In addition to the most common medical professionals such as physicians, Nurses, Physical Therapist, there are many more.  These include:

•  Licensed practical nurse, licensed vocational nurse, or registered nurse
• Occupational therapist
• Physical therapist
• Speech language pathologist and audiologist
• Medical technologist (clinical laboratory scientist)
• Physician assistant
• Medical technician (clinical laboratory technician)
• Pharmacist

Nonimmigrant Visas for Medical Professionals

Medical Professional like many other professionals can apply for both nonimmigrant and immigrant visas.  One of the most common Nonimmigrant visas is the H-1b visa.  The H-1B categories apply to aliens coming temporarily to perform services in a specialty occupation.  There is currently a cap of 65,000 workers per year.  

Labor Condition Application
The first step to hiring most H-1B workers from outside the U.S. is for the employer to file a labor condition application (LCA) with the Department of Labor (DOL). Then the employer is required to file the LCA approval notice with the I-129 petition. For specific procedures on filing, please visit the Department of Labor’s Employment and Training Administration.

Some terms and conditions of the H-1B classification:

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  • Work authorization for H-1B foreign specialty workers is employer-specific (i.e. limited to employment with the approved employer/petitioner).
  • A change of employer requires a new H-1B petition; under some circumstances, a nonimmigrant who was previously issued an H1-B visa or provided H1-B nonimmigrant status may begin working for a new H1-B employer as soon as the new employer files a “nonfrivolous” H1-B petition for the nonimmigrant. For more information, please go to our Changes to the HB Program page.
  • Multiple employers require multiple H-1B petitions.
  • The employer is responsible for return transportation costs for an employee terminated prior to the end of the approved period of employment.
  • H-1B foreign specialty workers are not required to maintain foreign residence and may seek permanent residence in the U.S.

Green Cards for Medical Professionals

A Permanent Labor Certification for the Department of Labor (DOL) is one of the avenues which allows an employer to hire a foreign worker to work permanently in the United States.  In most instances, before the U.S. employer can submit an immigration petition to the U.S. Bureau of Citizenship and Immigration Services (BCIS), the employer must obtain an approved labor certification request (Form ETA 750) from the DOL's Employment and Training Administration (ETA).  The DOL must certify to the BCIS that there are no qualified U.S. workers available and willing to accept the job at the prevailing wage for that occupation in the area of intended employment.

The DOL, in concert with the local State Workforce Agency  (SWA), processes applications for Alien Employment Certification (Form ETA 750).  The date the labor certification application is filed with the SWA is known as the priority date. After the labor certification application is approved by the DOL, it should be submitted to the BCIS service center with an I-140, Immigrant Petition for Alien Worker.  You may access the State Department Visa Bulletin to learn which priority dates are currently being processed.

Qualifying Criteria

• The employer must hire the foreign worker as a full-time employee;
• There must be a bona fide job opening;
• Job requirements must adhere to what is customarily required for the occupation in the U.S. and may not be tailored to the worker's qualifications. In addition, the employer shall document that the job opportunity has been and is being described without unduly restrictive job requirements, unless adequately documented as arising from business necessity.
• The employer must pay at least the prevailing wage for the occupation in the area of intended employment.

Process for Filing

DOL/SWA Processing

            Normal Processing

• The employer must complete an application for Alien Employment Certification (Form ETA 750).  The application describes in detail the job duties, educational requirements, training, experience, and other special capabilities the applicant must possess to do the work, and a statement of the prospective immigrant's qualifications.
• The employer must then submit the application to the SWA responsible for the specific job location. The SWA date stamps the application when it is received (priority date) and completes a preliminary review of the application. The SWA also notifies the employer of potential problems, including if the minimum requirements for the position are reasonable and job-related, and determines that the wage offered meets minimum prevailing wage standards.
• The SWA will then work with the employer to develop a job advertisement for placement in either a journal or newspaper of general circulation in the area of intended employment (depending on the nature of the job). The ad must contain a complete description of the vacancy including job responsibilities, duties, salary, and minimum qualifications (education, training, and experience). The employer must interview all candidates who apply and meet the position requirements.
• The employer will evaluate job candidates against the job criteria (as established in Form ETA 750), and must submit a recruitment report to the SWA after applications have been received and qualified applicants interviewed. The recruitment report is a summarization of the applicants received and the candidates interviewed, including any decisions made to hire or not hire the candidates.
• If any qualified U.S. workers are identified, the SWA will inform the employer that the application will likly be denied by the Certifying Officer in the regional office.
• The information gathered by the SWA will be collated and forwarded to the regional office for review and a decision. Generally, the SWA will notify the employer when the application and all associated documents have been forwarded to the certifying officer in the regional office.
• Once the certifying officer has reviewed the recruitment report and accompanying documentation, the certifying officer will issue a final determination granting or denying the application. The DOL may require additional information, interviews or advertisement if it feels the employer has not met all conditions for certification. The DOL may issue a Notice of Findings (NOF) indicating the certifying officer's intent to deny the application and identifying all reasons for the intended denial. The NOF will also offer the employer an opportunity to rebut the NOF within 35 days. The letter will also provide guidance to the employer regarding their right to appeal the final decision.

