Physician’s National Interest Waivers (PNIW) can only be filed with EB2 green card petitions and are usually granted to certain physicians who qualify for the advanced degree subcategory under the EB2 green card petition. The Physician’s National Interest Waiver takes away the PERM labor certification requirement and the U.S. sponsoring employer requirement of the regular EB2 green card petitions. In other words, under the INA §203(b)(2)(B)(ii), the Physicians National Interest Waiver allows the person to self-sponsor their EB2 green card petition because it does not require a U.S. sponsoring employer or an approved PERM labor certificate.
The physicians under the EB2 Physician’s National Interest Waivers (EB2 PNIW) are treating physicians (medical doctors) who agrees to provide healthcare services in an area that is designated by the U.S. Department of Health and Human Services (HHS) as having a shortage of medical professionals, or in a facility of the U.S. Department of Veterans Affairs. These physicians under the EB2 Physician’s National Interest Waivers (EB2 PNIW) must provide a total of 5-years of full-time work as an employee in a healthcare facility or by self-employment in their own clinic.
Designated medical personnel shortage areas under the EB2 Physician’s National Interest Waivers (EB2 PNIW) can include:
- Health Professional Shortage Area (HPSA)
- Medically Underserved Area (MUA)
- Physician Scarcity Area (PSA) for specialists
- Mental Health Professional Area (MHPSA) for psychiatrists
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A person qualified for a Physician’s National Interest Waiver must first qualify for the EB2 green card petition as an advanced degree professional (i.e., usually used EB2 subcategory) or a person with exceptional ability, and then the person must agree to work in a healthcare professional shortage area (HPSA) or work for certain federal agencies such as the U.S. Department of Veterans Affairs (VA).
Advanced Degree for Physicians
A qualified treating physician (doctor) under the EB2 Physician’s National Interest Waiver must be able to show that the person (1) has a qualified advanced degree and their job requires that type of advanced degree, (2) has obtained their state license at the time when the EB2 PNIW green card petition is filed or the state license must be able to be obtained within a proximate time of entry by completing a ministerial process (e.g., the physician cannot still be looking to fulfill a residency requirement), and (3) for persons who graduated from nonaccredited medical schools, there must be a passage of Part I-II of NBMEE (National Board of Medical Examiners Examination) or Steps 1-2 of USMLE (U.S. Medical Licensing Examination) and an ECFMG certification (Educational Commission for Foreign Medical Graduates) that shows the person’s English language competency.
Foreign Equivalent Medical Degree
For a foreign medical degree to qualify as equivalent to a U.S. MD degree under the EB2 green card petition, the foreign medical degree should (1) have required a bachelor’s degree for admission to its medical school, or (2) an education credential evaluation determined it as equivalent based on the degree alone, or (3) the person has passed the Steps 1, 2, and 3 of the USMLE.
The EB2 green card petition filed with a Physician’s National Interest Waiver has two main requirements that need to be satisfied: evidence must be provided to the USCIS to show that the physician has (1) agreed to work full-time for an aggregate of 5 years in a healthcare shortage area or for the Department of Veterans Affairs, and (2) a state public health department or federal agency has made a determination that the physician’s work is in the public interest.
The physician’s aggregate of 5 years full-time work must be completed on a valid nonimmigrant visa status (i.e., time on J-1 visa status is not counted) before they can be eligible for an adjustment of status or consular processing for their EB2 PNIW immigrant visa (i.e., green card). The time spent working in a qualified visa status and shortage area (or facility) before the EB2 Physician’s National Interest Waiver was filed can be used towards the aggregated 5 years of full-time work. There is also no time limit to complete the required 5-years medical work and the medical work can be done in multiple healthcare personnel shortage areas. And, physicians can choose to practice in primary or specialty care under the EB2 Physician’s National Interest Waiver green card petition.
Green card petitions and adjustment of status applications (when the priority date becomes current) can be filed for physicians before their 5-year work is completed or even if the doctor is still within the 3-year H1B employment that is required to satisfy the 2-year foreign residence waiver of their J1 visa status (Conrad 30 Waiver). The 5-years of work do not have to be continuous and it can be aggregated which means that full-time clinical work in a shortage area or at a U.S. Department of Veterans facility in a legal visa status (e.g., H1B visa) other than a J1 visa status can be counted even if it was done before the Physicians National Interest Waiver is submitted. However, the physician still needs to satisfy the required years of work before obtaining their green card status.
