dismissed EB-1A Case: Surgery

(b)(6)
U.S. Department of Homeland Security 
U.S. Citizenship and Immigration Services 
Office of Administrative App eals 
20 Massachusetts Ave., N.W ., MS 2090 
Washington, DC 20529-2090 
U.S. Citizenship 
and Immigration 
Services 
DATE: Office: TEXAS SERVICE CENTER FILE: 
JUL 1 8 2014 
IN RE: Petitioner: 
Beneficiary: 
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: 
Enclosed please find the decision of the Administrative Appeals Office (AAO) in 
your case. 
This is a non-precedent decision. The AAO does not announce new constructions of law nor establish agency 
policy through non-precedent decisions. If you believe the AAO incorrectly applied current law or policy to 
your case or if you seek to present new facts for consideration, you may file a motion to reconsider or a 
motion to reopen, respectively . Any motion must be filed on a Notice of Appeal or Motion (Form I-290B) 
within 33 days of the date of this decision. Please review the Form I-290B instructions at 
http:Uwww.uscis.gov/forms for the latest information on fee, filing location, and other requirements. 
See also 8 C.F.R. § 103.5. Do not file a motion directly with the AAO. 
Thank you, 
( ' Ron Rosenberg 
4:" Chief, Administrative Appeals Office 
www.uscis.gov 
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DISCUSSION: The Director, Texas Service Center, denied the immigrant visa petition and the 
matter is now before the Administrative Appeals Office on appeal. The appeal will be dismissed. 
The petitioner seeks classification as an employment-based immigrant pursuant to section 
203(b )(l)(A) of the Immigration and Nationality Act (the Act), 8 U.S.C. § 1153(b )(l)(A), as an alien 
of extraordinary ability in the sciences. The director determined that the petitioner had not met the 
requisite criteria for classification as an alien of extraordinary ability. 
Congress set a very high benchmark for aliens of extraordinary ability by requiring through the statute 
that the petitioner demonstrate the alien's "sustained national or international acclaim" and present 
"extensive documentation" of the alien's achievements. See section 203(b)(l)(A)(i) of the Act and 
8 C.F.R. § 204.5(h)(3). The implementing regulation at 8 C.F.R. § 204.5(h)(3) states that an alien can 
establish sustained national or international acclaim through evidence of a one-time achievement of a 
major, internationally recognized award. Absent the receipt of such an award, the regulation outlines 
ten categories of specific objective evidence. 8 C.F.R. § 204.5(h)(3)(i) through (x). The petitioner must 
submit qualifying evidence under at least three of the ten regulatory categories of evidence to establish 
the basic eligibility requirements. The director determined that the petitioner's evidence had met the 
categories of evidence at 8 C.F.R. § 204.5(h)(3)(iv) and (vi). 
On appeal, the petitioner submits a November 1, 2013 letter, and citation evidence that had 
previously been submitted in response to the director's request for evidence. In the letter, the 
petitioner asserts that he meets the additional category of evidence at 8 C.F.R. § 204.5(h)(3)(v). 
I. LAW 
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. 
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U.S. Citizenship and Immigration Services (USCIS) 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 H.R. 723 101st Cong., 2d Sess. 59 
(1990); 56 Fed. Reg. 60897, 60898-99 (Nov. 29, 1991). 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. !d.; 
8 C.P.R. § 204.5(h)(2). 
The regulation at 8 C.P.R. § 204.5(h)(3) requires that the petitioner demonstrate the alien's sustained 
acclaim and the recognition of his or her achievements in the field. Such acclaim must be established 
either through evidence of a one-time achievement (that is, a major, international recognized award) or 
through the submission of qualifying evidence under at least three of the ten categories of evidence 
listed at 8 C.P.R. § 204.5(h)(3)(i)-(x). 
In 2010, the U.S. Court of Appeals for the Ninth Circuit (Ninth Circuit) reviewed the denial of a petition 
filed under this classification. Kazarian v. USCIS, 596 F.3d 1115 (9th Cir. 2010). Although the court 
upheld our decision to deny the petition, the court took issue with our evaluation of evidence submitted 
to meet a given evidentiary criterion.
