Physician H-1B Visa
H-1B Visas. The H-1B is an employer-sponsored temporary work visa for foreign professionals, allowing IMGs to live and work in the U.S. for up to six years. Some IMGs attend U.S. residency programs on H-1Bs, with the residency program acting as the sponsoring employer. In contrast to J-1 physicians, who only need USMLE Parts I and II to work as residents, IMGs with H-1B visas must have completed all three parts of USMLE, or have completed Federation Licensing Exam (FLEX) or the National Board of Medical Examiners (NBME) exam. Before filing for an H-1B, physicians must be licensed in the state of intended employment.
The employer must file a Labor Condition Application with the U.S. Department of Labor and, subsequently, an H-1B petition with USCIS. The number of persons who may be sponsored for H-1B status is limited to 65,000 annually. The numerical cap is reached earlier each year. H-1B petitions must be filed before April 1 of each year. Visas are not issued until October 1 of that year. H-1B employment is unauthorized prior to the visa issuing.
Some hospitals, university affiliated teaching hospitals and certain non-profit entities are cap exempt. Cap exempt employers can file their petition at any time throughout the year and as the employer is cap exempt the visa can be issued by USCIS shortly thereafter. The beneficiary physician can begin employment when the visa is issued.
Permanent Residence ("green card"). IMGs in H-1B status may file for permanent residence or a green card if they wish to stay in the U.S. indefinitely. There are a number of ways IMGs may obtain green cards, including the national interest waiver (NIW) and the appropriate strategy will depend on each IMG's particular circumstances. What is important to remember is that IMGs on H-1B visas must obtain green cards before the H-1B expires. If they do not, they may fall out of legal status and be unemployable.