dismissed EB-1A Case: Cardiovascular Medicine

U.S. Citizenship 
and Immigration 
Services 
In Re: 17887008 
Appeal of Texas Service Center Decision 
Non-Precedent Decision of the 
Administrative Appeals Office 
Date: SEP. 17, 2021 
Form 1-140, Immigrant Petition for Alien Worker (Extraordinary Ability) 
The Petitioner , a cardiovascular diseases fellow, seeks classification as an individual of extraordinary 
ability. See Immigration and Nationality Act (the Act) section 203(b)(l)(A), 8 U.S.C. § 1153(b)(l)(A). 
This first preference classification makes immigrant visas available to those who can demonstrate their 
extraordinary ability through sustained national or international acclaim and whose achievements have 
been recognized in their field through extensive documentation. 
The Director of the Texas Service Center denied the petition , concluding that the record did not 
establish, as required, that the Petitioner satisfies at least three of the ten initial evidentiary criteria for 
this classification. The matter is now before us on appeal. 
In these proceedings , it is the Petitioner's burden to establish eligibility for the requested benefit. See 
Section 291 of the Act, 8 U.S.C. § 1361. Upon de nova review, we conclude that the Petitioner has 
not met that burden. Accordingly, we will dismiss the appeal. 
I. LAW 
Section 203(b)(l)(A) of the Act makes visas available to immigrants with extraordinary ability if: 
(i) the alien has extraordinary ability in the sciences, arts, education, business, or 
athletics which has been demonstrated by sustained national or international 
acclaim and whose achievements have been recognized in the field through 
extensive documentation , 
(ii) the alien seeks to enter the United States to continue work in the area of 
extraordinary ability, and 
(iii) the alien' s entry into the United States will substantially benefit prospectively 
the United States. 
The term "extraordinary ability" refers only to those individuals in "that small percentage who have 
risen to the very top of the field of endeavor." 8 C.F.R. § 204.5(h)(2). The implementing regulation 
at 8 C.F.R. § 204.5(h)(3) sets forth a multi-part analysis. First, a pet1t10ner can demonstrate 
international recognition of his or her achievements in the field through a one-time achievement (that 
is, a major, internationally recognized award). If that petitioner does not submit this evidence, then 
he or she must provide sufficient qualifying documentation that meets at least three of the ten criteria 
listed at 8 C.F.R. § 204.5(h)(3)(i) - (x) (including items such as awards, published material in certain 
media, and scholarly articles). 
Where a petitioner meets these initial evidence requirements, we then consider the totality of the 
material provided in a final merits determination and assess whether the record shows sustained 
national or international acclaim and demonstrates that the individual is among the small percentage 
at the very top of the field of endeavor. See Kazarian v. USCIS, 596 F.3d 1115 (9th Cir. 2010) 
( discussing a two-part review where the documentation is first counted and then, if fulfilling the 
required number of criteria, considered in the context of a final merits determination); see also 
Visinscaia v. Beers, 4 F. Supp. 3d 126, 131-32 (D.D.C. 2013); Rijal v. USCIS, 772 F. Supp. 2d 1339 
(W.D. Wash. 2011). 
II. ANALYSIS 
At the time of filin the Petitioner indicated he was workin as a cardiovascular diseases fellow at the 
University o . The Petitioner's curriculum 
vitae reflects that he also worked for .__ _____________ __, as an internal medicine 
resident between 2013 and 2016. In 2012, he received his bachelor of medicine and bajhelor of 
surgery degree from the I I Memorial Hospital and I _Medical 
College i~ I India. The Petitioner states that he is a specialist in cardiovascular disease and 
electrophysiology. 
Because the Petitioner has not indicated or established that he has received a major, internationally 
recognized award, he must satisfy at least three of the alternate regulatory criteria at 
8 C.F.R. § 204.5(h)(3)(i)-(x). In denying the petition, the Director determined that the Petitioner 
fulfilled two of the initial evidentiary criteria, judging at 8 C.F.R. § 204.5(h)(3)(iv) and authorship of 
scholarly articles at 8 C.F.R. § 204.5(h)(3)(vi). The record reflects that the Petitioner has peer 
reviewed a manuscript for the Journal of General Internal Medicine. In addition, he authored 
scholarly articles in professional publications including Annals of Hepatology, Journal of Vector 
Borne Diseases, and Indian Heart Journal. Accordingly, we agree with the Director that the Petitioner 
fulfilled the judging and scholarly articles criteria. 