1 
With respect to the criteria at 8 C.P.R. § 204.5(h)(3)(iv) and (vi), 
the court concluded that while users may have raised legitimate concerns about the significance of the 
evidence submitted to meet those two criteria, those concerns should have been raised in a subsequent 
"final merits determination." !d. at 1121-22. 
The court stated that our evaluation rested on an improper understanding of the regulations. Instead of 
parsing the significance of evidence as part of the initial inquiry, the court stated that "the proper 
procedure is to count the types of evidence provided (which we did)," and if the petitioner failed to 
submit sufficient evidence, "the proper conclusion is that the applicant has failed to satisfy the 
regulatory requirement of three types of evidence (as we concluded)." !d. at 1122 (citing to 8 C.P.R. 
§ 204.5(h)(3)). 
Thus, Kazarian sets forth a two-part approach where the evidence is first counted and then considered 
in the context of a final merits determination. In this matter, we will review the evidence under the 
plain language requirements of each criterion claimed. As the petitioner did not submit qualifying 
evidence under at least three criteria, the proper conclusion is that the petitioner has failed to satisfy the 
regulatory requirement of three types of evidence. /d. 
II. ANALYSIS 
A. Evidentiary Criteria2 
1 
Specifically, the court stated that we had unilaterally imposed novel substantiv e or evidentiary requirements beyond 
those set forth in the regulations at 8 C.F.R. § 204.5(h)(3)(i v) and 8 C.F.R. § 204.5(h)(3)(vi) . 
2 On appeal , the petitioner does not claim to meet any of the regulatory categories of evidence not discussed in this 
decision. Therefore , no determination has been made regarding whether the petition er meets the remaining categori es of 
evidence. 
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Evidence of the alien 's participation , either individually or on a panel, as a judge of the 
work of others in the same or an allied field of specification for which classification is 
sought. 
be oetitioner submitted evidence demonstrating that he peer-reviewed manuscripts for 
Accordingly, the 
director's finding that the petitioner's evidence meets this regulatory criterion is affirmed. 
Evidence of the alien 's original scientific, scholarly, artistic, athletic, or business­
related contributions of major significance in the field. 
The petitioner submitted letters of support, his publications and presentations, and citation evidence 
for his published work. The director acknowledged the petitioner's submission of the preceding 
evidence, but found that it was not sufficient to demonstrate that the petitioner's work equated to 
original contributions of major significance in the field. The director therefore concluded that the 
petitioner did not establish eligibility for this regulatory criterion. 
The plain language ofthe regulation at 8 C.F.R. § 204.5(h)(3)(v) requires "[e]vidence of the alien's 
original scientific, scholarly, artistic, athletic, or business-related contributions of major significance 
in the field." Here, the evidence must be reviewed to see whether it rises to the level of original 
scientific or scholarly-related contributions "of major significance in the field." The phrase "major 
significance " is not superfluous and, thus, it has some meaning. Silverman v. Eastrich Multiple 
Investor Fund, L.P., 51 F. 3d 28, 31 (3rd Cir. 1995) quoted in APWU v.' Potter, 343 F.3d 619, 626 
(2nd Cir. Sep 15, 2003). 
In the November 1, 2013 letter submitted on appeal, the petitioner states: 
The original submission as well as the response to the request for evidence confirm a 
substantial record of publication and presentation in prominent forums as well as in book 
chapters as well as numerous citations of these. Furthermore, he has been selected to serve 
as a reviewer for numerous prominent journals, further demonstrating his outstanding 
reputation within the field of surgery. This combined with his significant record of clinical 
expertise in the field of surgery as attested to by his peers through testimonial letters we 
respectfully assert shows that he has an outstanding reputation as a physician scientist and 
that he should be deemed to have satisfied the original contributions category, the third 
necessary category. 
With regard to the petitioner's "record of publication and presentation in prominent forums as well 
as in book chapters," in Kazarian v. USCIS, 580 F.3d at 1036, the court held that publications and 
presentations are not sufficient evidence under 8 C.P.R. § 204.5(h)(3)(v) absent evidence that they 
were of "major significance" in the field. In 2010, the Kazarian court reaffirmed its holding that the 
AAO did not abuse its discretion in finding that the alien had not demonstrated contributions of major 
significance. 596 F.3d at 1122. Thus, there is no presumption that every published article or 
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conference presentation is a contribution of major significance; rather, the petitioner must document 
the actual impact of his article or presentation. 
