U.S. Immigration Options for Physicians & Medical Specialists

About 23,600 openings for physicians and surgeons are projected each year between 2024 and 2034. An aging population, paired with rising rates of chronic disease, is expected to keep demand for physicians strong over the decade. Many of these openings will result from physicians retiring or otherwise leaving the profession.  

If you are a physician or medical specialist planning to work or settle in the United States, more than one immigration route may be available to you. The right one depends on your education, professional record, the type of work you plan to perform, whether an employer is involved, and your long-term goals in the United States. 

These options generally fall into four broad groups: green cards you can pursue on your own, employer-sponsored green cards, temporary work visas, and the training-and-waiver path that many international physicians follow after completing residency or fellowship. For physicians who plan to provide clinical care in underserved areas, the Physician EB-2 National Interest Waiver (NIW) can offer a path to permanent residence based on a qualifying service commitment.  

Physicians whose work focuses more broadly on medical research, healthcare innovation, public health, or improvements to healthcare delivery may instead consider the EB-2 NIW or, for those with the required level of national or international recognition, EB-1A. Temporary work visas may also provide options for physicians and other healthcare professionals who wish to work in the United States. 

Immigration Options as a Physician or Medical Specialist  

Physicians and medical specialists have several potential pathways to work and live permanently in the United States. The tables below organize the main options into three groups. 

Self-Petition Green Cards 

Pathway	Employer sponsor required?	Key feature
Physician National Interest Waiver (Physician NIW)	No	Self-petition for clinicians providing direct patient care, tied to a full-time (generally 40 hours per week), five-year commitment at a facility in a designated shortage area or at a VA facility.
EB-2 National Interest Waiver (NIW)	No	Self-petition for advanced-degree or exceptional-ability physicians whose work extends beyond direct clinical practice. Waives the job offer and labor certification.
EB-1A	No	Self-petition for physicians with sustained national or international acclaim.

Employer-Sponsored Green Cards 

Pathway	Employer sponsor required?	Key feature
EB-2 PERM	Yes	Sponsored EB-2. Employer files after PERM labor certification.
EB-1B	Yes	For academic or research physicians. Employer-filed, no labor certification, no self-petition.
EB-3	Yes	Sponsored green card. Requires a job offer and PERM labor certification.

Temporary Work Visas 

Pathway	Employer sponsor required?	Key feature
H-1B	Yes	Specialty-occupation visa. Capped, but many hospitals and universities are cap-exempt.
O-1A	Yes (employer or agent)	For physicians with extraordinary ability. No cap or lottery.
J-1	Yes (program or employer)	Training visa. Usually needs a waiver before H-1B or a green card.

Self-Petition Green Cards 

A physician can pursue these green card options without employer sponsorship. Because the physician files the petition on their own behalf, eligibility does not depend on a specific job offer or employer. For physicians who plan to provide direct patient care in underserved areas, the Physician NIW is often the most direct option because eligibility centers on a qualifying service commitment rather than requiring the physician to establish the national importance of a separate proposed endeavor. 

EB-2 National Interest Waiver (NIW) 

The EB-2 National Interest Waiver (NIW) is a green card pathway available to professionals who hold an advanced degree or demonstrate exceptional ability and whose proposed work meets the requirements for a national interest waiver. A medical degree such as an MD or DO generally satisfies the advanced-degree requirement. 

The EB-2 NIW waives two requirements that ordinarily apply to an EB-2 case: a permanent job offer and PERM labor certification. A physician can therefore self-petition without a sponsoring employer, although an employer may also file the petition. Our full EB-2 NIW guide covers the requirements and evidence in detail.  

Physicians, unlike other professions, can use the NIW in two different ways:  

Physician NIW 

It is a separate statutory route for clinical physicians who provide direct patient care in underserved areas. A physician may qualify by committing to five years of full-time clinical service in a designated Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), Mental Health Professional Shortage Area (MHPSA), or at a qualifying VA facility, and by obtaining the required public interest attestation.  

The main trade-off is timing: although the NIW petition may be approved earlier, permanent residence generally cannot be granted until the physician completes the required five years of service. USCIS sets out the terms on its Physician NIW page. 

EB-2 NIW 

While the physician-specific NIW applies to clinicians who provide qualifying service in designated shortage areas, the EB-2 NIW offers another pathway for physicians whose work does not fit that model or who do not wish to fulfill its five-year service requirement.  

This option may be appropriate for physician-researchers, medical innovators, public health experts, and other healthcare professionals advancing their fields through research, technology development, or improvements in healthcare delivery. Physicians engaged primarily in direct patient care may also qualify if their proposed work meets the standard NIW requirements. 

USCIS reviews these petitions under the three-prong standard from Matter of Dhanasar: whether the work has substantial merit and national importance, whether the physician is well positioned to advance it, and whether waiving the job offer benefits the United States. National importance depends on the significance of the work, not the size of the area it covers, so an endeavor centered on one community can still qualify. 

