EB-1 for Physicians: A Prescription for Success

By: Feige M. Grundman, Senior Associate of H. Ronald Klasko, ABIL Lawyer
Klasko Immigration Law Partners Blog

The EB-1 immigrant visa has generally been a challenging category for physicians, as the regulatory criteria for those in the sciences prioritizes academic research over the practice of medicine. However, this should not deter qualified physicians from applying for an EB-1 visa. The EB-1 practice team here at Klasko has been quite successful in obtaining immigrant classification for physicians in the EB-1 program’s Extraordinary Ability and Outstanding Researcher categories, having honed an approach that uses the classification’s comparable evidence clause to define the parameters of “extraordinary” and “outstanding” in a way that is tailored to each applicant’s individual situation. 
The good news is that you do not need to have developed an artificial heart or otherwise be a household name to obtain an EB-1 visa as a physician. You do, however, need to prove that your accomplishments are rare or unique in some way, and that they have furthered the area of medicine in which you practice. Even meeting the regulatory criteria to the letter does not guarantee approval of your petition. A successful petition must withstand the subjective assessment of the adjudicator’s “Overall Merits” analysis. This leaves a lot of room for taking a more creative, individually-crafted approach.

In our experience, physicians whose employers are willing to sponsor an Outstanding Researcher petition have a slight edge over those who take the self-sponsored Extraordinary Ability path, if only because the Outstanding Researcher classification has the formal sponsorship of an employer. However, there is no need to be discouraged if you don’t have employer sponsorship. Your home institution can still be a valuable ally, and most are happy to provide letters of reference that address vital EB-1 criteria even if they are not sponsoring the petition.

If you’re a physician or clinical researcher planning to pursue permanent residency through the EB-1 program, it’s important to start thinking creatively about your accomplishments and strengths and to begin gathering evidence in support of your petition. Below are some steps that you can actively take to bolster your chances of getting an approved EB-1 petition:

1. Document your influence on clinical practice. Take note of the ways in which you have advanced practice in your field, such as pioneering a medical procedure, reducing adverse events, proving that a certain procedure is under-used or over-used in a given population, or improving access to care. Your documentary evidence may include published articles, case reports, and presentations at professional gatherings. Establish professional relationships with people who are using your work to inform their own practice or research, as these professionals may make for excellent petition referees, as they can speak to the impact of your work.
2. Document any evidence-based recommendations or guidelines you’ve contributed to the field. If your influence on clinical practice has been incorporated into a formal guideline or published practice recommendation, that is a compelling piece of evidence. You do not, however, need to have influenced national practice guidelines; proving that you contributed an evidence-based recommendation to your hospital or health system, and that the recommendation is in current use, is also compelling.
3. Document the number of procedures you have performed, especially those that are challenging or rare. In addition to providing these numbers on their own, illustrate the ways in which your skills are unique and in demand in the United States or the world, backing it up with published reports or other evidence.
4. Demonstrate the ways in which you specialize in complicated or rare cases. Many physicians do not perform certain procedures but specialize in diagnosing, assessing, and managing patients with complex or rare diseases. One effective way to create documentation of your accomplishments in this area is to publish case studies.
5. Give presentations at other institutions detailing any original approaches to diagnosis or treatment you may have developed and implemented. Perhaps you’ve developed a novel or uncommon diagnostic methodology that you plan to publish. In the interim, you may want to present your methodology to the field. Giving presentations on your work at outside institutions, with the aim of educating other physicians, is an excellent opportunity to both expand your influence on clinical practice and raise your profile in the field.
6. Seek out opportunities to judge the work of others. Researchers generally provide evidence of peer review of manuscripts for scholarly journals to meet the ‘judge of the work of others’ EB-1 criterion, but physicians have room to be a little more creative. In addition to reviewing manuscripts, physicians may judge the work of others through grand rounds, through the assessment involved in teaching continuing medical education (CME) courses to peers, by serving on hospital advisory and quality assurance boards, and by training other health care professionals in a skill and evaluating the results.
7. Document the ways in which a fellowship you received or the board certification you were granted is considered prestigious. The fellowship may be prestigious because it is highly competitive or because it is at a renowned institution. A given board certification may require more experience or skill than others.

EB-1 petitions require a true partnership between you and your legal team. At Klasko, we use an in-depth client input process to gain a thorough understanding of you and your field so that we can tell your story in plain and persuasive language. For practicing physicians, preparing a strong EB-1 petition requires much more than checking off boxes on a list. A petition that clearly demonstrates the ways in which your accomplishments have had a measurable impact on your field as a whole—and made a personal difference to the patients you serve—has the best chance of success.
Click here for a case study summary of a successful EB-1 physician petition prepared by our team.