Foreign born physicians working in the US for healthcare organizations could be sponsored for permanent residence under the second preference employment based immigration system through: 1) Processing a PERM (labor certification); or 2) filing a National Interest Waiver application for those physicians who have a full time job offer in certain designated health professional shortage areas or in Veteran Affairs Hospitals. The National Interest Waiver option is attractive because the foreign physician will avoid lengthy labor certification processing delays and would go straight to filing the immigrant visa application (I-140). Often, if the alien physician has an immigrant visa immediately available, he/she will be eligible to file for adjustment of status concurrently, thereby saving considerable time.

I.  PERM Processing For Physicians:

This method represents an administrative procedure involving the filing of a labor certification application through a web-based system called PERM that allows the electronic filing of the application. The objective of this process is generally explained more fully in the PERM page of our website. However, the PERM process is intended to assure that the permanent employment of the foreign physician will not displace equally qualified US workers. Below is a visual illustration of the overall permanent residence process through PERM:

** Note that if your priority date is current, I-140 and I-485 are filed together.

As illustrated above, the I-140, which represents the Immigrant Petition, is the next step in the process once the PERM is approved. The I-140 is filed with the USCIS and is intended to confirm: 1) that the PERM is approved; 2) the employer has the financial means to pay the Physician’s wages; and 3) the alien is otherwise eligible to fill the position including that the physician has successfully completed examination Parts 1 and 2 of the National Board of Medical Examiners Examination or its equivalent. The Educational Commission for Foreign Medical Graduates ("ECFMG") oversees the Foreign Medical Graduates Examination in Medical Sciences ("FMGEMS"), previously known as the Visa Qualifying Examination (“VQE”), as well as the United States Medical Licensing Examination ("USMLE"). Steps 1, 2 and 3 may be taken in lieu of the NBMEE examination as it is recognized by regulation as a viable alternative.

II.  “National Interest Waiver” for Physicians

This category is available to Physicians who are licensed and will providing full-time clinical services in a medically underserved area (MUA), a primary medical health professional shortage area (HPSA), or a mental health professional shortage area (MHPSA), federally designated by the US Department of Health and Human Services OR in an VA hospital, AND where a State Department or agency of the federal government has determined that the physician’s work is in the “public’s interest.” As a prerequisite to approval of the petition, the physician must have worked for a total 5 year period for such areas or VA facility.

The National Interest Waiver petition begins with the filing of an I-140 petition directly without having to file for PERM referenced in the chart above. Hence, there is a substantial saving in time between the two processes. In addition, unlike the PERM process, the National Interest Waiver avenue could be “self petitioned,” thereby eliminating the need for an employer sponsorship.

Adjustment of Status and Concurrent Filing

Prior to filing an application for adjustment of status, it is worthy to note that certain Physicians who had previously held J-1 visas which carry a two (2) year home residency requirement subject to INA § 212(e) must show evidence that they had obtained a waiver of such home residency requirement prior to beginning either of the PERM or National Interest Waiver Process. Both PERM and National Interest Waiver Processes are within the Second Employment Based Immigrant visa process (EB-2), and as such the ability to file the Adjustment of Status process either concurrently or in series depends on whether there exists an immigrant visa immediately available to the alien Physician. Please refer to our I-485 Adjustment of Status page for a complete discussion of these issues as adjustment of status issues are the same across the board.

Permanent Residence processing through PERM or National Interest Waivers for foreign born physicians require the skills of experienced immigration lawyers. The attorneys at The Law Firm of Shihab & Associates, Co., LPA are experienced in handling these cases. Contact the lawyers at The Law Firm of Shihab & Associates by email or phone for a consultation at one of our locations in Columbus, Ohio, Cleveland, Ohio, Southfield, Michigan near Detroit, and Washington, DC.