A visit to the dentist is hardly a pleasurable exercise for many people! Dentists, however, are the unsung heroes of the medical profession as they perform a very important function in caring for our teeth. It is now well-recognized that good oral health is important to overall health as well self-esteem and well-being.
Recognition that good oral health is important and access to better insurance has led to a steady increase in those seeking dental care services. The demand is expected to outstrip supply –the Dept. of Health and Human Services expects that there will be a shortage of approximately 15,000 dentists by 2025!
The US is, therefore, a great place for foreign national dentists who want to work here. There are also a variety of nonimmigrant and immigrant visa options to choose from. Each visa option is designed to serve a particular need, and they come with their own requirements, advantages and limitations, often making it a difficult exercise for foreign national dentists and their employers to identify the one that would be most suitable in their situation. In this article we present a snapshot of the most popular visa options that are available to foreign national dentists who want to come and work in the U.S., either as a permanent resident or as a temporary working professional.
The TN For Dentists
The TN Classification allows Canadian and Mexican Nationals to seek temporary entry into the U.S. to engage in certain business activities at a professional level. The TN Classification is only available if the offered profession or occupation is on the NAFTA List. “Dentist” is on the TN NAFTA List.
The TN For Dentists – Eligibility Conditions
In order to be eligible for the TN for Dentists, the foreign national must have at least one of the following:
- A DDS (Doctor of Dental Surgery) or DMD (Doctor of Medicine in Dentistry) degree; OR
- Doctor en Odontologia or Doctor en Cirugia Dental; OR
- A state/provincial license.
Ultimately, the applicant must show proof of attainment of the professional degree in dentistry from the U.S., Canada or Mexico OR licensure in a U.S. or Mexican state or Canadian province.
The candidate must also have a prearranged full-time or part-time job with a U.S. employer in a position that requires someone in that professional capacity.
DID YOU KNOW?
Foreign national dentists who wish to enter on the dentist TN visa classification need not possess licensure to obtain the TN but must possess a license in order to begin employment and practicing. Licensure requirements vary from state to state. While all applicants for a dental license must meet certain basic requirements including passing the NBDE and minimum education requirements, individual states may have additional licensure requirements. Foreign national dentists who wish to work in the U.S. must, therefore, check with the respective state dental board for the most relevant and up-to-date information about licensure requirements.
How To Apply
Obtaining TN status does not require prior approval from US Citizenship & Immigration Services.
As Canadian nationals are exempt from having to obtain nonimmigrant visas (except E-1/E-2), Canadian Dentists may obtain TN status by applying directly with US Customs & Protection at a Class A Port of Entry or Pre-Clearance Inspection Station.
Mexican citizens can obtain the TN visa directly at a U.S. Consulate or Embassy.
Those in the U.S. in valid nonimmigrant status may have the Employer/Petitioner file an I-129 petition with USCIS in order to change status to TN.
Period of Admission
Canadian and Mexican national dentists who enter the U.S. with dentist TN visa classification may be admitted for a period of up to three years initially.
NOTE: Currently, because of visa reciprocity, TN visas for nationals of Mexico are limited to one year.
The spouse and children under the age of 21 may be eligible for TD nonimmigrant status. TD holders cannot work while in the U.S., but are permitted to study.
Applicants for TD status do not have to be Canadian or Mexican citizens. However, spouses and/or children of Canadian TN applicants who are not Canadian must apply for the TD visa at a US Consulate or Embassy.
The H1B For Dentists
The H1B program allows U.S. employers to employ foreign nationals in ‘Specialty Occupations’. The Immigration and Nationality Act defines specialty occupation as “an occupation that requires theoretical and practical application of a body of highly specialized knowledge, and attainment of a bachelor’s or higher degree in the specific specialty (or its equivalent) as a minimum for entry into the occupation in the U.S.” The position of “Dentist” is accepted by USCIS to be a specialty occupation.
The H1B For Dentists – Eligibility Conditions
In order to seek H-1B classification for dentists, the following important conditions, among others, must be satisfied:
1.The foreign national dentist must possess the first professional degree in dentistry or its equivalent. In the U.S., dental graduates obtain a post-graduate degree in dentistry, the DDS (Doctor of Dental Surgery). Foreign national dentists, with the exception of some Canadians, who do not possess a U.S. dental degree, must obtain an evaluation from a credentialing agency certifying that the foreign degree they have received is substantially equivalent to an American university degree in dentistry.
