THIS IS THE TITLE OF THE ARTICLE (HEADING 1)€¦ · ARC waivers, 87 . Conrad program waivers, 60 . DRA waivers, 91 . H-1B visas, 14–15, 120, 135–136 . H-4 visas for family members,

401 Copyright ©2019 Alan House Publishing.

INDEX Alphabetization is word-by-word (e.g., “R visas” precedes “REAL ID Act”)

A ABMS (American Board of Medical Special-

ties), 1, 33 Academic positions

outstanding professors and researchers, 202–205

special handling of, 186 Accreditation Council on Graduate Medical

Education (ACGME), 1 Acquisitions. See Mergers and acquisitions AC21. See American Competitiveness in the

Twenty-first Century Act of 2000 ACWIA. See American Competitiveness and

Workforce Improvement Act of 1998 Adjudicator’s Field Manual (USCIS), 46, 102,

148, 169, 203 Adjustment of status

Application to Register Permanent Resi-dence or Adjust Status (Form I-485), 170–171, 227, 240

backlogged processing, 194–195, 198 change of employers while application

pending, 226–228, 239 concurrent filing for, 176, 202 consular processing vs., 171 EB-2 visas and, 194, 198 filing for, 171–173 H-4 visas for family members pending ap-

plications, 152 interviews, 171 nonimmigrant who falls out of legal status

and, 224–225 petition to adjust J-1 status to LPR, 17, 46,

54 PNIW service and time of filing for, 194

portability, 227 travel while application pending, 172–173 working while pending, 172

Administrative processing advantages of PNIW petition in cases of,

198 visitor visa applications, 26

Advertising, PERM process, 180–181 Advisory opinion on home-residency waiver,

49 Affirmative immigration obligations, 228, 231 Agriculture Department, U.S., 71 American Bar Association on unbundling of

legal services, 263 American Board of Medical Specialties

(ABMS), 1, 33 American Competitiveness and Workforce

Improvement Act of 1998 (ACWIA), 182, 186, 235

American Competitiveness in the Twenty-first Century Act of 2000 (AC21), 127, 150–151, 202, 227–228

American Immigration Lawyers Association (AILA), 259

American Medical Association (AMA) “Fifth Pathway” certificate, 2, 7 types of graduate medical training pro-

grams, 5–6

American Medical Association’s Graduate Medical Education Directory (“The Green Book”), 6

402 THE PHYSICIAN IMMIGRATION HANDBOOK, 4TH ED.

American Medical Association’s Graduate Med-ical Education Directory (“The Green Book”), 6

Appalachian Regional Commission (ARC), 63, 69–71, 79–87, 245

Appeal of hardship or persecution waiver denial,

107–108 of home-residency waiver denial, 53 of PERM labor certification denial, 189 of researcher waiver applications, 79

Application for Alien Employment Certifica-tion (Form ETA-750B), 205, 208

Application for Employment Authorization (Form I-765), 151

Application for Naturalization (Form N-400), 219

Application for Permanent Employment Cer-tification (Form ETA 9089), 179, 183, 205, 208

Application for Waiver of the Foreign Resi-dence Requirement (Form I-612), 50, 53, 101

Application for Waiver of the Two-Year For-eign Residence Requirement of the Ex-change Visitor Program (Form HHS 426), 74, 78

Application to Extend/Change Nonimmigrant Status (Form I-539), 27, 149, 151

Application to Register Permanent Residence or Adjust Status (Form I-485), 170–171, 227, 240

Application to Replace Permanent Resident Card (Form I-90), 213

ARC. See Appalachian Regional Commission Arrival Departure Record (Form I-94)

Canadian physicians, 253 expiration, 27, 148–149 grace periods, 225 H-1B status, 128 H-4 status, 151 J-1 visas, 37–38 J-2 visas, 37–38

Association of American Medical Colleges (AAMC), Electronic Residency Application Service (ERAS), 6–7

Asylum process, 106–107, 143–144, 164 Attorneys, hiring of, 257–264

AILA membership, 259 attorney’s fees, 259

bar complaints, 264 board certification in immigration law, 261 caseload issues, 260 client references, 260 communication with and availability of at-

torney, 261 conflict of interest, 221–222, 262 determining when to hire, 257–258 disciplinary action against attorney, 259–

260 educational background, 261 engagement letters, 262 ethical conduct, 263 factors to consider when hiring, 259–263 focus of practice, 260 IMG Taskforce membership, 259 immigration consultants vs. attorneys, 258 immigration-exclusive practice, 260 in J-1 waiver process, 99 lack of funds or indigent clients, 263 language skills, 263 local vs. national, 262–263 malpractice actions, 264 merger attorney to communicate with im-

migration attorney, 241 mismanagement of case, 263–264 over-promising, 262 paralegal-attorney ratio in law firms, 260 personality compatibility, 262 promotional materials and marketing, 262 publishing and authorship, 261 rankings, 261 recruiters, role of, 249 reputation of attorney, 260 technology skills, 261 unbundling of services, 263 years in practice, 260

Attorney’s fees factor in choosing attorney, 259 H-1B visas, 11, 13, 15

Automatic visa revalidation, 155

B B-1 visas. See Visitor visas Backlogged processing

EB-1, 202 EB-2, 176, 208 family sponsorship, 164 H-4, 152

INDEX Conrad 30 waivers, 55–67

Copyright ©2019 Alan House Publishing. 403

LPR status, 152 PERM cases, 176 PNIW, 198 status adjustment, 194–195, 198

“Benching” barred, 134 Board certification, 1. See also Specialties Bureau of Human Rights and Humanitarian

Affairs, 106 Buy American, Hire American (BAHA) Exec-

utive Order (2017), xxxiii

C “California Letters,” 7 Canadian physicians, 48, 141, 155, 253–255 Cap-exemption strategies, 137–145

alternatives to H-1B visas, 140–145 avoiding H-1B cap, 137–139 E-3 visas, 140–141 filing concurrent H-1B visa petition, 139–

140 H-1B1 visas, 140–141 mergers and acquisitions and, 235 TN visas, 140–141

Certificate of Eligibility for Exchange Visitor (J-1) Status (Form DS-2019)

application process, 30–31 consular processing, 156 expiration, 36 J-1 visa requirements, 13 lost forms, 52 skills, 43–44 spouses and minor children, 32–33

Change of citizenship after coming to United States, 48–49

Change of employer adjustment of status application pending,

226–228, 239 before contract is finished, 251 during green-card processing, 226–228 H-1B visas, 130, 132, 148–149 H-4 visas for family members, effect on

when H-1B makes change, 148–149 PERM labor certification, 188 PNIWs, 194

Change of status to work visa, 54, 254 Children. See also H-4 visas for family mem-

bers; J-2 visas for family members adopted children, 166

Certificate of Eligibility for Exchange Visitor (J-1) Status (Form DS-2019), 32–33

citizenship of, 219 definition of, 165–166 Form DS-2019 (Certificate of Eligibility

for Exchange Visitor (J-1) Status), 32–33 green card based on parental status, 165–

166 home-residency requirement (J-1 visa), 45.

