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.

However, obtaining an H1B visa, as for all other workers, for foreign doctors and physicians, also comes with its educational requirements and other criteria.

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 trustfull immigration attorney by your side.

Contact the Herman Legal Group, a U.S. immigration law firm with over 25 years of experience representing individuals, families, and companies in all aspects of immigration law and helping them get the desired visa or become lawful permanent residents. Schedule a personal consultation with attorney Richard Herman by calling 1-800-808-4013 or 1-216-696-6170 or booking online. We nurture respectful attorney client relationship and we can conduct consultations by zoom, skype, WhatsApp, facetime, or in-office, whatever works best for you. 

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 vaiwed 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.

Now, when the Immigration and Nationality Act of 1990 medical is imposed, professionals that practice medicine and wish to engage in a clinical practice or in graduate medical training at medical schools can apply for the H-1B visa. If USCIS approves their petition, doctors and physicians can avoid the residency requirement and get the allowance to work in the U.S. for up to three years. 

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,

In case employers violate these requirements, they may face severe penalties.

The Purpose of Using H1B visa

A foreign doctors can obtain H-1B 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

Similarly, foreign physicians may utilize the H1B visa category if they will perform research or teaching or provide direct patient care as a medical doctor. A foreign physician who wants to obtain the H-1B visa status has to prove that it will be used for:

  • 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.

U.S. Immigration law requires most foreign physicians to meet various competency and licensing requirements. 

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 residencie 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 foreing 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.

Can H1B Visa holders Bring their Dependents?

A doctor or a physician holding H-1B visa status, may bring the spouse and unmarried children under 21 years of age to the U.S. on H-4 visa status. H-4 allows family members to live in the U.S. and attend school, but they cannot work until they get the work-authorized status.

However, if you wish to apply for this type of visa, it is wise to hire an immigration attorney who will asess your case and developed the winning strategy. Book your consultation with us today!

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