Physicians' and Surgeons' Guide to the O-1A Visa (2026)

TL;DR

• The O-1A is a nonimmigrant visa for individuals with extraordinary ability in the sciences, education, business, or athletics. Medicine and surgery fall squarely within the sciences category. No annual cap, no lottery, no degree requirement beyond demonstrated extraordinary ability, no prevailing wage obligation. Initial validity is three years with unlimited extensions.

• Physicians and surgeons are among the most natural candidates for the O-1A because the medical profession already produces most of the evidence the standard requires: peer-reviewed publications, peer review service, clinical guideline development, named lecture invitations, and institutional leadership. The challenge is not whether the evidence exists but whether it rises to the extraordinary ability standard and has been assembled in a form USCIS can evaluate.

• Three physician profiles exist within this category with distinct evidence strategies: clinician-scientists who combine active clinical practice with research careers, pure clinicians in high-volume or subspecialty practice, and academic physician leaders in department chair, division chief, or program director roles. Each requires a different emphasis across the eight criteria.

• The J-1 two-year home residency requirement under INA 212(e) affects most foreign medical graduates who trained in the United States on J-1 exchange visitor visas. This requirement restricts the ability to change status to O-1A from within the United States until it is satisfied or waived. Physicians must resolve the J-1 bar before pursuing O-1A change of status. Waiver options include Conrad 30, VA waiver, and interested U.S. government agency waiver.

• The physician National Interest Waiver under INA 203(b)(2)(B)(ii) is a separate and critically important pathway for foreign physicians. It provides a green card for physicians who commit to practicing medicine full-time in federally designated shortage areas for five years. The evidentiary standard is substantially lower than the standard O-1A or EB-2 NIW, and it is available to physicians without a research or publication record. For many foreign physicians, this pathway is more immediately accessible than the O-1A and deserves evaluation alongside it.

• Board certification, while required to practice, does not establish extraordinary ability. Fellowship designations such as FACS and FACC, while professionally significant, are widely held and typically do not satisfy the membership criterion without additional selectivity evidence. The evidence that matters for immigration purposes is recognition from within the field that places the physician above the broad population of fully qualified, board-certified specialists.

• USCIS applies the Kazarian two-step framework. At Step 1, USCIS evaluates whether evidence exists that at least three criteria are satisfied. At Step 2, USCIS evaluates the totality of evidence to determine whether it establishes sustained national or international acclaim at the very top of the field. Clearing Step 1 does not guarantee Step 2.

• Premium processing guarantees a USCIS response within 15 business days at $2,965 (effective March 1, 2026).

Before the O-1A: The Physician Immigration Landscape

Physicians have access to a more varied set of immigration pathways than most other professionals, and evaluating the O-1A petition in isolation misses the strategic picture. Understanding where the O-1A fits relative to other physician-specific pathways determines whether it is the right choice, the right timing, and the right combination of filings.

The H-1B for physicians is far more accessible than it is for most professionals because most hospitals, academic medical centers, and healthcare nonprofits are cap-exempt H-1B employers. Cap-exempt H-1B visa petitions can be filed at any time of year without lottery participation. For foreign physicians in J-1 status who have resolved the home residency requirement, or who trained in F-1 or other non-J-1 status, the cap-exempt H-1B at a hospital or academic medical center is often the most immediately available work authorization.

The physician National Interest Waiver under INA 203(b)(2)(B)(ii) is a statutory green card pathway available specifically to physicians who agree to provide medical services full-time in a federally designated Health Professional Shortage Area (HPSA) or Medically Underserved Area (MUA) for five years, and who have approbation from a state health department, the Department of Veterans Affairs, or another federal health agency. This pathway has a substantially lower evidentiary bar than either the standard EB-2 NIW or the O-1A. 

It requires no publications, no extraordinary ability demonstration, and no research record. It requires only that the physician commit to practicing in an underserved area and obtain the required approbation. For foreign physicians without a strong research or publication record who are willing to practice in a shortage area, the physician NIW may be a more direct path to a green card than the O-1A.

EB-1B green card (outstanding professor or researcher) is available to academic physician-scientists with a permanent position at a university or research institution, international recognition in the field, and at least three years of teaching or research experience. EB-1B requires a permanent job offer but no PERM labor certification, and its evidentiary standard of international recognition is somewhat below the extraordinary ability standard required for O-1A and EB-1A green cards. For academic physicians at medical schools and research hospitals, EB-1B is often the most appropriate green card pathway, and it can be pursued concurrently with O-1A for nonimmigrant work authorization.