This process can sometimes take several years depending on the state in which the job is being offered. States that are popular sites for immigrant hiring, such as New York, Texas, or California, may take much longer than states with less such activity. Click here for Processing Times.

            Reduction in Recruitment (RIR)

The "normal process" can be expedited by the use of RIR procedures. The employer must request RIR when submitting the Form ETA 750 to the SWA.

• The employer must document that it has engaged in, within the last six months, a pattern of recruitment in an effort to hire U.S. workers for the position, but has been unsuccessful in identifying qualified and available U.S. workers. The pattern of recruitment may vary depending on the nature of the occupation being requested and the labor market at the time of the job search. However, the minimum is one print advertisement and evidence of other actions taken to search the labor market. These other actions may include use of Internet, use of job markets on the Internet, participation in job fairs, use of union halls (where appropriate), participation in college job fairs, and other similar activities. • The employer must submit evidence of the pattern of recruitment to the SWA. In addition, a recruitment report must be provided of the active recruitment effort to hire U.S. workers at the prevailing wage at a minimum showing the number of U.S. workers who applied, and the reasons they were not accepted. If the certifying officer feels the pattern of recruitment is appropriate to the occupation and the labor market, the application will be approved with no need for the state to do an additional supervised recruitment process. Since supervised recruitment is the most time-consuming aspect of the permanent process, use of RIR can significantly reduce the time required in the DOL process. It is possible that the DOL phase of employment-based visas can be accomplished in under one year using the RIR process.

In either the case of normal processing or RIR, if a Form ETA 750 has been submitted but no response has been received, you may determine the status by contacting the SWA to whom the application was filed. If the SWA has informed the employer/agent that the application has been forwarded to the ETA regional office, you may find the status by contacting the appropriate regional office. Each regional office has a phone information retrieval system that allows interested parties to receive an automated response to the status of a case by using either the case number or the employer telephone number.

If the appropriate regional office approves the application, the Form ETA 750 is “certified” (stamped) by the certifying officer and returned to the employer/agent who submitted the application.

The BCIS Petition

After approval of the labor certification, the employer must file an “Immigrant Petition for an Alien Worker” with the Bureau of Citizenship and Immigration Services (BCIS), Form I-140. The employer then attaches the certified Form ETA 750 to a completed BCIS Form I-140, along with the appropriate fees, and submits the package to the appropriate BCIS Service Center. The petition is filed by the employer on behalf of the foreign worker and must include the approved labor certification and other BCIS specified documentation.

Schedule A Occupations

Schedule A is a list of occupations, set forth at Section 656.10 , for which the Department has determined there are not sufficient U.S. workers who are able, willing, qualified and available. In addition, Schedule A establishes that the employment of aliens in such occupations will not adversely affect the wages and working conditions of U.S. workers similarly employed.

The occupations listed under Schedule A include:

• Physical Therapists - who possess all the qualifications necessary to take the physical therapist licensing examination in the state in which they propose to practice physical therapy; and
• Professional Nurses - who have (i) passed the Commission on Graduates in Foreign Nursing Schools (CGFNS) Examination; or (ii) who hold a full and unrestricted license to practice professional nursing in the state of intended employment.

An employer shall apply for a labor certification for a Schedule A occupation by filing an Application for Alien Employment Certification Form ETA 750, in duplicate with the appropriate BCIS Center, NOT with the Department of Labor or a SWA.