Special Concurrent Adjustment of Status Application For Foreign Physicians
If the priority date is current (i.e. there is no green card visa availability backlog issue) when the foreign physician files for their EB2 green card application and Physician’s National Interest Waiver, the foreign physician can file for an adjustment of status application (Form I-485) and a EAD card (Form I-765 Employment Authorization Document) to legally work in the United States at the same time. The foreign physician can also file for an Advance Parole document (Form I-131) to travel internationally. The EAD card and Advance Parole document can be issued for 1 to 2 years at a time and can be renewed while the physician’s adjustment of status application is still pending.
Because of this special concurrent adjustment of status application situation, foreign physicians can choose to use the EAD that they received for their adjustment of status application based on this EB2 green card application to work for the required 5-year medical work. However, usually the better option would be to keep using a valid nonimmigrant visa, such as a H1B visa, while completing the required 5-year medical work.
Documents Required for EB2 Physician’s National Interest Waivers
Commonly used documents to prove that the physician is qualified under an EB2 Physicians National Interest Waiver green card petition includes but is not limited to:
- Employment contract
- If self-employed, an attestation that shows the physician’s intent to practice medicine in their solo practice
- If self-employed, usually a business plan, office lease, financing documents will be required
- Commitment letter from the U.S. Department of Veterans Affairs
- Documents that show employment in at a U.S. Department of Veterans Affairs facility, or in a U.S. Department of Health and Human Services (HHS) designated shortage area such as a Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), Medically Underserved Population (MUP), and Physician Scarcity Area (PSA)
- Letter from a federal agency or state public health department that attests that the physician’s work is in the public interest (the date of the letter must be within 6 months prior to filing the EB2 Physician’s National Interest Waiver)
- Physician’s professional credentials such as M.D., USCMLE, ECFMG, board certificates, and state medical license
- Approved Conrad Waiver §212(e) (Form I-797 Notice of Approval for J1 visa waiver)
The original statutory wording for the evidentiary requirements of the EB2 PNIW green card petitions (Physician’s National Interest Waiver) can be found in 8 CFR 204.12(c).
Documents Required After 2 Years Medical Work
The physician is required to file the additional documents listed below within 120 days after the Form I-140 has been approved for 2 years:
- Letter from U.S. employer that includes the date that the physician started to provide medical work and confirmation that the physician has worked there full-time for 2 years. Any breaks during the physician’s medical work should also be disclosed.
- Federal income tax returns, W-2 Forms
- If the physician is self-employed working for their own practice, documents can include the legal formation documents of the private practice, business license, business tax returns, tax withholding documents…etc.
Documents Required After 5 Years Medical Work
The physician is required to file the additional documents listed below within 120 days after the Form I-140 has been approved for 5 years:
- Letter from U.S. employer that includes the date that the physician started to provide medical work and confirmation that the physician has worked there full-time for 5 years. Any breaks during the physician’s medical work should also be disclosed.
- Federal income tax returns, W-2 Forms
- If the physician is self-employed working for their own practice, documents can include the legal formation documents of the private practice, business license, business tax returns, tax withholding documents…etc.
- Medical examination and vaccination record (Form I-693)
The total time an EB2 green card filed with a Physician’s National Interest Waiver (EB2 PNIW) takes is consisted of the processing time for (1) the EB2 green card petition (Form I-140 and the Physician’s National Interest Waiver) filed with the USCIS, and (2) the change of status when the person’s priority date becomes current by filing the Form I-485 application if adjusting status within the United States or the DS-260 application if doing consular processing at a U.S. consulate or embassy located outside the United States.
Factors that influence the EB2 PNIW green card petition’s processing time usually include but is not limited to where the person (or spouse) was born, if there was any Request for Evidence (“RFE”) issued, and the caseload of the USCIS service center and the U.S. consulate or embassy.
