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.