The O-1A is most appropriate for physicians whose clinical or research accomplishments clearly exceed the standard for a competent, board-certified specialist, who have documented recognition from the broader medical community, and who either do not qualify for or are not interested in the physician NIW pathway. The O-1A does not require a commitment to shortage area practice, does not require a permanent job offer, and is available to physicians across all specialties without geographic restriction.

The J-1 Two-Year Home Residency Requirement

Most foreign medical graduates (FMGs) trained in the United States on J-1 exchange visitor visas for residency and fellowship. The J-1 visa for medical training is classified as a program type that triggers the two-year home residency requirement under INA 212(e) in most cases.

The two-year home residency requirement means the physician cannot change status to H-1B, O-1A, or certain other nonimmigrant categories from within the United States, and cannot adjust status to permanent residence, until they have either physically resided in their home country for an aggregate of two years, or obtained a waiver of this requirement.

Waiver pathways available to physicians include:

• Conrad 30: each state's public health department may grant up to 30 waivers per year to physicians who agree to practice medicine full-time in a shortage area in that state for three years. Conrad 30 waivers are then used as the basis for an H-1B petition (not O-1A) at the shortage area employer. This pathway leads to a J-1 waiver and a cap-exempt H-1B, not directly to the O-1A.

• VA waiver: the Department of Veterans Affairs may request a waiver for physicians it intends to employ full-time. VA employment is a cap-exempt H-1B context as well.

• Interested U.S. government agency (IGA) waiver: federal agencies with research or public health missions (HHS, NIH, USDA, and others) may request waivers for physicians whose work serves an agency research interest.

• No-objection statement: the physician's home country government may issue a no-objection statement indicating they do not object to the physician remaining in the United States without completing the two-year home residency. These are rare and highly dependent on home country policy.

The J-1 waiver process is separate from and must precede the O-1A change of status. A physician who obtains a Conrad 30 waiver and then spends three years at a qualifying employer typically becomes eligible to pursue an O-1A change of status (or H-1B transfer to a non-shortage-area employer) after satisfying the waiver's service obligation. 

Alternatively, a physician who departs the United States, physically resides in their home country for two years, and then applies for an O-1A visa from abroad can enter in O-1A status without requiring a waiver.

The Three Physician Profiles

Clinician-Scientists

Academic physician-scientists who maintain active clinical practices alongside research careers are the strongest O-1A candidates in medicine. Their careers naturally produce evidence across multiple criteria: peer-reviewed publications, citation records, grant funding, peer review and editorial service, institutional leadership, and, for those whose research is recognized beyond their institution, press coverage and invited lectures.

The scholarly articles criterion, original contributions criterion, and judging criterion together anchor most clinician-scientist O-1A cases, with critical role and awards supporting the overall case. This profile overlaps substantially with the researcher guide in this series, with the addition of clinical leadership and medical specialty-specific evidence.

Subspecialty Clinicians

Pure clinicians, including high-volume surgeons, interventional specialists, and subspecialists who do not maintain active research programs, face a more challenging O-1A case because the excellence of their clinical work is not directly captured by the criteria as written.

Surgical skill, clinical judgment, and patient outcomes are real measures of distinction in medicine. USCIS evaluates them as extraordinary ability only when they are translated into objective, independently verifiable recognition: 

• Publications of novel techniques and outcomes data published and cited by other physicians

• Named lectureships where the physician was specifically selected for their clinical expertise and training program leadership for others in the specialty

• Letters from surgeons or specialists at other institutions who specifically describe the physician's clinical innovations and their adoption

A subspecialty surgeon who invented or substantially developed a surgical technique, published it with a series documenting outcomes, and can show that other surgeons cite and use the technique has made an original contribution of major significance. A surgeon with high volume and excellent outcomes who has not published, led, or been externally recognized for their specific clinical approach has accomplished a great deal clinically but has not yet generated the evidence USCIS needs to evaluate extraordinary ability.

The profile-building roadmap for subspecialty clinicians centers on converting clinical excellence into publicly documented recognition: publishing case series, technical notes, and clinical reviews; applying for speaking roles at national specialty conferences; pursuing society committee and leadership positions; and documenting outcomes data in a way that can be shared without HIPAA violations.