See also J-2 visas for family members Immigrant Petition for Alien Worker

(Form I-140), 16 orphans, 166 out-of-wedlock, 165 stepchildren, 165

China backlogged in EB-2 category, 176, 208 nationals from, 48, 121, 228

Citizenship, 213–219 absence for six months to a year in five

years prior to application, 216–217 benefits of naturalization, 213–214 change of citizenship after coming to Unit-

ed States, 48–49 children’s applications, 219 comparison to lawful permanent residency

(LPR), 164 costs of naturalization, 215 ease of travel, 215 exceptions to requirements, 219 good moral character, 219 loss of home-country citizenship, 215 naturalization petition, 219 negatives of, 215 residence, definition of, 216 spouse of U.S. citizen applying for, 218–

219 U.S. citizen employed abroad, spouse of,

218–219 U.S. residence requirements, 213–215 waiver of residence requirements, 217–218

Communicable diseases denial of green card due to, 173 HIV and TB testing of Conrad program

waiver applicants, 64 Composition-of-the-family hardship, 103 Conrad 30 waivers, 55–67

contract provisions, 61–62, 355–391 costs, 60 credentials and résumé, 63–64

Consolidations. See Mergers and acquisitions


differences between state programs, 58–64 elderly patients, 62 exhaustion of state waivers, 66–67 fees, 60 filing of multiple applications, 66 flex slots, 55, 59–60, 192, 236, 355–391 funding for application from home coun-

try, 65 H-1B cap and, 65 HHS-designated shortage area, 57–58 HIV and TB testing of applicants, 64 indigent patients, 62 interested government agency (IGA) waiv-

ers vs., 70 languages, 62 letters from individuals in community, 61 limits on number of applications, 63 liquidated damages clauses, 61 local ties, 64 Medically Underserved Areas (MUAs), 55 noncompetition clauses, 61 primary care, state definition of, 355–391 primary-care physicians, 59 recruiting, 62–63, 355–391 requirements for, 55–57 scoring system to prioritize applicants, 58 self-petition by physician, 65 state chart, 355–391 state license, 66 states with federal programs, 63 subspecialties, 59, 355–391 telemedicine positions, 66 third-party employer sponsors, 64–65 timing, 58–59 types of facilities and locations eligible, 60 types of physicians, 59 wages, 62

Consolidations. See Mergers and acquisitions Consular processing of nonimmigrant visas,

155–161 adjustment of status vs., 171 Certificate of Eligibility for Exchange

Visitor (J-1) Status (Form DS-2019), 156 certified translation, 158–159 E-2 visas, 160–161 E-3 visas, 161 electronic filing, 157 family member processing, 158–159 H-1B visas, 161 H-1B1 visas, 161 J-1 visas, 35–36, 161

O-1 visas, 161 Online Nonimmigrant Visa Application

(Form DS-160), 156–158 photo requirement, 158 processing application at consulate differ-

ent than one on DS-160 form, 157 variations in, 155–156 website information, 155

Contracts for ARC waivers, 83–85 attorney input, importance of, 250 change of employer before contract is fin-

ished, 251 for Conrad program waivers, 61–62, 355–

391 for DRA waivers, 89–91 for HHS clinical waivers, 73 for J-1 visas, 17 Labor Condition Application (LCA), con-

tract restrictions, 251 mergers and acquisitions, sample transac-

tion contract language, 242–243 PNIWs, 195–196 primary-care physicians, contract require-

ments, 73, 83–85 Corporate name changes. See Mergers and

acquisitions Costs. See also Attorney’s fees

ARC waivers, 87 Conrad program waivers, 60 DRA waivers, 91 H-1B visas, 14–15, 120, 135–136 H-4 visas for family members, 151 J-1 visas, 14–15 of naturalization, 215 new I-129 filing, 235 payment of fees when hiring foreign work-

er, 251

INDEX Educational Commission on Foreign Medical Graduates (ECFMG)


D Defense Department, U.S., 100 Deference to prior decisions absent fraud or

clear error, rescission of memorandum re-quiring (2017), xxxiii–xxxiv

Delta Regional Authority (DRA), 63, 69–71, 87–93, 245

Departments. See name of specific department Deportation, 214 DHS (Homeland Security Department, U.S.),

138, 152–153 Disciplinary actions against attorneys, 259–260 Displacement of U.S. workers, 124, 230 Diversity Visa Lottery, 107, 164 Divorce

J-2 spouse, 44, 100, 111 stepparent relationship and immigration

benefits after, 165 Driver’s license of J-2 visa holders, 114 Dual intent visas, 17, 121, 147 Due-diligence checklist, immigration docu-

ments for, 241–242

E E-1 visas, 134, 223 E-2 treaty investor visas

as alternative to H-1B visa, 141–142 documents to present at U.S. consulate,

160–161 grace period, 134 layoffs, 223

E-3 visas as alternative to H-1B visa, 140–141 cap-exemption strategies, 140–141 documents to present at U.S. consulate,

161 grace period, 134 layoffs, 223

EAD. See Employment Authorization Docu-ment

Ease of travel, 215. See also Travel in and out of United States

EB-1 visas credentialing examinations, 169 extraordinary ability, 175, 227 as green-card category, 167 individual as beneficiary, 145

