Your Complete Guide to National Interest Waivers and EB1 Green Cards

H-1B Visa Options and Requirements for Doctors

H-1B Visas for Physicians

Foreign medical graduate physicians may utilize the H-1B visa category if they are performing research or teaching or providing direct patient care as a medical doctor. A physician may also obtain an H-1B visa by participating in a residency program.

Most physicians enter the United States on a J1 visa for their graduate medical training. After completing their training, the doctor must return home for two years pursuant to Section 212(e) of the Immigration and Nationality Act. However, if they obtain a waiver of the two year home country residency requirement, they may apply for an H-1B visa. Many J1 waivers, such as the Conrad 30 waiver, ARC waiver, DRA waiver and VA waiver, require the doctor to work for three years at the designated facility under the terms specified by the interested agency or by law. Consequently, the physician must apply for an H-1B visa to work lawfully for the three year period. If the physician works for a non-profit or public institution (or a VA facility), he or she is also not subject the 65,000 numerical H-1B cap. At the end of the three year period, the physician may apply for lawful permanent residency. It is important to note that if the physician violates the terms of their employment as specified by the waiver during the three year period, the physician will become subject to the two-year home country residency requirement.


insignia.jpgClinical Physicians and Residency Program Participants

In order for a clinical physician or a graduate medical trainee (in a residency program) to qualify for H-1B status, the physician must meet the following standard H-1B requirements, licensure and credential requirements as specified below:


Standard H-1B visa requirements apply to Physicians:

  • The position must be a specialty occupation. By definition doctors fall within the regulatory definition of a “specialty occupation.”

  • The hospital, private practice or public health care institution must pay the doctor the prevailing wage as set forth in the Department of Labor’s (DOL) regulations.

  • The employer must file an H-1B petition on behalf of the doctor, and the doctor must work for the petitioning employer pursuant to the terms of the approved H-1B status. The doctor may work part-time for more than one hospital if each hospital petitions the physician. Of course, it should be noted that if the doctor obtained a J1 visa waiver in conjunction with the H-1B petition, part-time employment is likely not an option.

  • The employer must file a labor condition application (LCA) with the DOL. The Immigration Attorney will assist the employer in complying with the DOL’s regulatory requirements for filing the LCA.

Credentialing and Licensing Requirements for doctors providing patient care (including graduate medical trainees in a residency program):

These requirements do not apply to doctors who have graduated from U.S. medical schools or to doctors who are primarily teaching or conducting research at a public or nonprofit private educational or research institution.

  • Degree Requirement: The physician must demonstrate that he or she has a degree from an accredited medical school in the U.S. or have the foreign degree equivalent of an M.D. degree in the U.S.

  • English Competency Requirement: The physician must demonstrate competency in written and oral English examination administered by the Educational Commission for Foreign Medical Graduates (ECFMG). Canadians are not subject to the English proficiency requirement.

  • Examination Requirements: The physician must have passed the United States Medical Licensing Examination (USMLE) Parts 1, 2 and 3. The Federation Licensing Examination (FLEX) and the National Board of Medical Examiners (NBME) certifying examinations have been replaced with the USMLE. As such, the USCIS will not accept a combination of examinations for purposes of H-1B eligibility.

  • Licensing Requirement: The doctor must have an unrestricted state license which allows them to practice medicine in the state where they practice medicine or have authorization to practice medicine. Every state has unique requirements regarding post-graduate medical training, educational requirements, and licensing requirements. Doctors who have graduated from a U.S. medical school or who are internationally renowned in the field must demonstrate that they have the appropriate state license. However, these physicians do not need to demonstrate their competency in English or have passed the USMLE.

  • ECFMG: Physicians entering the U.S. to participate in medical training programs must obtain ECFMG certification. The physician must pass 4 examinations to receive certification, USMLE Parts 1 and 2, Test of English as a Foreign Language (TOEFL) and Clinical Skills Assessment (CAS).

To learn about your H-1B options contact our office at 415-986-6186 or

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Disclaimer: The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. We invite you to contact us and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established.
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