The petitioner, a Brazilian-trained orthopedic physician and surgeon, proposed to work in a U.S. clinic or hospital treating orthopedic patients, while also training other doctors and instructing medical students.

Prong 1 — national importancenot established · dispositive

“a shortage of qualified professionals does not render the work of an individual physician or surgeon nationally important under the Dhanasar decision”

“The record does not establish that his proposed endeavor will have national or global implications within his field.”

“The record shows how the field in general may have an economic impact, but it does not show how the Petitioner's specific endeavor will have substantial positive economic effects or national implications”

“the Petitioner has not shown that his proposed endeavor stands to sufficiently extend beyond his patients or students to impact the medical field at a level commensurate with national importance”

AAO decision text

How the evidence was treated

• recommendation letter · discounted

  “The record shows how the field in general may have an economic impact, but it does not show how the Petitioner's specific endeavor will have substantial positive economic effects”

  AAO decision text
• resume experience · credited
• degree · ignored

  “we will reserve the issue of the Petitioner's eligibility for the EB-2 classification”

  AAO decision text
• business plan · discounted

  “The record does not establish that his proposed endeavor will have national or global implications within his field.”

  AAO decision text
• other · discounted

  “a shortage of qualified professionals does not render the work of an individual physician or surgeon nationally important”

  AAO decision text

Where this case turned

• Economic claims unsupported · p1 — job/revenue projections with no corroborating basis
• Field importance conflated with endeavor · p1 — argues the field matters, not the specific endeavor
• Occupational shortage argument rejected · p1 — argues a labor shortage — the labor-certification question, not Dhanasar

Notable

The AAO expressly disagreed with the Director's finding that the endeavor was too vague to assess substantial merit, and found substantial merit met, but still dismissed on national importance grounds. It also noted that the petitioner's prior disclaimer of physician-specific NIW eligibility under 203(b)(2)(B)(ii) undermined his appeal-stage claim of intending to serve rural/underserved areas.

Authorities this decision leans on

From the doctrinal survivor set — 187 authority tests across 47 distinct authorities cleared the differential-lift gates. Only those appear here.

• 8 C.F.R. 103.3
• Matter of L-A-C-
• Poursina v. USCIS

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