1. Post-Residency Options for International Medical Graduates H. Ronald Klasko, Esq. K lasko, R ulon, S tock & S eltzer, LLP 1800 JFK Blvd. Suite 1700 317 Madison Ave. Suite 1518 Philadelphia, PA 19103 New York, NY 10017 215.825.8600 212.796.8840 rklasko@klaskolaw.comrklasko@klaskolaw.com www.klaskolaw.com

2. Klasko, Rulon, Stock & Seltzer, LLP H. Ronald Klasko, Esq. H. Ronald Klasko is the Managing Partner of Klasko, Rulon, Stock & Seltzer, LLP. Ron and his firm were chosen by clients and peers as one of the top six immigration firms in the country and “the strongest in the country in representing clients in the university research and medical sectors.” He is a former National President of the American Immigration Lawyers Association. He has been a featured invited speaker for the American Association of Medical Colleges (AAMC) and the Educational Commission for Foreign Medical Graduates (ECFMG). He has been Adjunct Professor of Immigration Law at Villanova University Law School and is a frequent author and lecturer on immigration law issues related to academic healthcare institutions. Mr. Klasko is selected annually for inclusion in Best Lawyers in America. Mr. Klasko is the founder and co-chair of NAFSA’s Healthcare Interest Group. His practice emphasizes representation of universities, hospitals and research institutions and their students, scholars, staff and employees.

3. Klasko, Rulon, Stock & Seltzer, LLP Post-Residency Options for International Medical Graduates Agenda ■ I am on a J-1 completing my residency at Hahnemann. What do I need to think about relating to immigration? ■ I am on an H-1B completing my residency at Hahnemann. What do I need to think about relating to immigration? ■ How can I get green card, and when can I start the process?

4. Klasko, Rulon, Stock & Seltzer, LLP  Getting a waiver of two year return requirement Hardship waiver Persecution waiver Interested government agency waiver based on research  Usually HHS or NSF I am on a J-1 completing my residency at Hahnemann. What do I need to think about relating to immigration?

5. Klasko, Rulon, Stock & Seltzer, LLP  Interested government agency waiver based on clinical service Health professional shortage area or medically underserved area Flex 5 State (Conrad) 30 waiver VA waiver Other government agency waiver  ARC, DRA, HHS  Timing and steps of waiver process I am on a J-1 completing my residency at Hahnemann. What do I need to think about relating to immigration?

6. Klasko, Rulon, Stock & Seltzer, LLP  What happens if you get waiver? All options available unless clinical waiver If clinical waiver, must be H-1B for 3 years for shortage area employer Spouse can’t work unless separate H-1B employer  What happens if you can’t get waiver? O-1 visa Return home I am on a J-1 completing my residency at Hahnemann. What do I need to think about relating to immigration?

7. Klasko, Rulon, Stock & Seltzer, LLP  Do I qualify for O-1 visa You need to prove “extraordinary ability”  “one of a few at the top of your peers”  National or international acclaim and recognition  Clinical, research or both Employment must sponsor Reference letters critical Spouse can’t work 3 year approval and unlimited one year extensions I am on a J-1 completing my residency at Hahnemann. What do I need to think about relating to immigration?

8. Klasko, Rulon, Stock & Seltzer, LLP Can never apply for permanent residence unless  Waiver  Aggregate of 2 years in country of nationality or last residence  Cannot satisfy requirement in a different country I am on a J-1 completing my residency at Hahnemann. What do I need to think about relating to immigration?

9. Klasko, Rulon, Stock & Seltzer, LLP  Finding an employer Will the employer sponsor you for H-1B?  Issues for employer  Paying prevailing wage  Government filing fees  Attorneys fees  Other requirements I am on an H-1B completing my residency at Hahnemann. What do I need to think about relating to immigration?

10. Klasko, Rulon, Stock & Seltzer, LLP  Getting a license Required at time of filing H-1B  Timing and Procedure Labor Condition Application (approximately 7 days) H-1B petition  15 days or less with premium processing  2 to 4 months with regular processing I am on an H-1B completing my residency at Hahnemann. What do I need to think about relating to immigration?

