Foreign health care professionals must navigate a complex regulatory regime in the U.S., which includes complex immigration issues. This is due, in large part, to the difficulties of balance training, licensing, and certification requirements with the immigration authorization required at each stage. Specific immigration requirements, procedures, or options may only apply to certain occupations or groups of occupations. Examples of these include physicians, nurses, physical therapists, speech language pathologists and audiologists, medial technologists, physician assistants, and medical technicians. For other health care professionals, (such as dentists, pharmacists, veterinarians, chiropractors, optometrists, psychologists, and health care technicians and assistants) other, less tailored, but equally complex, immigration options are available.
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Physicians intending to train or practice in the United States face some very specific immigration issues and requirements. Those seeking to practice oftentimes must undergo additional graduate medical training. Accordingly, doctors with foreign degrees often utilize the J-1 Exchange Visitor classification to complete medical residency in the United States. Other temporary visa classifications, such as the H-1B Specialty Occupation, can also be used to complete residency training or work in the medical field after completing a U.S. residency program.
As with any occupation, physicians may pursue lawful permanent residency through the employer-sponsored PERM labor certification process. Labor certification is a complex process that involves testing the U.S. labor market for qualified, able, and willing U.S. workers, before a foreign physician may be hired. However, some physicians are eligible for a National Interest Waiver (NIW), allowing physicians to bypass the labor certification process if they can demonstrate their work benefits the national interest. Physicians who can demonstrate extraordinary ability in the sciences, education, or business may be eligible to bypass both the labor certification and the sponsorship requirements in applying for permanent residency.
The representation of foreign physicians – and the hospitals and medical practices that employ them – is a complex subspecialty within the field of immigration law. Our attorneys are highly experienced with handling immigration matters for physicians. Please contact our office if you have any questions or if you wish to explore the immigration options for physicians further.
There are a few options available to nurses who wish to work temporarily or live permanently in the United States.
Lawful Permanent Residence for Nurses
In order to apply for lawful permanent residence as a nurse, you must meet several requirements, including the following:
- Possess a diploma from a nursing school in your home country or the United States.
- Pass the Commission on Graduates of Foreign Nursing Schools (CGFNS) or National Council Licensure Examination for Registered Nurses (NCLEX-RN) licensing exam, or be in possession of a “full and unrestricted” RN license. If you are already in the U.S., you may take the NCLEX exam in any state.
- Possess a VisaScreen certificate. This is issued by the CGFNS, the VisaScreen certificate demonstrates that your education, licensure, and training are equivalent to that of the U.S. and that you are competent in oral and written English. You do not need to have the certificate at the time of application, but you must have the certificate before you will be able to obtain lawful permanent residence.
- Have an employer file an immigrant visa petition for you along with a Labor Certification Application.
With regard to the labor certification application, nurses are on the Department of Labor’s (DOL) “Schedule A” – a list of shortage occupations. As a result, employers sponsoring nurses do not need to first file the labor certification application with the DOL, but rather can file it simultaneously with the visa petition to the U.S. Citizenship and Immigration Services. This cuts down significantly on the time it takes for the application to be approved, allowing the nurse to begin work much more quickly, provided that an immigrant visa number is available.
Temporary Work Visas
There are two types of temporary visas available to nurses: the Trade NAFTA (TN) Visa and the H-1B visa. It should be noted that H-1B visas are available to nurses in limited circumstances as most nurses are not required to have a four year degree. The TN Visa carries similar requirements as the H-1B, with the exception that the nurse must be a citizen of either Canada or Mexico. Also there is no annual quota on the number of TN visas that can be issued in a given year.
Immigration and Certification of Physical Therapists
Physical Therapists, like Nurses, are listed on the U.S. Department of Labor’ (DOL) list of shortage occupations, “Schedule A”. This means that the DOL has determined that there are not enough able, willing, and qualified physical therapists in the United States, and so some of the requirements for foreign physical therapists have been relaxed. Specifically, physical therapists who wish to immigrate to the United States do not have to file a labor certification with the DOL before being permitted to apply for an immigrant visa. The form must be completed, but it is filed directly with the immigrant petition. This exemption is a significant benefit to foreign physical therapists, as it greatly reduces the amount of time it takes to apply for an immigrant visa.
In order to work in the United States as a physical therapist, whether temporarily under a nonimmigrant visa such as the H-1B, or permanently through employment based immigration, as a physical therapist you must provide a special certification called a VisaScreen from an approved organization. The purpose of the certification is to verify that your training, license, experience, and English-language ability meet minimum legal standards and are comparable to that of American physical therapists. As part of the certification, you may be required to take the ETS TOEFL exam to test your English-language ability.
There are two organizations authorized to issue the certificates for physical therapists: The Commission on Graduates of Foreign Nursing Schools (CGFNS) and the Foreign Credentialing Commission on Physical Therapy (FCCPT).
Most healthcare workers must provide a special certification called a VisaScreen from an approved organization in order to work in the United States. The purpose of the certification is to verify that the healthcare worker’s training, license, experience, and English-language ability meet minimum legal standards and are comparable to that of American healthcare workers. The certification requirement applies to not only nurses and physical therapists, but also to occupational therapists, speech language pathologists and audiologists, medial technologists, physician assistants, and medical technicians.
The main organization authorized to issue the certificates for healthcare workers is the Commission on Graduates of Foreign Nursing Schools (CGFNS).