Physicians can work in the US on an H-1B visa. Eligibility depends on medical credentials, a sponsoring employer and, for most hospitals, the annual cap. Cap-exempt employers, such as universities and affiliated nonprofits, can file at any time of year. Fee rules changed sharply in 2025 and 2026, so the current status of each fee is covered below.
TL;DR
- H-1B is open to physicians who show the required medical degree, licensing exams or exemption, and a sponsoring employer.
- Cap-exempt employers (universities, affiliated nonprofits, nonprofit and government research organizations) file year-round. Most private practices and for-profit hospitals go through annual registration.
- A $100,000 payment applies to certain new petitions for workers outside the US. A court ruling has stopped collection for now, and the proclamation was extended to September 2027.
- Standard government fees are separate and add up to several thousand dollars. Premium processing is optional.
- Maximum stay is generally 6 years, with limited extensions.
Table of Contents
- Who Qualifies for H-1B as a Physician
- The Annual Cap and Cap-Exempt Hospitals
- The $100,000 Fee: Current Status
- Standard H-1B Costs
- H-1B Timeline for Doctors
- Duration and Extensions
- How Many Doctors Use H-1B
- Perspective
- Find Sponsoring Employers
- FAQ
- Sources
Who Qualifies for H-1B as a Physician
H-1B covers workers in a specialty occupation. USCIS describes the classification as covering people who perform services in a specialty occupation. Physicians fit when the job requires the medical degree.
Special rules for physicians sit in 8 CFR 214.2(h)(4)(viii). A medical school graduate may be admitted in two main situations, per USCIS decision text citing the regulation:
- Coming to teach or conduct research at a public or nonprofit private educational or research institution.
- Having passed the Federation licensing examination (or an equivalent) and showing competency in oral and written English, or having graduated from an accredited medical school.
The petition must also show state authorization for direct patient care, or an exemption by law. It must show a full and unrestricted license to practice medicine in a foreign state, or graduation from a US or foreign medical school. Physicians of national or international renown are exempt from the examination requirement in paragraph (B).
Teaching and research roles
A physician who comes primarily to teach or research, with patient care only incidental, is not held to the same examination requirement. An immigration law firm's licensure page notes that a state license is generally not required for these roles.
Direct patient care roles
Patient-care physicians need an employer sponsor and a genuine employer-employee relationship. They must pass FLEX or an equivalent exam and show English competency, unless an exception applies, as summarized by an immigration firm. In practice, the USMLE sequence is the exam path most graduates follow. The state license is a separate step.
State licensing timelines affect the start date. Physicians already licensed in one state can read the Interstate Medical Licensure Compact checklist for multi-state practice. Physicians trained abroad can find background in the guide to medical registration across borders.
No home-residency requirement
Unlike J-1, H-1B carries no 2-year home residence requirement, according to immigration information for international medical graduates. That difference is why many physicians prefer H-1B after residency. Physicians who held J-1 status and need a waiver can read about the Conrad 30 waiver program.
The Annual Cap and Cap-Exempt Hospitals
The H-1B classification has an annual cap of 65,000 new visas or statuses per fiscal year. Another 20,000 petitions for beneficiaries with a US master's degree or higher are exempt from that cap. Employers of the following types are not subject to the cap, per USCIS:
- Institutions of higher education
- Their affiliated or related nonprofit entities
- Nonprofit research organizations
- Government research organizations
Cap-exempt employers can file any time of year. A private practice or for-profit hospital is generally cap-subject and must go through annual registration, per the same law firm summary.
What counts as related or affiliated
A nonprofit qualifies as related or affiliated with a university if it meets any one of four conditions, per NAFSA's reproduction of 8 CFR 214.2(h):
- Shared ownership or control by the same board or federation.
- Operation by a university.
- Attachment to a university as a member, branch, cooperative or subsidiary.
- A formal written affiliation agreement with a university for research or education, where directly contributing to that mission is a fundamental activity.
Many nonprofit teaching hospitals meet the fourth condition. A physician employed elsewhere can still qualify if at least half of work time is spent at a qualifying institution and the duties directly further its fundamental purposes (NAFSA, citing 8 CFR 214.2(h)(8)(iii)(F)(4)).