2.The foreign national dentist must take and pass the National Board Dental Examination (NBDE). This is a requirement for all U.S. and foreign educated dentists.
3.The foreign national must be licensed in the state where he or she intends to be employed or be eligible for licensure.
It’s important to remember that licensure requirements vary from state to state. While all applicants for a dental license must meet certain basic requirements including passing the NBDE and minimum education requirements, individual states may have additional licensure requirements. Foreign national dentists who wish to work in the U.S. must, therefore, check with the respective state dental board for the most relevant and up-to-date information about licensure requirements.
NOTE: USCIS will not deny a petition for the H1B solely for lack of licensure if a state has a specific prerequisite for licensure that would be impossible for the foreign national to possess or obtain before obtaining the visa or work authorization. The employer will have to show that the candidate is otherwise eligible for licensure. USCIS may limit the validity of the approved petition to 1 year in cases where a license cannot be produced.
4.The employer must submit and receive a certified Labor Condition Application (LCA) from the Department of Labor.
How To Apply
In order to obtain the H-1B visa or status, the employer must:
- File a Labor Condition Application (LCA) with the U.S. Department of Labor
- File USCIS Form I-129, Petition for nonimmigrant worker with H supplement and supporting documentation and the approved LCA with the USCIS
The H1B Quota And Timing
Timing is a critically important factor to keep in mind when evaluating the H-1B for Dentists. The H1B classification is subject to an annual numerical quota of 65,000, commonly known as the “H1B cap”. When submitting an H1B petition, the employer must be sure that the cap is still open, i.e., the numerical limit has not been reached for the present fiscal year.
It’s important to note that USCIS’ fiscal year goes from October 1 to September 30 of each year. As there have been more applications received by USCIS than there are available H-1B’s in recent years, USCIS must run an “H-1B Lottery” each year. In order to be eligible for the Lottery, H-1B petitions must be received during the first week of April. Employers and prospective employees must strategize, prepare and timely file the H-1B in order to have a chance at “winning the lottery.” [For more information, check out VisaPro’s Free EBook: A Practical Guide to filing H-1B Cap 2018 Petitions.]
Employers and foreign national dentists must consider issues related to the start date of the H-1B when evaluating options- if a dentist needs to begin on August 1 but the H1B will not begin until October 1, the employer and dentist may need to find a way to “bridge the gap” or find a suitable alterative.
Exemptions To The H-1B Cap
The regulations provide several exemptions to the numerical cap that some foreign dentists may be eligible for:
- Foreign nationals who are employed or have received an offer of employment at an institution of higher education, a related or affiliated nonprofit entity, or a nonprofit or governmental research organization are exempt from the H-1B numerical cap;
- An additional 20,000 H-1B’s are set aside for US Advanced Degree holders- commonly referred to as the “Master’s Cap”. Foreign national dentists who obtain their DDS from a US institution would be eligible for the Master’s Cap.
Period of Admission on A H1B Dentist Visa
All foreign nationals who seek to enter on the H1B visa, including dentists, may be admitted for an initial period of up to three years and the period of admission may be extended for an additional three years, for a maximum of six years. Periods of stay may be limited for several reasons including limited duration contracts and limited licensure. Generally, the H1B visa is limited to a total of six years unless certain conditions are met. Furthermore, spouses and unmarried children under 21 years of age may also seek admission in the H-4 dependent nonimmigrant classification.
The ‘Dentist’ Green Card
Unlike the dentist TN visa and the H1B visa for dentists as above, which are nonimmigrant visa classifications that allow foreign national dentists to live and work in the U.S. temporarily, the “Green Card” or Legal Permanent Residency allows a foreign national dentist to stay and work in the U.S permanently. Under U.S. immigration law, employment-based Green Cards or Immigrant Visas are divided into 5 preference categories. Among those 5 categories, most dentists will fall into the Second Employment-Based Preference Category while a few may fall into the Third Employment-Based Preference Category.
