dismissed EB-1A Case: Medicine

U.S. Citizenship 
and Immigration 
Services 
In Re : 22678700 
Appeal of Texas Service Center Decision 
Non-Precedent Decision of the 
Administrative Appeals Office 
Date: OCT. 18, 2022 
Form I-140, Immigrant Petition for Alien Worker (Extraordinary Ability) 
The Petitioner, who describes his job title as "biopsychosocial specialist," 1 seeks classification as an 
individual of extraordinary ability. See Immigration and Nationality Act (the Act) section 
203(b )(1 )(A), 8 U.S.C. § 1153(b )(1 )(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 that the Petitioner had satisfied at least three of ten initial evidentiary criteria, as required. 
The matter is now before us on appeal. 
In these proceedings, it is the Petitioner's burden to establish eligibility for the requested benefit 
Section 291 of the Act, 8 U.S.C. § 1361. Upon de nova review, we will dismiss the appeal. 
I. LAW 
Section 203(b)(l)(A) of the Act makes immigrant visas available to individuals with 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; who seek to enter the United States to continue work in the area of 
extraordinary ability; and whose 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 petitioner 
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. 
1 The Petitionerprovides the SOC (Standard Occupational Classification) code 11-9111, which corresponds to "Medical 
and Health Services Managers." 
Where a petitioner meets the initial evidence requirements through either a one-time achievement or 
meeting three lesser criteria, 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); Rijalv. USCIS, 772 F. Supp. 2d 1339 (W.D. Wash. 2011). 
II. ANALYSIS 
After earning medical degrees at various universities in Venezuela, the Petitioner established an 
obstetrical/gynecological (OB/GYN) practice in !Venezuela in 2010, and worked at 
I !University Hospital also inl I In that practice, 
the Petitioner stated: "I designed my own approach model ... , which I named 'Biopsychosocial 
Evaluation."' The Petitioner stated that "biopsychosocial evaluation ... is structured to evaluate three 
aspects as follows: biological, psychological, and family-social," allowing for "a personalized action 
plan." The Petitioner entered the United States as a B-2 nonimmigrant visitor in August 2014. The 
Petitioner is not licensed to practice medicine in the United States.2 He does, however, hold several 
certifications and registrations in the health care field, as a medical assistant, surgical assistant, 
professional midwife, and medical sonographer. Since 2018, he has worked as a midwife and 
sonographer atl I inl I Florida. 
Because the Petitioner has not indicated or shown that he 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). The Petitioner initially claimed to have satisfied eight of these criteria, summarized below: 
• (i), Lesser nationally or internationally recognized prizes or awards; 
• (ii), Membership in associations that require outstanding achievements; 
• (iii), Published material about the individual in professional or major media; 
• (iv), Participation as a judge of the work of others; 
• (v), Original contributions of major significance; 
• (vi), Authorship of scholarly articles; 
• (vii), Display at artistic exhibitions or showcases; and 
• (viii), Leading or critical role for distinguished organizations or establishments. 
The Director concluded that the Petitioner met only one of the criteria, relating to authorship of 
scholarly articles. On appeal, the Petitioner asserts that he also meets five other criteria, relating to 
memberships, published material, participation as a judge, original contributions, and leading or 
2 In his initial statement, submitted with the petition, the Petitioner stated: "I will not rest until I obtain my MD license in 
this country so that I can fully pursue my profession and my passion." On appeal, the Petitioner states: "I am continuing 
my education to obtain a license as MD." The Petitioner does notspecifywhathaspreventedhim fromobtaininga license 
to practice medicine in the United States. 
2 
critical roles. The Petitioner does not contest the Director's conclusions regarding the criteria relating 
to prizes and display, and therefore we consider those issues to be abandoned. 3 
The Petitioner cites his intention to continue working in the area of claimed extraordinary ability, 
stating: "To my understanding, this forms part of part of one of the ten categories." But such an 
intention relates to a separate requirement, at section 203(b )(1 )(A)(ii) of the Act and 8 C.F.R. 
§ 204.5(h)(5). 
Upon review of the record, we conclude that the Petitioner has satisfied two criteria, relating to 
authorship of scholarly articles and participation as a judge of the work of others. We will discuss the 
other claimed criteria below. 
Documentation of the alien's membership in associations in the field for which 
classtfication is sought, which require outstanding achievements of their members, as 
judged by recognized national or international expe1ts in their disciplines or .fields. 
8 C.F.R. § 204.5(h)(3)(ii). 
The Petitioner claimed several memberships under this criterion. He is an "Active Member" of the 
VenezuelanAssociationfortheAdvancementofScience(AsoVAC, or AsoVac ); an "Affiliated Member" 
of the Society of Obstetrics and Gynecology of Venezuela (SOGV); and an active member of the 
American College of Nurse Midwives (ACNM). As explained below, we agree with the Director's 
conclusion that the Petitioner has not shown that the associations have sufficiently restrictive membership 
requirements. 