The petitioner submitted citation evidence from Google Scholar reflecting an aggregate of ten cites to 
his body of research work since 2008. The submitted documentation reflects that none of the 
petitioner's articles was cited to more than seven times. Specifically: 
1. 
2. 
3. 
4. 
The submission of docwnentation reflecting that the petitioner's work has been cited by others in 
their published work is insufficient to establish eligibility for this criterion without documentary 
evidence reflecting that the petitioner's work has been of "major significance in the field." 
Generally, the number of citations is reflective of the petitioner's original findings and that the field 
has taken some interest to the petitioner's work. However, it is not an automatic indicator that the 
petitioner's work has been of major significance in the field. The petitioner has not established that 
the number of independent cites per article for his published work is indicative of original scientific 
contributions of major significance in the field. 
In regard to the petitioner ' s service as a peer reviewer for various medical journals, the regulations 
contain a separate criterion for judging the work of others, 8 C.P.R. § 204.5(h)(3)(iv), a criterion that the 
petitioner has already met. Evidence relating to or even meeting the judging the work of others criterion 
is not presumptive evidence that the petitioner also meets this criterion. The regulatory criteria are 
separate and distinct from one another. Because separate criteria exist for judging the work of others 
and original contributions of major significance, USCIS clearly does not view the two as being 
interchangeable. To hold otherwise would render meaningless the statutory requirement for extensive 
evidence or the regulatory requirement that a petitioner meet at least three separate criteria. 
Furthermore, articles are selected for publication in scientific journals through the peer review 
process. Ajournal's editorial staffwill enlist the assistance of professionals in the field who agree to 
review submitted papers. It is not unusual for a publication to ask several reviewers to review a 
manuscript and to offer comments. The publication's editorial staff may accept or reject any 
reviewer's comments in determining whether to publish or reject submitted papers. The petitioner 
fails to explain how his task of reviewing articles for various medical journals rises to the level of 
original contributions of major significance in the field. 
In addition , the petitioner points to the "testimonial letters" from his peers as evidence that he meets 
the criterion at 8 C.P.R. § 204.5(h)(3)(v). 
Dr. , Associate Staff Vascular Surgeon at the stated: 
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Presently, rthe etitioner] is a vascular surgeon at 
. In this post, he treats patients suffering from the most advanced 
vascular 
conditions, including abdominal aortic aneurysms, which is a frequently fatal condition 
requiring immediate treatment. The surgical treatment of vascular injuries is highly complex, 
and [the petitioner] is able to share his expertise in this area with patients who travel from 
across the tri-state region for these operations. 
His nresentatio on the comolex tooic of 
-Early arid Mid-term outcomes, was well taken in 
the in June 2011 in · USA. In 
this work, [the petitioner] showed the advantages of hybrid endovascular repair for a highly 
complex, and challenging pathology. 
In addition to his impressive emplo ment positions, rthe petitioner is a well ublished. One 
of his research articles titled 
journal in 2011 and was 
well acknowledged by peers. [The petitioner] concluded in this article that Low Body Mass 
Index is associated with increased mortality in critically ill patients and a BMI of less than 
18.5 kg!m2 is an independent factor affecting outcome in surgical critical care patients. 
Dr. comments on the petitioner's presentation at the Annual Meeting of the in 2011. 
With regard to the petitioner's conference presentation, many professional fields regularly hold 
meetings and conferences to present new work, discuss new findings, and to network with other 
professionals. Professional associations, educational institutions, employers, and government 
agencies promote and sponsor these meetings and conferences. Participation in such events, 
however, does not equate to original contributions of major significance in the field. There is no 
documentary evidence showing that the petitioner's presented work has been frequently cited by 
independent researchers, has substantially impacted the surgical field, or has otherwise risen to the 
level of contributions of major significance in the field. 
In addition, Dr points to the article coauthored by the petitioner and six others in 1 
on October 1, 2011 and states that the article "was well acknowledged by peers." 
The petitioner submitted citation evidence from Google Scholar showing that the preceding article 
garnered only seven citations. Again, the petitioner has not established that such a level of citation 
over a period of two years is indicative of scientific contributions of major significance in the field. 
