Permanent Resident Options

There are many options to gain permanent resident status. The United States limits the number of foreign nationals who can gain permanent resident status or as it is more commonly known - green card status. If you are from India or China, you already know that you face significant backlogs in the quota lines in order to gain permanent resident status. If you are from other countries of the world, you should recurrently check on the backlog quota situation because there very well may be more backlogs in the world-wide quota as well.

If you are a J-1 physician who has gained a waiver, you need to complete your three year H-1B service obligation prior to gaining eligibility for permanent resident status. You can certainly start your case for permanent residence during this three year period of time, but you will not be able to actually file your final application for permanent residence until you have completed your three years of mandatory H-1B employment.

There are generally four basic pathways in order to attain permanent åresidence status:

  1. Family relationships: The first general pathway to permanent residency is based on family relationships. Therefore, if you are married to a U.S. citizen spouse, or if you have grown, U.S. citizen children of over 21 years of age, or if you have U.S. citizen parents, that could afford you a good, strong direct pathway to permanent residence. But even in these cases it is important to note these points:
    • If you are a J-1 physician being married to a U.S. citizen spouse that does not override your two year home residence obligation. You still need a waiver.
    • If you get a waiver, you still need to complete your three year H-1B period of service before gaining permanent residence.
    • Other family relationships could also result in permanent residency, but these need to be analyzed on a case-by-case basis.
  2. Employment: A second way to gain permanent residence is based on employment as a physician. There are two grounds under which a foreign physician can gain permanent residence based on employment:
    • One is under the direct sponsorship of your employer who would file a Labor Certification Application, which requires an extensive recruitment and advertising campaign.
    • An alternative way is based on a national interest waiver. Here, you could sponsor yourself for permanent residence, but it is only available if you are a physician. You could be a medical specialist or a primary care physician who is working in a designated medically underserved area. And under a national interest waiver, you have to work in a qualifying designated medically underserved area for five years before you can gain permanent resident status.
  3. Fear of persecution: A third way to gain permanent residence is if there is a fear of persecution back in the home country. That is called the Law of Asylum. An application needs to be filed directly to the immigration authorities requesting the protection of the United States.
  4. Special programs: A fourth way to get permanent residence is under certain special programs created by the U.S. government such as the green card lottery or perhaps some specific immigration initiatives which need to be analyzed on a case-by-case basis.

Permanent residence can be time-consuming, it can be complex, but it certainly can be successfully utilized for a broad range of foreign physicians seeking long-term residence and employment authorization in the United States. It requires some advanced planning, and above all, it requires the full participation and cooperation of you as the physician, your immigration attorney, and your employer. But given this conjunction of your participation and the participation of your employer, it is certainly a process that can be successfully negotiated for a very broad range of physicians working in the United States.

This article is included to inform you, in general, about U.S. immigration law. The information contained herein is not intended to provide solutions to individual problems. Thus, it cannot be relied on as legal advice. We caution you to not attempt to solve individual problems on the basis of this information and advise you to seek competent legal counsel to address your specific issues.

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