On appeal, the Petitioner asserts that the Director erroneously determined that he does not meet two 
additional criteria, related to original contributions in the field and leading or critical role for 
organizations or establishments, which we will discuss below. 1 After reviewing all the evidence in 
1 We note that the Director determined that the Petitioner claimed, but did not establish, that he meets the criterion related 
to membership in associations. See 8 C.F.R. § 204.5(h)(3)(ii). On appeal, the Petitioner does not contest the Director's 
finding that he does not meet this criterion or offer additional arguments. Therefore, we consider this issue to be 
abandoned. See Sepulveda v. US. AttJJ Gen., 401 F.3d 1226, 1228 n. 2 (11th Cir. 2005); Hristov v. Roark, No. 09-CV-
27312011, 2011 WL 4711885 at *L *9 (E.D.N.Y. Sept. 30, 2011) (the court found the plaintiffs claims to be abandoned 
as he failed to raise them on appeal to the AAO). 
2 
the record, we conclude that the record does not support a determination that the Petitioner satisfies 
the requirements of at least three criteria. 
Evidence of the individual's original scientific, scholarly, artistic, athletic, or business­
related contributions of major sign[ficance in the field. 8 C.F.R. § 204.5(h)(3)(v). 
In order to satisfy the regulatory criterion at 8 C.F.R. § 204.5(h)(3)(v), a petitioner must establish that 
not only has he made original contributions but that they have been of major significance in the field. 2 
For example, a petitioner may show that the contributions have been widely implemented throughout 
the field, have remarkably impacted or influenced the field, or have otherwise risen to a level of major 
significance in the field. The Petitioner claims that he has made original contributions of major 
significance in the field, as evidenced by his published research, citation record, letters from experts 
in the field, participation in professional conferences and symposia, and other evidence. On appeal, 
he emphasizes that the testimonial letters outline "the practical importance to the field of [his] past 
and ongoing research as well as his extraordinary clinical abilities." 3 
Here, although the Petitioner provided evidence reflecting the originality of his research through 
recommendation letters praising him for his contributions, the letters are lacking detail explaining how 
his research findings have already been widely accepted and implemented in the field to the extent 
that they have been regarded as contributions of major significance. In general, the letters recount the 
Petitioner's research and findings, and indicate their publication in journals and presentation at 
conferences. 
For example.__ _______ __.Professor of Medicine, Cardiolo,t=g:2:Y.....:D~iv:..:i~s1~· o:'.=n'.:..:a~t::.=::::::::::;--------' 
I I describes the Petitioner's novel finding of a role played byl f tissue in the 
pathophysiology o~ I and his development of a new method called the l I I I to help with risk stratification for patients with the disorder. 
He indicates that the Petitioner's research paper about this work was one of only six papers discussing 
clinical conditions that modify the response to.__ ________ __. accepted for oral presentation 
at the American Heart Association Annual Scientific Sessions in 201 7, but he does not explain how 
the Petitioner's research findings went on to significantly impact or influence the field. As previously 
discussed, although funded and published work may be "original," the publication or presentation of 
one's work alone is not sufficient to establish that the work is of major significance. 
----------.1 Director of Interventional Echocardiography and Professor of Medicine at 
~------_ ...... fdescribes the Petitioner's research findings as "extreme! im ortant" because 
they "provide an accurate means to measure the risk of recurrencl-'-'-'-'-'---~~---------' 
as well as "an objective measure to decide whether to perform.__ ___ __. at all." She does not 
explain, however, how his work in that area or hisl I method has been particularly influential 
2 See 6 USCIS Policy Manual F.2 appendix, https://www.uscis.gov/policy-manual/volume-6-part-f-chapter-2 (providing 
guidance on the review of evidence submitted to satisfy the regulatory criteria at 8 C.F.R. § 204.5(h)(3)(i)-(x)) (stating that 
although funded and published work may be "original," this fact alone is not sufficient to establish that the work is of 
major significance). 