Although the petitioner's research findings have value, any research must be original and likely to 
present some benefit if it is to receive funding and attention from the scientific or medical 
community. In order for a university, publisher or grantor to accept any research for graduation, 
publication or funding, the research must offer new and useful information to the pool of knowledge. 
Not every surgery researcher who performs original research that adds to the general pool of 
knowledge in the field inherently has inherently made a contribution of "major significance" to the 
field as a whole. 
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Dr. Chief Scientific Officer of the 
Recentlv. rthe oetitioner'sl research work titled 
and Dean of the 
stated: 
was published in· the J 
with an impact factor of 3.285. In this study, [the petitioner] examined the 
effect of obesity on morbidity and mortality of about 1800 patients admitted to the surgical 
intensive care unit, where he found that obesity does not affect the mortality of patients 
admitted to the surgical intensive care unit and that it cannot be used as an independent 
predictive mortality outcome variable in these patients. This study provides some important 
information on a highly debatable topic. 
Dr. states that the petitioner's article entitled 
"provides some important information on a highly 
debatable topic." However, according to t e submitted citation evidence from Google Scholar, the 
aforementioned article has not garnered any independent citations. In addition, Dr. _j fails to 
provide specific examples of how the petitioner 's findings affected surgical procedures at various 
hospitals or were otherwise of major significance to the field. 
Dr. and Assistant Professor, 
Department of Surgery, stated: 
[The petitioner] has distinguished himself as a surgeon by demonstrating his superior ability 
to understand and perform a variety of advanced, cutting edge surgical procedures. He is 
extremely well read and has an almost unsurpassed knowledge and understanding of the 
fundamentals of medicine. He is praised for staying ahead of curve on new, cutting edge 
medications and therapies. 
[The petitioner] has special expertise in surgical oncology and laparoscopic surgery. As an 
advanced laparoscopic surgeon, he conducts complicated laparoscopic procedures such as 
laparoscopic colon surgery, laparoscopic colectomy, laparoscopic pancreatic surgery and 
laparoscopic hernia surgery. 
In particular, [the petitioner 's] exceptional skills in laparoscopic colon surgery provide a 
significant benefit to the U.S. The American College of Surgeons estimates that there are 
106,000 new cases of colon cancer and 41,000 new cases of rectal cancer each year incurring 
estimated costs of $8.3 billion a year. Surgery is the main treatment for colon cancer, and the 
traditional operation has been the open, partial colectomy. This is a highly invasive 
procedure with a long recovery time. [The petitioner] is one of a minority of surgeons who is 
capable of performing laparoscopic colon resections. These surgeries are minimally invasive 
with a much shorter recovery time. With the laparoscopic procedure, the patient saves time, 
costs, and endures less pain. Accordingly, there is an increasing need for well-trained 
laparoscopic surgeons in the U.S. 
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Dr. comments on the petitioner's surgical abilities, medical knowledge, expertise in surgical 
oncology and laparoscopic surgery, and exceptional skills in performing laparoscopic colon surgery. 
In addition, Dr. asserts that the petitioner "is one of a minority of surgeons who is capable of 
performing laparoscopic colon resections" and that "there is an increasing need for well-trained 
laparoscopic surgeons in the U.S." Assuming the petitioner's surgical skills and knowledge are 
unique, the employment classification sought was not designed for alleviating skill shortages in a 
given field. The issue of whether similarly-trained workers are available in the U.S. is an issue 
under the jurisdiction of the U.S. Department of Labor through the alien employment certification 
process. See Matter of New York State Department of Transportation, 22 I&N Dec. 215, 221 
(Comm'r 1998). Dr. fails to provide specific examples indicating that the petitioner's work 
has influenced the surgical field or has otherwise been of major' significance to the field. 
Dr. 
[I]n the work 
and Associate Professor, Department of Pediatrics, 
, stated: 
., presented at lthe petitionerJ showed that the tiulure ot 
conventional abdominal aortic aneurysm (AAA) repair may occur as a result of late para­
anastomotic aneurysm due to the breakdown of the anastomotic suture line. Additional 
causes could include aortic wall fragility or erosion by infection. In the work, [the petitioner] 
showed the advantages of endovascular repair as an alternative and corrective measure. He 
noted that endovascular repair offers a minimally-invasive approach, with decreased 
morbidity and mortality in these cases. 
points to the petitioner's presentation entitled 
' but the petitioner has failed to 
establish, for example, the Impact or mfluence ot hiS presentation beyond those in attendance so as 
to establish that his work was majorly significant to the field. Dr. does not provide specific 
examples of how the petitioner's work has influenced the field as a whole or otherwise constitutes an 
original contribution of major significance in the surgical field. 