Academic Physician Leaders

Department chairs, division chiefs, residency and fellowship program directors, and hospital clinical leadership roles carry organizational authority that directly supports the critical role criterion. For academic physicians in these positions at recognized academic medical centers, the organizational structure itself establishes a form of distinction that is documentable through the institution's standing, the scope of the department or division, and the physician's specific authority within it.

Academic leaders at medical schools and research hospitals also typically have research programs or at minimum involvement in the institution's research mission, which contributes to the scholarly articles and original contributions criteria. Their leadership roles may include journal editorial board membership, grant review service, and conference program committee involvement, all of which support the judging criterion.

The Eight Criteria Mapped to Physician Evidence

Criterion 1: Scholarly Articles in Medical Journals

For clinician-scientists and research-active physicians, this is typically the foundation of the O-1A case. Medical research has a well-developed journal hierarchy, and publications in recognized specialty journals or general medical journals establish the scholarly article criterion clearly.

• The strongest journal venues in medicine include general high-impact journals (NEJM, JAMA, The Lancet, BMJ) and the leading specialty-specific journals (JACC for cardiology, Annals of Surgery for surgery, JCO for oncology, and comparable journals in every medical specialty). The petition should establish each journal's standing for a USCIS adjudicator who may not recognize specialty publications: acceptance rate, impact factor, readership, and standing in the specialty.

• Citation data from Google Scholar, Web of Science, or Scopus establishes how the field is engaged with published work. Field-normalized citation metrics, which compare the physician's citation performance to the average for papers published in the same specialty area and year, are more useful to USCIS than raw citation counts because they provide the comparative context an adjudicator needs to evaluate significance.

For surgical journals specifically, technical notes and case series describing novel operative approaches are recognized scholarly contributions even when they do not involve large clinical trials or research datasets. A well-documented case series in a recognized surgical journal establishing the safety and efficacy of a novel technique satisfies the scholarly articles criterion and, when others cite and adopt it, also satisfies the original contributions criterion.

Criterion 2: Original Contributions of Major Significance

This criterion captures the clinical innovation dimension of physician careers that the scholarly articles criterion does not: developing a novel surgical technique, establishing a new treatment protocol, creating a diagnostic algorithm, or producing research findings that changed clinical practice.

The significance must be established by how others engaged with the contribution. For clinical innovations: other physicians and surgeons at different institutions who cite the physician's published work, who describe adopting the technique or protocol in their own practice, and who credit the physician's contribution as having advanced their field are the core independent validators.

• Letters from surgeons or specialists at other institutions who specifically describe using a technique the physician developed, and who explain how it changed their clinical approach, are among the most powerful evidence available for this criterion in medicine. A letter that says "Dr. Chen's 2020 publication of the modified laparoscopic approach we now use at our center" is more compelling than general praise of clinical excellence.

• Research findings that influenced clinical guidelines are an especially strong form of this evidence. A paper cited in the AAOS or ACC or ACS guidelines, or a study whose results informed a change in specialty society recommendations, has documented field-level significance that is independently verifiable through the guidelines themselves.

• NIH-funded research is specifically recognized as a positive factor in O-1A adjudication under USCIS guidance: being named as a principal investigator on a competitively funded NIH grant establishes both the significance of the research agenda (as evaluated by peer review) and the physician's field-level recognition as a leading investigator.

Criterion 3: Judging the Work of Others

Physicians have several strong forms of judging activity available through normal professional practice that require only systematic documentation.

• Peer review for medical journals: every invitation to review a submitted manuscript for a recognized journal is evidence for this criterion. The documentation needed is the invitation email from the editor, confirmation of review submission, and evidence of the journal's standing. Medical journals typically send formal review request letters from editors identifying the physician's expertise as the basis for the invitation. A Publons or Web of Science verified reviewer record provides a systematic exportable record of review activity.

• Grant review panels: serving as a study section reviewer for NIH, serving on a grant review panel for a specialty society foundation (AHA, ACS, ASCO, and their research grant programs), or serving on a Disease-Specific Research Program review panel documents that a major funding agency trusted the physician's expertise to evaluate research proposals submitted by other physicians.

