Guidance on H-1Bs for Nurses

Many American healthcare organizations rely on nurses from overseas, but some requirements of the H-1B visa program have made it difficult for foreign nurses to obtain a visa under this classification. While nursing might seem like the kind of specialty occupation that the H-1B program was designed to support, the technical definition of “specialty occupation” has left out many nurses.

What’s so “special” about nursing?

A "specialty occupation" is defined in the Immigration and Nationality Act (INA) as a job that requires two conditions:

  1. The "theoretical and practical application of a body of highly specialized knowledge," and

  2. The "attainment of a bachelor's, or higher, degree in the specific specialty or its equivalent."

It’s the second condition in the above definition that has long been a problem in the nursing profession. This is because most registered nurse (RN) positions generally require only a two-year associate’s degree in nursing (ADN), rather than a four-year bachelor's degree. Many RNs, therefore, would not qualify for H-1B status because the RN position they apply for is not technically a specialty occupation.

What’s a nurse to do?

A typical RN position, then, may not by itself qualify as a specialty occupation. However, there’s no need to nurse a grudge over this. A petitioning employer may be able to demonstrate that a particular RN position qualifies as a specialty occupation. In general, you’ll be able to obtain an H-1B visa if your employer can demonstrate one of the following:

  • That a bachelor's or higher degree (or its equivalent) is normally the minimum requirement for entry into that particular position;
  • That the degree requirement is common in the industry for parallel nursing positions;
  • That the employer normally requires a degree or its equivalent for the position; or
  • That the nature of the position's duties is so specialized and complex that the knowledge required to perform them is usually associated with the attainment of a bachelor's or higher degree (or its equivalent).

What, exactly, does “or its equivalent” mean? In short, prospective H-1B beneficiaries are allowed to substitute work experience for years of education. U.S. Citizenship and Immigration Services (USCIS) uses the following formula: three years of specialized training and/or work experience is equal to one year of college-level training. So if the particular position you are interested in requires a two-year associate’s degree in addition to six years of nursing experience, that will be considered the equivalent of a bachelor’s degree, and the position will therefore qualify as a specialty occupation.

Not all nurses are created equal

While the section above lists ways that a particular nursing position may qualify as a specialty occupation, USCIS has also recognized several categories of registered nurse that are more likely to require the level of education needed for the specialty occupation classification. These categories are:

  • Addiction nurses
  • Cardiovascular nurses
  • Critical care nurses
  • Emergency room nurses
  • Genetics nurses
  • Neonatology nurses
  • Nephrology nurses
  • Oncology nurses
  • Pediatric nurses
  • Perioperative (operating room) nurses
  • Rehabilitation nurses

While USCIS recognizes these positions as more likely to meet the requirements, this does not mean that they are automatically deemed specialty occupations. A position in one of the categories listed above might qualify, but it still depends on the particular facts of a given case. While your chances may be higher with one of these positions, you will still have to prove that it qualifies.

Hello, (advanced) nurse!

USCIS also recognizes “advance practice registered nurse” (APRN) positions as more likely to qualify as specialty occupations. APRN positions demand expanded skills, experience, and knowledge, and therefore a more advanced level of education and training. While APRNs go by different names in different states, and regulations vary by location, the following categories have been singled out by USCIS:

  • Certified Nurse-Midwife (CNM);
  • Certified Clinical Nurse Specialist (CNS);
  • Certified Nurse Practitioner (CNP); and 
  • Certified Registered Nurse Anesthetist (CRNA).

Need more information?

To help clarify the issues surrounding nursing and H-1B visas, USCIS issued a memo in 2015, which is filled with additional, pertinent details. Of particular interest is a section that lists the kinds of documentary evidence that can help establish that a particular position qualifies as a specialty occupation (Section V). Click here to read the memo in full.

Our experienced immigration attorneys are here to guide professionals through the complicated H-1B application process, and minimize any and all confusion or challenges. We understand how important an H-1B visa is to you, whether as the employer or the prospective employee. Our seasoned staff and years-long track record of success make Zhang & Associates the natural choice to facilitate your H-1B petitions.

For more detailed information on the H-1B category, including minimum requirements and USCIS policies, refer to the following links:

General H-1B Topics

H-1B Articles


Updated 04/26/2017