Work Visas for Physicians and Health Care Workers

Goulder Immigration Law Firm assists health care providers with their US solutions. We have experience assisting physicians, nurses and health care providers with employment visas. US immigration law is federal law. This enables Goulder Immigration Law Firm to assist individuals and companies throughout the U.S. and around the world with work visas for physicians, nurses and health care providers.

More common visa solutions for the physicians and healthcare providers include:

• Cap-Exempt H-1B visa for physicians and researchers;
• J-1 Visa, including waiver of INS 212(e) for J-1 physicians pursuing graduate medical education;
• O-1 Extra-Ordinary Ability Visa for Physicians;
• TN Visa for Nurses and teaching/research physicians;
• National Interest Waiver (NIW) for waiver of requirement physician have a full-time job offer;
• Foreign Medical Graduate Physician and Conrad 30 Waiver.<

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North Carolina Visa Attorney for Physicians Seeking H-1B Visa

The H-1B visa category is for temporary workers in a specialty occupation; H-1B visa is often the only nonimmigrant visa category available for a US employer seeking to employ a foreign national. The H-1B employer must be seeking to fill a “specialty occupation” with a qualified foreign national. A qualified individual is one who possesses the minimum credentials necessary to practice the specialty occupation, i.e., the appropriate academic degree or the equivalent of a degree. Where US state licensure is required in order to practice the occupation without restriction, the USCIS requires the individual to possess the license before H-1B status is granted.

An H-1B employer must agree to pay the foreign national H-1B employee a requiredwage rate and agree to numerous additional H-1B employer responsibilities outlined in the employer’s DOL labor certification attestations

There is a statutory cap that limits approval of new H-1B petitions in a fiscal year and the cap is currently set at 65,000. Foreign nationals who are employed, or who have received an offer of employment, by institutions of higher education or a related or affiliated nonprofit entity, as well as those employed, or who will be employed, by a nonprofit research organization or a governmental research organization are exempt from the H-1B cap.

The H-1B petition may be approved for a maximum initial period of three (3) years and may be extended for an additional three (3) years. A foreign national’s total period of continuous stay in the U.S. may only exceed six (6) years under certain special circumstances. Petition approval authorizes the foreign national’s employment in the position and location stated on the petition.

Licensure and Educational Requirements

An H-1B petition filed on behalf of a foreign national physician must include evidence that the foreign national physician has a full and unrestricted license to practice medicine in a foreign state or has graduated from a medical school, whether in the United States or abroad. Physicians who are to perform direct patient care, need to have any license or other authorization required by the state of intended employment.

The H-1B petition must also include evidence the physician has passed the U.S. Medical Licensing Exam or has graduated from a U.S. medical school. The physician must be competent in oral and written English as demonstrated by passage of the proficiency test required by the Educational Commission on Foreign Medical Graduates. If the physician has graduated from a medical school accredited by the US DHHS, English language competency is not required.

J-1 Visa and Obtaining a Waiver of 212(e) with the assistance of a North Carolina Visa Attorney

Foreign national physicians and research scholars may be eligible for J-1 Exchange Visitor status. All foreign national physicians pursuing graduate medical education or training in J-1 status are subject to a requirement that they return to their home country (or country of last residence) for two (2) years after completing a clinical J-1 program before they may be eligible for a new US nonimmigrant or immigrant visa. In some instances, these foreign nationals may qualify for a waiver of the home residence requirement.


• There are generally four (4) methods for obtaining a waiver:
• A no objection statement from the home country;
• A finding of hardship to a U.S. citizen or Lawful Permanent Resident spouse or child if required to return for two (2) years to the home country;
• A finding that the foreign national would be persecuted if returned to the home country; and
• A request by an Interested Government Agency.


US immigration law precludes using a no objection statement as the sole basis for a waiver if the foreign national is a physician receiving graduate medical education. A waiver on the basis of a request by a state department of health in the US, its equivalent, or an interested U.S. government agency is allowed. There are certain strict requirements that must be met in connection with a waiver request by a state department of health.

North Carolina Visa Attorney for Nurse and Teaching Physician or Researcher TN Visa

The TN-1 visa category is available to Canadian and Mexican citizens for certain occupations.