• Institutional Review Board service: IRB membership at one's own institution is standard employment activity. But serving on IRBs at other institutions, or serving as an external reviewer for multicenter research protocols, establishes a judging role with a genuine external component.

• Residency and fellowship program review: participating in the evaluation of residency or fellowship program applications for recognized training programs (not the physician's own institution's program) documents that the field recognizes the physician's standing to evaluate the next generation of specialists.

Specialty society committee membership with a specific peer review function (guidelines development committees, quality metrics committees, credentialing committees) involves formal evaluation of standards and evidence by recognized expert panels. Documenting the committee's function and the physician's role within it establishes this as judging activity with institutional backing.

Criterion 4: Critical or Leading Role at a Distinguished Organization

Academic medical centers, major research hospitals, and recognized specialty programs are distinguished organizations in the medical context. The evidence markers for an academic medical center's distinction include its US News & World Report hospital rankings (for the specialty department in question), its NIH funding rank, its residency and fellowship programs' national reputation, and recognized press coverage of the institution's clinical and research achievements.

The physician's critical role within the organization must be documented at the level of individual authority and specific organizational function. A department chair has authority over a department's clinical and research programs, faculty appointments and promotions, and departmental budget and strategy. A fellowship program director has authority over training standards, curriculum, and the development of the next generation of specialists in the field. A division chief has authority over a specialized clinical or research unit within a larger department.

For subspecialty clinicians without formal leadership titles, the critical role argument requires more specific construction: the petition must document what the physician specifically contributes that the institution could not replicate with another board-certified specialist. A surgeon who performs a procedure category that no other surgeon at the institution has training in occupies a critical role not because of title but because of unique, indispensable expertise.

Criterion 5: Awards and Prizes for Excellence

Medical specialty societies confer named lectureships and awards that function as genuine peer recognition of outstanding achievement. These are among the most credible award criterion evidence in medicine because the selection processes are peer-evaluated by recognized authorities in the specialty.

• Named lectureships from specialty societies: invited lectureships at major society annual meetings (ACS Clinical Congress, AHA Scientific Sessions, ACC Annual Scientific Session, ASCO Annual Meeting, and comparable major meetings), and specialty society awards specifically for research excellence or clinical innovation satisfy this criterion when the selection process is peer-evaluated and documented.

• Research grants from competitive programs: NIH K awards (K08, K23, K99/R00) are competitively awarded to physician-scientists in the early stages of independent research careers. The peer review selectivity of the K award program and the NIH's recognized standing as the premier biomedical research funding agency make an awarded NIH K grant strong evidence for the awards criterion as well as for the original contributions criterion.

• Specialty society presidency, board membership, or other leadership positions reached through election or competitive selection by the physician's peers document recognition by the specialty community at a national level.

Criterion 6: Membership in Selective Associations

The major medical specialty fellowship designations warrant careful evaluation for this criterion. FACS (Fellow of the American College of Surgeons) is held by more than 80,000 surgeons in the United States and Canada. FACC (Fellow of the American College of Cardiology) is similarly broadly held among cardiologists. These are professionally significant credentials but they are not selective in the sense the O-1A membership criterion requires: a large proportion of board-certified practitioners in the specialty hold them.

The petition may attempt to satisfy this criterion with these fellowship designations but should do so with realistic expectations about their weight, particularly at Step 2. More selective and more credible membership evidence includes: election to membership in the National Academy of Medicine, election as a fellow in a specialty society that has a documented election process by peer nomination and expert evaluation with a meaningfully low acceptance rate, and membership in invite-only specialty working groups or expert panels convened by recognized national or international bodies.

Criterion 7: Published Material About the Physician

Media and professional press coverage specifically about the physician and their clinical or research work. For physicians, strong evidence includes: 

• Coverage in recognized health media (JAMA News, NEJM Perspective, Medscape, HealthDay) specifically about the physician's research findings or clinical innovations

• Profiles in major general media (Wall Street Journal Health, New York Times Health, NPR Medicine) covering the physician's work

• Invitations to provide expert commentary on the physician's specific area of specialization that are published by recognized outlets

• Profiles in specialty society publications that specifically recognize the physician's contributions to the field

Coverage of the physician's institution or research program that mentions them in passing does not satisfy this criterion. Coverage specifically about the physician and their individual work, initiated by an editor or journalist because the physician's perspective has field-level value, does.

