U.S. Department of Homeland Security 

U.S. Citizenship 

and Immigration 

Services 

www.uscis.gov 

U.S. Citizenship and Immigration Services 

Office of the Director 

Camp Springs, MD 20588-0009 

August 16, 2023 PA-2023-23 

Policy Alert 

SUBJECT: Physician National Interest Waivers 

Purpose 

U.S. Citizenship and Immigration Services (USCIS) is issuing policy guidance in the USCIS Policy 

Manual to confirm the evidentiary requirements for physicians seeking a national interest waiver of 

the job offer requirement based on work in an underserved area or at a U.S. Department of Veterans 

Affairs facility. 

Background 

The Immigration and Nationality Act (INA)1 states that an employer can file an Immigrant Petition 

for Alien Workers (Form I-140) for a person of exceptional ability or a member of the professions 

with an advanced degree.2 Under this immigrant visa classification, employers are generally 

required to obtain a permanent labor certification from the U.S. Department of Labor. The INA, 

however, provides a waiver of the job offer requirement if doing so is in the national interest. 

In the case of physicians who have worked or agree to work full time in areas designated by the 

Secretary of Health and Human Services as having a shortage of health care professionals or at a 

health care facility under the jurisdiction of the Secretary of Veterans Affairs, the job offer 

requirement, and therefore the permanent labor certification requirement, may be waived.3 To 

qualify for this waiver, a federal agency or a state department of public health must have 

determined that the physician’s work is in the public interest.4 

USCIS is now updating its guidance to confirm that, for physician national interest waiver petitions, 

the required contracts and public health letters need to be dated within 6 months immediately before 

the petition filing date only for work that the physician has not yet started.

5 The 6-month requirement 

does not apply to work that the physician has already started or completed before the petition filing 

date. 

1 See INA 203(b)(2)(B)(i). In addition, see 8 CFR 204.5(k)(4)(ii). 2 See 8 CFR 204.5(k)(1). 3 See INA 203(b)(2)(B)(ii)(I). 4 See INA 203(b)(2)(B)(ii)(I). 5 See 8 CFR 204.12(c). 

To provide feedback on this update, email USCIS at policyfeedback@uscis.dhs.gov. 
 

PA-2023-23: Physician National Interest Waivers 

Page: 2 

This guidance, contained in Volume 6 of the Policy Manual, is effective immediately. The guidance 

contained in the Policy Manual is controlling and supersedes any related prior guidance on the 

topic. 

Policy Highlights 

• Confirms that, when a physician has yet to start the relevant work, the required employment 

contract or employment commitment letter must be issued and dated within 6 months before 

the filing date of the petition. 

• Confirms that, when a petitioner has yet to start the relevant work, the required public interest 

letter from a federal agency or state department of public health must be issued and dated 

within 6 months before the filing date of the petition. 

Summary of Changes 

Affected Section: Volume 6 > Part F > Chapter 6 > Section B, Physician National Interest Waiver 

• Revises the first two bullets and first full paragraph of subsection 3 (Evidence). 

USCIS may also make other minor technical, stylistic, and conforming changes consistent with this 

update. 

Citation 

Volume 6: Immigrants, Part F, Employment-Based Classification, Chapter 6, Physician 

[6 USCIS-PM F.6].