Nurses and physical therapists are able to obtain permanent residency and are not required to obtain a labor certification since there is a recognized shortage of nurses in the U.S. “Schedule A Worker Category”.
Nurses must meet a myriad of qualifications, including passing nursing exams and English tests. Specifically, in order to be eligible for permanent residency, nurses must pass the TOEFL or IELTS exam, which evaluates the nurse’s English skills.
What is a Schedule A Green Card
There are three broad categories of employment-based green cards: the EB-1, EB-2, and EB-3. The EB-2 and EB-3 green cards generally require a PERM labor certification. However, for certain specialties of healthcare services, the certification process can be bypassed. Under the U.S. immigration law, there is a special arrangement called Schedule A, which is specifically designed for health practitioners, especially nursing and physical therapy professionals.
To qualify for Schedule A, Group I processing, a nurse must be employed as a professional nurse and must hold either a Commission on Graduates of Foreign Nursing Schools (CGFNS) certificate or unrestricted license to practice professional nursing in the state of intended employment.
A schedule A occupation refers to job classifications that the U.S. Department of Labor (DOL) has designated due to the fact that that there are insufficient numbers of qualified and willing American workers available to fill these roles.
That it would also not negatively affect the wages of American workers if an employer employs a non-U.S. worker for those occupations. Qualified jobs in this category are listed on DOL’s “Schedule A” list, which gives U.S. employers the ability to employ foreign nationals for those positions without undergoing the PERM recruitment and application processes. In 2005, the Schedule A list of occupations was amended and split into Group I and Group II:
Schedule A Group I Occupations
Schedule A Group I Occupations is specifically for the following health professionals:
- Professional nurses who are licensed and possess certain educational qualifications
- Physical therapists who meet all the requirements to take the licensing examination for physical therapists in their intended state of practice in the U.S.
Other Types of Green Cards for Healthcare Professionals
Apart from the EB-2 and EB-3 Schedule A arrangements, foreign healthcare practitioners may also qualify for other green card categories without also going through the labor certification process.
EB-1 Green Card
The EB-1A category for those with extraordinary achievement is a permanent resident status granted to profoundly skilled people in their area of expertise. A candidate can demonstrate exceptional skills in one of two ways: by giving evidence in at least three of the various other categories indicated to verify qualifications or by presenting an internationally recognized award (e.g., MacArthur Foundation Fellowship, Oscar, Nobel Prize, etc.). Once in the United States, an EB-1 beneficiary must continue to work in their area of expertise.
The EB-1A petition places significant value on an individual’s achievements, so physicians who wish to apply for an EB-1A petition should start preparing evidence well in advance of submitting a petition.
Physicians who will serve as faculty in a teaching hospital can be excellent candidates for EB-1B researchers and professors. The person must have at least three years of university education or research experience and enter the United States to pursue a comparable research position at a university or other higher education institution. Here is the complete guide on the EB-1 green card requirements and processes for medical professionals.
While other subcategories of the EB-2 immigrant visa require you to either qualify for a Schedule A job or undergo the PERM labor certification process, the EB-2 combined with a National Interest Waiver does not require either. The NIW waives the job certification if it can be proven that the employee’s skills are in the national interest of the U.S.
Generally, National Interest Waiver is granted after considering the following criteria:
- Whether the foreign national’s work in the United States has substantial merit and national significance
- If the candidate is well placed to continue with the proposed work
- If the U.S. will benefit greater from waiving the PERM requirement than it would be enforcing it.
As a healthcare professional, you may qualify for the EB-2 NIW green card if you possess a graduate degree and are able to demonstrate extraordinary ability in three of the following criteria:
- Evidence that you command a salary or other compensation that demonstrates exceptional ability in your medical specialty
- The official transcript showing that you hold a diploma, degree, certificate, or similar award from a school, university, college, or other educational institution related to your field
- Recognition of your outstanding achievements and significant contributions to the medical field by colleagues, government agencies, professional, or business organizations
- License to practice or certification for the medical specialty
- Membership of professional associations
Nonimmigrant Visas for Healthcare Professionals
Apart from green cards, foreign health professionals may also qualify for nonimmigrant visas. Some of the most common visas for medical experts are as follows:
To obtain an O-1 visa, a person must demonstrate extraordinary ability in education, business, arts, athletics, or science.
An O-1 visa can be a good option for medical institutions looking to hire qualified physicians. This visa requires a significant amount of top-level credentials. For instance, the physician must demonstrate outstanding achievements through awards or publications in the medical field.
The job position must also require someone with skills and experience far above the average person in the field. The professional’s skills should be shown through consultation letters, which are detailed recommendation letters from other respected experts in the field.
While it may take some time to collect all of the documentation and evidence needed to apply for an O-1 visa, the adjudication period is relatively quick. Once everything is submitted, O-1 visas are often processed faster than the H-1B visa or most other nonimmigrant visa options. Additionally, physicians who qualify for an O-1 visa are exempt from the United States Medical License Examination (USMLE) requirement.
You may also qualify for the H-1B visa as a medical professional. Although U.S. employers cannot readily employ and obtain H-1B visas for most international medical graduates (IMGs), who are living abroad. This is because IMGs are generally mandated to complete medical residencies in the United States before they can qualify to obtain state licenses. To complete a residency program in the United States, many IMGs do enter the country on a J-1 nonimmigrant visa for exchange visitors. Medical residents who obtain J-1 status must return to their home countries or last residence for two years before reentering the U.S. as permanent residents or as H or L (intracompany transferee) visa holders.
However, many J residents obtain waivers of the two-year home residency requirement. Also, many IMGs obtain H-1B visas to pursue medical residencies. IMGs who complete medical residency programs without obtaining J-1 status are eligible to be sponsored for H-1B visas by private employers and/or for permanent residence upon completion of their programs.
How Healthcare Professionals Can Meet H-1B Visa Requirements
Before the 1990 Act of Immigration, the only way doctors came to the United States to participate in postgraduate medical training was to enter through J-1 status. But the 1990 Act removed this requirement, and for many years doctors were able to use the H-1B visa to access residency and scholarship programs.
Doctors looking for work in the United States should be aware that there are special licensing requirements and therefore should start planning before obtaining their medical degree. Due to the lottery process, getting an H-1B visa is far from guaranteed even if you have the qualifications.
You can also use an H-1B visa for healthcare professionals to participate in clinical practice or university medical training. In general, several requirements must be met, including the following:
- You must have a license or other permission needed by the state in which you will be practicing.
- You must possess an unrestrained license to practice medicine in your home country or have graduated from a foreign or the United States medical school.
- You must pass the appropriate exams.
How Our Immigration Attorneys Can Help
Here in the U.S., the healthcare industry is highly regulated. Any foreign national that wants to practice in the country must be ready to demonstrate exceptional skills in his or her specialty. Whether you are pursuing an immigrant or nonimmigrant visa, you must be thorough and detail-oriented in your visa application. To avoid red flags that can cause delays or denial, it is best to work with an experienced immigration law firm.
Here at our firm, we have a team of immigration lawyers with extensive knowledge of green card and nonimmigrant visa applications for healthcare professionals. We have a track record of helping clients obtain their visas in a timely manner. Working with us will significantly boost your chances of making your dream of working in the U.S. a reality. You can reach us and book a consultation with one of our attorneys today by filling out this contact form.