The definition does not appear to include an alien who has graduated from a medical school in the United States. Generally, the evidence submitted would have to show a degree of excellence comparable to that which would normally result in national renown in the United States. However, such aliens must still establish proficiency in written and oral English. The only approved body is the LCME and it limits itself to evaluating and accrediting only medical schools located in the United States and Canada. The first preference employment-based category requires no labor certification as a condition of visa issuance.
Labor certification is similar to the employment validation process in Canada.
In other words, persons falling under the first preference category are not required to establish that they are not taking jobs from qualified U.S. workers. Foreign medical graduates applying under the first subgroup are not required to have a job offer but must possess extraordinary ability in the sciences which has been demonstrated by sustained national or international acclaim and their achievements must have been recognized in the field through extensive documentation. Persons applying under the second subgroup must be internationally recognized as outstanding in their specific academic area, have a minimum of three years of experience in teaching or research in the area and be entering the U.S. in a tenure or tenure track teaching or comparable research position at an institution of higher education. Given the extremely high standard which is applied, only the most well-known physicians will be approved under this category. An advanced degree means any academic degree or a foreign equivalent degree above that of baccalaureate.