Neufeld memorandum, 239–240 outstanding professors and researchers,

202–205 who is included, 199–200

EB-1A visas, 199–202 EB-1B visas, 199, 204–205 EB-1C visas, 199 EB-2 visas, 205–208

adjustment of status for physicians from EB-2 backlogged countries, 194–195, 198

backlogged processing, 176, 208 credentialing examinations and, 169 as employment-based green-card category,

167 Immigrant Petition for Alien Worker

(Form I-140), 208 layoffs and, 227 LPR status and, 144–145, 167, 170 mergers and acquisitions, effect of, 239 PERM cases, 175–176 PNIW cases, 191

EB-3 visas, 145, 167 EB-4 visas, 167 EB-5 visas, 208–212

amount of investment, 210 application process, 209 eligible investments, 209–210 as employment-based green-card category,

168 evidence required, 210–211 full-time vs. part-time jobs, 211 investor involvement, 211–212 LPR status and, 168 methods of investment, 210 multiple investors, 211 qualifying businesses, 209 requirements, 209

Economic hardships, 103 Educational Commission on Foreign Medical

Graduates (ECFMG) applying for ECFMG J-1 sponsorship, 30–

31 certification, 1–5 educational requirements for certification,

4–5 electronic credentials evaluation pilot pro-

gram, 5 identification number provided by, 2, 7 J-1 visas and, 11, 29. See also J-1 visas J-2 visas for family members, ECFMG J-1

sponsorship and, 30

Elderly patients, 62


Medical Education Credentials Submission Form (Form 344), 9

Medical School Release Request (Form 345), 9

notification of hospital merger or acquisi-tion, 238

Online Applicant Status and Information System (OASIS), 7, 30–31

state requirements, 267–309 termination of employment with teaching

hospital, 222 travel in and out of United States approval,

36–37 types of medical degrees recognized, 187

Elderly patients, 62 Elective clerkship, 22 Elective positions, eligibility for, 214 Electronic Residency Application Service

(ERAS), 6–7 Electronic System for Travel Authorization

(ESTA), 20–21 Employment Authorization Document (EAD)

H-4 spouses, 150–153 J-2 spouses, 16 litigation, 152–153

Employment contracts. See Contracts Employment Eligibility Verification (Form I-

9), 114, 131 Energy Department, U.S., 100 ERAS (Electronic Residency Application Ser-

vice), 6–7 ESTA (Electronic System for Travel Authori-

zation), 20–21 Evidence standards for EB-1A visas, 201–202 Exceptional hardship, defined, 102 Exchange Visitor Waiver Review Board

(EVWRB), 74–75, 78–79 Extension of status

H-1B visas, 16, 127 H-4 visas, 149–150 J-1 visas, 53–54 J-2 visas, 114 visitor visas, 27

Extraordinary ability, 12, 142–143, 200–201. See also EB-1A visas; O-1 visas

F Falling out of legal status, 224–225 Family members. See also H-4 visas for family

members; J-2 visas for family members preference categories for, 166 quotas applied to, 166

Federal grants, 214 Federal jobs, 214 Federation of State Medical Boards (FSMB), 2 Fees. See Attorney’s fees; Costs “Fifth Pathway” certificate, 2, 7 Flowcharts

H-1Bs, 353–354 J-1 waivers, 351–352

Foreign Affairs Manual (FAM) B-1 and B-2 status, 21, 109–110 on extension of stay if waiver granted, 53 medical residency programs not mentioned

in, 21 Foreign residence requirement. See Home-

residency requirement (J-1 visa) Form 344 (Medical Education Credentials

Submission Form), 9 Form 345 (Medical School Release Request), 9 Form AR-11 (Change of Address), 213 Form DS-156E (Investor Visa, Treaty Trader

Application), 160–161 Form DS-160 (Online Nonimmigrant Visa

Application), 23–24, 156–158 Form DS-2019 (Certificate of Eligibility for

Exchange Visitor (J-1) Status) application process, 30–31 consular processing, 156 expiration, 36 J-1 visa requirements, 13, 109 lost forms, 52 skills, 43–44 spouses and minor children, 32–33

INDEX Grace period


Form DS-3035 (J-1 Visa Waiver Recommen-dation Application), 50–51, 101, 111

Form ETA-750B (Application for Alien Em-ployment Certification), 205, 208

Form ETA 9035. See Labor Condition Appli-cation

Form ETA 9089 (Application for Permanent Employment Certification), 179–180, 183, 205, 208

Form G-28 (Notice of Entry of Appearance as Attorney or Accredited Representative), 74, 91, 99

Form HHS 426 (Application for Waiver of the Two-Year Foreign Residence Requirement of the Exchange Visitor Program), 74, 76, 78

Form I-9 (Employment Eligibility Verifica-tion), 114, 131

Form I-90 (Application to Replace Permanent Resident Card), 213

Form I-94 (Arrival Departure Record) Canadian physicians, 253 expiration, 27, 148–149 grace periods, 225 H-1B status, 128, 148 H-4 status, 151 J-1 visas, 37–38 J-2 visas, 37–38, 113

Form I-94W (Nonimmigrant Visa Waiver Ar-rival/Departure Record), 20

Form I-129 (Petition for a Nonimmigrant Worker), 15, 135, 235

Form I-130 (Petition for Alien Relative), 170–171

Form I-140 (Immigrant Petition for Alien Worker)

EB-1A petitions, 202 EB-2 petitions, 208 green-card process, 170–171 H-1B extensions, 17, 127 home-residency requirement, 46 layoffs, 227–228 LPR status and, 170–171 PERM process, 176, 188–189 PNIW cases, 198 spouses and children, 16 successor employers, 239–240

Form I-485 (Application to Register Perma-nent Residence or Adjust Status), 170–171, 193, 227, 240

Form I-526 (Immigrant Petition by Alien En-trepreneur), 209

Form I-539 (Application to Extend/Change Nonimmigrant Status), 27, 110, 149, 151

Form I-612 (Application for Waiver of the Foreign Residence Requirement), 50, 53, 101–102