The choice usually depends on the nature of the physician’s proposed work. Physicians focused on research, innovation, or systems-level improvements often pursue the standard EB-2 NIW, which does not carry a five-year service requirement. Physicians who plan to provide direct clinical care in a qualifying underserved area may instead pursue the Physician NIW by committing to five years of full-time clinical service in that area. 

A U.S. medical license is not required for the standard EB-2 NIW, although appropriate licensure may help demonstrate that a physician is well positioned to carry out proposed clinical work. Several states have recently widened licensure options for internationally trained physicians. 

Both routes start with Form I-140 (Immigrant Petition for Alien Workers). Premium Processing requires USCIS to act within 45 business days, but that covers only the petition decision. The green card still depends on your priority date and country of chargeability, and physicians from high-demand countries such as India and China generally wait longer.  

EB-2 NIW Approvals for Physicians 

Below are five EB-2 NIW approvals Colombo & Hurd has secured for physicians across different areas of medicine. USCIS approved each of these petitions. 

Neurologist Expanding Alzheimer’s Care in Rural Communities 

A neurologist from Colombia built his career in Alzheimer’s disease and cognitive disorders, combining clinical neurology with public health and direct experience in rural dementia care. His proposed endeavor centers on affordable, non-pharmacological interventions that expand access to dementia care and caregiver support in underserved rural communities. 

Physician Improving Surgical Safety Through Cardiovascular Protocols 

A physician from Colombia works in perioperative and cardiovascular care, with research on cardiovascular risk and anticoagulation management in surgical patients. Her proposed endeavor applies data analytics and artificial intelligence to build technology-integrated protocols that improve perioperative risk assessment and reduce preventable complications. 

Physician Using AI to Expand Telemedicine Access 

A physician from Uruguay combines clinical practice with healthcare administration and has developed technology aimed at improving patient outcomes. His proposed endeavor uses artificial intelligence and data tools to build scalable telemedicine solutions that widen healthcare access in rural and underserved communities. 

Radiologist Focused on Cancer Prevention and Early Detection 

A physician from Peru built her career in radiology and oncology, spanning cancer screening, diagnostic support, and physician training. Her proposed endeavor focuses on cancer prevention education and early detection outreach for Spanish-speaking communities that face barriers to screening. 

Infectious Disease Specialist Advancing HIV and STI Prevention 

A physician from Venezuela specializes in infectious diseases and hospital infection control, with a record of leading infection-control programs and designing evidence-based prevention initiatives. Her proposed endeavor is to establish and advance a nonprofit organization focused on HIV and sexually transmitted infection prevention in immigrant and other high-risk communities. She brings experience in infectious diseases and hospital infection control, with a record of leading infection-control programs and designing evidence-based prevention initiatives. 

EB-1A (Extraordinary Ability) 

The EB-1A is a green card for individuals with extraordinary ability, shown through sustained national or international acclaim. Like the EB-2 NIW, a physician can self-petition, with no job offer and no labor certification.  

The EB-1A classification can be one of the fastest green card pathways for physicians who demonstrate sustained national or international recognition. As the highest employment-based preference category, EB-1 is often current for many countries of chargeability. However, visa availability is governed by the State Department’s Visa Bulletin, and backlogs may apply for certain nationalities. 

Eligibility comes from either a single major internationally recognized award or by meeting at least three of ten regulatory criteria. USCIS then weighs the full record in a final merits determination, so meeting three criteria is a starting point, not an automatic approval. Our full EB-1A guide explains the standard and the evidence.  

For physicians, the EB-1A criteria often correspond with evidence such as peer-reviewed publications and citations, awards, service as a peer reviewer or journal editor, leadership or critical roles, and recognition in the medical or scientific press. Meeting individual criteria, however, does not by itself establish eligibility. USCIS considers the evidence as a whole to determine whether the physician has reached the level of sustained national or international acclaim required for EB-1A classification. 

Premium Processing is available for the Form I-140, requiring USCIS to take adjudicative action within 15 business days. As with the EB-2 NIW, Premium Processing speeds up the petition but not the green card process itself. When permanent residence becomes available still depends on the physician’s priority date and country of chargeability. 

EB-1A Approvals for Physicians 

Below are two examples of EB-1A petitions for physicians, both approved by USCIS. 

Cancer Genetics Physician Recognized for Sustained Impact 

A physician-scientist from Colombia has spent more than 16 years in oncology and medical genetics, building and leading genetic testing programs that ensure the accuracy of hereditary cancer diagnostics used in patient care. His work continues in precision oncology, developing tools that help clinicians interpret complex genetic information for treatment decisions. 