Cap-subject employers and the weighted selection
For cap-subject employers, DHS announced a final rule on December 23, 2025, for the Weighted Selection Process, effective February 27, 2026 for the FY27 registration. The process prioritizes higher-paid wage levels. Many non-trainee physicians fall into wage levels III or IV, which makes selection more likely. Trainees on lower wage levels face lower odds.
The same law firm commentary describes cap exemption as a strong option for most physicians. Routes include a J-1 waiver through an interested government agency, or work at a nonprofit hospital with ongoing ties to a university.
The $100,000 Fee: Current Status
This is the part that changes most often. Facts below are dated. Always check the official pages before filing.
What the proclamation does
On September 19, 2025, a presidential proclamation restricted entry of new H-1B workers unless the sponsoring employer pays $100,000. This sits on top of existing fees. According to the Congressional Research Service, it applies to new petitions filed after September 20, 2025 for workers abroad. Existing H-1B visas, renewals and changes of status are generally not subject to it.
Medical associations and higher education groups asked for exemptions. They argued that H-1B workers provide services critical to the national interest, including care in medically underserved areas.
Court ruling and extension
A US district judge voided the fee in June 2026, according to a news headline in search results. On September 18, 2026, the administration extended the proclamation for another year, through September 21, 2027. Health recruiter guidance states the payment is not currently collected due to a court ruling. The policy stays in place for another year if the government prevails.
In practice: the requirement is on hold, but the outcome depends on litigation. Employers hiring physicians from abroad plan for both outcomes.
Who is exempt
Commentary on residency programs notes that most teaching hospitals and residency programs are generally not paying the fee for foreign physicians. The reasons are the type of petition, the location of the worker and employer status. A physician already in the US who is changing status, such as from J-1 or F-1, generally is not covered by the proclamation, per the CRS summary above. Individual cases vary, so the employer's immigration counsel confirms the position.
Proposed rule: $103,265 fee
On August 25, 2026, DHS published a proposed rule for a $103,265 fee on every cap-subject H-1B petition, including changes of status for people already in the US. Under the proposal, cap-exempt employers would be exempt from the fee: higher education institutions, government research organizations and certain nonprofits. It is a proposal, not a final rule.
On September 24, 2026, the AMA urged the administration to exempt physicians. The AMA also supports the H-1Bs for Physicians and the Healthcare Workforce Act, which would exempt physicians and other health professionals from the $100,000 fee for new petitions. Bills can change or stall, so the congressional record is the place to check.
Standard H-1B Costs
The fees below are in addition to any proclamation payment. Employers normally pay these.
| Fee | Amount | Source |
|---|---|---|
| Form I-129 filing | $780 standard, $460 small employers and nonprofits | 8 CFR 106.2 |
| ACWIA fee | $1,500 or $750 | 8 CFR 106.2 |
| Fraud Detection and Prevention | $500 | 8 CFR 106.2 |
| Asylum Program Fee | $600 (more than 25 employees), $300 (25 or fewer), $0 nonprofits | USCIS filing fees |
| Premium processing (optional) | $2,965 since March 1, 2026 | University of Michigan International Center |
Nonprofit hospitals and university employers pay the lower tiers. Cap-exempt status also avoids the registration step.
H-1B Timeline for Doctors
A new H-1B from abroad follows a fixed order. Typical durations from a medical center's timeline:
- Petition preparation: about 6 weeks.
- USCIS decision: 15 days with premium processing.
- Approval notice (I-797): about 2 weeks.
- Visa interview at a US consulate.
- Administrative processing: sometimes an extra 1 to 3 months.
- Visa issuance and travel.
The petition has three formal parts: a labor condition application to the Office of Foreign Labor Certification, a certified LCA with Form I-129 to USCIS, and the visa from the Department of State.
Cap-subject employers add registration and selection before step 1. Cap-exempt employers skip this, which is why cap-exempt jobs can start sooner.