11. Klasko, Rulon, Stock & Seltzer, LLP  When can you start working? October 1 if you are subject to H-1B quota Immediately if not subject to H-1B quota (portability)  What is H-1B quota? When will quota be used up? What happens when quota is used up? I am on an H-1B completing my residency at Hahnemann. What do I need to think about relating to immigration?

12. Klasko, Rulon, Stock & Seltzer, LLP Who is not subject to H-1B quota?  Already counted against quota  Employer is quota exempt  University  Nonprofit affiliated with university  Nonprofit or government research organization  Concurrent H-1B  What if there’s a gap between the end of the Hahnemann H-1B and the start of a new employer H-1B? I am on an H-1B completing my residency at Hahnemann. What do I need to think about relating to immigration?

13. Klasko, Rulon, Stock & Seltzer, LLP  How long can you stay on H-1B? 6 years Can add all days outside the U.S. Can extend beyond 6 years if start the green card process one year before the end of the 6 years  Extension possible even if change of employer New 6 years if leave U.S. for one year. I am on an H-1B completing my residency at Hahnemann. What do I need to think about relating to immigration?

14. Klasko, Rulon, Stock & Seltzer, LLP If two H-1B spouses, both spouses need to start green card process in order to get both H-1B extensions after 6 years  Are there any other options? O-1 visa EAD through permanent residence application J-1 Visa I am on an H-1B completing my residency at Hahnemann. What do I need to think about relating to immigration?

15. Klasko, Rulon, Stock & Seltzer, LLP  You can sponsor yourself, if Extraordinary ability (same standard as O-1) Research-based national interest waiver  Exceptional ability  National impact How can I get green card, and when can I start the process?

16. Klasko, Rulon, Stock & Seltzer, LLP Investment  $500,000 or $1,000.000  Own business or regional center Asylum Lottery (www.travel.state.gov) How can I get green card, and when can I start the process?

17. Klasko, Rulon, Stock & Seltzer, LLP  Family sponsorship U.S. citizen spouse  Can get EAD in 2 to 3 months Other family relationship  Many year quota backlog How can I get green card, and when can I start the process?

18. Klasko, Rulon, Stock & Seltzer, LLP  Employer sponsorship Clinical national interest waiver  Shortage area  5 years commitment  Can get EAD quickly if not born in India or China How can I get green card, and when can I start the process?

19. Klasko, Rulon, Stock & Seltzer, LLP Labor certification application  Employer must engage in recruitment (4 to 6 months)  Prevailing wage (approximately 2 months)  No U.S. worker available  Employer must pay attorney fees and advertising costs  Timing and procedure How can I get green card, and when can I start the process?

20. Klasko, Rulon, Stock & Seltzer, LLP When should your employer start processing?  As soon as possible  No later than beginning of year 4 of H-1B  Can be prospective job offer  But you must meet requirements at time of filing  Can start before J-1 waiver How can I get green card, and when can I start the process?

21. Klasko, Rulon, Stock & Seltzer, LLP When can you and your spouse get an EAD and a travel document?  2 to 3 months after labor certification approved and I-485 filed if not born in India or China  Many years later if born in India or China When can you leave the employer?  When I-140 is approved and I-485 pending 180 days How can I get green card, and when can I start the process?

22. Klasko, Rulon, Stock & Seltzer, LLP  Can file I-140 and I-485 concurrently if not born in India or China  Must be employed in “similar occupation”  Wage, location, hours per week irrelevant  Many years later if born in India or China How can I get green card, and when can I start the process?

23. Klasko, Rulon, Stock & Seltzer, LLP Questions ?

24. Klasko, Rulon, Stock & Seltzer, LLP For Further Information H. Ronald Klasko, Esq. Klasko, Rulon, Stock & Seltzer, LLP 1800 John F. Kennedy Blvd., Suite 1700 Philadelphia, PA 19103 rklasko@klaskolaw.com 215-825-8600 www.klaskolaw.com