A National Interest Waiver (NIW) exists for physicians in Medically Underserved
Areas (MUA). Generally, if immigration is based on an employment offer
as a physician, the applicant must have an employer petitioner and obtain
a labor certification (LC) unless exempted from that requirement. Physicians
working in MUA's may qualify for a NIW and may be exempt from the
labor certification requirements. To qualify for the NIW:
- the doctor agrees to work full-time in a health shortage area or for the VA; or
- a federal agency or a state public health department determines that the
work is in the public interest;
- and the physician must work full-time for five years in authorized status
before he or she is eligible for permanent resident status.
Time in J visa status is not considered toward the five year requirement.
The physician must be pursuing the type of medical service that is the
basis for the NIW. Petitions and adjustment applications can be filed
prior to the date the five year service is completed provided that the
immigrant visa is has a currently available priority date, including during
the 3-year period of H-1B employment for the physician receiving the waiver.
To support an NIW, a physician must present with the immigrant petition:
- contract of employment or if self-employed an attestation;
- evidence of employment in a HPSA or VA and in a designated specialty by
HHS for the HPSA;
- a letter dated within 6 months of filing the petition from a federal agency
or from the department of public health of the state attesting that the
physician's work is in the public interest;
- evidence that the physician meets the admissibility requirements of INA
regarding USMLE; and
- waiver of the home residency requirement if needed.
A physician with an approved employment based visa petition and a National
Interest Waiver may file an adjustment application even if the three or
five year medical service is not completed. The adjustment application
will not be approved until the physician has fulfilled the 3- or 5-year term.