Form I-693 (Report of Medical Examination and Vaccination Record), 172

Form I-765 (Application for Employment Au-thorization), 113, 151

Form I-766. See Employment Authorization Document

Form I-797 (Notice of Action), 21, 51 Form IAP-66. See now Form DS-2019 (Certifi-

cate of Eligibility for Exchange Visitor (J-1) Status)

Form N-400 (Application for Naturalization), 219

For-profit hospitals, 15, 118, 138–139, 143, 236 Fraud, 26, 173, 227 Fringe benefits, 123, 229 FSMB (Federation of State Medical Boards), 2 Full-time vs. part-time jobs

EB-5 requirement to create, 211 H-1B visas, 134 PERM labor certification, 186 PNIWs, 192

G Glossary, 393–400 Governor’s role in ACR waivers, 82 Grace period

E-1 visas, 134 E-2 treaty investor visas, 134 E-3 visas, 134 following termination of employment, 225 Form I-94 (Arrival Departure Record), 225 H-1B visas, 18, 134, 225 H-1B1 visas, 134 high-skilled worker regulation, 225 J-1 visas, 39 J-2 visas, 39 L-1 visas, 134 O-1 visas, 134

Graduate medical training in United States, 1–9


TN visas, 134 Graduate medical training in United States, 1–

9 accreditation of programs, 1 Educational Commission on Foreign Med-

ical Graduates (ECFMG) role, 1–5 “Fifth Pathway” certificate, 2, 7 PERM labor certification and, 185 repeating graduate medical training, 34 USMLE, 2–5 visas for. See specific types of visas

Grant-funding, 78–79 “The Green Book,” 6 Green cards. See Lawful permanent residency

H H-1B visas, 117–136

adding or changing employers, 130 advantages and disadvantages, 14–18 alternatives to, 140–145 Arrival Departure Record (Form I-94), 128 attorney’s fees, 11, 13, 15 “benching” barred, 134 Canadian physicians, 253–254 cap/quota, xxxv, 14, 65, 106, 118–120,

132, 147, 150, 222, 235. See also Cap-exemption strategies

change from J-1 status to, 46 change in nature of employment, 133 change of employers, 130, 148–149 change of status, 27–28 conversion to J-1 status, 143 costs, 14–15, 120, 135–136 documents to present at U.S. consulate,

161 dual intent visas, 17, 121 ease of administration, 15 employer penalties, 17, 230 employment flexibility, 17–18 exam requirements, 14 faster processing fee, 135 flowchart, 353–354 for-profit hospitals, 15 full-time vs. part-time jobs, 134 grace period, 18, 134, 225 “H-1B dependency,” 229–230, 232 hardship or persecution waiver and, 105–

107 home-residency requirement compared, 12

Immigrant Petition for Alien Worker (Form I-140), 17, 127

international renown, 125–126 J-1 visas compared, 11–18 Labor Condition Application (LCA), 13,

122–125 layoffs, 223 licenses, 126–127 locum tenens positions, 246–247 lotteries, 107 mergers and acquisitions, effect of, 234–

237 multiple employers filing for same worker,

132–133 national renown, 125–126 necessary factors, 118–121 petition. See Form I-129 petitioner (institution as), 11 planning for six years, 120–121 portability, 130–132, 222–223, 226–227 post-training physicians on, 353–354 premium processing, 136 prevailing wages, 120–122 qualifying for, 124–125 quotas, 14 renown, 125–126 secondary employers and, 230 self-employed individuals, 246 60-day grace period, 18 at teaching hospitals, 122, 236 termination of employment implications,

229–231 third-party employers, 128–130 timing issues, 16–17 training periods, 14 travel outside of United States, 134 USMLE requirements, 3–4, 125–126 validity duration, 127–128 visitor visas, change of status to, 223

H-1B1 visas, 134, 140–141, 161, 223 H-4 visas for family members, 147–153

Arrival Departure Record (Form I-94), 151 backlogged processing of green cards, 152 change of employer by H-1B, effect of,

148–149 change of status to H-1B, 150 costs, 151 definition of H-4 visa, 147 dual intent visas, 147 EAD litigation, xxxv, 152–153 educational studies of, 148

INDEX Home-residency requirement (J-1 visa), 41–54


employment authorization, 150–153 extension of employment authorization,

152 extension of stay, 149–150 H-1B cap and, 147 H-1B1 spouses, 152 H-2 spouses, 152 H-3 spouses, 152 LPR status, waiting for, 152 meeting I-9 requirements for employment,

152 pending adjustment applications, 152 process for obtaining, 149 processing time for EAD, 151 proving spousal relationship, 151 status when H-1B traveling outside United

States, 148 validity duration, 147

Hardship and persecution waivers, 101–108 appeal of denial, 107–108 composition-of-the-family hardship, 103 economic hardships, 103 examples of hardship factors, 103–105 exceptional hardship, defined, 102 J-1 hardship waiver, 12, 102, 106–107 medical hardships, 104 persecution vs. asylum process, 106–107 persecution waiver, 105–107 political and security-related hardships,

104 process of seeking, 101–102 psychological hardships, 104 public policy, 105 separation for two years, 105 sociocultural hardships, 104 source of funds, 105

Health and Human Services Department (HHS)

clinical waivers, 71–75 designation of medically underserved are-

as, 57–58, 192 Exchange Visitor Waiver Review Board

(EVWRB), 74–75, 78–79 grant-funding, 78–79 locum tenens and, 245–246 Medically Underserved Areas (MUAs),

57–58, 246 primary-care physicians, HHS waivers, 72 public interest waivers, 69–71 researcher waivers, 75–79 specialties, clinical waivers, 72

waiver application requirements, 73–74 Health Professional Shortage Areas (HPSAs).

