H-1B for Physicians

Helping Foreign Physicians Obtain Visas

Foreign medical graduates have been admitted under the H-1B category since the Immigration Act of 1990 amended the Immigration and Nationality Act (INA). Under this visa category, the physician can participate in the direct care of patients by taking part in a medical training program or simply by being a practicing physician. Before 1990, physicians could only obtain H-1B status if they were primarily teaching or researching at a public or nonprofit institution or where nationally or internationally recognized doctors were located.

Physicians must meet several other requirements beyond the typical H-1B requirements. These additional requirements are dependent upon whether the foreign medical graduate will be providing direct patient care, teaching, or conducting research.

Work with The Law Firm of Shihab & Associates if you are a physician and would like to process an H-1B visa. Our Columbus immigration lawyers are experienced and have represented physicians and other foreign medical graduates in a variety of immigration aspects.

Reach out to us at (888) 915-5057 or contact us online. The Law Firm of Shihab & Associates has locations in Columbus, OH, Cleveland, OH, Fairfax, VA, Southfield, MI, and Washington D.C. We are ready to help you.

Main Categories

The three main categories under which foreign physicians can obtain H-1B status are:

• Academic institution positions
• Clinical positions
• Residencies/fellowships

First, foreign medical graduates wanting to obtain an H-1B visa to pursue a research or teaching position may only obtain clinical responsibilities that are related to their teaching and research responsibilities. Although the regulations do not explicitly say what related incidental patient care is, some kind of clinical duties are often required when educating medical students and faculty. Nevertheless, because it is not expressly defined if a foreign medical graduate intends to perform any clinical duties while in a research or teaching position, it is a good idea to provide documentation as if the physician had a clinical position. If this type of documentation cannot be provided, the foreign physician should restrict his or her clinical responsibilities to the very minimum. The clinical duties of the position should also be described in the H-1B support letter. This will help avoid a Request for Evidence and possible visa petition denial.

Second, to qualify for an H-1B visa as a clinical physician, a foreign medical graduate must show that licensure requirements are satisfied and that he or she has the necessary credentials. Qualifying for an H-1B visa is dependent upon whether the physician has a petitioner acting in an employer-employee relationship. This is actually more complex than it sounds. For example, most physicians in the U.S. have their own practice and simply maintain privileges at hospitals. These hospitals, however, are not actually their employers. Additionally, it is important to consider that many states and jurisdictions do not allow hospitals to legally hire a foreign medical graduate.

Third, graduate medical training comes in the form of either a residency or a fellowship. Because these areas involve employment, education, and training, graduate medical training can be considered more complex than the research or clinical positions. Since graduate medical trainees are also medical doctors, they are considered to be employed in a specialty occupation, as necessary for an H-1B. Although the H-1B is regarded higher by physicians because it allows them to remain in the United States after completing their training, there are still some difficulties that exist.

Potential Complications with the H-1B Visa

An H-1B allows a foreign medical graduate six years of status. Coincidentally, several residencies are actually longer than six years and those individuals hoping to complete a residency and fellowship often need more than six years. Further, even if a residency program is under six years, the foreign national will likely have used most of the six-year time frame on the residency. Therefore, he or she will have a very short period of time to secure employment if continuing to work in the United States is the goal. Accordingly, it is advised that foreign physicians establish their long-term career goals and immigration options at the outset of their medical training.

Another potential complication with the H-1B visa is that many residency and fellowship programs do not want to petition for an H-1B visa for a foreign medical graduate. These programs have a number of reasons for this and therefore require the foreign physician to participate in their programs under the J-1 visa. The H-1B visa does require more time and energy than the J-1 visa, which might discourage the employer from filing. However, the benefits to the foreign physician are much greater with the H-1B visa compared to the J-1 visa.

Credentialing and Licensure Requirements

Credentialing and licensure requirements for physicians seeking H-1B status to perform clinical work have been established by the INA. However, these are not required of physicians seeking H-1B status to teach or conduct research.