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Top 6 Alternatives to H-1B Visas for Foreign Physicians


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This educational session is designed to take the mystery out of complex immigration rules and provide you with the basic knowledge to successfully place foreign national physicians.

Watch and get an in-depth overview of the most common H-1B visa alternatives and strategies that can help you place these physicians faster.

Here's a summary of what you can expect to learn:

You'll learn about other visa options to hire qualified medical providers now.
You'll learn how some employers can avoid the H-1B cap and get H-1B visas year-round through available exemptions (“cap exemptions”)
You’ll learn about a certain loophole in the H-1B cap – the concurrent H-1B – that can let private employers
You'll learn about green card options as a viable alternative to H-1B visas

Published in: Law
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Top 6 Alternatives to H-1B Visas for Foreign Physicians

  2. 2. WELCOME NCHCR! Practice Leader Immigration Section Cowles & Thompson, PC Ann Massey Badmus Presenter
  3. 3. ? Ask questions at any time ? Use your Q&A pane at the bottom of your screen to type and send your questions. ? Questions will be answered during the presentation and during the Q & A session.
  4. 4. AGENDA H-1B Visa Overview Alternative Hiring Options Alternative Temporary Visa Options Green Card Options
  5. 5. H-1B Visa Overview
  6. 6. H-1B Nonimmigrant Visas A nonimmigrant (temporary) visa that allows a non-citizen to be employed in the United States for up to 6 years in a “specialty occupation” for a specific employer (“petitioner”).
  7. 7. What is a Specialty Occupation? An occupation that requires highly skilled specialized knowledge and A bachelor’s or higher degree (or its equivalent) in the specific specialty as a minimum for entry into the occupation
  8. 8. Employee Qualifications Have completed a U.S. bachelor’s or higher degree (or its foreign equivalent) or Have education, training, or experience in the specialty equivalent to the completion of such degree (3:1 rule) and Possess full state licensure if required to practice in the state of employment
  9. 9. H-1B Numerical Limitations - “H-1B Cap” Quota of 65,000 new H-1B visas per fiscal year (except Free Trade Act (FTA) nationals) 20,000 per fiscal year for persons who hold US Master’s degrees or higher Applies to first-time H-1B or previously cap-exempt H-1B employees
  10. 10. Alternatives to Cap-Subject H-1B Visas
  11. 11. COMMON REASONS TO LOOK FOR OTHER OPTIONS H-1B visa cap application rejected Too late to apply for H-1B cap visa H-1B maximum limit of 6 years has been reached H-1B visa application denied
  12. 12. HIRING OPTIONS – CURRENT H-1B PHYSICIANS H-1B candidates previously counted in the cap or former J-1 waiver doctors Remaining time on 6 year maximum period Check previous H-1B applications for the physicians Inside or outside the U.S. Can apply any time
  13. 13. Cap-exempt employers Universities and non-profit petitioners affiliated with post- secondary educational institutions Government research organizations and non-profit petitioners affiliated with government research institutions For-profit employers who place employee at a non-profit, university-affiliated facility for at least 50% of work week Cap-exempt beneficiaries Physicians who are beneficiaries of J-1 IGA waivers only (does not include hardship waivers or persecution waivers) HIRING OPTIONS – CAP EXEMPTIONS
  14. 14. For profit employer offers part-time employment to the provider (ranges from 5 to 60 hours/week) The start date of the H-1B must be a date before the physician’s cap- exempt H-1B expires. Concurrent H-1B petition is filed and approved before current cap-exempt employment ends. HIRING OPTIONS – CONCURRENT H-1B
  15. 15. Temporary Visa Options – Country Specific H-1B1 Chile and Singapore E-3 Australian TN Trade NAFTA E-2 Treaty Investor or Trader
  16. 16. Nationality – must be citizen of Singapore or Chile Specialty occupation and other requirements similar to H-1B Annual quota of 6,800 (1,400 professionals from Chile and 5,400 professionals from Singapore), never reached 18 month period of employment – no limit on extensions and can change to H-1B if available Dependent spouses cannot work H-1B1 Specialty Occupation Professional Visa
  17. 17. Nationality – must be citizen of Australia Specialty occupation and other requirements similar to H-1B Annual quota of 10,500, never reached Two year period of employment – no limit on extensions Spouses can work upon USCIS approval E-3 Specialty Occupation Professional Visa
