dismissed EB-1A Case: Medicine

U.S. Department of IIomeland Security 
20 Mass. Ave., N.W., Rrn. 3000 
Washington, DC 20529 
U. S. Citizenship 
and Immigration 
PETITION: 
 Immigrant Petition for Alien Worker as an Alien of Extraordinary Ability Pursuant to 
Section 203(b)(l)(A) of the Immigration and Nationality Act, 8 U.S.C. $ 1153(b)(l)(A) 
ON BEHALF OF PETITIONER: 
INSTRUCTIONS: 
This is the decision of the Administrative Appeals Office in your case. All documents have been returned to 
the office that originally decided your case. Any further inquiry must be made to that office. 
\A . 
fiobert P. Wiemann, Chef 
Administrative Appeals Office 
DISCUSSION: The Director, Texas Service Center, denied the employment-based immigrant visa 
petition, which is now before the Administrative Appeals Office (AAO) on appeal. The appeal will be 
dismissed. 
The petitioner seeks classification as an "alien of extraordinary ability" in the sciences, pursuant to 
section 203(b)(l)(A) of the Immigration and Nationality Act (the Act), 8 U.S.C. 5 1153(b)(l)(A). The 
director determined the petitioner had not established the sustained national or international acclaim 
necessary to qualify for classification as an alien of extraordinary ability. 
On appeal, counsel's sole assertion is that the director erred in denying the petition because the 
director's request for additional evidence (RFE) only asked for evidence of the petitioner's intent to 
continue in his field, which the petitioner provided. Counsel does not address the director's specific 
concerns, submit additional evidence to address the deficiencies identified by the director in the denial 
or assert that additional evidence of the petitioner's alleged acclaim exists. Rather, counsel simply 
requests that the petition be approved based on the director's alleged procedural error. 
The regulation at 8 C.F.R. 5 103.2(b)(8) provides that if there is evidence of ineligibility in the record, 
an application or petition shall be denied on that basis notwithstanding any lack of required initial 
evidence. While the director's RFE could have been more comprehensive by noting the deficiencies 
raised in the final denial, this omission could most expediently be remedied by considering on appeal 
any evidence that might have been submitted in response to a more comprehensive RFE. We do not 
consider approving a petition that lacks supporting evidence of eligibility to be an appropriate remedy. 
The denial provided notice of the deficiencies in the record. Neither counsel nor the petitioner has 
made any attempt to address those deficiencies or identify evidence that might have been submitted to 
address those deficiencies. Thus, counsel has provided no reason why this office should remand the 
matter to the director for a more comprehensive WE. As such, the appeal will be adjudicated on the 
evidence previously submitted. For the reasons discussed below, we concur with the director that the 
evidence reveals that the petitioner does not enjoy the necessary sustained national or international 
acclaim. 
Section 203(b) of the Act states, in pertinent part, that: 
(1) Priority workers. -- Visas shall first be made available . . . to qualified immigrants who are 
aliens described in any of the following subparagraphs (A) through (C): 
(A) Aliens with extraordinary ability. -- An alien is described in this subparagraph 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. 
Citizenship and Immigration Services (CIS) and legacy Immigration and Naturalization Service (INS) 
have consistently recognized that Congress intended to set a very high standard for individuals seeking 
immigrant visas as aliens of extraordinary ability. See 56 Fed. Reg. 60897, 60898-9 (Nov. 29, 1991). 
As used in this section, the term "extraordinary ability" means a level of expertise indicating that the 
individual is one of that small percentage who have risen to the very top of the field of endeavor. 
8 C.F.R. 5 204.5(h)(2). The specific requirements for supporting documents to establish that an alien 
has sustained national or international acclaim and recognition in his or her field of expertise are set 
forth in the regulation at 8 C.F.R. 5 204.5(h)(3). The relevant criteria will be addressed below. It 
should be reiterated, however, that the petitioner must show that he has sustained national or 
international acclaim at the very top level. 
