outside the United States, then you will need to apply for consular processing. To do this, you will need to complete Form DS-160, which will take around 90 minutes to fill in. You will also need to pay the application fee and schedule an interview at a U.S. embassy or consulate near you.
Once you have arranged an interview, you will need to bring documents such as:
Your passport. This should be valid for at least six months beyond your intended date of entry to the United States.
A printout of the confirmation page from your Form DS-160.
A copy of your approved I-129 petition and your I-797 approval..
Receipts showing you have paid your application fees.
A passport-sized photo of you that follows U.S. State Department requirements.
What’s next
Currently, H-1B visa holders may apply for a green card. However, there may be lengthy delays. This means that any children who moved with you may “age out” of their visa status, which is tied to your H-1B visa. Under the current system, if they turn 21 before their green card is approved, they will need to apply for another visa to stay, such as a student visa. The Biden administration may remove this, and also make it easier for dependents of H-1B visa holders to gain work authorization.
H-1B FAQ
When can I register electronically for the H1B lottery, and when I will know the results?
The dates vary each year, in 2024 USCIS announced that people could register for the H-1B lottery from March 1 through 17th and that it would let people know if they had been selected to file for an H-1B visa by March 31, 2024.
How do I check the results of H1B lottery?
To see if you are eligible to file for an H-1B visa, you can check your USCIS online account. The account will show the status of your application.
Can I expedite my H1B visa?
Yes, premium processing is available for the H1B visa. To request premium processing, you will need to submit Form I-907, Request for Premium Processing Service, and pay the filing fee to USCIS. You can do this at the same time as you file your Form I-129 petition. If you have already filed your petition, you can request premium processing at a later date by sending your form to the same service center as your original Form I-129.
Can I travel outside the U.S on a H1B Visa?
Having a valid visa allows you to go to a U.S. port of entry and request entry to the U.S.. If you leave the U.S. for travel and return, as long as your H-1B visa is still valid, you may be able to be admitted on H-1B status. You may wish to bring evidence of your employment or your visa validity with you to present at the border.
When can I start filling my H1B application?
If your H1B visa is subject to the cap, you will need to register online first. You should keep in mind that being selected in the lottery allows you to apply for a visa for the following financial year. If you are selected, you and your employer can petition for a H-1B visa on your behalf. You can expect to have around 90 days to apply for your visa, but the filing period and location will be on your H-1B Registration Selection Notice from USCIS. You can apply for your visa up to six months before your visa start date.
Where do I file my H1B application?
If your H-1B visa is under the cap and you have been selected to apply for a visa, your selection notice will let you know which USCIS address you can file your application at. If the H1-B visa cap does not apply to you, for example, if you are being employed by an institute of higher education, then you can file your application at the USCIS California service center.
Can I extend my H1B Visa?
Your H1B visa is generally valid for three years, and can usually be extended for up to six years. To do this, your employer will need to complete and file Form I-129 again on your behalf, along with any supporting documents, and pay the filing fee.