See also Conrad 30 waivers defined, 57–58 Delta Regional Authority physicians, 89 HHS clinical waivers and, 72 PNIW and, 192 state programs, 311–344

HHS. See Health and Human Services De-partment

Higher Education Act of 1965, 135 High-skilled worker regulation

adjustment portability, 227 caps, 131–132, 138–139 employment authorization criteria, 145 employment termination, 140, 225 governmental research organization, de-

fined, 139 grace period, 225

HIV and TB testing of Conrad program waiv-er applicants, 64

Homeland Security Department, U.S. (DHS), 138, 152–153

Home-residency requirement (J-1 visa), 41–54 advisory opinion, 49 appeal of waiver denial, 53–54 asylum, 107 Canadian physicians, 254 change of citizenship after coming to Unit-

ed States, 48–49 change of status to work visa, 54 commuting to work in United States, 48 defined, 41–43 denial of green card due to failure to satis-

fy, 173 extension of stay if waiver granted, 53–54 failure to satisfy, 45–46 Form DS-3035 (J-1 Visa Waiver Recom-

mendation Application), 51, 101 H-1B visa compared, 12 Immigrant Petition for Alien Worker

(Form I-140), 46 leaving United States and re-entering in

another nonimmigrant category, 46 location to satisfy requirement, 46–47 petition to adjust status to LPR, 17, 46, 54 physicians subject to, 43–45 processing time for waiver, 52–53 proving requirement has been satisfied, 47 return to home country, 47–48

Hospitals


spouse and children, 45. See also J-2 visas for family members

substantial compliance, 49 time spent in home country during J-1 pro-

gram not counted, 47 unclear whether requirement applies, 49 waiver case number, 51–52 waiver process, 50–51 working for home country in place other

than home country, 47 Hospitals

for-profit hospitals, 15, 118, 138–139, 143, 236

teaching hospitals. See Teaching hospitals types eligible for state J-1 waivers, 60

Housing and Urban Development Department (HUD), 71

HPSAs. See Health Professional Shortage Ar-eas

I IGA waivers. See Interested government agen-

cy (IGA) waivers IMED (International Medical Education Di-

rectory), 5 IMGs. See International Medical Graduates Immigrant investors, 208–212. See also EB-5

visas Immigrant Petition by Alien Entrepreneur

(Form I-526), 209 Immigrant Petition for Alien Worker (Form I-

140) EB-1A petitions, 202 EB-2 petitions, 208 green-card process, 170–171 H-1B extensions, 16, 127 home-residency requirement, 46 layoffs, 227–228 LPR status and, 170–171 PERM process, 176, 188–189 PNIW cases, 198 spouses and children, 16 successor employers, 239–240

Immigration and Nationality Act of 1952 (INA)

§204(j), 226 §212(e), 12–13, 22, 41–49, 52, 69–70, 96,

101, 111–112, 253

§214(b), 26, 33, 46 §214(l), 55–56 §248, 96 §248(a), 42 §319(b), 218

Immigration consultants, 258 Independent contractors, 246 India

backlogged in EB-2 category, 176, 208 nationals from, 121, 228

Indian Self-Determination and Education As-sistance Act, 72

Indigent patients, 62, 85–86 Insurance requirements for J-1 visas, 35 Intent to return home

J-1 visas, 33 J-2 visas, 33

Interested government agency (IGA) waivers, 69–71, 100, 351–352. See also Public inter-est waivers

Interior Department, U.S., 100 Internal medicine, 6 International Medical Education Directory

(IMED), 5 International Medical Graduates (IMGs). See

also Graduate medical training in United States; H-1B visas; J-1 visas

employment resources, 265 government resources, 265–266 IMG Taskforce, 259 locum tenens positions, 245–247 organizations involved in processing, 265 qualifying for graduate medical training, 1 websites applicable, 265–266

Investors. See E-2 treaty investor visas; EB-5 visas

Investor Visa, Treaty Trader Application (Form DS-156E), 160–161

J J-1 visas, 29–39

advantages and disadvantages, 14–18 applying for ECFMG J-1 sponsorship, 30–

31 ARC sponsorship, 81 Arrival Departure Record (Form I-94), 37–

38 Canadian physicians, 253–254

INDEX Labor Condition Application (LCA, Form ETA-9035)


Certificate of Eligibility for Exchange Visitor (J-1) Status (Form DS-2019), 13

change of specialties after arrival, 34 change of status, 27–28 contracts, 17 conversion to H-1B status, 246 conversion to J-2 status, 112 costs, 14–15 dependents, 33. See also J-2 visas for fami-

ly members documentation needed, 29, 31–32, 35–36 documents to present at U.S. consulate,

161 ease of administration, 14 ECFMG and, 2, 11, 29 employment flexibility, 17–18 exam requirements, 14 extension of status, 53–54 extension to sit for specialty board exami-

nation, 39 filing at consulate for, 35–36 foreign residence requirement upon pro-

gram conclusion, 12 Form I-94 (Arrival Departure Record), 37–

38 grace period at end of stay, 39 H-1B visa compared, 11–18 H-1B visa converted to J-1 status, 143 hardship or persecution waiver and, 12,

102, 106–107. See also Hardship and per-secution waivers

home-residency requirement, 41–54. See also Home-residency requirement

institution’s preference for, 11 insurance requirements, 35 intent to return home, 33 Labor Condition Application (LCA), 13 locum tenens positions, 245–247 maintaining status in United States, 38–39 mergers and acquisitions, effect of, 236 moonlighting, 35 primary-care physicians, J-1 waivers, 15 qualifications, 29 requirements and restrictions, 12–13 research positions, 33–34 Statement of Need, 30 termination of employment implications,

222 timing issues, 16–17 training periods, 14 travel in and out of United States, 36–37 underserved areas, 12, 17

unlawful presence policy, 38–39, 86 USMLE requirements, 4, 13 validity duration, 34 visa revalidation for certain trips outside of

United States, 37 waivers, 15–16, 51–52, 100, 352

J-1 Visa Waiver Recommendation Application (Form DS-3035), 51, 101

J-2 visas for family members, 109–115 advantages and disadvantages of H-1B and

J-1 status, 16 application process, 110–111 Arrival Departure Record (Form I-94), 37–

38 conversion to H-1B status, 112 conversion to J-1 status, 113 divorce, effect of, 44, 100, 111 driver’s license, 114 duration of status, 109 ECFMG J-1 sponsorship and, 30–31 eligible persons, 109 employment authorization, 113 extension of status, 114 family member other than spouse or minor

child, 109–110 family member qualifying for other status,

110 Form I-94 (Arrival Departure Record), 37–

38 grace period at end of stay, 39 home-residency requirement, 45, 111–112 intent to return home, 33 procedure for including dependents, 32–33 remaining in United States while J-1 trav-

els outside of United States, 115 school enrollment, 114 Social Security numbers, 114 travel in and out of United States, 36–37,

115

L L-1 visas, 12, 134, 223 Labor Certification Application (Form ETA-

9089), 205, 208 Labor Condition Application (LCA, Form

ETA-9035) contract restrictions, 251 H-1B visa and, 13, 122–125 J-1 visa and, 13

Labor Department, U.S.


mergers and acquisitions, effect of, 234–235

purpose of, 123–124 Labor Department, U.S.

