In our last blog our guest blogger from Ogletree Deakins went through some of the considerations practices have to go through when hiring a J-1 candidate. In this blog we discuss the same topic but for practices considering an H-1B candidate. For more information on Ogletree Deakin’s Immigration practice, please go to Additionally, if you want a very high level view of the requirements to hire H-1B candidates, view the blog we recently posted.

The Physician Who Trains in H-1B Status

Some U.S. training programs sponsor foreign national residents and fellows in H-1B status. One major benefit of the H-1B is the ease of transfer to another employer-sponsor; however, this benefit is generally unavailable for physicians who train in H-1B status for teaching hospitals and seek to transfer to for-profit healthcare employers. As background, institutions of higher education and non-profits affiliated with institutions of higher education (i.e. teaching hospitals) can sponsor H-1B employees at any time because these employers are exempt from the annual H-1B cap. Employers who don’t qualify for this exemption (i.e. the majority of U.S. employers) must compete each year for the 85,000 total H-1B visa slots available annually. In order to transfer an H-1B from a “cap-exempt” employer to a “cap-subject” employer, the physician must compete for one of the 85,000 slots, just like the hundreds of thousands of other professionals seeking H-1Bs to work in the U.S. The deadline to file a cap-subject H-1B is strict: employers must file the H-1B petition on April 1 and, if selected and approved, the physician can begin working for the employer no earlier than the following October 1. The likelihood of winning the H-1B lottery is quite low (historically, between 30-40%), so this cap-subject H-1B sponsorship is not a sure thing for both the private healthcare employer and the physician.

There is one additional consideration when onboarding a physician who trains in H-1B status. Importantly, H-1Bs are valid for up to six years. Residency programs plus fellowships can extend well beyond four years. Practically, an employer might not want to hire someone with just two years of work authorization remaining – this would be a poor investment. Note that H-1Bs can be extended beyond the six-year max out date if the physician has the first step of the green card process in place by his/her fifth year in H-1B status. Green card sponsorship is a timely and expensive investment for employers, so an individual’s remaining H-1B time is an essential consideration when hiring foreign national physician talent.

If you have any questions about the hiring process when considering visa candidates, feel free to email DaVita SOURCE at We’ll try our best to answer any questions you have or direct you to an expert on the subject.