Dr. Professor of r stated: 
Recently, [the petitioner] published 
- ~ 
a high impact factor publication in medicine. 
In this work, [the petitioner] answered an important question: if the administration of heparin 
for deep vein thrombosis prophylaxis to neurosurgical patients is safe and whether the 
administration of heparin is an independent risk factor for bleeding in this patient population. 
Five hundred twenty-two neurosurgical patients were included in the study. . . . It was 
concluded that administration of heparin dosed according to the risk for thromboembolism 
does not appear to contribute to postoperative hemorrhage in neurosurgical patients. 
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This study supports the concept that the administration of subcutaneous heparin is safe in 
postoperative neurosurgical population, and provides very valuable evidence on the topic in 
this field. 
* * * 
Further, [the petitioner] has recently written a chapter on' 
the online encyclopedia of the 
Dr. states that the petitioner's article entitled ' 
"for 
·· "supports the 
concept that the administration of subcutaneous heparin is safe in postoperative neurosurgical 
population, and provides very valuable evidence on the topic in this field." According to the 
submitted citation evidence from Google Scholar, the aforementioned article has been cited to only 
once since 2012. There is no documentary evidence showing that the preceding article in the 
· or that the petitioner's chapter on "Abdominal Aortic Aneurysm" for the 
have been frequently cited by independent researchers, have led to 
widespread changes in surgical protocols with corresponding improvement in patient outcomes, or 
have otherwise been indicative of contributions of major significance in the field. 
Dr. Chief of the 
Surgery, stated: 
----------------------~-
[The petitioner] is working in the Vascular Surgery department, and his day to day practice 
involves performing complex endovascular procedures (minimally invasive vascular 
surgery). This requires sound theoretical knowledge, and a very high level of technical 
skills, and I have no doubt in saying that [the'petitioner] is an expert in the field. 
[The petitioner] has performed many complex cases, which are worth mentioning, I 
remember one of the cases, in which his outstanding care is particularly evident. This patient 
is a retired 71 year old grandfather, who presented with abdominal pain. He had significant 
past medical history of hypertension, coronary artery disease, chronic obstructive pulmonary 
disease and also history of repair ·of abdominal aortic aneurysm in 2004. His workup 
revealed recurrence of aortoiliac aneurysm, which is a life threatening, abnormal dilatation of 
the bifurcation of the largest blood vessel in the body. Normally, that condition would 
require a very big operation to repair the aneurysm and place a graft to save the patient's life, 
but with the expertise of [the petitioner], and a team effort of vascular surgery, interventional 
radiology, and surgical intensive care unit, it became possible to place a stent in the enlarged 
blood vessel, and perform an endovascular repair of the aneurysm. This was a minimally 
invasive procedure performed through only two small incisions in the groin, in contrast to an 
open repair, which would have involved a large incision in the abdomen. Patient did 
remarkably well, and was discharged home the next day. 
Dr. comments on the petitioner's ability to perform complex endovascular procedures, 
his theoretical knowledge and technical skills, and his success in utilizing a minimally invasive 
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endovascular procedure to repair a patient's aortoiliac aneurysm, but the evidence submitted does 
not demonstrate that the petitioner's work has affected the surgical field in a major way or that his 
work was otherwise indicative of original contributions of major significance in the field. 
Dr. 
stated: 
Professor of Clinical Surgery at 
At the [the petitioner] performs numerous critical functions 
such as teaching medical students , residents and applying his expert endovascular skills to 
the extremely complex vascular patients, which few in this country can apply. 
I would like to mention a few instances , where [the petitioner] saved a patient's limb and life 
by his excellent clinical and operative skills. A 50 year old father of three girls, presented to 
emergency department with pain and swelling of the base of the left neck, above his collar 
bone. [The petitioner] diagnosed him with ruptured aneurysm/pseudo-aneurysm arising from 
a branch of the left thyrocervical trunk, with a CT scan. This was a life threatening condition 
and the patient was taken emergently to the operating room, where [the petitioner] first 
inserted coils to stop the leaking blood, and then placed a stent graft to maintain the blood 
flow to the arm. Patient was discharged hoine 2 days later. 