This petition seeks to classify the petitioner as an alien with extraordinary ability as a physician. The 
regulation at 8 C.F.R. fj 204.5(h)(3) indicates that an alien can establish sustained national or 
international acclaim through evidence of a one-time achievement (that is, a major, international 
recognized award). Barring the alien's receipt of such an award, the regulation outlines ten criteria, at 
least three of which must be satisfied for an alien to establish the sustained acclaim necessary to qualify 
as an alien of extraordinary ability. The petitioner has submitted evidence that, he claims, meets the 
following criteria.' 
Documentation of the alien S receipt of lesser nationally or internationally recognized prizes or 
awards for excellence in the field of endeavor. 
Initially, counsel asserted that the petitioner was submitting evidence of "Awards and Memberships in 
Societies." Under this heading, however, counsel only discussed the petitioner's alleged "leading and 
critical roles," his work as a "prolific teacher," the publication of the petitioner's case studies, his 
presentations and his memberships. The director concluded that no evidence was submitted of lesser 
nationally or internationally recognized prizes or awards and we concur with that conclusion. All of the 
evidence discussed by counsel under this heading relates to other criteria and will be discussed below. 
None of those claimed accomplishments constitute prizes or awards. 
Documentation of the alien's membership in associations in the jeld for which classification is 
sought, which require outstanding achievements of their members, as judged by recognized national 
or international experts in their disciplines orjelds. 
' The petitioner does not claim to meet or submit evidence relating to the criteria not discussed in this 
decision. 
Initially, counsel asserted that the petitioner had been "selected for membership to the most respected 
and renowned gastroenterology societies in the country and the world." The petitioner submitted letters 
from the American Society for Gastrointestinal Endoscopy (ASGE) and the New York Society for 
Gastrointestinal Endoscopy (NYSGE) affirming his membership in these societies. The petitioner also 
submitted evidence that ASGE has over 9,000 members "who utilize endoscopy as a diagnostic and 
therapeutic method of treatment for diseases of the digestive tract." These materials do not indicate or 
suggest that ASGE requires outstanding achievements of its members. Rather, it appears to be a 
professional association open to most if not all members of the profession. The petitioner did not 
submit the membership requirements for the NYSGE. Regardless, this appears to be a local 
association. 
The petitioner also submitted evidence that the American College of Gastroenterology is open to those 
who meet certain education requirements. First, the petitioner has not demonstrated that he is a 
member of the college. Regardless, meeting education requirements is not an outstanding achievement. 
Rather, the education required appears commensurate with the petitioner's occupation. Thus, it does 
not appear that recognized national or international experts in the discipline judge prospective 
members. 
In light of the above, we concur with the director that the societies of which the petitioner is a member 
do not require outstanding achievements. As such, he has not established that he meets this criterion. 
Evidence of the alien's original scientijic, scholarly, artistic, athletic, or business-related 
contributions of major sign2Jicance in the field 
According to the regulation at 8 C.F.R. 5 204.5(h)(3)(v), an alien's contributions must be not only 
original but of major significance. We must presume that the phrase "major significance" is not 
superfluous and, thus, that it has some meaning. To be considered a contribution of major 
significance in the field of clinical medicine, it can be expected that a new diagnostic procedure 
would be widely adopted or at least under consideration at a number of hospital or clinics. 
Otherwise, it is difficult to gauge the impact of the petitioner's work. 
The petitioner relies at least partly on reference letters to meet this criterion. The opinions of experts 
in the field, while not without weight, cannot form the cornerstone of a successful claim of sustained 
national or international acclaim. CIS may, in its discretion, use as advisory opinions statements 
submitted as expert testimony. See Matter of Caron International, 19 I&N Dec. 791, 795 (Commr. 
1988). However, CIS is ultimately responsible for making the final determination regarding an 
alien's eligibility for the benefit sought. Id. The submission of letters from experts supporting the 
petition is not presumptive evidence of eligibility; CIS may evaluate the content of those letters as to 
whether they support the alien's eligibility. See id. at 795. CIS may even give less weight to an 
opinion that is not corroborated, in accord with other information or is in any way questionable. Id. 
at 795; See also Matter of SofJici, 22 I&N Dec. 158, 165 (Commr. 1998) (citing Matter of Treasure 
Craft of California, 14 I&N Dec. 190 (Regl. Commr. 1972)). 
