On June 17, 2009, the USCIS amended the Adjudicator’s Field Manual to explain how to determine if a foreign medical degree is the equivalent of a U.S. Doctor of Medicine (M.D.). This issue of interest for foreign medical graduates (FMGs) who frequently have MBBS degrees or other medical degrees that have different educational requirements from the U.S. system. Affected IMGs who seek H-1B visa classifications and PERM labor certification to practice as physicians in the U.S. will find this helpful.
An M.D. is considered one of the advanced degrees beneficiaries must have when seeking an employment-based second preference (EB-2) classification. An M.D. is also sufficient for an employment-based third preference (EB-3) classification.
To have EB-2 classification for a physician, the employer must first obtain an approved PERM labor certification from the Department of Labor for the EB-2 category. In order to demonstrate that the foreign educated physician has an advanced degree, and that it is the equivalent of an M.D., the employer must demonstrate:
- That the physician’s medical program requires students to obtain a bachelor’s degree (or it’s equivalent) prior to admission; or,
- That the student’s medical program, if the student can be admitted immediately after high school, is longer in length than a normal bachelor’s degree program (approximately 5-7 years); or,
- That the physician was awarded a foreign medical degree and passed the National Board of Medical Examiners Examination (NBMEE) or its equivalent, or the U.S. Medical Licensing Examination (USMLE) steps 1, 2 and 3.
The USCIS also requires that the foreign educated physician has or had a full, unrestricted license (as opposed to a limited license) to practice medicine in the state of intended employment, or the foreign medical degree conclusively meets the eligibility requirements for licensure in the state of intended employment.
Additional Considerations Affecting Foreign Educated Physicians:
- Foreign Educated Physicians engaging in patient care must show eligibility for the position described on the labor certification application as of the date of filing, including admissibility.
- Additional admissibility regulations that apply to physicians are that they must have passed an examination certified by the Department of Health and Human Services: NBME or NBMEE, the Visa Qualifying Exam (VQE), the Comprehensive Foreign Medical Graduate Examination (FMGEMS) or the USMLE. Currently, only the USMLE is administered.
- A Foreign Educated Physician must demonstrate licensure eligibility by
- Being an initial application for licensure- this means the physician has never before had a U.S. license to practice medicine, or sometimes, never had a Canadian license to practice medicine, either. The physician must then demonstrate he is eligible because he has obtained the education, training residency and certifications required by the state’s licensing board. The applicant must have already filed the application for licensure at the time of filing the labor certification application.
- Being an applicant for licensure by endorsement means the physician already has a U.S. issued license (and in limited circumstances, a foreign-issued medical license) and will be able to obtain licensure in the state of intended employment through reciprocity or endorsement. Reciprocity or endorsement is not automatic, and the applicant must still have already filed an application for licensure at the time of filing the labor certification application.
- Each state has its own regulations regarding reciprocity, education, training, residency and board certifications in order to be eligible for licensure. This information can be found here: http://www.fsmb.org and the websites of the U.S. medical boards.
- If a nursing applicant possesses a foreign medical degree, an EB-2 classification will not automatically be awarded. To be eligible for an EB-2 classification, not only must the alien possess an advanced degree, but an advanced degree must be normally required for the position being offered to the alien. Both these requirements must be met in order to be eligible for an EB-2 classification.