Professionals: Special Rules for H-1B Physicians

USCIS regulations proscribe special criteria for foreign physicians to qualify for H-1B status. The criteria are very strict in the direct patient care setting.

Physicians in Teaching and Research Positions

Physicians coming to the United States to teach or conduct professional research need only prove graduation from a U.S. or foreign medical school or a full unrestricted license to practice medicine in the person’s home country. If there is any patient care involved in the position, it can only be incidental to the research or teaching.

Physicians Involved in Direct Patient Care

Physicians coming to the United States to engage in positions involving direct patient care must meet additional regulatory burdens. Specifically, the foreign physician must:

1. Have a license or other authorization required by the state of intended employment to practice medicine if the physician will perform direct care and the state requires the license or authorization;
2. Have a full and unrestricted license to practice medicine in a foreign country or have graduated from a medical school in the U.S. or a foreign country;
3. Pass the Federation Licensing Examination (FLEX) or an equivalent examination as determined by the U.S. Department of Health and Human Services. Parts I, II, and III of the National Board of Medical Examiners (NBME) and Steps 1, 2 and 3 of the U.S. Medical Licensing Examination, the (USMLE), have been determined to be equivalent to the FLEX; and
4. Demonstrate competency in oral and written English or prove graduation from a medical school accredited by the U.S. Department of Education. Competency is demonstrated by passing the Educational Commission for Foreign Medical Graduates’ English examination.

It should be noted that a foreign physician is exempt from the licensing requirements if the physician can demonstrate he/she is a physician of “national or international renown.”

A Canadian physician possessing a Licentiate from the Medical Council of Canada is no longer considered equivalent to passing the FLEX.