State licensing and credentialing run alongside the visa steps. Many physicians start both early. The healthcare job search checklist for doctors lists the documents to gather.
Duration and Extensions
H-1B allows an initial period of up to 3 years and an extension of up to 3 more, for 6 years in total. After six years in H or L status, a person generally spends a year outside the US before returning in that status, per the firm summary.
Exceptions exist. USCIS explains that extensions beyond 6 years are permitted in limited cases:
- At least 365 days have passed since a permanent labor certification or immigrant petition was filed (1-year increments).
- An immigrant visa petition is approved and a visa is not yet available (3-year increments).
Physicians planning a green card typically start the process during the first H-1B period.
How Many Doctors Use H-1B
In FY 2024, H-1B-sponsored health professionals accounted for 0.97% of physicians: 11,080 of 1,138,056, per JAMA. Those physicians are concentrated in specific settings. One report counted 325,000 foreign-born doctors in the US, with immigrants making up half or more of the workforce in some fields such as primary care and oncology.
The workforce context is covered in the 2026 US physician shortage analysis.
Perspective
Visa rules shift quickly. Employer type shifts the picture most: cap-exempt status changes timing, fees and risk.
ConnectedMedics is built for healthcare only. Profiles are verified. The jobs board carries specialty-specific filters, with over 22,000 active healthcare vacancies. A physician can filter by specialty and review roles at nonprofit and academic employers, then confirm the employer's sponsorship position directly.
Employers on the platform can post roles and reach verified clinicians. Peer discussion and the knowledge hub cover licensing, compensation and career moves in one place.
Work permits are available online through the platform. Visa advice stays with qualified immigration counsel.
David
Find Sponsoring Employers
Physicians seeking H-1B roles can search healthcare jobs by specialty on ConnectedMedics. Employers can post roles to verified clinicians. The Growth plan is £99 per month. Free, Growth and Enterprise tiers are listed on the employer plans page. Larger hiring teams can review Premium Employer.
Physicians can start from the ConnectedMedics homepage. Compensation context is in the 2026 physician compensation trends.
FAQ
Does H-1B apply to physicians?
Yes. Physicians qualify when the role requires a medical degree and the petition meets 8 CFR 214.2(h)(4)(viii). Patient-care roles need the exams and state authorization. Teaching and research roles have lighter requirements.
Who is exempt from the $100,000 fee?
The proclamation generally targets new petitions for workers outside the US. Renewals, extensions and changes of status are generally not covered. Collection is currently paused by a court ruling. The employer's immigration counsel confirms exemptions for a specific case.
Which hospitals are cap-exempt?
Universities, their related or affiliated nonprofits, and nonprofit or government research organizations. Many nonprofit teaching hospitals qualify through a written affiliation agreement. Private practices and for-profit hospitals generally do not.
How long does H-1B take for a doctor?
About 6 weeks for petition preparation, 15 days with premium processing, and about 2 weeks for the notice. Consular processing can add 1 to 3 months. Cap-subject petitions add registration time first.
How long can a doctor stay on H-1B?
Generally 6 years: an initial 3 plus an extension of up to 3. Limited extensions exist when a green card process is underway.
Sources
- USCIS: H-1B Specialty Occupations
- USCIS decision text on 8 CFR 214.2(h)(4)(viii)
- Peryeva Immigration Law: licensure and credentialing
- Ellis Porter: H-1B for doctors
- AMA: immigration information for international medical graduates
- NAFSA: 8 CFR 214.2(h)
- Bernstein Shur: weighted selection and physicians
- Congressional Research Service: new H-1B fee
- AAPPR: changes to the H-1B and J-1 process
- KFF: proposed $103,265 fee
- AMA: H-1B fee increase threatens patient access
- AMA: exempting physicians from the H-1B fee
- eCFR: 8 CFR 106.2 USCIS fees
- USCIS: H and L filing fees for Form I-129
- University of Michigan International Center: fees
- H-1B visa timeline
- USCIS: FAQs for individuals in H-1B status
- JAMA: health care professionals sponsored for H-1B
- NPR: new policies and foreign-born physicians