  18. 18. Nationality – must be citizen of Mexico or Canada Profession must be listed on the NAFTA occupations list - 8 CFR § 214.6 – Physicians – research only with limited clinical No quota or limit on the number of TN visas each year Three year period of employment – no limit on extensions Dependent Spouses cannot work TN Trade NAFTA Professional Visa
  19. 19. Nationality – owner and employee must be citizen of treaty country – Investment must be substantial in a real, operating enterprise – e.g. medical practice Treaty investor must have controlling interest (50% or more) in the company Independent contractor Spouses can work with USCIS approval Treaty Investor (E-2) Visa Program
  20. 20. Must show sustained national or international acclaim in applicant’s field of endeavor Overall evidence must show applicant has “risen to the top of the field” Employer required and expert/peer consultation required Three year initial period of employment, unlimited extensions Dependent spouses cannot work O-1 Extraordinary Ability Visa
  21. 21. National or internationally recognized prizes or awards Membership in organizations requiring outstanding accomplishments Published materials in major or professional media about applicant’s work Judging the work of others, individually or on a panel Original contributions of major significance to the field O-1 Extraordinary Ability Visa (cont) Must meet three(3)of these criteria:
  22. 22. Authorship of scholarly articles High salary or compensation as compared to others in the field Performance in a leading or critical role for distinguished organizations Other comparable evidence O-1 Extraordinary Ability Visa (cont)
  23. 23. Temporary Visa Options – Dependent Spouses H-4 (H-1B spouse with pending green card application) E-2 dependent E-3 dependent L-2 J-2 (may require waiver)Employment Authorization Document (EAD)
  24. 24. Green Card Options
  25. 25. Employer’s application for specific physician Employer must show no available and qualified U.S. citizen or permanent resident physician through local recruitment Employer must show ability to pay prevailing wage Employee must be qualified at the time of filing of labor certification H-1B alternative: not a good option for doctors from India or China because of long delays (5 years or more) EB-2 PERM Labor certification
  26. 26. General – applies to any profession if work is in national interest (physician researchers) Physician – 5 years medical care in HPSA or MUA – specialties accepted Self-sponsored and self-employment possible – job offer not required Employment authorization document available while application is processing, for most applicants H-1B alternative: not a good option for doctors from India or China because of long delays (5 years or more) EB-2 National Interest Waiver
  27. 27. Must show sustained national or international acclaim in applicant’s field of endeavor Overall evidence must show applicant has “risen to the top of the field” Must show prospective contribution to the United States Can be self-sponsored but must show prospective employment in the U.S EB-1A Extraordinary Ability Great option for Indian doctors, if qualified
  28. 28. TIMELINE Immigrant Visa Number must be available. There are long visa backlog delays – EB-2 doctors from India or China Employment authorization available within 4 to 8 months while waiting for approval (in most cases ) Permanent Residence (green card) within 1.5 to 3 years for most (subject to fluctuation)
  29. 29. • Facts of each case are different. • Other options may be available depending upon employment circumstances. • The information provided here is general in nature and should not be relied upon for specific situations and is not legal advice. • Consult with an experienced immigration attorney to get the right advice and direction.
  30. 30. QUESTIONS?
  31. 31. THE IMMIGRATION PRESCRIPTION Step by step, this book will show you how international medical graduates can legally practice medicine in the United States. You will learn:  The various ways to waive the two- year foreign residency requirement for the J-1 visas  The best paths to permanent residence (green card) and citizenship  Your responsibilities as a legal immigrant  How to get and maintain legal immigration status for family members  And more…! For your copy and immigration updates, visit
  32. 32. FOR FURTHER INFORMATION Ann Massey Badmus 901 Main Street Suite 3900 Dallas, Texas 75202 214-672-2161