In evaluating the reference letters, we note that letters containing mere assertions of widespread 
acclaim and vague claims of contributions are less persuasive than letters that specifically identify 
contributions and provide specific examples of how those contributions have influenced the field. 
In addition, letters from independent references who were previously aware of the petitioner through 
his reputation and who have applied his work are far more persuasive than letters from independent 
references who were not previously aware of the petitioner and are merely responding to a 
solicitation to review the petitioner's curriculum vitae and work and provide an opinion based solely 
on this review. Ultimately, evidence in existence prior to the preparation of the petition carries 
greater weight than new materials prepared especially for submission with the petition. An 
individual with sustained national or international acclaim should be able to produce unsolicited 
materials reflecting that acclaim. 
On his curriculum vitae, the petitioner indicated that he had worked as a house staff physician at Coney 
Island Hospital in Brooklyn from June 2002 through June 2005 and that he has since been working as a 
physician at the Maimonides Medical Center, which is affiliated with the Mount Sinai School of 
Medicine in New York. 
The petitioner submitted a letter from 
 who identifies himself as a eve- 
American College of Gastroenterology and submits his letter on the college's letterhead. 
is based on a review of the petitioner's resume and his reputation in the field. A 
curriculum vitae, however, reveals that he is also currently an assistant professor 
of medicine at the Mount Sinai School of Medicine. 
 Moreover, the record establishes that he 
coauthored a study with the petitioner pres n e 
 2006 meeting of the American College of 
Gastroenterology. Thus, it would appear that wb knowledge of the petitioner actually derives 
from his personal association with the petitioner. 
asserts that the petitioner is "one of our nation's foremost experts" in the most advanced 
form of endoscopy, endoscopic ultrasound (EUS), "whereas the vast majority of his peers rely on 
conventional methods." explains that EUS is less invasive than traditional endoscopy and 
discusses the importance of EUS as a diagnostic test. acknowledges, however, that the 
Maimonides Medical Center "is one of only [a] few centers e ui ped with this novel modality and they 
have performed over many [sic] procedures." While asserts that the petitioner is one of the 
few physicians with the expertise to perform the procedure, he does not explicitly rule out the 
possibility that the limited number of these procedures might be due more to the lack of equipment than 
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expertise. He does not explain how having more physicians with this expertise can overcome the lack 
of equipment at most facilities. We note that the classification sought was not designed merely to 
alleviate skill shortages in a given field. In fact, the issue of whether similarly-trained workers are 
available in the United States is an issue under the iurisdiction of the Department of Labor. Matter 
of New York State Dep 't of Transp , 22 I&N Dec. 2 1 5, 22 1 (Cornmr. 1 958). Moreover, - 
does not explain how learning to use technology developed by others or even passing on that 
knowledge to interns is an original contribution. 
Page 6 
, Director of the Division of Liver Diseases at the Mount Sinai School of 
Medicine, discusses the petitioner's work at that institution. Specifically, asserts that 
the petitioner's case studi 
 to lead to improvements in the course of treatment for 
gastroenterology patients." 
 discusses the details of a few studies, noting their potential 
rovides no examples of independent hospitals adopting new techniques or 
case studies. 
Medical Center at the Mount Sinai School of Medicine. has coauthored studies with the ~etitioner. 
discusses the importance and complexity of colorectal screening. We do not contest the 
importance of the petitioner's area of employment or the general value of having doctors who are 
trained in the latest diagnostic technology.2 At issue for the classification sought is whether the 
- 
petitioner is one of the small percentage who has ris 
 of the field and who enjoys 
sustained national or international acclaim in 
 rovides a similar discussion for 
other procedures the petitioner has mastered. 
 does not, however, explain how using 
technology developed by others is an original contribution or provide any examples of how the 
petitioner's ability to perform procedures developed by others has impacted the field. 