A Canadian citizen may submit the appropriate paperwork to an Immigration Officer at a US port-of-entry, a US airport handling international traffic or a US pre-flight inspection station. A Mexican citizen seeking TN status must submit the appropriate paperwork to a US Embassy or Consulate in Mexico and obtain a TN visa stamp before entering the United States in TN status.

The TN category allows for an initial entry of up to three (3) years, with three (3) year extensions available.

North Carolina Visa Attorney for Physician Conrad 30 J-1 Visa Waiver

The Conrad 30 Waiver program allows J-1 medical doctors to apply for a waiver for the 2-year residence requirement upon completion of the J-1 exchange visitor program. There are a limited number of Conrad 30 waivers in each state.

The Conrad 30 waiver applies to a foreign medical graduate (or international medical graduate, IMG) who seeks an IGA Waiver, which will enable her/him to temporarily waive the J-1 visa 2-year home-country physical presence requirement. If s/he obtains this waiver, s/he can be the beneficiary of an H-1B petition by the employer who sponsored the waiver.

A foreign medical graduate who is granted the J-1 visa 2-year home-country physical presence waiver, but who does not fulfill the requisite three (3) year employment contract or otherwise comply with the terms and conditions imposed on the waiver is ineligible to apply for change of status to any other nonimmigrant classification. (The NC Conrad 30 waiver imposes a four (4) year rather than a three (3) year contract.)

Although each state has developed its own application rules and guidelines, the following program requirements apply to all J-1 medical doctors. The J-1 medical doctor must:

• Agree to be employed full-time in H-1B nonimmigrant status at a health care facility located in an area designated by U.S. Department of Health and Human Services (HHS) as a Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), or Medically Underserved Population (MUP).  
• Obtain a contract from the health care facility located in an area designated by HHS as a HPSA, MUA, or MUP
• Obtain a “no objection” letter from his or her home country if the home government funded his or her exchange program
• Agree to begin employment at the health care facility within 90 days of receipt of the waiver, not the date his or her J-1 visa expires.

The physician’s proposed employment must be in an area designated by the US DHHS as either a Medically Underserved Area and Medically Underserved Population (“MUA/MUP”) or Health Professional Shortage Area (“HPSA”).

Medically Underserved Areas/Populations are areas or populations designated by HRSA as having too few primary care providers, high infant mortality, high poverty or a high elderly population. Health Professional Shortage Areas (HPSAs) are designated by HRSA as having shortages of primary medical care, dental or mental health providers and may be geographic (a county or service area), population (e.g. low income or Medicaid eligible) or facilities (e.g. federally qualified health center or other state or federal prisons). These MUA/MUP areas are searchable on the DHHS HRSA website.

The NC Conrad 30 program (and Appalachian Regional Commission) do not grant waivers for MUAs/MUPs. If the proposed employment is at an institution in an MUA but not in an HPSA, the requirements for DHHS or other IGA waivers should be reviewed to see if that program accepts MUAs/MUPs.

Health Professional Shortage Areas (HPSAs) have shortages of primary medical care, dental or mental health providers and may be geographic (a county or service area), demographic (low income population) or institutional (comprehensive health center, federally qualified health center or other public facility). DHHS maintains a searchable database of HPSAs at the HRSA website.

If the foreign national physician received funding from his/her home country government for the medical training, s/he must obtain a no-objection letter from his/her government prior to applying for an IGA waiver.

The waiver of the 2-year home-country physical presence requirement is handled by the US Department of State. The foreign national physician must submit a Form DS-3035.

The North Carolina Conrad 30 Program requires foreign-educated primary care physicians seeking a J-1 visa 2-year home-country physical presence waiver to sign a four-year contract to work in a non-profit clinic (accepting Medicaid and Medicare) in an HPSA.

Gerald Goulder is an experienced North Carolina immigration lawyer helping individuals and businesses in North Carolina and throughout the United States and around the world with employment-based permanent residence (“green card” through employment). US immigration law is federal law. This enables Goulder Immigration Law Firm to assist individuals and companies throughout the U.S. and around the world.

If you are a physician, nurse, hospital or other health care provider seeking immigration or visa solutions for physician H-1B visa, other physician visa options, visa for health care researchers, nurse or physician TN visa options, or J-1 Visa waiver for physician through Conrad 30 program, call immigration attorney Gerald Goulder at Goulder Immigration Law Firm (336) 808-1119 or ask him a question using this online email form:

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