3 Although we focus on those letters highlighted by the Petitioner on appeal and do not discuss every letter submitted, we 
have reviewed and considered each one. 
3 
or impactful in the field or explain how it has been applied by others, so as to constitute a contribution 
of major significance within the meaning of 8 C.F.R. § 204.5(h)(3)(v). 
Professor of Medicine at states that 
~th_e_P_e-ti-ti_o_n-er_'_s_r_e_s-ea_r_c_h~proj ect inc=] India that screens in real-time for using 
I I technology has "demonstrated the reliability of .__ _________ ___.that could 
provide a distinct national benefit forl lof the United States .... " He describes the Petitioner 
as "one of the best residents we have trained" and asserts that this research project, "as well as others, 
have had a tremendous impact in international scientific and medical communities." However, he 
does not explain in detail how the Petitioner's work has been widely accepted or implemented in the 
field to support his conclusion that his work has "had tremendous impact in international scientific 
and medical communities," and he does not describe "others" of the Petitioner's research studies or 
speak to their originality or impact in the field. 
,..__ ________ .._Aa..=s=s1=· s"""tant Professor in Medicine, Cardiovascular Division atl.__ _____ __, 
'--------------~d~e=s=cr=i=b=es~an=-',additional research study performed b the Petitioner that 
demonstrated that.__ ________ __. was not a more accurate measure o '------.---- ...... 
in certain patients with acute cardiac arrest when compared with measurements taken by.___~ 
I I He speaks to the potential or future benefit of the Petitioner's work, stating that his 
research both in this area and in assessing the risk of recurrence ofi I 
"have produced important results that will aid physicians in the diagnosis of various heart ailments 
and will likely reduce the number of unnecessary invasive surgeries to prevent these various cardiac 
diseases," but his assertions do not demonstrate his research has already had an impact or influence 
commensurate with "major significance." 
Some of the testimonials detail the benefits patients received from the Petitioner's clinical skills in 
individual cases. For example, of the relates details 
of the Petitioner's performance of a bedsid L...,.,.....--r ___ .....__.. ......... 1 iagnosis of a~-,-----,-,-----~ 
heart attack in a young patient requiring immediat '------~ He claims that the Petitioner saved 
the patient's life through his "accurate diagnosis and correct decision regarding the patient's 
treatment." I I chief of cardiovascular medicine a~ ,I 
provides that the Petitioner diagnosed and treated a rare form o in an elderly patient 
who presented with an.__ __________ ~ ______ __,and asserts that due to his 
"superior diagnostic ability" the patient avoided the cost and risk of surgical implantation of a 
permanent pacemaker. In addition, and em hasize the im ortance of the 
Petitioner's clinical experience in treating and employing 
advanced diagnostic techniques and interventional procedures such as ~---~~____,,..., cardiac 
catheterization, and insertion of transvenous pacemakers. Regardless of the field of endeavor, the plain 
language of the phrase "contributions of major significance in the field" requires evidence of an impact 
beyond one's employer and clients or customers. See Visinscaia v. Beers, 4 F. Supp. 3d 126, 134-135 
(D.D.C. 2013). 
Letters that specifically articulate how a petitioner's contributions are of major significance to the field 
and its impact on subsequent work add value. On the other hand, letters that lack specifics do not add 
value, and are not considered to be probative evidence that may form the basis for meeting this 
4 
criterion. 4 Moreover, USCIS need not accept primarily conclusory statements. 1756, Inc. v. The US. 