Labor Condition Application, filing with. See Labor Condition Application

mergers and acquisitions, effect of, 234–235

payment of fees when hiring foreign work-er, restrictions on, 99, 120, 251

PERM process. See PERM labor certifica-tion

prevailing wage determination, 121–122 termination of employment, factors in de-

termining, 229 withdrawal of H-1B petition required to

eliminate liability for foreign worker, 132, 229

withdrawal of VA sponsorship for waiver, notice to, 99

Language skills attorney choice and, 263 Conrad 30 waivers, 62 PERM labor certification, 186

Lawful permanent residency (LPR), 163–173 as alternative to H-1B visa, 144–145 application process, 170–171 asylees and refugees, 164 backlogged process, 152 cancellation of removal, 164 categories of, 164 child, defined, 165–166 comparison to citizenship, 164 credentialing examinations for physicians

to qualify for, 168–169 defined, 163 denial of, 173 diversity immigrant visas, 164 EB-2 visas and, 144–145, 168, 170 EB-5 visas and, 168 employment-based (EB) categories, 164,

167–168 family sponsorship, 164 first preference, 165–166 fourth preference, 165, 167 green-card categories, 165 H-4 visas for family members and, 151 Immigrant Petition for Alien Worker

(Form I-140), 170–171 J-1 doctors and, 17

layoff, effect on already held LPR status, 228

layoff, effect on pending application, 226–228

legalization program, 164 license requirements, 168 lottery. See Diversity Visa Lottery mergers and acquisitions, effect on, 239–

240 methods to obtain, 163 O-1 visas and, 145 parent, defined, 165–166 per-country limits, 168 permanent residency following, 173 PERM labor certification and, 144, 170 petition to adjust J-1 status to, 17, 46, 54 PNIWs and, 144, 168 priority dates, 227–228 registry, 164 second preference, 165, 167 spillovers, 168 spouse, defined, 165–166 termination of employment, effect of, 228 third preference, 165, 167 wait time for processing, 170

Layoffs, 221–232. See also Termination of em-ployment

LCA. See Labor Condition Application Liaison Committee on Medical Education

(LCME), 29, 255 Licensing requirements by state, 9, 254, 267–

309 Liquidated damages clauses, 61, 251 Locum tenens, 245–247 Lotteries

Diversity Visa Lottery, 107, 164 H-1B visas, 107

LPR. See Lawful permanent residency

M Married couples. See also H-4 visas for family

members; J-2 visas for family members green card based on marriage, 165–166 J-2 spouse who previously had J-1 status,

45 same-sex marriages, 165

INDEX Naturalization. See also Citizenship


“The Match,” 7–9 MAVNI (Military Accessions Vital to the Na-

tional Interest) program, expiration of, xxxv

Medical clerkship, 22 Medical Education Credentials Submission

Form (Form 344), 9 Medical hardships, 104 Medically Underserved Areas (MUAs). See

also Conrad 30 waivers Conrad 30 waivers, 55 DRA, 89 HHS designations, 57–58, 246 HPSA requirement, 72 J-1 visas, 12, 17 locum tenens, 246 PNIW, 192 primary-care physicians, 57–58 state programs, 311–344 waivers, 12, 17

Medical residency programs. See also National Resident Matching Program; Teaching hospitals

Electronic Residency Application Service (ERAS), 6–7

Foreign Affairs Manual silent on, 21 July 1 as start date of, 236 licensing requirements by state, 9, 254,

267–309 “The Match,” 7–9

Medical School Release Request (Form 345), 9 Medical Student Performance Evaluations

(MSPEs), 7 Medicare, number of resident positions de-

termined by, 7 Mental Health Professional Shortage Areas

(MHPSA), 57, 89, 192, 311–344 Mergers and acquisitions, 233–243

cap-exemption strategies and, 235 determining effect of deal on immigrant

physicians, 233–234 due-diligence checklist, immigration doc-

uments for, 241–242 green-card applications, effect on, 239–240 H-1B visa holders, effect on, 234–237 immigration issues to consider, 240–241 J-1 visas, effect on, 238 sample corporate reorganization memo,

237–238 sample transaction contract language, 242–

243

successors in interest, 234–235, 239–240 timing of closing, 234 travel in and out of United States, effect

on, 241 types of deals, 234

MHPSA. See Mental Health Professional Shortage Areas

Military Accessions Vital to the National In-terest (MAVNI) program, expiration of, xxxv

Moonlighting, 35 MSPEs (Medical Student Performance Evalu-

ations), 7 MUAs. See Medically Underserved Areas Multiple employers and H-1B visas, 132–133 Multiple locations of employment, 187, 247

N NAFTA (North American Free Trade Agree-

ment), 141 National Aeronautics and Space Administra-

tion (NASA), 100 National Board of Medical Examiners

(NBME), 2 National Health Service Corps (NHSC) pro-

gram, 72 National Institutes of Health (NIH), grant-

funding, 79 National Interest Waivers (NIWs). See EB-2

visas; Physician National Interest Waivers National Prevailing Wage Center (NPWC),

181 National Resident Matching Program, 2, 4, 7–

9 National Science Foundation, 100 Native American/Alaskan Native tribal facili-

ties, HHS clinical waivers for, 71–72 Naturalization. See also Citizenship

age requirement, 215 benefits and costs of, 213–215 physical requirements for, 216 U.S. residence requirement, 216

