Employment Based Immigration for Academic Physicians and Residents

Transcription

1 Employment Based Immigration for Academic Physicians and Residents NAFSA Members Healthcare Institution Interest Group Janice Bogen Thomas Jefferson University Janice Bianco The Cleveland Clinic Parker Emerson Yale University Suzanne Seltzer Klasko, Rulon, Stock & Seltzer Michele Stelljes The Methodist Hospital System

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3 NAFSA 2012 Houston Workshops, Sessions, Colloquia and meetings of interest to HIIG members

4 Networking Opportunities HIIG Website Discussion Forums NAFSA 2012 Annual Conference, Houston Get Networked in NAFSA Fair ISSS Networking Center Thursday evening informal gathering details to follow

5 HIIG Workshops Pathways to Permanent Residency Sunday, May 27 8 am 6 pm Cost: $349 member/$474 nonmember Advanced Immigration Issues for Academic Medicine Monday, May 28 8 am 5 pm Cost: $309 member/ $434 nonmember

6 HIIG Conference Sessions Wednesday, May 30 Best Practices Advising International Healthcare Students: 8:45 am 9:45 am Colloquium on Internationalizing Schools of Medicine and Public Health: 8 am 3:30 pm ($179 member/$259 non-member with full conference registration)

7 HIIG Sessions and Meetings Thursday, May 31 Dialogue with Medical and Nursing School Professionals in International Student Offices: 8 am 9 am Healthcare Institutions MIG meeting: 9:30 am 10:30 am Hot Immigration Issues for U.S. Academic Healthcare Institutions: 2 pm 3:15 pm

8 HIIG Sessions and Meetings Friday, June 1 Medical Student Global Mobility: Challenges and Opportunities: 3:15 pm 4:15 pm Additional opportunities will be available to chat about HIIG issues in the KCISSS Lounge watch for announcements! See session listing on NAFSA Annual Conference website:

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10 Employment Based (EB) Permanent Residency: EB-1 Extraordinary Ability Self-Petition no need for employer sponsor Must meet 3 regulatory criteria Factors Considered for Clinicians Development of clinical protocols followed by others Chapters/articles/case reports Role on national committees/associations Rare expertise in specific procedure(s) or management of specific condition(s) ie one of a handful of clinicians in x, y, z Teaching other experts in the field Peer Review/Manuscript Review Work References from independent Experts For more information, visit

11 Employment Based: EB-1 Outstanding Researcher/Professor Similar analysis to Extraordinary Ability Must meet 2 regulatory criteria Requires employer sponsor At least 3 Years experience teaching or research Permanent job offer: no fixed duration ; or Tenure or tenure track Universities or Institutions of higher learning (cont d) For more information, visit

12 New EB-1 Guidance (Kazarian) Issued December 2010 Establishes Two-Part Analysis of EB-1 Does Petition Contain Evidence of Requisite Number of Criteria? Final Merits Analysis does evidence demonstrate that beneficiary is one of a very few at the top of the field? For more information, visit

13 New EB-1 Guidance Implications of Two Part Analysis (cont d) Final merits analysis is an opportunity to second guess the criteria more subjective adjudication USCIS provides no clear guidelines for applying final merits analysis Confusion among adjudicators as to the correct standards to apply For more information, visit

14 New EB-1 Guidance Continued Developments: October 2011 AAO requested amicus on final merits analysis January 2012 USCIS holds stakeholder call seeking input on final merits analysis; stakeholders respond by requesting that focus return to the evidentiary criteria For more information, visit

15 Employment Based: EB-2 National Interest Waiver/EB-2 Self-Petition, no employer sponsor required Three Prong Test Field is of Substantial Intrinsic Merit National Impact of Your Contributions You Are Substantially Better Than Your Peers India/China backlog forward and back For more information, visit

16 Employment Based: EB-2 National Interest Waiver/EB-2 Self-Petition, no employer sponsor Requirements: MUST commit to work in a HPSA or MUA/P Contract to reflect 5 year service commitment Concurrence letter from State Dept of Health USMLE/ECFMG I-485 not adjudicated til 5 years complete India/China backlog For more information, visit

17 Employment Based: EB-2 Labor Certification Application (PERM) Employer sponsored (and MUST Pay Costs) Two Routes: Professional Special Handling (cont d) For more information, visit

18 Professional Employment Based: EB-2 Professional PERM Requires several sources of recruitment Priority to US workers who meet the minimum requirements for the position Must be filed within 6 months of starting the recruitment process (cont d) For more information, visit

19 Special Handling Employment Based: EB-2 Special Handling PERM Positions that involve teaching/instruction (Mercer University, BALCA: 2011 PER (March 6, 2012)) Recruitment National Professional Journal one print ad, or 30 day internet posting Best Qualified Standard Must be filed within 18 months of selection (cont d) For more information, visit

20 Prevailing Wages Medical Residents and Fellows Processing Times, Safe Harbor, Surveys Discussion ACWIA Wage data

21 Prevailing Wage Determination Options OFLC's National Prevailing Wage Center (NPWC) icert ETA 9141 icert ETA 9141 Submission of Surveys Employer determinations using the Online Library ACIWA wage data

22 Safe Harbor OFLC's National Prevailing Wage Center (NPWC) 20 CFR sec (a)(2)(ii)(A)(3) state that when an employer obtains a prevailing wage determination from the National Prevailing Wage Center, the Department of Labor will accept that wage as correct and will not question its validity, i.e. the employer is granted "safe harbor". hrough the icert Portal System.