Att)· Gen., 745 F. Supp. 9, 15 (D.C. Dist. 1990). The Petitioner asserts that the above-referenced 
statements and those of others who have worked with him show that his "clinical abilities are far 
superior to others in the field." Here, the letters do not, for example, indicate that therapeutic 
treatments were being developed as a result of the Petitioner's research, that his research has already 
influenced medical practices, that his clinical or research work has already had a widespread impact, 
or that it substantially influenced the nature or direction of research being conducted in his area of 
specialty, and the record does not contain supporting evidence demonstrating this influence. The 
record contains ample evidence regarding the prevalence and seriousness of cardiac rhythm and 
cardiovascular disorders. While we recognize the importance of this field of medical research, the 
record does not contain sufficient evidence to support the Petitioner's claim that his work has already 
had a major influence in his field such as, for example, by significantly influencing treatment practices, 
development of therapeutics, or the direction of farther research. 
Rather than providing specific examples of how the Petitioner's work has already substantially 
impacted his field, the submitted reference letters point to the Petitioner's anticipated publication of 
his research in respected journals and the presentation of his work at prestigious conferences as 
evidence that validates the importance of his work. In addition, on appeal, the Petitioner emphasizes 
that his published research has been cited over 60 times illustrating "the major contributions" he has 
made to the field. However, the Petitioner's publications, conference presentations, and citation 
history, considered independently and in context with the evidence as a whole, are insufficient to 
satisfy this criterion. The record provides evidence that the Petitioner has published his research and 
presented at professional conferences in his field. Such evidence verifies that the Petitioner has shared 
his original research. To satisfy this criterion, he must demonstrate that the reaction from others in 
the field is such that it supports a finding that his work rises to the level of "contributions of major 
significance" in the field. For example, peer-reviewed presentations at academic symposia or peer­
reviewed articles in scholarly journals that have provoked widespread commentary or received notice 
from others working in the field, or entries (particularly a goodly number) in a citation index which 
cite the petitioner's work as authoritative in the field, may be probative of the significance of their 
contributions to the field of endeavor. 5 
Regarding his citations, within his initial submission the Petitioner provided evidence from Google 
Scholar reflecting 50 cumulative citations. Specifically, the record shows that his three cited articles 
received 35 (Annals of Hepatology), 12 (Journal of Vector Borne Diseases), and 3 (Indian Heart 
Journal), citations, respectively. 6 Generally, citations to a given article can serve as an indication that 
the field has taken interest in a petitioner's work; however, the fact that a petitioner has published 
articles that other researchers have referenced, is not, by itself: sufficient to establish that he meets this 
criterion. Here, the Petitioner has not presented sufficient evidence establishing that the citation 
numbers recorded in Google Scholar confirm that one or more of his publications has provoked 
widespread commentary or received notice from others working in the field at a level consistent with 
"contributions of major significance in the field." Although he has submitted evidence that his work 
has been cited by other researchers throughout the United States and internationally, he has not 
4 See 6 USC1S Policy Manual, supra, at F.2 appendix. 
5 Ibid. 
6 The Petitioner's remaining 10 articles garnered no citations. 
5 
sufficiently shown that his work has been cited as authoritative in the field or has otherwise influenced 
the field in a significant way. Further, while the Petitioner submitted corroborating evidence in the 
form of expert opinion letters, that evidence, for the reasons already discussed, is not sufficient to 
establish that any of the Petitioner's research findings have remarkably impacted or influenced his 
field. Although the Petitioner's citations indicate that others in the field have referenced his work, he 
did not establish that the submitted citation statistics alone reach the threshold of "major significance" 
as required by the regulation at 8 C.F.R. § 204.5(h)(3)(v). 
Further, the record indicates that the Petitioner submitted samples of several research articles that cited 
to his work. A review of those articles, though, does not show the significance of the Petitioner's 
research to the overall field beyond the authors who cited to his work. 7 The submitted research articles 
reference the Petitioner's work as evidence ofrecent research, and, while the articles indicate that the 
authors' own research built upon the Petitioner's work, as well as the work of the other cited scientists, 
the Petitioner did not demonstrate that the overall field views his published findings as original 
contributions of ma·or si nificance. For instance the Petitioner rovided a co of a 2014 article 
titled 
(Indian Journal of Pathology & Microbiology) that references the ~----------~ Petitioner's 2 09 article in the Annals of Hepatology. 8 However, the article does not distinguish or 
highlight the Petitioner's written work from the other cited papers, or otherwise indicate that the 
Petitioner's article is authoritative or otherwise viewed as being majorly significant in the field. 