NBME (National Board of Medical Examiners), 2


NBME (National Board of Medical Examin-ers), 2

Neufeld memorandum (Aug. 2009), 239–240 NHSC (National Health Service Corps) pro-

gram, 72 NIH (National Institutes of Health), grant-

funding, 79 NIWs (National Interest Waivers). See EB-2

visas; Physician National Interest Waivers Noncompetition clauses, 61, 251 Nonimmigrant visas. See also Consular pro-

cessing of nonimmigrant visas; E-2 treaty investor visas; J-1 visas; Visitor visas

falling out of legal status, 224–225 Form DS-160 (Online Nonimmigrant Visa

Application), 23–24, 156–158 Form I-129 (Petition for a Nonimmigrant

Worker), 15 Form I-539 (Application to Extend/Change

Nonimmigrant Status), 27, 149 leaving United States and re-entering in

another nonimmigrant category, 46 physicians coming to United States for

training, 163 Nonimmigrant Visa Waiver Arri-

val/Departure Record (Form I-94W), 20 North American Free Trade Agreement

(NAFTA), 141 Notice of Action (Form I-797), 21, 51 Notice of intent to deny (NOID), xxxiv Notice to Appear (NTA), xxxiv NPWC (National Prevailing Wage Center),

181

O O-1 visas

aliens of extraordinary ability, 142–143 documents to present at U.S. consulate,

161 EB-1A visas and, 200–201 grace period, 134 J-1 visas and, 12, 46, 96 letters of recommendation, 77–78 LPR status and, 145

Observerships, 22 Online Applicant Status and Information Sys-

tem (OASIS), 7, 30–31 Online Nonimmigrant Visa Application (Form

DS-160), 23–24, 156–158 Outstanding professors and researchers, 199,

202–205 Overstay

denial of green card due to, 173 VA waiver and, 95

P Part-time positions. See Full-time vs. part-time

jobs Patriotism, 213, 215 Penalties

H-1B violations, 17, 230 payment of fees when hiring foreign work-

er, 251 Permanent residency

Canadian physicians, 254–255 paths to achieving, 199–212. See also EB

visa headings PERM labor certification leading to, 175–

189 time after lawful permanent residency for,

173 PERM labor certification, 175–189

academic positions, special handling of, 186

adjudication process, 188 advertising requirements, 180–181 appeal of denial, 189 audits, 188 backlogged processing, 176 change of employer, effect of, 188 contacting applicants and interview pro-

cess, 184 disadvantages of, 176 EB-2 visas, 175–176 employer’s attestations, 183 failure to complete training prior to starting

position, 187 full-time vs. part-time jobs, 186 graduate medical training in United States

and, 185 hiring both qualified candidate and immi-

grant candidate, 188

INDEX Primary-care physicians


Immigrant Petition for Alien Worker (Form I-140), 176, 188–189

J-1 visas and, 17 language requirements, 186 layoffs, 226 license requirements, 168 LPR status and, 144, 170 minimum job requirements, 184–185 multiple worksites, 187 notice requirements, 180 permanent residency, leading to, 175–189 PNIW compared to, 175–176, 198 prevailing wages, 181–182 protected U.S. workers, 185 relocation of physician during process, 188 for residents and fellows, 185 rural health clinics, 177 self-employed physicians, 187 steps in process, 176–179 type of medical degree, 187 validity duration of PERM approval, 189 valid reasons to reject U.S. candidates,

183–184 wage requirements, 181–182

Persecution. See Hardship and persecution waivers

Petition for Alien Relative (Form I-130), 170–171

Petition for a Nonimmigrant Worker (Form I-129), 15, 135, 235

Physician National Interest Waivers (PNIWs), 191–198

adjustment of status before completion of service, 194

administrative processing, advantages of PNIW petition in cases of, 198

approved labor certification, 205 backlogged processing, 198 change of employers, 194 clinical work, 192 continuous service, 193–194 credit for work in shortage area prior to fil-

ing application, 193 definition of, 191 EB-2 visas, 191 employment contracts, 195–196 evidence, 206–208 five-year service requirement, 193–194 flex slots, 192 full-time vs. part-time jobs, 192 HPSAs and, 192

Immigrant Petition for Alien Worker (Form I-140), 198

J-1 three-year service and, 195 LPR status and, 144, 168 Medically Underserved Areas (MUAs),

192 new employers, 208 no limits on number allowed, 192 PERM compared with, 175–176, 198 petitioners, 205 premium processing of I-140 petitions, 197 primary-care physicians, 195 proving completion of service, 197 same government agency letter for both J-1

waiver and PNIW, 196 self-employment, 196 self-petitions, 196 shortage areas qualified for, 192 specialties, 195 sponsoring government agencies, 193 state programs, 311–344 state restrictions, 196–197

Political and security-related hardships, 104 Political contributions, 214 Portability of H-1B visas, 130–132, 222–223,

226–227 Postgraduate Training Authorization Letters

(PTALs), 7 Prevailing wages

H-1B visas, 120–122 PERM labor certification, 181–182

Primary-care physicians ARC sponsorship, 81, 86 Conrad 30 waivers, 59 definition of primary care (by state Conrad

30 program), 355–391 definition of primary care (by state NIW

program), 311–344 DRA waivers, 89, 92 employment contract requirements, 73,

83–85 graduate medical training programs, 6 HHS waivers, 72 IGA waivers, 70 J-1 waivers, 15 MUAs, 57–58 PNIW, 195

Program Electronic Review Management System. See PERM labor certification


Program Electronic Review Management Sys-tem. See PERM labor certification

Psychological hardships, 104 PTALs (Postgraduate Training Authorization

Letters), 7 Public interest waivers, 69–100

application contents for IGA waivers, 70–71

HHS, 69–71 interested government agency (IGA) waiv-

ers vs. Conrad 30 waivers, 70 rules governing interested government

agency (IGA) waivers, 69–70 Public policy waiver, 105

Q Questionnaires

for physician candidate, 249–250, 345–347 for physician employer, 249–250, 349–350

R Reciprocity of licensing, state provisions, 267–

309 Recruiting

ARC waivers, 83 Conrad program waivers, 62–63, 355–391 DRA waivers, 88 HHS clinical waivers, 73 physician expectations, 251–252 role of recruiter, 249–252 VA waivers, 94–95, 99

Refugees, 164 Report of Medical Examination and Vaccina-

tion Record (Form I-693), 172 Reputation of attorney, 260 Request for evidence (RFE), xxxiv Researcher waivers, 75–79 Research scholars