23 icert Portal ETA From 9141 for Prevailing Wage Requests

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26 OFLC Online Data Center

27 Internists, General

28 Internists, General

29 Health Diagnosing and Treating Practitioners, All Other Healthcare Practitioners and Technical Workers, All Other

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31 Physicians and Surgeons, All Other

32 Physicians and Surgeons, All Other Family and General Practitioners Internists, General Health Diagnosing and Treating Practitioners, All Other ACWIA DATA AVAILABLE Healthcare Practitioners and Technical Workers, All Other

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34 icert Prevailing Wage Module Enhancements February Enhancement 2 Elimination of Separate Employer Wage Survey Submissions: Significantly reduces administrative time and costs by allowing customers to upload wage surveys (e.g., employer provided survey, CBA, SCA) or other supporting documentation to the NPWC as part of the ETA Form 9141 submission process in either Microsoft Word, Adobe PDF, or text file formats for more efficient storage and retrieval by the NPWC in processing the application;

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38 Survey Use of PW In preparation for a workshop in NAFSA Region XI, surveyed H-1B petitioners. Region XI Responses = 19 National Responses = 55

39 Preferred Wage Source For the majority of your normal H-1B processing, which prevailing wage source does your institution prefer to use (assuming all are equally accessible/ e.g. no stoppage)?

40 Why use sources other than i-cert?

41 i-cert Problem Areas Are there certain fields of research, or job titles that are problematic with i-cert determinations?

42 i-cert Problem Areas continued

43 Re-Using an Approved i-cert PW Is there ever an occasion to use an approved ETA-9141 determination again at a later date (during validity) for a similar H-1B employee petition?

44 Tricks and Tools in i-cert If you are a registered i-cert user, please share some best practices

45 Major Areas of Concern in Using i- CERT Timelines Inconsistency / In accuracy No ACWIA job titles (medical fields, etc..) Issue "combination of occupations" wage Wages too high/ not real Issue Inappropriate Level E&T lists Bachelors degree - skews wage results Too many jobs lumped together (e.g. Edu Admin) = inaccuracy Issue Level III when PhD and no experience required

46 Using Surveys in filing Labor Condition Applications Medicine & Life Sciences Towers Watson Surveys Association of American Medical Colleges (AAMC) Survey Janice M. Bianco Mgr, International Physician Svcs.

47 Disclaimer The information provided is neither an endorsement or recommendation of one service over another. This information is provided as examples of data services available to healthcare institutions. Use of any of the referenced data sources does not guarantee safe harbor or risk-free LCA filing/audits.

48 Towers Watson Survey /services/data-services This example from the 2010 survey shows the geographic breakdowns used in compiling the data. Wherever possible Towers Watson will breakdown to the metropolitan area level provided there is enough data. They also offer custom surveys.

49 This view shows the data for 1 st year residents: including weighted average; also broken down for Not-for-Profit Organizations

50 Towers Watson was able to provide data for three states in this survey.

51 How can I find surveys? 1) If you do not work in the GME Office, contact them to see how they arrive at the salary rates for residents. 2) If GME cannot help, contact the compensation department to see if they participate in any compensation/benefits surveys. Chances are if they do and it is a healthcare industries survey, there will be data for residents. 3) If you are part of a university, there may be a survey for educational institutions for data on faculty.

52 Culpepper does not offer survey services for patient care occupations, however they do offer a wide range of data for life sciences occupations including clinical research and medical laboratory (pathology, virology, immunology) professions. Here is a blurb from their website: The Life Sciences Compensation Survey includes over 150 life science job families covering life science executives, biotechnology, pharmaceuticals, medical devices & equipment, contract research, clinical research & development, clinical trial services, laboratory services, medical & disease science, research data & information, research & development, production, product quality, professional services & field support, and life science operations. Job families in Culpepper Compensation Surveys include a wide range of levels from entry level associates to top executives, allowing you to accurately match more of your jobs

53 Additional Survey Sources Milliman Milliman offers regional and city surveys for the West coast. SullivanCotter highly specific physician compensation, call-pay and benefits data for subspecialties in a tertiary care teaching hospital A simple google for Healthcare Industry Compensation Survey, provided a very long lists of providers. The best place to start is your HR or compensation department. They may have knowledge of some surveyors and can provide recommendations and information.

54 Pricing Most of the survey providers offer free access to data to participants or subscribers to their compensation survey series. For example, Towers Watson provides the data in either electronic or printed formats, pricing for electronic data is as follows: Participants: $700 Nonparticipants: $1700 SullivanCotter will provide the report free to participants (except for custom surveys). Check with your compensation department, they may be a participant and have access to this data.

55 AAMC Salary of Resident/Fellow Stipends & Benefits The survey is available online, free of charge; however, DOL considers the data sample too widespread. AAMC will give you a breakdown to a metropolitan area or State level for a fee. AAMC members: $500; non-members: $1000 Check with your medical school or GME office, your dean or GME director may be a member Contact Jennifer Gold at jgold@aamc.org

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57 AAMC LCA

58 AAMC LCA

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