A translated letter from the secretary general of Aso V AC's Chapter reads, in part: 
Aso Vac accepts as members those professionals who complete a rigorous process of 
background screening where it is confirmed that the candidate is an individual who has 
exceptional achievements with research capabilities able to meet the provisions of 
Chapters V and VI of the Statutes of our organization .... 
. . . [ A ]11 the information submitted is evaluated by an Expert Committee composed of the 
most important scientists who are members of the association. 
Aso VAC's Statutes, also in the record, do not corroborate the above statement. The Statutes state: "In 
order to be an Active Member it is required to hold a Superior Education Degree and conduct research, 
promotion and diffusion activities of scientific and/or technical knowledge, and be so lventwith the yearly 
fee." The Statutes also describe a separatemembership category, "Honorary Members," "who desetVe 
this distinction owing to their scientific work." Nominations for honorary membership are to be submitted 
to "the National Steering Committee," whereas individuals seeking active membership "request their 
registration ... before the [local] Chapter Steering Committee." 
3 See Matter of R-A-M-, 25 T&N Dec. 657, 658 n.2 (BIA 2012)(stating that when a filing party fails to appeal an issue 
addressed in an adverse decision, that issue is waived). See also Sepulveda v. US. Att'y Gen., 401 F.3d 1226, 1228 n. 2 
(11th Cir. 2005), citing United States v. Cunningham, 161 F.3d 1343, 1344 (11th Cir. 1998); Hristov v. Roark, No. 09-­
CV-2 7312011, 2011WL4711885 at* 1, *9 (E.D.N.Y. Sept. 30, 2011) (plaintiff's claims were abandoned as he failed to 
raise them on appeal to theAAO). 
3 
Aso VAC's governing documents do not establish that the association requires outstanding achievements, 
as judged by recognized national or international experts, as a condition for active membership, and they 
do not corroborate claims that stricter requirements exist for the level of membership that the Petitioner 
holds. Participation in research and payment of membership dues are not outstanding achievements. We 
note that the record indicates that the Petitioner joined Aso V AC as an active member in November 2000, 
when he was still a medical student His admission at this early stage inhiscareerdoesnotreadilysuggest 
the exclusivity that the regulation requires. 
SOGV documents list the following requirements for affiliated membership: 
• A "Medical Doctor or Surgeon" degree, recognized by "the Venezuelan university authorities"; 
• Recognition as a specialist in OB/GYN, registered with the Venezuelan Medical Association; 
• Submission of a resume and "the Deontological Certificate issued by the corresponding Medical 
Association"; 
• Completion of a three-year "postgraduate course on Obstetrics and Gynecology"; 
• A letter of intention to become a member; 
• Sponsorship by two full members; 
• Up-to-date payment of Medical Association fees; 
• Completion of "the Medical Census Form"; and 
• Payment of registration fees. 
The Petitioner did not establish that any of these requirements, which include what appear to be basic 
professional credentials, amount to outstanding achievements as judged by recognized national or 
international experts. 
Regarding the Petitioner's active membership in ACNM, that organization's bylaws show no substantive 
requirement for active membership except an active or past credential as a certified midwife or certified 
nurse midwife. The Petitioner has not established that these certifications are outstanding achievements 
as judged by recognized national or international experts, rather than basic credentials for the occupation. 
Beyond the above points, the record shows that the Petitioner did not join ACNM until December 30, 
2021, several weeks after the Director issued a request for evidence (RFE) on December 8, 2021. The 
Petitionermustmeetalleligibilityrequirements as of the petition'sfilingdate. See 8 C.F.R. § 103.2(b)(l). 
In this case, the Petitioner filed his petition on November 15, 2021. Other issues aside, this December 
2021 membership cannot retroactively establish eligibility as of the November 2021 filing date. 
Also in response to the RFE, the Petitioner submitted a membership certificate from the Society of 
Diagnostic Medical Sonography (SDMS). The Petitioner has not submitted any evidence to show the 
SDMS's membership requirements, and therefore he has not established that the SDMS requires 
outstanding achievements of its members as judged by recognized national or international experts. 
Furthermore, the certificate indicates that the Petitioner joined the SDMS in 2021, but did not specify the 
exact date. Therefore, the document does not indicate that the Petitioner was already a member when he 
filed the petition in November 2021. Because the burden of proof is on the Petitioner, we will not presume 
that he joined the SDMS before the filing date. We note that he did not claim SDMS membership when 
he first filed the petition. 