J-1 visas, 33–34 outstanding professors and researchers,

199, 202–205 Resources and websites, 265–266 Return fare, 229 Rural health clinics

HHS clinical waivers, 72 HPSA designation, 58

PERM qualifications, 177 state J-1 waivers, 60, 72

S Same-sex marriages, 165 Save Jobs USA, 152 Schooling for family members

H-4 visas, 148 J-2 visas, 114

Secondary employers and H-1B workers, 230 Security clearances for visitor visa applica-

tions, 26 Self-employed physicians

H-1B visas, 246 PERM labor certification, 187 PNIWs, 196

Self-petitions Conrad 30 waivers, 65 PNIWs, 196

Severance benefits, 224 SEVIS (Student and Exchange Visitor Infor-

mation System), 30 Shortage areas. See Health Professional Short-

age Areas; Medically Underserved Areas; Mental Health Professional Shortage Areas

SMSA (Standard Metropolitan Statistical Ar-ea), 235

SOAP (Supplemental Offer and Acceptance Program), 9

Social Security Act, 72 Sociocultural hardships, 104 Specialties

American Board of Medical Specialties (ABMS), 1, 33

board certification, 1 change of specialties after arrival (J-1), 34 Conrad program waivers, 59, 355–391 extension of J-1 visa to sit for specialty

board examination, 39 HHS clinical waivers, 72 PNIWs, 195 requirements for practice in, 5–6

INDEX United States Medical Licensing Examination (USMLE)


Spillovers, 168 Spin-offs. See Mergers and acquisitions Spouses. See Citizenship; H-4 visas for family

members; J-2 visas for family members Standard Metropolitan Statistical Area

(SMSA), 235 State chart of Conrad 30 waivers, 355–391 State Department policies

administrative processing, 26 Foreign Affairs Manual, 21 IGA waivers. See Interested government

agency (IGA) waivers medical residency programs, 21 VA waivers, 94 Visa Bulletin giving wait times by visa cat-

egories, 170 State licensing requirements, 9, 254, 267–309 Statement of Need, 30 State Physician National Interest Waiver

(PNIW) programs, 311–344 Student and Exchange Visitor Information

System (SEVIS), 30 Successors in interest, 234–235, 239–240 Supplemental Offer and Acceptance Program

(SOAP), 9

T Taxation, 214–215 TB testing of Conrad program waiver appli-

cants, 64 Teaching hospitals. See also Educational

Commission on Foreign Medical Gradu-ates; Medical residency programs

classification of residents and fellows, 122 H-1Bs at, 122, 236 July 1 as start date of residency in, 236 owned by for-profit hospital systems, 118 termination of employment with, 222

Telemedicine positions, 66 Temporary Protected Status (TPS), 143–144 Termination of employment, 221–232

change of status to visitor status, 223 employers’ consequences, 229–231 factors in determining, 229 falling out of legal status, 224–225 grace period after, 225 “H-1B dependency” and, 229–230, 232 H-1B visas, implications for, 229–231

J-1 visas, implications for, 222 LPR status, effect on, 228 notice, 221, 231 pending green card applications, 226–228 portability. See Portability of H-1B visas strategies for preventing negative immigra-

tion consequences, 231–232 unemployment compensation, eligibility

for, 224 voluntary termination, 230

Third-party employers H-1B visas, 128–130 as sponsors, 64–65

TN visas, 134, 140–141, 223 TPS (Temporary Protected Status), 143–144 Translation of documents, 5, 9, 158–159 Travel in and out of United States

adjustment of status application pending, 172–173

ECFMG and, 36–37 H-1B visa holders, 134 H-4 visa holders, 148 J-1 visa holders, 36–37 J-2 visa holders, 36–37 J-2 visa holders remaining in United States

while J-1 travels outside of United States, 115

leaving United States and re-entering in another nonimmigrant category, 46

mergers and acquisitions, effect on, 241 visa revalidation for certain trips outside

United States, 37 Tuberculosis testing of Conrad program waiv-

er applicants, 64

U Unemployment compensation, 224 United States Departments. See name of specif-

ic department United States Medical Licensing Examination

(USMLE) Bulletin of Information, 2–3 Canadian physicians, 254 fee schedule, 4 graduate medical training, 2–5 H-1B visa requirements, 3–4, 125–126 J-1 visa requirements, 4, 13 state requirements, 267–309

University professors


University professors outstanding professors and researchers,

199, 202–205

V Veterans Administration, 71 Veterans Affairs Department (VA), 69–70, 93–

99, 192, 245 Visa Bulletin, 170 Visa revalidation, 37 Visa Waiver Program (VWP), 19–21, 155 Visitor visas, 19–28

administrative processing, 26 application process, 23–24 approval of applications, 25 change of status, 27–28 denial of applications, 25–26 documents to present at U.S. consulate or

port of entry, 24–25, 159–160 Electronic System for Travel Authorization

(ESTA), 20–21 entry stamp, 27 exceptions, 19–21 extension of stay, 27 Form DS-160 (Online Nonimmigrant Visa

Application), 23–24, 156–158 Form I-94 (Arrival Departure Record), 27 Form I-539 (Application to Extend/Change

Nonimmigrant Status), 27 H-1B visa seeking change of status to, 223 interviews, 25 legitimate reasons for, 21–22 multiple entries, 21 photograph for, 23 port-of-entry interview, 27 validity duration, 21 Visa Waiver Program (VWP), 19–21, 155 wait time for processing applications, 22–

23 Voting rights, 213 VWP (Visa Waiver Program), 19–21, 155

W Wages. See Prevailing wages Waiver Review Division, 102, 105 Waivers. See also Conrad 30 waivers; Hard-

ship and persecution waivers; Interested government agency (IGA) waivers; Physi-cian National Interest Waivers; Public in-terest waivers

flowchart, 351–352 J-1 visa holders, 15–16, 51–52, 99 medically underserved community work,

12, 17

Documents

THIS IS THE TITLE OF THE ARTICLE (HEADING 1)€¦ · ARC waivers, 87 . Conrad program waivers, 60 . DRA waivers, 91 . H-1B visas, 14–15, 120, 135–136 . H-4 visas for family members,