Criterion 8: High Salary or Remuneration

Physician compensation varies widely by specialty, and for several subspecialties, compensation places senior physicians in the top percentile of all U.S. occupations. According to BLS data and specialty compensation surveys, orthopedic surgeons, neurosurgeons, radiologists, anesthesiologists, and cardiologists are among the highest-earning occupational groups in the United States.

The documentation approach is the same as in prior guides: total compensation compared to specialty-specific and location-specific benchmarks. MGMA (Medical Group Management Association) salary data and Medscape physician compensation reports provide specialty-specific benchmarks that establish what physicians in the same specialty, at the same career stage and geographic location, typically earn. A physician in a high-demand subspecialty whose total compensation significantly exceeds the MGMA median for their specialty and region can establish this criterion.

For academic physicians at medical schools, total compensation including grants-funded salary, clinical income, and supplemental compensation may differ from what a solely private practice physician earns. The comparison should be against the appropriate benchmark for the specific employment context.

The Clinical Excellence Translation Problem

The most important unique challenge in physician O-1A cases is the gap between genuine clinical excellence and USCIS-evaluable evidence of extraordinary ability. A surgeon who performs the most complex cases in a region, with outcomes significantly better than the national benchmark, is genuinely among the best in their field. 

But if that surgeon has not published the technique, received named lecture invitations for it, or been recognized by surgeons at other institutions for it, the underlying clinical excellence exists without the evidence USCIS needs to evaluate it.

The translation tools are specific:

• Outcomes data documentation: mortality rates, complication rates, length of stay, and patient-reported outcomes for specific procedure categories, compared to national benchmarks (National Surgical Quality Improvement Program data, the STS database, or specialty-specific quality databases). This data can establish that the physician's clinical outcomes are in the top percentile for their procedure category. It can be submitted to USCIS without disclosing individual patient information (HIPAA applies to patient identifiers, not aggregate outcomes data presented at a group level). Letters from hospital quality officers or department leadership documenting these outcomes and attributing them to the physician's specific clinical approach strengthen the record.

• Published technique documentation: converting clinical innovation into published record is the single most valuable profile-building action a subspecialty surgeon can take. A technical note in a recognized surgical journal, documenting a modified or novel operative approach with a case series establishing safety and outcomes, creates a citable, externally verifiable record of the clinical contribution.

• Training program role: surgeons who train other surgeons in advanced techniques are specifically selected because the field recognizes their expertise in those techniques. A surgical teaching role at a nationally recognized training program, with letters from the program director establishing why this specific surgeon was selected as a trainer, converts clinical expertise into documented field-level recognition.

Profile-Building: A 12-Month Roadmap for Physicians

Months 1 to 3: Audit and J-1 Status Resolution

Before any profile-building activity, determine whether the J-1 two-year home residency requirement applies and, if so, what pathway to waiver or satisfaction is most appropriate. This issue must be resolved before O-1A change of status can be pursued.

Simultaneously, conduct an evidence audit:

• For a clinician-scientist, the audit covers publications, citations, grant history, peer review activity, and any awards or recognition.
  
  

• For a subspecialty clinician, the audit covers any publications, any named lectures or invited presentations, any society committee memberships, and any outcomes data.
  
  

• For an academic leader, the audit covers the leadership role documentation, the department or division's standing, and any publications or external recognition.

Months 3 to 6: Build the Research and Publication Record

• For subspecialty clinicians who have not yet published, this is the period to identify one or two clinical observations or innovative approaches worth publishing and to draft them for submission. Technical notes, case series, and surgical technique descriptions are all publishable in recognized specialty journals and do not require large clinical trials or years of data collection.

• For clinician-scientists, use this period to submit abstracts to national specialty meetings, expand peer review activity, and identify targeted journals for paper submissions. Contact journal editors to offer review availability for manuscripts in your specific subspecialty area.

• Apply for specialty society committee positions. Most specialty society websites describe their committee structures and provide application processes. A standing committee member on a specialty society guidelines or quality committee has documented judging activity with institutional backing.

Months 6 to 9: Build National Visibility and Expert Letter Relationships

• Apply for speaking slots at the national meetings of your specialty society. The ACS Clinical Congress, AHA Scientific Sessions, ACC Annual Scientific Session, and comparable major specialty meetings have abstract and speaker application processes. Accepted abstract presentations generate documented field-level recognition of your research or clinical work.