4 
The Director determined that the Petitioner had not shown that the memberships described above meet 
the regulatory requirements to satisfy the criterion. On appeal, the Petitioner maintains that his 
memberships are qualifying, but cites no specific evidence to show that the Director erred in reaching the 
above conclusion. The Petitioner does ref er to "Chapter V, Article 28" of Aso V AC's Statutes, but the 
cited passage lists the membership categories, and states no requirements for active membership other 
than a qualifying college degree and involvement in research, while indicating that applications for active 
membership are filed with local chapters. 
The Petitioner has not met the requirements to satisfy this criterion. 
Published material about the alien in professional or major trade publications or other 
major media, relating to the alien's work in the field for which classification is sought 
Such evidence shall include the title, date, and author of the material, and any necessary 
translation. 8 C.F.R. § 204.5(h)(3)(iii). 
An article on the subject of I appeared in Ciencia Medica al Dia. The article 
quotes the Petitioner, who stated that exercise offers a number of benefits but cautioned that some 
circumstances may limit physical activity. The Petitioner's medical specialty is relevant to the subject of 
the article, but the article is not about the Petitioner, relating to his work in the field. Rather, the article, 
including the Petitioner's quotation, consists of general advice and recommendations. Also, the Petitioner 
has not established that Ciencia Medica al Dia qualifies as a professional or major trade publication or 
other major media. The Petitioner must establish that the circulation ( online or in print) is high compared 
to other publications of its kind. 6 USCIS Policy Manual F.2 appendix, https://www.uscis.gov/ 
policymanual. The Petitioner did not submit circulation or page view data. A printout from the 
magazine's Face book page shows 7854 followers; the Petitioner provided no comparative evidence to 
show that this is a high number for that type of publication in Venezuela. 
The host ofthel !Television program stated that the Petitioner"was invited to 
this prestigious program as a SPECIAL GUEST on multiple occasions" ( emphasis in original), first on a 
monthly basis, but then weekly "due to the constant and countless calls from our audience." The 
Petitioner submitted photographs from the program, but no transcripts or other materials to establish the 
full content of the broadcast material. The regulation does not simply require evidence that published 
material exists; the Petitioner must submit the published material itself. In the case ofradio or television 
broadcasts, a transcript will suffice. See 6 USCIS Policy Manual, supra, at F.2 appendix. Because the 
Petitioner has not provided a transcript of the broadcast material, he has not shown that his television 
appearances constituted published material about him, rather than, as above, general medical advice. 
Also, the Petitioner has not provided the dates of the broadcasts, asrequiredby 8 C.F.R. § 204.5(h)(3)(iii). 
We note that the three submitted photographs all appear to show the same broadcast. 
In the RFE, the Director asked for evidence to show that the submitted materials meet the regulatory 
requirements to satisfy the criterion. The Petitioner's response to the RFE did not address this criterion. 
The Director therefore concluded that the Petitioner had not satisfied this criterion. 
On appeal, the Petitioner asks that the Director's conclusion be "reconsidered," but he does not explain 
how that conclusion is in error. 
5 
The Petitioner has not met the requirements to satisfy this criterion. 
Evidence of the alien's original scientific, scholarly, artistic, athletic, or business-related 
contributions of major significance in the field. 8 C.F.R. § 204.5(h)(3)(v). 
The Petitioner submitted two letters under this criterion. The first letter is from onel l a 
physician who studiedatthe same medical school as the Petitioner. Some ofl lletterconsists 
of general asse1iions about the importance of the Petitioner's work, without sufficient details to identify 
specific contributions by the Petitioner and explain how they are of major significance. For example, he 
states that the Petitioner's "innovative medical unit for the care of pregnant adolescents ... makes 
available resources which did not previously exist in health centers, such as interactive workshops." This 
statement does not explain how the Petitioner's innovation is of majorsignificance in the field, as opposed 
to more localized impmiance to a small number of patients in direct contact with the Petitioner or the 
center that employed him. Statistics about improved patient outcome at one hospital do not show 
implementation of the Petitioner's work beyond that one facility, and the letter does not establish that the 
Petitioner's work was solely or primarily responsible for the improvements. 
___ described and praised the Petitioner's "great Bio-psycho-social Assessment model that 
provides solutions to pregnantwomen,"buthe did not showthatthismodelhas been of major significance 
to the field as a whole, rather than the Petitioner's own patients. Furthermore, I claims no 
particular expertise in OB/GYN or biopsychosocial evaluation. Rather, he describes his specialty as 
"Obesity, Nutrition and Anti-Aging Medicine." Because he and the Petitioner practice different 
specialties, it is not readily evident that I possesses sufficient knowledge in the Petitioner's 
field to evaluate the significance of the Petitioner's contributions. 
