The Petitioner, a resident physician, proposed to conduct research in PET-CT and PET-MRI imaging for evaluation and treatment of heart disease, cancer, liver and kidney failure, and infectious diseases, while also providing clinical radiology care and teaching radiology residents.

Prong 1 — national importancenot established

“the vast majority of her 'time is and will be spent on clinical duties' at [employer] rather than medical imaging research.”

“the record does not include sufficient information or supporting evidence identifying the specific research projects she intends to undertake at [employer]”

“the record does not establish that her clinical and instructional work would impact the fields of diagnostic radiology, nuclear medicine, and molecular imaging or the U.S. healthcare industry more broadly, as opposed to being limited to the patients she serves and her medical trainees.”

“the Petitioner's clinical work as a radiologist and activities as a medical instructor do not meet the 'national importance' element of the first prong of the Dhanasar framework.”

AAO decision text

Prong 2 — well positionednot established

“She does not, however, offer comparative statistics demonstrating the significance of this level of citation within her field”

“she has not presented evidence illustrating the significance of this information, or establishing that her research has been implemented, utilized, or applauded by those viewing it.”

“The Petitioner has not shown that her published and presented work has been frequently cited by independent researchers or otherwise served as an impetus for progress in the field, that it has affected clinical practice, or that it has generated substantial positive discourse in the broader medical community.”

“the evidence is insufficient to demonstrate that she is well positioned to advance that research under prong two.”

AAO decision text

How the evidence was treated

• recommendation letter · discounted

  “letters discussing her medical training, clinical work, and research projects”

  AAO decision text
• citations publications · discounted

  “she does not, however, offer comparative statistics demonstrating the significance of this level of citation within her field”

  AAO decision text
• resume experience · credited
• other · discounted

  “downloads of the Petitioner's articles corroborate that she has disseminated her findings, but they are not sufficient to demonstrate a record of success of, or interest in, her research.”

  AAO decision text
• degree · credited

Where this case turned

• Employer-specific benefit · p1 — "work furthers my company's product" — value accrues to one firm
• Endeavor too vague · p1 — described as a job role, not a defined undertaking
• Local, not national scope · p1 — impact confined to clients / a region
• Citations insufficient · p2 — citation counts without qualitative account of impact
• Letters conclusory · p2 — letters praise skills in general terms without tracing specific impact
• Record of success insufficient · p2 — a claimed track record the documents do not establish

Notable

The AAO explicitly stated that all prong failures are 'each considered as an independent and alternate basis for the decision,' making all analyzed prongs co-dispositive rather than sequentially dispositive. The AAO declined to reach prong 3 because prongs 1 and 2 were not met. Six of ten citations to the Petitioner's key article were self-citations by a co-author, which the AAO flagged in a footnote. The AAO also noted, consistent with Dhanasar itself, that teaching activities do not rise to national importance when they do not impact the field more broadly, citing Dhanasar at 893.

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