A rough estimate for the Form I-140 petition is around 6 to 12 months. Premium processing is not available for EB2 green card petitions that are filed with Physician’s National Interest Waivers.
Priority Date for Status Change
There are two parts in the processing time for a change of status: (1) the time to when the person’s EB2 PNIW green card petition priority date becomes current which can range from no wait time to multiple years depending on what country the person or their spouse was born in, and (2) the time to process Form I-485 for adjustment of status or DS-260 for consular processing which a rough estimate can range from 4 to 15 months.
After the USCIS approves the EB2 PNIW green card petition (Form I-140 and the physician’s national interest waiver), the person will then wait for their priority date to become current to apply for a change of status into a green card holder (lawful permanent resident). The priority date for EB2 PNIW green card petitions (EB2 Physician’s National Interest Waiver) is the date that the USCIS receives the immigration petition (Form I-140). For people from most countries, their EB2 PNIW green card petitions will usually have a current priority date at the time of filing (or a priority date with a relatively short wait time to become current). For people from China and India, the wait time for their priority date under an EB2 PNIW green card petition to become current is relatively long with this green card visa category.
The reason as to why there are different wait times for a priority date to become current is due to the total limit on how many green cards (immigrant visas) can be given out each year and a separate limit on how many green cards are allotted for each country. For people born in certain countries (based on country of birth and not country of citizenship) such as China or India, there is usually not enough available visas (green cards) each year due to high-volume immigration from those countries so they would have to wait for their visas (green cards) to become available which would be based on when their priority date becomes current in the monthly Visa Bulletin released by the U.S. Department of State (DOS).
Cross-Chargeability
Cross-chargeability is often used when the person’s country of birth has a visa backlog problem but the country of birth for the person’s spouse does not. The person born in the country that has a visa availability backlog problem will use the cross-chargeability rule to be charged against (use the quota of) the spouse’s country instead (this usually results in obtaining the green card much earlier). For example, a person born in China (which usually has a visa availability backlog problem) with a spouse born in South Korea (which does not have a visa availability backlog problem): both of them can use the quota of South Korea instead of China when they apply to change into their green card visa status. It does not matter which person is the primary person pursuing the green card petition.
Minor children can be charged to either parent’s country of birth, or in some circumstances the child can be charged to a third country that neither parent was born in or had residence in when the child was born. For example, both parents were born in Japan but their child was born in China during a temporary vacation there: the child can be charged against the quota of Japan. Under most circumstances, derivative beneficiaries (such as the spouse or children of green card visa applicants) cannot be eligible to apply to change into their green card visa status before the principal green card visa applicant.
Please note that parents cannot use their minor children’s country of birth under the cross-chargeability rule. For example, both parents were born in China and their child was born in Japan. The parents cannot use Japan which is their child’s country of birth and would still need to use China which is their own country of birth to wait for their green card.
The EB2 Physician’s National Interest Waiver allows the physician’s H1B visa status to extend past the 6-year limit, however, portability based on the adjustment of status application (Form I-485) cannot be used for physicians changing employers under the EB2 physician’s national interest waiver.
For physicians who changes their job to work in a different medical personnel shortage area, an amended EB2 Physician’s National Interest Waiver green card petition (Form I-140 petition and physician’s national interest waiver) must be filed, however, their original priority date can be retained.
Changing into the green card visa status (the lawful permanent resident immigrant visa status) is the final step in being able to work freely and live permanently in the United States. There are two ways to obtain the green card visa status: adjustment of status and consular processing.
Adjustment of status is usually for a person who is already in the United States with a valid nonimmigrant visa status and has maintained a lawful visa status throughout their time within the United States. On the other hand, consular processing is for a person living outside the United States or for a person who is ineligible in adjusting their status in the United States.
For a person who is residing overseas (outside the United States) or a person who is ineligible for an adjustment of status with the Form I-485 application, consular processing must be done to obtain the EB2 PNIW green card visa status (i.e., lawful permanent resident). Consular processing usually involves the person attending an in-person interview at the U.S. consulate or embassy located in their home country. In certain circumstances, a person can do consular processing in another country as a “Third Country National.”
