H1B Cap Issues for Physicians

The US. Citizenship and Immigration Serviceprocessing). Of course, this strategy alone can be
(USCIS) imposes an annual H-1B cap of 58,200unreliable and can often result in a gap in status. It
(congressional cap of 65,000 less 6,800 set asideis often the case that a physician whose H-1B
for workers from Singapore and Chile by theexpires on June 30 and is approved for an H1B
Free Trade Act). In addition, USICS exemptswith a new employer (subject to the cap) on
from the H-1B cap 20,000 aliens with a U.S. -October 1 finds that he is suddenly without status
earned master's or higher degree. Otherfor the period June 30 to October 1. In such
exemptions to the cap are available to aliens whocases, aliens should consider changing their status
are currently in H-1B status or who will beto H-4 or to B-2 in order to prepare and take the
employed at an institution of higher education or aBoard exams. In addition, it would be wise to
related or affiliated nonprofit entity, or at aextend an exempt H-1B to cover the July to
nonprofit research organization or a governmentalOctober gap. Foreign nationals should be aware
research organization.that a temporary extension with the H-1B
Medical Professionals and Strategies Regardingexempt employer is possible even where the
H-1B Transfer Cap Issues:physician will provide services a few hours per
The limited amount of H-1Bs available each fiscalweek. Otherwise, physicians who are not able to
year poses a wide range of problems to U.S.pursue the above options may be forced to leave
employers and may have lasting effects on aliens.the country until they can return in H1B status on
Many foreign national physicians face uniqueOctober 1.
challenges regarding the H-1B cap upon completionAnother excellent option to avoid the "cap gap"
of their residency or fellowship or when theyproblem is the NIW/HPSA immigration strategy.
attempt to enter the job market by accepting aAn NIW/HPSA is an immigrant petition in which
private practice position (for example, in thethe alien agrees to serve as a primary care
context of someone moving from an employerphysician (unless employer is a VA) for a
that is cap exempt to one that is not).five-year period in an underserved area. The
In such cases, a "cap gap" problem may arise ifbenefit of such an application is that the alien may
the USCIS improperly interprets INA 214(g)(6),be able to file an I-485 adjustment of status
which states that an alien who ceases to beimmediately and work authorization (as long as
employed by an exempt employer and has notsuch is not prohibited by retrogression in the EB-2
been previously counted should be counted thecategory). This allows the applicant and his or her
first time the alien is employed by a non-exemptderivative family members to receive
employer. My opinion, is that INA 214(g)(6) doesemployment and travel authorization for the
NOT block such a transfer as long as it submittedduration of the pending application and it prevents
as an application to extend status. To thethe alien from falling out of status. In addition,
contrary it is my opinion that the numericalmany foreign nationals fear this type of application
restrictions only apply when new H-1 status isbecause they do not want to commit to one
sought, that is when the applicant is applying for aemployer for such a long period of time.
change of status to H-1B from a differentHowever, the terms of employment can allow
nonimmigrant status such as the H-4 or B-2 orthe five year contract to terminate at will or by
when consular notification is requested rather thangiving due notice. The alien may not indeed
extension of H-1B status.actually need to complete the five year
The basis for this view is a precise reading of thecommitment either. This strategy can be
statutory language of INA 214(g) and numeroussupplemented by an independent immigration
explicit directives issued by USCIS. Specifically,strategy such as a labor certification or a self
INA 212(g) holds that the numerical limitation onlysponsored EB-1 which if successful would allow
apply to those who are being "provided" H-1Bimmigration to complete in a shorter time period.
status, not to those already in such status andIn many circumstances, physicians may pursue
seeking its extension.other avenues such as the O-1 or EB1/NIW
Therefore, it is my belief that a physician who ispetitions.
finishing a residency or fellowship and going intoAlthough navigating through the transfer process
private practice (not cap exempt) MAY apply foris a meticulous one when the H-1B cap is an issue,
a change in previously approved employment sophysicians may gain comfort in the fact that
long as the physician applies for an extension ofoptions and relief are available to their unique
his H-1B from within the US (not through consularchallenges.