H-1B Procedure

FMGs seeking H-1B status must comply with identical procedures applicable to other professionals seeking H-1B classification. Their employer must file a petition for H-1B status with the INS, and the petition must be supported by a labor condition application (LCA). Furthermore, once the petition is approved, the FMG must obtain a visa from a U.S. consulate prior to admission to the United States.

Alien physicians of extraordinary ability also have the option of using the O-1 nonimmigrant category. Such physicians must have sustained national or international acclaim, with extensive documentation of their achievements in the medical field. With regard to graduates of foreign medical schools who meet these standards, seeking entry in the O-1 category may be the better alternative than the H-1B category given the simpler procedures involved in obtaining O-1 status.

Canadian and Mexican physicians may also be eligible for TN status under the North American Free Trade Agreement (NAFTA). The main disadvantage in using this category, however, is that the TN physician may engage only in teaching or research and cannot engage in direct patient care; this rule applies as well to Canadian and Mexican nationals who are graduates of U.S. medical schools.

The H-1B petition for an FMG must be submitted to the INS with the following:

1. A company letter stating the specialty occupation of the beneficiary and containing a full description of the nature of the duties which the beneficiary will be performing, the anticipated length of stay and the arrangements for remuneration.
2. A copy of the LCA certified by the DOL .
3. Form I-129W.
4. Evidence that the FMG passed the Parts I and II of the Federal Licensing Examination (FLEX) or an equivalent examination (Steps 1, 2, and 3 of the U.S. Medical Licensing Examination (USMLE) or Parts I, II, and III of the National Board of Medical Examiners certifying examinations (NBME).
5. Evidence that the alien has competency in oral and written English.
6. Evidence that the resident/physician position to be filled by the FMG is a specialty occupation.
7. Evidence that the FMG has a license or authorization required by the state of intended employment, if the state requires such license or authorization.
8. Evidence that the physician has a full and unrestricted licensure to practice medicine in a foreign state or has graduated from a medical school in the United states or in a foreign state.
9. The employment contract (because a written contract is not required, a summary of an oral understanding can be substituted).
10. Evidence of the alien’s status during past six years if within U.S. during this time.
11. Filing fee.