EB-2 Green Card Category: This category is reserved for foreign national professionals holding Advanced Degrees, like the DDS (generally meaning a degree beyond a four-year bachelor’s or a bachelor’s degree + five years of experience) or for Individuals with Exceptional Ability in the arts, sciences, or business.
EB-3 Green Card Category: This category is reserved for foreign national professionals and skilled workers. Professional means a person whose job requires at least a U.S. baccalaureate degree or a foreign equivalent and who is a member of a profession. Dentists fall under the definition of ‘Professional’.
Green Card For Dentists: The Process
Barring a few exceptions, almost all Employment Based Green Card Categories require foreign nationals to already have a job offer from a U.S. employer (the “sponsor”). In the first step of the Green Card process, the sponsoring employer must obtain an approved labor certification from the U.S. Department of Labor (DOL), which verifies that:
- There are insufficient available, qualified, and willing U.S. workers to fill the position being offered at the prevailing wage; and
- Hiring a foreign worker will not adversely affect the wages and working conditions of similarly employed U.S. workers.
For individuals with Advanced Degrees or Exceptional Ability (EB-2), an exception to the above mentioned labor certification requirement is provided under the ‘National Interest Waiver’ (NIW). Here the labor certification requirement may be waived for foreign nationals whose employment in the U.S. would greatly benefit the nation. No such “waiver” is available for foreign nationals applying under the EB-3 Green Card category.
Once the labor certification is approved by the DOL, the sponsoring employer must file a Form I-140, Petition for Alien Worker, demonstrating among other things, that the employer has ability to pay the offered wage and that the foreign national dentist satisfies the minimum qualifications required to fill the position that is being offered to him or her.
Once the Immigrant Visa Petition is approved by the USCIS, the next step in the Dentist Green Card process depends on where the foreign national dentist is physically located – in the U.S. in valid nonimmigrant status or outside the U.S.:
- Adjustment of Status
If the applicant is in the U.S. in valid nonimmigrant status or is otherwise eligible, the foreign national can file for “Adjustment of Status” with USCIS and may continue to remain in the U.S. until the application is adjudicated and the foreign national is granted the green card. The beneficiary can also concurrently file applications for Employment Authorization and travel documents with the Adjustment of Status application.
- Consular Processing
In cases where the beneficiary is outside the U.S., the approved visa petition is forwarded to the National Visa Center (NVC). The NVC will issue instructions on the next steps, including instructions regarding the fees that must be paid and later, the forms and documentary evidence to be submitted. The NVC, upon receipt of all fees and documents, will schedule the applicant for an interview at a U.S. Consulate in their home country or where they presently reside. If approved at the interview, he or she will be issued an Immigrant visa that will be valid for 6 months. He or she will also be given a sealed envelope which he or she must present to the immigration officer upon landing in the U.S.
NOTE: Regardless of where the foreign national dentist resides, he or she cannot continue to the next step after the immigrant petition approval until his or her “priority date” is current as per the Visa Bulletin (there are only 140,000 immigrant visas available each year for all the employment based categories and there is a further 7% cap for each country). The priority date is generally the date the labor certification application was received by the Department of Labor (DOL) or in the case of NIWs, the date the I-140 petition was received by USCIS.
With a valid Green Card, a foreign national dentist can stay and work in the U.S. as a permanent resident. The spouse and minor children of a Green Card holding dentist are also eligible to apply for a Green Card but each individual must file their own application.
As seen here, foreign national dentists who wish to come to the U.S. to practice in the U.S. have a variety of nonimmigrant and immigrant visa options to choose from. Regardless of the visa option chosen, the eligibility of a foreign national dentist to work in the U.S. primarily depends on his or her ability to satisfy the degree and licensure requirements, which, in turn, varies from state to state. It is therefore necessary that foreign national dentists check with the state dental board where they wish to practice and live regarding the licensure requirements in the respective state before embarking on any immigration related process.
There may be other visa options available based on the specific situation presented by the foreign national or the employer. Hence, it is advisable that a foreign national dentist and the employer carefully evaluate all the options against their individual situation and speak with an experienced immigration professional before deciding on which visa option to exercise.
Contact VisaPro if you have any questions regarding immigration for dentists, or any type of business or work visas. Our experienced attorneys will be happy to assist you.
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