The immigration landscape for foreign RNs and PTs has changed in recent years due in most part to the retrogression of immigrant available visa numbers and US education requirements for these occupations. RNs and PTs must therefore adjust their strategies to allow them to immigrate to the US.  There are two avenues for working in the US: the nonimmigrant and immigrant visas.  The first is a temporary visa for a fixed number of years while the latter is to live permanently in the US.

Many US employers would like to evaluate a foreign PT to ensure they are a good fit with their organization before sponsoring them for immigrant visas.  The nonimmigrant working visa is a good mechanism to allow for this.  The most common of these is the H-1B visa.   This is a working visa for occupations that require the minimum of a specialized bachelor's degree for entry into the field. The USCIS will begin accepting H-1B visa petitions on April 1, 2010 for employment to begin on October 1, 2010. 

The occupation of PT falls within the H-1B because the minimum education level for entry into the occupation is a bachelor's degree.  However, the Commission on Accreditation in Physical Therapy Education's (CAPTE) stopped accrediting bachelor's degree PT programs as of January 1, 2003.  Since that date, accredited USdegrees in physical therapy are now only offered at the master's level.   This means that any PT degree earned after January 1, 2003 must be an advanced master's degree.  This includes foreign educated PTs whose education will be evaluated to determine if it is equivalent to a US master's degree curriculum.  Some foreign bachelor's degree programs may be found the equivalent to an accredited degree if sufficient advanced clinical and class courses have been completed.

Many foreign PTs who earned (or are completing) a PT degree after 2003, will need to return to school for additional course work or complete a masters degree.  Those intending to work in the US, and who are still enrolled in school, should identify which courses they need to complete for CAPTE equivalency.  This would mean taking on advanced electives in order to qualify to work in the US.  It is disheartening to learn, after the fact that if one took an advanced manual therapy clinic instead of badminton he would have been eligible to work in the US. Carefully choosing courses and electives may prevent the need for additional schooling.

RNs are in a somewhat similar predicament to PTs. Unfortunately, the minimum education required for entry into the occupation of RN in the US is an associate's degree.  The immigration service, therefore, generally does not recognize RN positions as qualifying for a H-1B visa.  It is important to note that immigration looks at what the labor market says the occupation requires.  Since most employers in the US only require an associate's degree for general RN positions, the occupation cannot qualify for H-1B.  But, there are specialties within nursing that require the minimum of either a bachelor's degree or master's degree.  Examples of these are Nurse Anesthesiologist, Nurse Oncologists, Geriatrics Nurse, Registered Nurse Practitioner and in some cases, Operating Room Nurse.   Because most of these typically require a master's degree, they would qualify for H-1B.

An RN who wishes to work in the US will be able to work sooner by attaining the equivalent of a US master's degree in a nursing specialty.  This will require one to two years more of schooling but will allow the RN to be in the US sooner.

Generally, the only other option for RNs to work in the US is to be petitioned for an immigrant visa as a skilled worker.  Due to enormous worldwide demand for the skilled worker visas, a backlog of several years presently exists.  Availability of visas is very difficult to gauge with some estimates of 4 years to others as high as 12 years.  This means an employer sponsoring a RN today, will have to wait several years before the RN may begin working for them.  Most healthcare employers are taking a wait and see approach and are unwilling to commit to such long wait times.   Given this immigration climate, a RN who goes on to pursue a specialized master's degree in nursing, will be eligible to work in the US once they have obtained the master's degree.  They are immediately more attractive to sponsoring employers because they are allowed to work right away.

The advanced degrees in Nursing and Physical Therapy also provide an enormous advantage to obtain an immigrant visa.  Occupations that require a master’s degree for entry into the field are known as advanced degree professionals. Advanced degree professionals have their own immigrant visa number quota which is presently current for most countries. This means that when the immigration service approves the immigrant visa, the advanced degree RNs or PTs and their immediate family members may immigrate to the US without delay. 

Today's immigration climate favors RNs and PTs with master's degrees.  Those who wish to be sponsored for work in these fields in the US are best served by obtaining these advanced degrees.  It is impractical for most healthcare employers to sponsor skilled workers.   Until the US Congress increases skilled worker immigrant visa numbers for RNs and PTs, or allocates them their own visa numbers as it has done in the past, the best way to immigrate is through an advanced degree. Please tune into this week's episode of the Immigration Experts for more information on RN and PT immigration options.

Author's Note: The analysis and suggestions offered in this column do not create a lawyer-client relationship and are not a substitute for the individual legal research and personalized representation that is essential to every case.

Robert L. Reeves is a licensed Californiaattorney and is certified by the California State Bar as an Immigration and Nationality Law Specialist. He has been specializing in immigration law for over 30 years and is admitted to practice before the US Supreme Court, the US Court of Appeals for the Ninth Circuit, several US District Courts and California State Courts. He is the Managing Partner of Reeves & Associates with offices located in Pasadena, San Francisco, Las Vegasand Makati City.  Philippine Contact Numbers: 759.6777 or Toll Free: 1-800-10-7733837 E-mail:immigration@rreeves.comWebsite: www.rreeves.com.