• Identify five to six physicians at other institutions who are familiar with your work, who have benefited from your clinical innovations, publications, or training, and who have the standing in the field to write credible independent expert letters. Begin those conversations now, with enough time for the letter writers to formulate specific, substantive letters rather than generic endorsements.

Months 9 to 12: Document Clinical Outcomes and Assemble the Case

• Work with your hospital's quality department to assemble outcomes data for your procedure categories, compared to national benchmarks. This data exists in most hospitals through quality improvement programs and can be obtained in aggregate, de-identified form for immigration purposes.

• Finalize compensation documentation: most recent employment agreement or compensation statement, MGMA benchmark comparison for your specialty and geographic area, and any performance-based compensation or RVU-based productivity data establishing how your compensation compares to specialty peers.

The Kazarian Two-Step for Physician Cases

At Step 1, USCIS evaluates whether evidence exists that at least three criteria are satisfied. A clinician-scientist with publications, peer review service, and a critical role at an academic medical center typically clears Step 1. A subspecialty surgeon with publications, a named lecture, and high compensation at a recognized medical center can clear Step 1.

At Step 2, USCIS evaluates the totality of evidence to determine whether it establishes sustained national or international acclaim at the very top of the medical field or the specific specialty. The most common Step 2 failure for physician cases is that the evidence establishes a highly competent, board-certified specialist at a good hospital rather than a physician whose recognition clearly extends beyond their institution and places them in the top tier of their specialty nationally or internationally.

The evidence that closes this gap at Step 2 for physicians is external recognition: independent letters from recognized physicians at other institutions who can describe the specific influence of the petitioning physician's work on their own clinical practice or research, publications cited by researchers at other institutions who built upon the physician's contributions, named lectureships that required selection by a peer evaluation process, and outcomes data that objectively places the physician's clinical performance above national benchmarks.

Frequently Asked Questions

I am a fellow in subspecialty training. Can I file now or should I wait?

Fellowship training is not a bar to O-1A eligibility. USCIS evaluates extraordinary ability based on the evidence presented, regardless of career stage. A fellow with a meaningful publication record, active peer review service, an NIH career development award, and recognition from the broader medical community can qualify. 

That said, most fellows are still accumulating the evidence that will support an O-1A case, and waiting until evidence is genuinely strong typically produces better outcomes than filing prematurely with a thin record.

Does board certification or FACS status satisfy any O-1A criterion?

Board certification is a threshold requirement for medical practice, not a recognition of extraordinary ability among board-certified physicians. 

It does not satisfy any O-1A criterion. FACS and FACC are professionally significant but broadly held fellowship designations that are typically insufficient to satisfy the membership criterion on their own, because the proportion of board-certified surgeons or cardiologists who hold them is large enough that the designation does not establish standing in the small percentage at the top of the field. 

Stronger membership evidence is election to organizations with documented achievement-based admission processes among a clearly selective proportion of practitioners.

My clinical outcomes are among the best in the country but I have not published. How do I document this?

Aggregate, de-identified outcomes data does not constitute HIPAA-protected patient information and can be included in an O-1A petition. 

Work with your hospital quality department to obtain procedure-specific outcomes data compared to NSQIP, STS, or specialty-specific national benchmarks. 

Letters from hospital leadership and from surgeons or specialists at other institutions who are aware of your outcomes and who can speak to their significance add qualitative context that USCIS can evaluate.

How does the physician NIW compare to the O-1A?

The physician NIW under INA 203(b)(2)(B)(ii) is a direct path to a green card for physicians willing to commit to five years of full-time practice in a federally designated shortage area, with state health department or VA approbation. It does not require publications, extraordinary ability evidence, or a research record. 

It is substantially more accessible for physicians without strong research profiles than the O-1A. However, it requires a specific employment commitment and geographic constraint that the O-1A does not. The two are not mutually exclusive: some physicians pursue both, using the physician NIW to establish a green card priority date while using the O-1A for nonimmigrant work authorization without shortage area restriction.

This article is intended for general informational purposes only and does not constitute legal advice. O-1A requirements, J-1 waiver programs, physician NIW eligibility, and USCIS policies change frequently. For guidance specific to your medical specialty, career stage, and immigration history, consult a licensed immigration attorney experienced in physician immigration cases.