The second letter is from one I I "a specialist in Gynecology and Obstetrics [ and] 
Sonographer," specialties that more closel conform to the Petitioner's own areas of expertise. As with 
I I letter, however did not establish the significance of the Petitioner's w01k 
beyond one institution. ___ __,stated that "the Bio-psycho-social Assessment of Pregnant Patients 
[is] a model used in the most important hospital in the city of I Implementation at one 
hospital does not show field-wide significance. She also noted the Petitioner's "offering of free 
sonography courses for postgraduate residents." I did not explain how these activities were 
of major significance throughout the field, rather than locally in We acknowledge her assertion that 
there is a shortage of trained sonographers, but the record does not show that the Petitioner's work in this 
area has significantly alleviated that shortage, andl I did not explain how providing training in 
existing technology constitutes an original contribution. 
In the denial notice, the Director stated: 
Evidence must demonstrate that the beneficiary's contributions are not only originaL but 
that they are of major significance in the field. The evidence does not demonstrate the 
major significance of the petitioner's original contributions. The letters praise the 
petitioner's work as a physician and as a great OB/GYN but they do not show major 
contributions as a Biopsychosocial Specialist in the field of biological, psychologicaL and 
family-social and contributions related to scientific, scholarly, artistic or business fields. 
6 
On appeal, the Petitioner asserts that his prior work in OB/GYN and sonography should not be viewed 
separately from his work with biopsychosocial evaluation. This objection, however, does not establish 
the claimed major significance ofbiopsychosocial evaluation. The Petitioner states that he developed the 
technique, but he has not submitted evidence of its widespread adoption by others or otherwise shown its 
major significance. The Petitioner claims that his biopsychosocial evaluations reduced local mmiality 
rates, but he does not establish that this reduction spread to a larger area, or that the rates have stayed low; 
the provided statistics span the years 2010 to 2014, years before the petition's filing date. 
The Petitioner has not met the requirements to satisfy this criterion. 
Evidence that the alien 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). 
The Petitioner claims to have satisfied the requirements of this criterion through his work as a physician 
in the OB/GYN Service of 4 
The Director concluded that the Petitioner had not shown his roles to have been leading or critical. On 
appeal, the Petitioner asserts that political conditions in Venezuela prevented him from receiving 
significant recognition, whereas, he contends, "any developed country would have awarded [him] with 
recognition of the highest honor." 
The Petitioner submitted background materials aboutl but he did not claim to have performed 
in a critical role for the entire hospital. Because his role was focused on the OB/GYN Service, he must 
show that that department or division has a distinguished reputation. See 6 USCIS Policy Manual, supra, 
at F.2 appendix. The Petitioner has not submitted evidence to establish that I IOB/GYN 
Service, in particular, has more than a local reputation. Without showing that the department or division 
has a distinguished reputation, more detailed discussion of the nature of his role within that department 
or division would serve no practical purpose in this proceeding. 
The Petitioner has not met the requirements to satisfy this criterion. 
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 lesser 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 conclusion 
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. U.S. Citizenship and 
Immigration Services 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 recognition of his work is 
4 The Petitioner does not, on appeal,pursue an earlier claim that his work with the localOsectionofthe Venezuelan 
Red Cross also constituted a critical role. 
7 
indicative of the required sustained national or international acclaim or demonstrates a "career of 
acclaimed work in the field" as contemplated by Congress. H.R. Rep. No. 101-723, 59 (Sept. 19, 
1990); see also section 203(b )(l)(A) of the Act. Moreover, the record does not othe1wise demonstrate 
that the Petitioner is one of the small percentage who has risen to the very top of the field of 
endeavor. See section 203(b )(l)(A) of the Act and 8 C.F.R. § 204.5(h)(2). The Petitioner's colleagues 
in Venezuela regard him as a skilled physician who has helped many patients, but much of the 
Petitioner's evidence indicates at most a degree ofrecognition within the State ore=J He had been 
in the United States for over seven years at the time of filing, but the record does not establish that the 
U.S. medical community has adopted his biopsychosocial evaluation. He satisfied two of the threshold 
criteria at 8 C.F.R. § 204.5(h)(3), but neither of those criteria includes any intrinsic requirement of, or 
reference to, acclaim or recognition. Rather, he judged the work of medical students and published 
the results of medical research, both activities which appear to be routine in academia rather than 
privileges reserved for the most acclaimed professionals in the field. While the Petitioner has shown 
himself to be an able and dedicated physician in Venezuela, and has found ways to contribute in the 
United States without a license to practice medicine, he has not shown that his work has had a 
widespread and lasting impact on his field, and he has not otherwise established the sustained national 
or international acclaim that the statute and regulations require. 
The Petitioner has not demonstrated eligibility as an individual of extraordinary ability. The appeal 
will be dismissed for the above stated reasons. 
ORDER: The appeal is dismissed. 
8