After the interview approval at the U.S. consulate or embassy, the person would have to be admitted entry into the United States by the CBP officer at the border (usually at the airport). In other words, the person would have to physically enter the United States after their interview approval as the final step for their EB2 PNIW green card (EB2 Physician’s National Interest Waiver) visa status to be activated.
For a person who is already in the United States with a valid nonimmigrant visa, there are usually two options available to obtain the EB2 PNIW green card (EB2 Physician’s National Interest Waiver) visa status (Lawful Permanent Resident):
(1) Adjustment of Status: this is the more commonly chosen option where the person would file a Form I-485 application to adjust their status without leaving the United States. The person would attend an in-person interview at a local USCIS office in the United States and the interview approval would serve as the final step for their EB2 PNIW green card (EB2 Physician’s National Interest Waiver) visa status to be activated.
The adjustment of status application (Form I-485) can be filed when the person’s priority date becomes current in the Visa Bulletin which means that there are no backlogs in visa availability for the person’s country of birth (not country of citizenship). This can happen while the green card petition (Form I-140) is still pending (i.e., before approval) with the USCIS or after the green card petition (Form I-140) is approved by the USCIS. It can also happen in concurrent filings (Form I-140 and Form I-485 sent together) where the person’s priority date is already current at the time of filing the green card petition (Form I-140) to the USCIS.
When the adjustment of status application (Form I-485) is filed, applications for the employment authorization document (Form I-765, commonly known as the “EAD card”) and the travel document (Form I-131, commonly known as “Advance Parole”) can also be filed at the same time.
The EAD card allows unrestricted employment where a person can change their job freely and can legally work for any employer in the United States, unlike a work visa such as an H1B visa which restricts a person to work for a specific employer in the United States.
Advance parole allows a person to travel internationally while their adjustment of status is still pending. If a person has a pending adjustment of status application (Form I-485) with the USCIS but leaves the United States without advance parole and does not have a certain valid nonimmigrant visa status (H1B visa, H4 visa, L1 visa, L2 visa, K3 visa, K4 visa, V visa) that allows international travel, their adjustment of status will be considered abandoned.
(2) Consular Processing: this is usually chosen if a person cannot show that they have maintained their lawful visa status in the United States or when the processing time for consular processing is much faster than the adjustment of status.
When the EB2 PNIW green card petition (Form I-140 and the Physician’s National Interest Waiver) is approved, the person’s spouse and dependent children (unmarried and under the age of 21) may be eligible to enter the United States under the E-21 or E-22 immigrant status, respectively.
The EB2 Physicians National Interest Waiver (EB2 PNIW) is for persons who are treating physicians (medical doctors) providing healthcare services in an area that is designated by the U.S. Department of Health and Human Services (HHS) as having a shortage of medical professionals, or at a Department of Veterans Affairs facility in the United States. The physician’s work under the EB2 PNIW green card petition must be full-time and it must be for a total of 5 years in a qualified legal visa status (i.e., work done on a J1 visa does not qualify).
Evidence that a state public health department or federal agency determined the physician’s work is in the public interest and that the physician agreed to work full-time for an aggregate of 5 years in a healthcare shortage area or for the Department of Veterans Affairs must be provided under the EB2 Physicians National Interest Waiver green card petition (EB2 PNIW).
One of the main benefits of the EB2 PNIW green card petition (Physician’s National Interest Waiver) is that it does not require a PERM labor certification which means that the physician can avoid the uncertainty that a lengthy PERM labor certification usually presents in most employment-based green card petitions.
The EB2 PNIW green card petitions (Physician’s National Interest Waiver) do not require a U.S. sponsoring employer and can be self-sponsored which means that the physician can start and pay for their own green card petition.
For people who qualify for an EB2 PNIW green card petition (Physician’s National Interest Waiver), there is a possibility that the person also qualifies for an EB1 green card petition (that requires a higher standard in eligibility) which includes: (1) persons who are nationally or internationally recognized for their extraordinary ability in the sciences, arts, education, business, or athletics (EB1a green card), (2) professors or researchers who are internationally recognized as outstanding in their academic field (EB1b green card), or (3) executives or managers of multinational companies (EB1c green card). EB1 green card petitions do not require a PERM labor certification and the EB1a green card subcategory (for aliens of extraordinary ability) does not even require a specific U.S. employer for the petition just proof that the person will continue to work in their field of expertise.