Internal Medicine Physician Recognized for Clinical and Educational Leadership 

An internal medicine physician from Mexico brings more than 25 years across clinical care, medical education, and public health, including an outpatient treatment model adopted by other physicians and years spent teaching medical students. She continues to work in a medically underserved region while contributing to research and community health initiatives. 

Employer-Sponsored Green Cards 

These green cards need a U.S. employer to sponsor the petition. Some also require PERM labor certification through the Department of Labor. 

EB-2 PERM 

EB-2 PERM is the employer-sponsored route within the EB-2 category. Like the EB-2 NIW, it requires the physician to qualify based on an advanced degree or exceptional ability, but it follows the standard job-offer and labor-certification process rather than seeking a waiver of those requirements. 

A physician may turn to EB-2 PERM when a self-petition route is not the best fit. For example, a clinician’s work may be difficult to establish as nationally important under the standard EB-2 NIW, while the physician may not want to complete the five-year service commitment required for the Physician NIW. If a U.S. employer is willing to sponsor the physician for a permanent position, EB-2 PERM may provide another path to permanent residence. Whether it is the right choice depends on the physician’s qualifications, the position, the employer, and the expected timeline. 

The sponsoring employer generally must obtain PERM labor certification from the Department of Labor before filing Form I-140. Because the process is tied to the sponsoring employer and offered position, some physicians pursue a self-petitioned EB-2 NIW at the same time to preserve an independent path to permanent residence. 

PERM processing currently extends well beyond a year and does not offer Premium Processing. Once the labor certification is approved and the employer files Form I-140, however, Premium Processing is available for the I-140 petition. 

Our comparison of EB-2 PERM and the EB-2 NIW lays out where they differ.  

EB-1B (Outstanding Professor or Researcher) 

EB-1B, the outstanding professor or researcher category, skips PERM labor certification but cannot be self-petitioned. A U.S. employer must offer a qualifying research or teaching position, such as medical school faculty or a physician-researcher role, and file Form I-140.  

It generally calls for at least three years of teaching or research experience and international recognition in the field. Our comparison of EB-1A and EB-1B explains where the two diverge. 

EB-3 (Employment-Based Third Preference) 

EB-3, the employment-based third preference, is a sponsored green card that requires a permanent job offer and PERM labor certification, and it cannot be self-petitioned. Since most physicians meet the higher EB-2 threshold on their degree, EB-3 is a less common physician route, though it can apply in specific situations depending on the role. Our look at EB-2 NIW versus EB-3 sets out the trade-offs.  

Temporary Work Visas 

These nonimmigrant visas grant temporary work authorization. They do not lead to permanent residence on their own, though some can be held while a green card case moves separately. 

H-1B (Specialty Occupation) 

The H-1B is a temporary visa for specialty occupations, meaning positions that normally require at least a bachelor’s degree in a specific field, and many physician positions qualify. A U.S. employer sponsors the physician by filing Form I-129, Petition for a Nonimmigrant Worker. 

Most H-1B petitions are subject to an annual cap and, when registrations exceed the available numbers, a selection process. Certain employers are cap-exempt, including institutions of higher education, qualifying nonprofit organizations affiliated with them, nonprofit research organizations, and governmental research organizations. These employers can generally sponsor H-1B workers without going through the annual cap selection process. 

Physicians coming to the United States to perform direct patient care must also meet additional H-1B requirements. Depending on the position and the physician’s background, these may include ECFMG certification, the required medical licensing examinations, and authorization under state law to practice medicine in the state where they will work. 

Because the H-1B permits dual intent, many physicians file an EB-2 NIW self-petition while on H-1B to gain independence from a single employer. H-1B rules and fees have shifted recently, so confirm current requirements on the USCIS H-1B page. Our H-1B resource answers common questions. 

O-1A (Extraordinary Ability) 

The O-1A is a temporary visa for individuals with extraordinary ability. A U.S. employer or agent must file it, so a physician cannot self-petition directly, although a physician who sets up a U.S. business entity may have that entity file. Unlike the H-1B, there is no cap and no lottery.  

It suits physicians with a documented record of national or international recognition, and whether a given physician meets the standard depends on the evidence in the case. Our O-1 guide for healthcare professionals covers how the standard applies in medicine. 

J-1 and the Path Through a Waiver 

Many international medical graduates complete U.S. residency or fellowship training in J-1 exchange visitor status. Physicians who enter the United States for graduate medical education or training in J-1 status are generally subject to the two-year home-country physical presence requirement under Section 212(e) of the Immigration and Nationality Act. Before becoming eligible for certain immigration benefits, including H-1B status or permanent residence, they generally must satisfy that requirement or obtain a waiver. 

The best-known waiver route for physicians is the Conrad 30 program, which allows each state to recommend waivers for up to 30 qualifying J-1 physicians each year. In return, the physician generally must agree to work full time for at least three years in H-1B status at a qualifying healthcare facility serving an underserved area or patient population. 