Instead, the article briefly references his work as one of many previous studies assessing the short­
term prognosis ofi ~ I The Petitioner has not shown that his published articles 
through citations rise to a level of "major significance" consistent with this regulatory criterion. 
Considered together, the evidence consisting of the citations to the Petitioner's published findings, the 
citation statistics, and the reference letters from his colleagues and other experts, establishes that the 
Petitioner has been productive, and that his published data and findings have been relied upon by 
others in their own research. It does not demonstrate that the Petitioner has made an original 
contribution of major significance in his field. 
Further, the Petitioner has not established, as asserted, that publication of his articles in highly ranked 
or popular journals inevitably demonstrates that the field considers the research and work to be an 
original contribution of major significance. Moreover, a publication that bears a high ranking or 
impact factor reflects the publication's overall citation rate; it does not show an author's influence or 
the impact of research on the field or that every article published in a highly ranked journal 
automatically indicates a contribution of major significance. Here, the Petitioner has not established 
that publication in a popular or highly ranked journal alone demonstrates a contribution of major 
significance in the field. Publications and presentations are not sufficient under 8 C.F.R. 
§ 204.5(h)(3)(v) absent evidence that they were of "major significance." See Kazarian v. USCIS, 
580 F.3d 1030, 1036 (9th Cir. 2009), ajf'd in part, 596 F.3d 1115. 
7 See 6 USC1S Policy Manual, supra, at F.2 appendix; see also Visinscaia, 4 F. Supp. 3d at 134-35 (upholding a finding 
that a ballroom dancer had not met this criterion because she did not corroborate her impact in the field as a whole). 
8 Although we discuss an example article, we have reviewed and considered each one. 
6 
For the reasons discussed above, considered both individually and collectively, the Petitioner has not 
shown that he has made original contributions of major significance in the field. 
Evidence that the individual has performed in a leading or critical role for 
organizations or establishments that have a distinguished reputation. 8 C.F.R. 
§ 204.5(h)(3)(viii) 
On appeal, the Petitioner contends that he played a leading and critical role as a cardiovascular diseases 
fellow at th~ I He also claims that he performs a leading and critical role in his 
current position as a clinical cardiac electrophysiology fellow at the I I 
I 1- 9 As it relates to a leading role, the evidence must establish that a petitioner is or 
was a leader. A title, with appropriate matching duties, can help to establish if a role is or was, in fact, 
leading. 10 Regarding a critical role, the evidence must demonstrate that a petitioner has contributed 
in a way that is of significant importance to the outcome of the organization or establishment's 
activities. It is not the title of a petitioner's role, but rather the performance in the role that determines 
whether the role is or was critical. 11 
Regarding his current position, he references a letter from ~----------' chief of 
electrophysiology at I I who confirms the Petitioner's pos1t10n as a clinical cardiac 
electrophysiology fellow. 12 However, the record establishes that the Petitioner did not hold this 
position at the time the petition was filed in March 2019. In its response to the Director's request for 
evidence (RFE), the Petitioner provided hisl rr Fellow Appointment Agreement which shows that 
his appointment was to begin in July 2019. The Petitioner must establish that all eligibility 
requirements for the immigration benefit have been satisfied from the time of the filing and continuing 
through adjudication. 8 C.F .R. § 103 .2(b )(1 ). Because this criterion requires evidence that he "has 
performed" in a leading or critical role in the past, and because the Petitioner must establish eligibility 
at the time of filing in accordance with 8 C .F .R. § 103 .2(b )( 1 ), he cannot establish his eligibility under 
this criterion based on a position he held beginning in July 2019, even if we were to determine that it 
otherwise satisfies all elements of this evidentiary criterion. 
