A South African-trained physician sought an NIW, initially describing multiple possible paths (treating underserved populations, pathology, practice management, pharmaceutical consulting) before narrowing on appeal to a combination of clinical practice, particularly in underserved areas, and research on COVID-19/long COVID.

Prong 1 — national importancenot established

“The Petitioner's initial submission did not describe a single, consistent endeavor that the Petitioner proposes to undertake.”

“Just as a teacher has a limited number of students, so does a physician serve a limited number of patients.”

“Congress created a separate procedure to provide the national interest waiver to physicians seeking to practice in underserved areas.”

“Statistics about the aggregate impact of all physicians do not specifically show that the work of any one single physician has national importance.”

AAO decision text

Prong 2 — well positionednot established · dispositive

“Here, the Petitioner did not claim any research experience at the time he filed the petition.”

“The two identified expert opinion letters do not discuss the Petitioner's research plans in any depth, and they do not indicate that he is well positioned to advance the research element of his proposed endeavor.”

“The Petitioner's need to pursue further education shows that he was not well positioned to pursue a proposed endeavor in research when he filed the petition.”

“The record, therefore, does not indicate that the Petitioner had made progress toward advancing the research element of his proposed endeavor as of the filing date.”

“As a result, the Petitioner has not shown that he had a specific model or plan for future activities at the time of filing.”

AAO decision text

How the evidence was treated

• recommendation letter · discounted

  “The two identified expert opinion letters do not discuss the Petitioner's research plans in any depth”

  AAO decision text
• business plan · discounted

  “the 26-page business plan submitted with the petition includes three sentences about the possibility that the Petitioner would engage in research”

  AAO decision text
• degree · discounted

  “Any experience or education that the Petitioner gained after the September 2021 filing date cannot retroactively establish eligibility at the time of filing”

  AAO decision text
• resume experience · discounted

  “he did not claim any research experience at the time he filed the petition”

  AAO decision text
• other · discounted

  “The human resources representative did not confirm moving forward with employing the petitioner in a research or any other position.”

  AAO decision text

Where this case turned

• Endeavor too vague · p1 — described as a job role, not a defined undertaking
• Field importance conflated with endeavor · p1 — argues the field matters, not the specific endeavor
• Local, not national scope · p1 — impact confined to clients / a region
• Occupational shortage argument rejected · p1 — argues a labor shortage — the labor-certification question, not Dhanasar
• Business plan speculative · p2 — projections without a documented basis or steps
• Education alone insufficient · p2 — degrees offered as positioning — credentials are not a track record
• Letters conclusory · p2 — letters praise skills in general terms without tracing specific impact
• No progress evidence · p2 — no documented movement toward the endeavor since filing
• Record of success insufficient · p2 — a claimed track record the documents do not establish

Notable

The AAO emphasized that a physician cannot bypass the separate statutory/regulatory framework for physicians serving in underserved areas (section 203(b)(2)(B)(ii), 8 C.F.R. 204.12) by instead relying on the general Dhanasar framework; it also faulted the Petitioner for shifting his described endeavor across filing stages (from underserved-area practice to COVID-19 research) and noted this shift occurred only after the Director flagged the underserved-area issue, implicating the material-change bar under Matter of Izummi.

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. 103.2(b)(1)
• 8 C.F.R. 103.3
• Matter of Izummi
• Matter of Katigbak
• Matter of L-A-C-

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