Most employment-based permanent residency applications require the applicant to go through the PERM labor certification process where the U.S. Department of Labor (DOL) certifies that there are not sufficient U.S. workers able, available, and qualified to fill a position. However, DOL recognizes nurses and physical therapists as shortage occupations or “Schedule A” occupations, where the DOL has determined there are not sufficient U.S. workers to fill these openings, so hiring foreign nationals would not displace U.S. workers.

Even with annual springtime “Match Day” seasons for incoming medical professionals expanding to nurses and other novel innovations underway, the reported trend of nursing shortages remains. For instance, a 2022 published workforce analysis in Health Affairs found that the supply of registered nurses decreased by more than 100,000 from 2020 to 2021 – the largest drop ever observed over the past four decades. This shortage of registered nurses is projected to spread nationwide through 2030.

The Schedule A process provides for a fast-track green card process for candidates in occupations currently in critical demand at hospitals and medical centers where employers are struggling to fill positions. Applicants in these occupations can skip the PERM labor certification process, which currently takes about 18 months, and directly proceed to file the I-140 Alien Worker Petition with the U.S. Citizenship and Immigration Service (USCIS). 

The Process for Qualified Nurses and Physical Therapists: 20 CFR §656.15

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Prevailing Wage Determination (PWD): Employer must obtain a Prevailing Wage Determination from DOL. Currently it takes between 5-6 months to process. Notice of Filing: Provide notice that the employer is seeking to fill the Schedule A position to the employees or bargaining representative (if available). The notice must be posted for 10 consecutive business days. Quiet Period: Employer must wait 30 days after the Notice of Filing is properly posted and completed to be able to file the I-140 Petition with USCIS. File the I-140 Alien Worker Petition: The I-140 petition must be filed within the validity period of the PWD. Adjustment of Status or Consular Process – depending on Priority Dates being current

Qualifications Required for Nurses:

  • Schedule A only applies to “professional nurses.” Practical nurses, nurse assistants, and other nursing aides do not qualify for a Schedule A process.
  • A current permanent, full and unrestricted license from the state where the applicant will be employed.
  • CGFNS Certification/ NCLEX Certification/Visa Screen: The professional nurse must have received a certificate from the Commission on Graduates of Foreign Nursing Schools or have passed the National Council Licensure Examination for Registered Nurses (NCLEX-RN), administered by the National Council of State Boards of Nursing. The visa screen is a comprehensive screening service as required by immigration regulations in order to receive U.S. permanent residency or nonimmigrant visa. (8 USC 1182 (A)(5) (C)

Qualifications Required for Physical Therapists:

  • Able to demonstrate that he or she has all the qualifications necessary to take the physical therapist licensing examination in the particular state the physical therapist plans to practice. Typically the candidate must possess at least a bachelor’s degree in physical therapy or the equivalent. Depending on the state, the requirement may be a master’s degree.
  • Possess a permanent license to practice or a statement by a licensing official stating that the applicant is qualified to take the written examination for physical therapist.
  • Undergo a visa screen, a comprehensive screening service required by immigration regulations in order to receive U.S. permanent residency or nonimmigrant visa. (8 USC 1182 (A)(5) (C)