NATIONAL INTEREST WAIVERS FOR PHYSICIANS TO DELIVER MEDICAL
SERVICES IN DESIGNATED SHORTAGE AREAS
A physician who intends to practice full-time in an area designated by the Secretary
of Health and Human Services (HHS) as having a shortage of health care professionals,
or in a facility operated by the Department of Veteran Affairs (VA), for the period
fixed by statute, may obtain a national interest waiver (NIW). For most cases,
the required period of service is five (5) years. The U.S. Citizenship and Immigration
Services (USCIS) will credit the time a physician served in a qualifying capacity
in shortage areas and in VA facilities prior to the approval of the Form I-140
if: (1) the physician was in lawful status (other than J-1 nonimmigrant status)
at the time of service and (2) the physician is able to provide a public interest
letter from the state department of health or VA certifying that the medical service
provided by the physician was or is in the public interest. Additionally, the
physician must show that, at least at the time the work was commenced, the work
was in an HHS-designated shortage area or VA facility.
Applicants who decide to change job locations and/or employers after obtaining
the NIW approval will need to submit a new I-140 Petition and provide evidence
that their proposed work at a new site and/or with a new employer continues
to be “in the public interest.”
Based on a recent memorandum dated January 23, 2007, the USCIS has stated that
NIW processing will be available for physicians in primary care and specialty
care. Primary care medicine is defined as family or general medicine, pediatrics,
general internal medicine, obstetrics/gynecology, and psychiatry. A specialty
physician is defined as other than a general practitioner, family practice practitioner,
general internist, obstetrician or gynecologist. Dentists, chiropractors, podiatrists,
and optometrists do not qualify for a National Interest Waiver.
Applicants must provide to the USCIS the following documents when submitting
the I-140 petition:
1. An employment contract covering the requisite five (5) year clinical service
in an HHS designated area or in a VA facility, which must be dated within
six (6) months of the filing of the I-140 petition;
2. Letter from HHS, VA, another federal agency or a State Department of Health
attesting that they have knowledge of the physician’s qualifications
and that the physician’s work is “in the public interest”,
which also must be dated within six (6) months of the filing of the I-140
petition. This certification must explicitly cover any past periods of employment
that the physician wishes to have credited towards his or her service requirement,
and must make a present statement for purposes of qualifying further medical
service employment. Additionally, the physician must show that, at least at
the time the work commenced, the work was in an HHS-designated shortage area
or VA facility;
3. Evidence that the physician has a license required by the state of intended
employment.
Statutory provisions state that physicians on valid H-1B status who obtained
a J-1 waiver may apply for adjustment of status (I-485) immediately upon filing
the I-140 NIW application, but must complete the J-1 Waiver requirements on
a valid H-1B. Physicians who were never on J-1 status are eligible to apply
for adjustment of status (I-485) immediately upon filing the I-140 NIW application.
Thereafter, the applicant may obtain an employment authorization document
(EAD) and will no longer need to rely on a non-immigrant visa to work in the
U.S. Upon completion of the service requirements listed above, the applicant
must submit evidence that he/she has completed their requisite years of service,
and the USCIS may thereafter adjust the applicant’s status to that of
permanent resident.
| 
