Medical Professionals

There are many special opportunities and additional requirements in the immigration laws for foreign medical professionals wishing to work in the United States and medical centers wishing to hire them. Most require licensing in the United States and may have special restrictions.

Physicians and H-1B Visas

Upon completion of their residency program, foreign medical graduates may obtain H-1B visas to practice in the U.S. if they have passed the FLEX, the NBME, or the USMLE examinations, and are competent in English, usually requiring taking the test given by the Educational Commission for Foreign Medical Graduates. The foreign medical graduate must also have a license to practice medicine from a foreign state and have a license/authorization to practice in the state of employment (usually requiring completing a U.S. residency program). The number of H-1B visas available every year is severely limited. However, non-profit medical centers associated with a university or other institution of higher education, or hospitals qualifying as non-profit research organizations may be cap exempt.

Physicians and Legal Permanent Residence

Medical employers can also sponsor physicians for legal permanent residence, or “green cards”, without requiring that they pass the FLEX or even obtain a state medical license. However, they must show they are unable to find a U.S. physician to fill the position through labor certification. Physicians are generally considered “second preference” workers and as such may face shorter waits before receiving permanent residence. If their work is of substantial value to the U.S. as a whole or they are of “extraordinary ability” they may also be able to skip the labor certification process or petition by themselves without an employer-sponsor.

Physicians from Foreign Medical Schools and J-1 Visas

Most foreign medical graduates (except those from Canadian schools) have to complete residencies in the U.S. to obtain state licenses to practice, a pre-requisite for most H-1B visas. Therefore, most foreign graduates enter the U.S. as J-1 trainees. Foreign medical residents on J-1 visas must then return home for two years before gaining legal permanent residence (a “green card”) or H or L visas. However, physicians may be able to obtain a waiver of this home residency requirement.

Nurses and Legal Permanent Residence

Because nurses, as well physical therapists, are officially considered in short supply, employers may sponsor them for permanent residence in the U.S. without having to go through the time-consuming labor certification process. Nurses must have a diploma from a nursing school in their home country, an RN license in their country, and either a license to practice in the state of employment or a certification by the Commission on Graduates of Foreign Nursing Schools or the National Council Licensure Examination for Registered Nurses. If a non-English speaker, the nurse must also have certain scores on the TOEFL.