Regardin~ts fonner nosition as a rrdiovascular diseases fellow, the Petitioner provided testimonial 
letters fro ~-------~chief of cardiovascular medicine at I I The 
letters, however, do not establish that he held a leading position, nor do they contain specific 
information signifying the Petitioner's critical role. 13 In his first letter, dated July 2018,I I 
indicates he worked with the Petitioner for two years, and he provides that during that time the 
9 The Petitioner previously claimed that he also meets this criterion based on his role as an internal medicine resident at 
. I betwee_n 2013 ~nd 20) 6 On a:nneaJ t:he Petitioner flaims eligibility based on the roles 
ment10ned above and does not address his role w1thl----------------:i~· ---·------·---------
10 See 6 USC1S Policy Manual, supra, at F.2 appendix. 
11 Id. 
12 Although the Petitioner's appellate brief asserts thatL Is letter is attached, the record in this case does not 
contain a copy of it. Rather, the Petitioner submitted!.__-------'~ letter in support of a subsequent employment­
based, second-preference petition he filed in December 2019. 
13 See 6 USCIS Policy Manual, supra. at F.2 appendix (stating that letters from individuals with personal knowledge of 
the significance of a petitioner's leading or critical role can be particularly helpful in making this determination as long as 
the letters contain detailed and probative information that specifically addresses how the role for the organization or 
establishment was leading or critical). 
7 
Petitioner evaluated patients with life threatening cardiac problems and performed diagnostic and 
therapeutic procedures, including echocardiography, coronary angiography, angioplasty, and 
pacemaker insertions, independently and under supervision. I I further emphasizes the 
Petitioner's work "is providing an enormously important national benefit to the United States" as there 
is a "great need for specialists" in the area of cardiology and the subspecialty of arrhythmia. Assuming 
the Petitioner's skills are unique, the classification sought was not designed merely to alleviate skill 
shortages in a given field. 
In an additional letter, dated March 2019,I I asserts that the Petitioner "has been a critical 
member of our cardiology team and an asset to our institution due to his one-of-a-kind clinical and 
research work" and claims "he is one of a very few number of physicians at our institution who have 
a wide range of experience in taking care of exceedingly complex patients who often come to the 
hospital with cardiac emergencies." I b statements establish that the Petitioner performed 
admirably in his role as a cardiovascular diseases fellow in his division. They do not offer probative 
details explaining how his fellowship role is a "leading" role based on his placement within the 
school's organizational structure or provide sufficient support for a finding that his role was of 
significant importance to the school's standing or success consistent with the meaning of "critical role." 
Further, although he claims the Petitioner performed "one-of-a-kind" research work he does not discuss 
any of the Petitioner's research and publications or establish how his research activities within his 
division establish his leading role withi~ I 
In light of the above, the Petitioner has not shown that he satisfies this criterion. 
III. CONCLUSION 
The Petitioner has not submitted the required initial evidence of either a one-time achievement or 
documents that meet at least three of the ten criteria. As a result, we need not provide the type of final 
merits determination referenced in Kazarian, 596 F.3d at 1119-20. Nevertheless, we advise that we 
have reviewed the record in the aggregate, concluding that it does not support a finding that the 
Petitioner has established the acclaim and recognition required for the classification sought. 
The Petitioner seeks a highly restrictive visa classification, intended for individuals already at the top 
of their respective fields, rather than for individuals progressing toward the top. USCIS has long held 
that even athletes performing at the major league level do not automatically meet the "extraordinary 
ability" standard. Matter of Price, 20 I&N Dec. 953,954 (Assoc. Comm'r 1994). Here, the Petitioner 
has not shown that the significance of his work is indicative of the required sustained national or 
international acclaim or that it is consistent with a "career of acclaimed work in the field" as 
contemplated by Congress. H.R. Rep. No. 101-723, 59 (Sept. 19, 1990); see also section203(b)(l)(A) 
of the Act. Moreover, the record does not otherwise demonstrate that the Petitioner has garnered 
national or international acclaim in the field, and he is one of the small percentage who has risen to 
the very top of the field of endeavor. See section 203(b )(1 )(A) of the Act and 8 C.F .R. § 204.5(h)(2). 
For the reasons discussed above, the Petitioner has not demonstrated his eligibility as an individual of 
extraordinary ability. The appeal will be dismissed for the above stated reasons, with each considered 
as an independent and alternate basis for the decision. 
8 
ORDER: The appeal is dismissed. 
9