One timing note: the Conrad 30 program’s statutory authorization lapsed on October 1, 2025, and reauthorization is pending in Congress. Physicians who held J-1 status on or before September 30, 2025, may still fall under it, while eligibility for newer entrants depends on whether Congress renews the program. Confirm the current status on the USCIS Conrad 30 waiver page before planning around it.  

How These Pathways Fit Together 

These routes are not always an either-or choice. A physician pursuing a Physician NIW based on a qualifying service commitment may later qualify for an EB-2 NIW or EB-1A as their career develops, particularly if their work expands into research, medical innovation, public health, or broader improvements in healthcare delivery. Depending on the circumstances, physicians may also pursue more than one immigrant petition at the same time. 

A frequent question for physicians is how a temporary visa and a green card can fit into a single immigration plan. One common strategy pairs an EB-2 NIW self-petition with H-1B status or an employer-sponsored green card process. Because the NIW does not depend on continued sponsorship from a particular employer, it can provide greater flexibility if the physician later changes jobs. 

Another strategy uses H-1B or O-1A status to authorize employment while the physician continues developing a professional record that may later support an EB-1A or EB-2 NIW petition. Research publications, citations, peer review, leadership roles, medical innovations, and evidence that others have adopted or relied on the physician’s work may become relevant as that record develops. Whether to pursue these options together or in sequence, and in what order, depends on the physician’s qualifications, immigration status, career plans, and long-term goals. 

Frequently Asked Questions 

Can a physician get a green card without an employer? 

Yes. Physicians who qualify under the EB-2 NIW, the Physician NIW, or EB-1A may self-petition without employer sponsorship. Which option is available depends on the physician’s qualifications, proposed work, and, for the Physician NIW, whether they will complete the required service commitment. 

What is the difference between the Physician NIW and the EB-2 NIW? 

Both are NIW routes within EB-2, and both waive the job offer and PERM labor certification requirements. The EB-2 NIW requires the physician to satisfy the three-prong test under Matter of Dhanasar, including showing that the proposed endeavor has substantial merit and national importance. This route can fit physicians working in research, medical innovation, public health, healthcare delivery, or qualifying clinical work.  

The Physician NIW follows a separate statutory standard based on five years of full-time clinical service in a designated shortage area or at a qualifying VA facility, along with the required public interest attestation. Although the Physician NIW petition may be approved earlier, permanent residence generally cannot be granted until the required service is complete. 

Does the EB-2 NIW require a physician to work in an underserved area? 

The EB-2 NIW does not. National importance depends on the significance and prospective broader impact of the proposed work, not simply the geographic area where the physician works. The five-year service requirement in a designated shortage area applies to the Physician NIW, not the EB-2 NIW. 

Can a physician on H-1B self-petition for a green card? 

Yes. H-1B classification permits dual intent, so a physician can maintain H-1B status while pursuing an EB-2 NIW or EB-1A self-petition. This can give physicians an independent path to permanent residence that does not depend on continued sponsorship from a particular employer. 

How long does the EB-2 NIW process take for physicians? 

The EB-2 NIW process begins with Form I-140. With Premium Processing, USCIS must take adjudicative action on the I-140 within 45 business days. Premium Processing does not accelerate the later green card stage, which depends on visa availability based on the physician’s priority date and country of chargeability. Physicians chargeable to countries with significant visa backlogs, particularly India and China, may face substantially longer waits. 

What is the difference between the EB-1A and the EB-2 NIW for physicians? 

Both can be self-petitioned without a job offer or PERM labor certification. The main difference is the legal standard. EB-1A requires extraordinary ability demonstrated through sustained national or international acclaim and recognition that the physician is among the small percentage who have risen to the very top of the field. The EB-2 NIW requires the physician first to qualify for EB-2 as an advanced-degree professional or person of exceptional ability and then satisfy the three-prong NIW under Matter of Dhanasar. Which category fits, if either, depends on the physician’s qualifications, proposed work, and supporting evidence. 

Is the Conrad 30 waiver available right now? 

The Conrad 30 program’s statutory authorization expired on October 1, 2025, and legislation to extend the program remains pending in Congress. However, the expiration does not affect all J-1 physicians in the same way, as eligibility may depend on when the physician entered or acquired J-1 status. Because the program’s availability is subject to congressional action and individual circumstances, physicians considering this route should confirm the current rules on the USCIS Conrad 30 waiver page before proceeding. 

Next Steps

If you are exploring your immigration options as a physician or medical specialist, an immigration attorney can look at your degree, your credentials, and the work you plan to do, then explain how each route compares for you.   

Colombo & Hurd works with physicians and medical specialists on the EB-2 NIW and other employment-based petitions. Schedule a free eligibility evaluation to see which visa fits your profile.  

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