an associate professor of medicine at the Indiana University School of Medicine 
and another governor for the American College of Gastroenterology, does not explain how he came to 
know of the petitioner and his work. We note that, according to his curriculum vitae, he was an invited 
speaker at the Mount Sinai School of Medicine in 2006. asserts that there is a shortage 
of qualified gastroenterologists in the United States. As stated above, however, the question of labor 
shortages does not fall under our jurisdiction. NYSDOT, 22 I&N Dec. at 221. Rather, the issue of 
shortages in a given occupation falls un 
 ion of the Department of Labor through the alien 
employment certification process. Id 
 further asserts that the petitioner's expertise in 
both hepatology and advanced therapeutic "ERCP" allows the petitioner to identify and manage 
cirrhosis and end stage liver disease as well as Hepatitis. Merely having a diverse skill set, however, 
would not appear to be an original contribution of major significance in and of itself. Rather, the record 
- - 
must be supported by evidence that the petitioner has already used those combined skills to impact the 
field at the national or international level in an original way. 
While 
 asserts that the petitioner is "far more qualified than the vast majority of his peers" 
to keep patients alive while waiting for a liver transplant and after receiving the transplant, he dies not 
provide examples of unique 
 the petitioner or explain how they are being 
adopted nationwide or worldwide. 
 does assert that the petitioner uses "the latest 
Congress has devised the alien employment certification process, under the jurisdiction of the Department 
of Labor, to address the issue of whether there are sufficient workers who are able, willing, qualified and 
available. Section 212(a)(5)(A)(i) of the Act; 20 C.F.R. fj 656.1(a). Congress has also designed a program to 
address the need for physicians in designated shortage areas or veterans facilities. Section 203(b)(2)(B)(ii) of 
the Act. The petitioner in this matter does not seek benefits under either program. 
medications." 
 does not explain why prescribing medications developed by others is 
either original or of major significance to the field of medicine. Rather, it would appear that even the 
etent physician would take advantage of the latest medicines where appropriate. 
asserts that the etitioner took part in a liver study that "provided critical insight 
Ddoes not discuss the results of this study or explain 
how it has impacted the treatment of liver disease. We will discuss the petitioner's publication record 
and the lack of evidence of its impact in the field below. 
1 an assistant professor of medicine at the University of Arkansas, 
is opinion is an independent one based on the petitioner's "reputation in the field as well as 
asserts that hi 
a review of his CV." m 
does not state whether or not he had ever heard of the petitioner 
prior to being asked to provide a letter of support. We note that, according to his own curriculm vitae, 
- 
did his resi 
 ur Lady of Mercy Medical Center in New York from 
provides general praise of the petitioner, asserting that 
his exuertise with the most modern and comulex urocedures has resulted in the survival of uatients who 
kight'otherwise not have lived. 
 discusses a single patient treated by &e petitioner 
but does not explain how the petitioner's treatment of this patient has impacted the field of 
gastroenterology nationally or internationally. 
 also notes that the petitioner instructs 
interns. Participation in the routine training of interns in the latest procedures developed by others is 
not original and cannot establish that the petitioner has already impacted the field nationally or 
internationally. 
The record also contains evidence that the petitioner has published and presented case studies in 
distinguished journals and conferences. The petitioner has not established that the mere authorship of 
case studies is indicative of or consistent with a contribution of major significance. The Internet 
materials for Chest, submitted by the petitioner, indicate that it publishes "cutting edge clinical 
investigations" in addition to "case studies," suggesting that not every case study represents a cutting 
edge clinical investigation. 
More persuasive than the case studies themselves would be objective evidence of their influence in the 
field, such as evidence that they are widely and frequently cited on a level consistent with sustained 
national or international acclaim. 
 The petitioner submitted an exhibit entitled "citations." 
 The 
evidence included in the exhibit, however, does not establish that the petitioner has ever been cited. 
