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Permanent Residence Options for Foreign Physicians

Permanent Residence Options for Foreign Physicians in Columbus 

Understanding the Steps to Take to Become a Permanent Resident in the US 

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)
  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 

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.

With offices in Columbus Ohio, Cleveland Ohio, Southfield Michigan and Washington, D.C., The Law Firm of Shihab & Associates can help you understand your options. Call (888) 915-5057 today.

PERM Processing for Physicians in the US

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:

StageProcessProcessing Times
PERMPre-filing Case Preparation2-3 months
ProcessUSDOL ProcessingUSDOL Processing Times
I-140USCIS ProcessingUSCIS Processing Times
Waiting Time Due to Visa Unavailability Pursuant to the Visa Bulletin
I-485USCIS ProcessingUSCIS Processing Times

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.

“National Interest Waiver” for Physicians

This category is available to Physicians who are licensed and will be providing full-time clinical services in:

  • A medically underserved area (MUA)
  • A primary medical health professional shortage area (HPSA)
  • A mental health professional shortage area (MHPSA)
  • A VA hospital

Underserved areas must be federally designated by the US Department of Health and Human Services. A State Department or agency of the federal government must have also 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 savings of 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 employer sponsorship. 

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