Another alternative that has a slightly higher standard in eligibility for people who qualify for an EB2 PNIW green card petition (Physician’s National Interest Waiver) is the EB2 NIW green card petitions (National Interest Waiver). A national interest waiver (NIW) can be filed with an EB2 green card petition when the person qualifies for an EB2 green card and is also qualified in being able to make contributions that can substantially benefit the United States as a nation.
For people who do not qualify for the EB2 PNIW green card petition (Physician’s National Interest Waiver) yet, the other alternatives that require a similar or lower standard include: (1) EB2 green card petitions under the exceptional ability subcategory (science, art, business), (2) EB2 green card petitions under the advanced degree subcategory, (3) EB2 green card petitions under Schedule A Group II (performing art, science, art), (4) EB2 green card petitions under Schedule A Group I (professional nurses, physical therapists), or (5) EB3 green card petitions (professionals, skilled workers, other workers).
The exceptional ability EB2 green cards are for persons who have exceptional ability in the sciences, arts, or business. The advanced degree EB2 green cards are for persons who have at least a master’s degree and have a job offer for a position that requires that specific type of degree. The Schedule A Group II EB2 green cards are for persons who have exceptional ability in the performing arts, sciences, or arts. The Schedule A Group I EB3 green cards are for persons who are professional nurses and physical therapists.
The EB3 green card petition are for 3 groups of workers: professional workers, skilled workers, and other unskilled workers. Professional workers under the EB3 green card petition are required to be a member of a profession with at least a bachelor’s degree (or its foreign equivalent) and a job offer that requires a bachelor’s degree. Skilled workers under the EB3 green card petition are required to have qualifications to perform a job that requires at least 2 years of training or work experience. Other workers under the EB3 green card petition are only required to be able to perform an unskilled job that requires less than 2 years of training or work experience. Similar to EB2 green card petitions, the EB3 green card petitions also generally require a sponsoring U.S. employer and a PERM Labor Certification.
If you have an EB2 Physician’s National Interest Waiver green card (EB2 PNIW) immigration question, please fill out our contact us form or send us an email with some basic information about your background and your immigration needs. We will do our best to respond within 48 hours.
How we can help?
Kylie Huang Law’s immigration attorney will help identify whether the EB2 PNIW green card (Physician’s National Interest Waiver) is the appropriate immigrant visa category for the client’s professional background. We will work closely with our client to prepare a convincing case for their EB2 PNIW green card petition and we will also strategize on how the EB2 physician’s national interest waiver should be presented to achieve the best chances of approval. It is strongly advised and common practice to retain an immigration attorney for an EB2 PNIW green card petition (Physician’s National Interest Waiver) due to the complexities in the immigration process and visa requirements.
What does the typical process look like to retain (hire) us?
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- Fill out the form (with some basic information on what your immigration needs are)
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- Attend scheduled appointment (typically a phone call or zoom meeting)
- Retainment (signing a contract to hire us)
- Start processing case
- Gathering required documents
- Preparing paperwork
- Confirming contents of documents that will be submitted
- Filing the case
- Following up on the status of the case
- Close the case when a final determination is issued
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- Fill out the form (on what your immigration needs are)
- Sign up and log into the client portal to schedule an appointment
- Attend scheduled appointment (typically a phone call or zoom)
- Retainment (signing a contract to hire us)
- Start processing case
- Gathering required documents
- Preparing paperwork
- Confirming contents of documents that will be submitted
- Filing the case
- Following up on the status of the case
- Close the case when a final determination is issued
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- Fill out the form (on what your immigration needs are)
- Sign up and log into the client portal to schedule appointment
- Attend scheduled appointment (typically a phone call or zoom)
- Retainment (hire us)
- Start processing case
- Gathering required documents
- Preparing paperwork
- Confirming content of documents that will be submitted
- Filing the case
- Following up on the case status
- Close the case when a final determination is issued