Rather, the petitioner simply searched for his own last name on Scholar.google.com and the name of 
his coauthor on Yahoo.com and submitted the results. The Scholar.google.com results pulled up 
articles by the petitioner but the links below the individual articles, which will list the number of 
citations when there are any, do not list any citations. While the search results may include several hits 
for the petitioner's last name, without submitting a list of all of the results, we cannot conclude that any 
of them represent citations of the petitioner's articles or even relate to the petitioner as opposed to other 
individuals with the same last name. The petitioner has not explained the significance of the 
Yahoo.com search for his coauthor's last name. 
While the petitioner is well trained and his case studies are no doubt of value, it does not follow that 
every well-trained physician who writes up case studies that add to the general pool of knowledge 
has inherently made an original contribution of major significance to the field as a whole. Without 
letters from a wide selection of independent hospitals or clinics who have adopted the petitioner's 
original procedures, if, in fact, the petitioner has even developed any original procedures, evidence of 
wide and frequent citation of his case studies or comparable evidence of an impact on the field, we 
cannot conclude that he meets this criterion. 
Evidence of the alien S authorship of scholarly articles in thejeld, in professional or major trade 
publications or other major media. 
While counsel has not explicitly asserted that the petitioner meets this criterion, the petitioner did 
submit evidence relating to this criterion. As stated above, the petitioner has published and presented 
several case studies in journals and at conferences. Several of the petitioner's references assert that the 
invitations to present his work at different locations demonstrate his widespread notoriety. As stated 
above, however, the record lacks any evidence that other clinicians have cited or otherwise relied on his 
case studies. Even if we were to conclude that the petitioner meets this criterion because publication is 
not necessarily inherent to the occupation of a physician, the petitioner falls far short of meeting any 
other criterion for the reasons discussed above and below. 
Evidence that the alien has performed in a leading or critical role for organizations or 
establishments that have a distinguished reputation. 
While the petitioner may have performed a "leading role" on a particular case study, the criterion 
requires us to look at his role for a specific organization or establishment. We have already considered 
the petitioner's alleged contributions above. At issue for this criterion are the position the petitioner 
was selected to fill and the reputation of the entity that selected him. In other words, the position must 
be of such significance that the alien's selection to fill the position, in and of itself, is indicative of or 
consistent with national or international acclaim. The petitioner indicates on his curriculum vitae that 
he has worked as a physician and house staff physician for hospitals in New York City. We are not 
persuaded that either position is leading or critical beyond the obvious need for a hospital to employ 
competent physicians. Thus, the petitioner has not established that he meets this criterion. 
Finally, the conclusion we reach by considering the evidence to meet each criterion separately is 
consistent with a review of the evidence in the aggregate. Even in the aggregate, the evidence does not 
distinguish the petitioner as one of the small percentage who has risen to the very top of the field of 
endeavor. The petitioner, a physician, relies on his professional memberships, publication and 
presentation of case studies and the accolades of colleagues. is the Director of Medical 
Education and Research at the Maimonides Medical Center, Vice President of the New York State 
Society of Gastrointestinal Endoscopy 
 American College of Gastroenterology and 
the American College of Physicians. 
 authored 13 books and book chapters in 
addition to numerous articles and abstracts. 
 i has similar leading roles and fellowships and 
serves on the editorial board of four journals. Thus, the top of the petitioner's field appears to be far 
higher than the level he has attained. 
The documentation submitted in support of a claim of extraordinary ability must clearly demonstrate 
that the alien has achieved sustained national or international acclaim and is one of the small percentage 
who has risen to the very top of the field of endeavor. 
Review of the record, however, does not establish that the petitioner has distinguished himself as a 
physician to such an extent that he may be said to have achieved sustained national or international 
acclaim or to be within the small percentage at the very top of his field. The evidence indicates that the 
petitioner shows talent as a physician, but is not persuasive that the petitioner's achievements set him 
significantly above almost all others in his field. Therefore, the petitioner has not established eligibility 
pursuant to section 203(b)(l)(A) of the Act and the petition may not be approved. 
The burden of proof in visa petition proceedings remains entirely with the petitioner. Section 291 of 
the Act, 8 U.S.C. 5 1361. Here, the petitioner has not sustained that burden. Accordingly, the appeal 
will be dismissed. 
ORDER: The appeal is dismissed.