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H-1BH-1B visas are non-immigrant visas that allow for the temporary employment of professional foreign nationals with a minimum of a Bachelors degree in a specialty field. Foreign medical graduates (FMG) may be admitted into the U.S. with an H-1B in order to engage in direct patient care or as part of a medical training program or to teach or conduct research for a sponsoring employer. In order to be granted H-1B status, physicians must also show that they have the appropriate license or authorization for the state in which they intend to work. However, there is a limit to the number of H-1B visas available each fiscal year unless the sponsoring employer is exempt from the H-1B cap. Physicians who receive a waiver (through the Conrad waiver program or other state or federally sponsored program) of the J-1 two-year home residency requirement by agreeing to work in a Health Professional Shortage Area or Medically Underserved Area are permanently exempt from the H-1B cap regardless of whether or not the sponsoring employer is exempt from the cap. H-1B employers are required to file a Labor Condition Application with the Department of Labor agreeing to several conditions, promising that the H-1B employee will be paid the higher of the actual wage or prevailing wage for the position and that internal notices have been posted in each of the employee's anticipated work locations, or that notices have been provided to the union representative if applicable. Additional information about the LCA can be found at www.lca.doleta.gov. Please note that while audits by the Department of Labor are rare, careful preparation of the LCA and H-1B should be done by an immigration attorney knowledgeable in the subjects. H-1B visas are granted for an initial period of up to three years, with extensions permitted for a total of six years in H-1B status. Exceptions to the six-year limit will be made if an I-140 or labor certification application is filed at least 365 days before his or her 6 years expires. The six-year limit can be a challenge for individuals who participate in residency programs that may take longer than 6 years to complete and for whom the positions may not meet the requirements for labor certification or I-140. Furthermore, if the physician wants to remain in the U.S. to work after completion of their residency, that physician will need to obtain other employment authorization if he or she used most or all of their 6 years of H-1B time for residency training. H-1Bs are employer specific, thus if a physician changes jobs, the new employer must file a new H-1B with the immigration service before the physician can begin work. H-1Bs are location specific as well. Before the physician can move to another work location for the same employer, the sponsoring employer and/or physician should consult with an immigration attorney to determine whether or not a new H-1B may be required or if it will sufficient to file a new labor condition application (LCA) with the Department of Labor. More information regarding H-1B visas can be found in the temporary visa section of our website. [top] J-1J-1 exchange visitor visas are attractive to most medical residency and training programs because the application process is generally less complicated than applying for an H-1B and employers are not required to submit Labor Condition Applications. However, foreign medical graduates who enter the U.S. with a J-1 visa are subject to the two-year home residence requirement under section 212(e) of the Immigration and Nationality Act. Individuals who are subject to 212(e) must return home to their home country for an aggregate of two years before they are eligible to change to another non-immigrant status or apply for permanent residence in the U.S. [top] O-1
The O-1 temporary employment visa is reserved for aliens of extraordinary ability in the arts, sciences, athletics, education or business. The O-1 visa can be a welcome option for highly talented physicians who can prove that they are among the top in their field. O-1 visas require a contract with a sponsoring employer or agent and are granted for an initial period of no longer than three years. Extensions are relatively easy and unlimited, granted in 1-year increments.
There are several advantages to the O-1 category, including: no cap on the number of O-1 visas granted in any fiscal year, no prevailing wage requirement, no minimum degree requirement, and more relaxed license requirements. Other visa categorites are frequently denied on the grounds that a license is required, even if the hospital does not require a license. O-1 visas cannot be denied on these grounds. The H-1B visa, in contrast, has annual quotas, strict license, credentialing and wage requirements, and a six-year limit.
Foreign medical graduates who enter the U.S. with a J-1 visa and are subject to the two-year home residence requirement 212(e) are eligible for an O-1 visa. However, they cannot change status in the U.S. and must consular process. Lastly, physicians who qualify for an O-1 visa may also be qualified to petition for permanent residency based on extraordinary ability, which bypasses the lengthy labor certification process (although in order to be granted permanent residency, they must address the 212(e) requirement).
In order to qualify for an O-1, a physician must be able to prove that he or she has substantial accomplishments. Most physicians who qualify under the O-1 category have publications and have played a critical role for institutions with prominent reputations. Being trained at a high level or posessing rare skills is not enough. An individual must show either a one-time achievement (such as receipt of a major internationally recognized), or satisfy at least 3 of the following criteria: - Receipt of lesser nationally and internationally recognized prizes or awards for excellence in the field of endeavor;
- Memberships in associations in the field which require outstanding achievements of their members, as judged by experts in the field;
- Published materials about the individual in professional or major trade publications, or appearance/published materials about the individual in other major media;
- Participation, either individually or as part of a panel, as a judge of the work of others in the field (including requests to serve as a reviewer for articles to be published, invitations to serve on discussion and advisory panels, etc.)
- Original scientific, scholarly, artistic, athletic or business-related contributions of major significance in the field;
- Authorship of scholarly articles in the field, as published in professional or major trade publications or in other major media;
- Display of the individual’s work in the field;
- Serving in a leading or critical role for organizations or establishments that have a distinguished reputation;
- Commanding a high salary or other significantly high remuneration for services, as compared to others in the field.
The CIS may also accept additional types of documentation of extraordinary ability if the above-mentioned factors do not readily apply to the individual’s field of expertise. For example, receipt of a prestigious and competitive medical fellowship based on excellence in the field of endeavor (not based on a proposal for future work).
A number of strong and focused letters from experts in the field serve as an advisory opinion that the individual does have a sustained reputation of extraordinary ability. It is important to show that the individual has already achieved the top level in his or her field.
O-3 visas are issued to the spouses and unmarried children of O-1 visa holders. Please note that O-3 visa holders do not have work authorization, but are permitted to study or volunteer.
[top] TNCanadian or Mexican physicians may be eligible for a TN visa if their position primarily involves teaching or research. Patient care is permitted as long as it is incidental to research or teaching duties. [top]
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Temporary Visas for Physicians 
