Foreign Medical Graduate (FMGs/IMGs) physicians presently employed by one medical facility but wish to moonlight at another need to consult an experienced attorney because of the complex requirements, qualifications and constraints imposed by the different visas and processes. This especially true for physicians who are bound to complete a waiver service due to a prior J-1 visa or a pending national interest waiver petition. Those physician who seek green card or waiver self-sponsorship faced additional complexities requiring consultation with an experienced attorney in the area. The following is a review of the options that may be available to moonlighting physicians.
Concurrent H-1B Visa For Moonlighting Physicians
H-1B visas are employer-specific. In other words, H-1B visa holders may only work for the employer who sponsored it. In order to moonlight or work for another employer, the physician must apply for another H-1B visa to be sponsored by a second employer (concurrent H-1B Visa). The duration of the second (concurrent H-1B) can be different from the first and part-time or flexible concurrent employment is supported by the new H-1B visa. Note that the concurrent H-1B may be approved even for an H-1B position subject to the cap even though the original H-1B visa is cap-exempt. This presents a significant advantage for H-1B visa holders who are in the process of completing the waiver service with a visa that is cap exempt. In any event, it is important to note that physicians seeking to moonlight must continue to meet their J-1 visa/national interest waiver service obligations.
TN Visa For Moonlighting Physicians
Our main visa options page for physicians reviews the general requirements for the TN visa status for Canadian and Mexican professionals. This visa can be used by moonlighting physicians in very limited fashion, if at all. It only permits physicians to engage in research and teaching activities and only in patient care incidental to those activities. This visa also poses problems for those physicians in the green card process as it does not permit dual intent as the H-1B visa does.
E-3 Visa For Moonlighting Australian Physicians
This option for Australian physicians is comparable to the H-1B visa above. It is not subject to the H-1B visa caps. However, premium processing is only available after appropriate regulations are made available. As such, processing times may be longer as H-1B visa portability is not supported by this option.
Moonlighting Visas for Physicians With Approved PERM Labor Certification Petitions
Physician with approved PERM labor certification applications may file I-140 green card petitions. Assuming that the visa numbers are available through the visa bulletin and the physician has completed his or her J-1 visa service obligation, an I-485 adjustment of status petition may be filed along with a request for a work authorization and a travel document, if needed. Upon approval of the work authorization, the physician may accept employment for moonlighting opportunities without applying for a separate visa. However, such physicians must be careful to maintain the terms and conditions of their pending I-140/I-485 petitions to prevent the moonlighting job from interfering with the validity of their underlying green card petition.
Moonlighting for Physicians with National Interest Waiver Green Card Applications
Most physicians as well as many legal practitioners are under the mistaken impression that only J-1 Visa Waiver physicians qualify for the national interest waiver green card process. To the contrary, the national interest waiver is available to J-1 or non J-1 physicians so long as they meet the requirements and commit to the required service in an underserved area (HPSA/MUA/MUP). Physicians who are completing their 5 year national interest waiver service may accept concurrent employment once the EAD card is approved. As with J-1 waiver physicians, national interest waiver physicians must continue to meet their visa waiver service obligations to completion.
Physician Moonlighting with EAD Card
Physician who have obtained EAD cards through a PERM labor certification and I-140/I-485 petitions may accept concurrent moonlighting opportunities. Again, those physicians must be careful to ensure that the part-time or moonlighting opportunities do not affect the underlying job that is sponsoring their green card process. Such physicians must also renew the EAD cards annually on a timely basis to ensure continuity of eligibility for employment.
Self-Sponsorship For Physician J-1 Visa Waivers and National Interest Waivers
Physicians who seeking J-1 visa waivers and or green cards may be able to self-sponsor by opening or buying a qualifying practice. Furthermore, under AC21, physicians that are presently serving their J-1 visa waiver or green card national interest waiver obligation may self-sponsor and transfer the service to a newly formed or purchased practice so long as the practice meets the requirements. Physicians who are considering this option should visit our [Physicians Visas-Waiver & Green Card Self-Sponsorship] page. Physician self-sponsorship is a fairly complex legal procedure that requires the guidance of an attorney experienced in matters related to physician visas.
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