Another patient was an 80 year old grandmother , who came to ER with her daughter and 
granddaughters with shoulder pain. She had history of cardiac arrhythmia, and her workup 
revealed aberrant right subclavian artery aneurysm (abnormal dilatation of the artery 
supplying the right arm), which is very uncommon , also limb and life threatening if ruptures. 
With a combination of open and minimally invasive approach, [the petitioner] successfully 
placed an Amplatzer plug in the area while maintaining the blood flow to the arm and the 
brain. The patient did very well and was discharged home the next day. 
Dr. points to the petitioner's instruction of medical students and residents, and successful 
treatment of two patients at but there is no documentary evidence 
showing that the petitioner 's specific work rises to the level of original contributions of major 
significance in the field. The plain language of the regulation at 8 C.F.R. § 204.5(h)(3)(v) requires 
that the petitioner ' s contributions be "of major significance in the field" rather than limited to the 
staff and patients at his hospital. See Visinscaia v. Beers, --- F. Supp. 2d ---, 2013 WL 6571822, at 
*4, *6 (D.D.C. Dec. 16, 2013) (upholding a finding that a ballroom dancer had not met this criterion 
because she did not demonstrate her impact in the field as a whole). 
Dr. a hospitalist at , stated: 
I am very impressed by [the petitioner ' s] research article titled ' 
published in J In this study, he wrote about the patients in 
the intensive care unit (ICU), who are at an increased risk of Deep vein thrombosis (DVT) 
and pulmonary embolism (PE) compared with the general population. [The petitioner] 
studied the safety and efficacy of early heparin administration for DVT prophylaxis in these 
critically ill patients with lower GI bleeding. 
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* * * 
This is one of the very few research articles, that has changed my practice. Now [the 
petitioner's] recommendation certainly influences my decision making while taking care of 
such patients. 
Dr. asserts that the petitioner's article in has changed 
his practice and influenced his decision making, but the submitted citation evidence from Google 
Scholar indicates that others in the field have cited to the article only once since 2012. There is no 
documentary evidence showing that the petitioner's findings been utilized by other surgeons or 
physicians at a level indicative of contributions of major significance in the field. 
Dr. a pulmonary critical care attending physician, 
, stated: · 
rThe petitioner 's 1 article titled ' 
was published in the _ with 
an impact factor of 3.285. This is an outcome study of 1792 patients, in which he examined 
the effect of obesity on morbidity and mortality in patients admitted to the Surgical Intensive 
Care Unit. 
The incidence of obesity is rising, and an increasing number of obese patients are admitted to 
surgical intensive care units. [The petitioner] found that mortality rates were not statistically 
significant among different obese groups when compared with the group with normal Body 
Mass Index and he concluded that obesity does not affect the mortality of surgical patients 
who are admitted to surgical intensive care units. 
[The petitioner's] research work showing that obesity cannot be used as an independent 
predictive outcome variable in patients admitted to the SICU is outstanding and changes the 
previous belief that obese patients have higher mortality. This definitely changed my 
practice and also of few of my colleagues. 
Dr. comments on the petitioner 's article in . but 
the submitted citation evidence from Google Scholar indicates that the petitioner's article has not 
garnered any independent citations. Although Dr. Singh asserts that the petitioner's work changed 
his practice and that of his colleagues, he does identify the other colleagues whose work that the 
petitioner has influenced. There is no documentation showing that the petitioner's specific findings 
have been implemented at a number of surgical intensive care units, that his findings are frequently 
cited by independent researchers, or that his work otherwise equates to original contributions of major 
significance in the field. 
The opinions of the petitioner 's references are not without weight and have been considered above. 
users may, in its discretion, use as advisory opinions statements submitted as expert testimony. 
See Matter of Caron International, 19 I&N Dec. 791, 795 (Comm'r. 1988). However, USCIS is 
ultimately responsible for making the final determination regarding an alien's eligibility for the 
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Page 12 
benefit sought. !d. The submission of reference letters supporting the petition is not presumptive 
evidence of eligibility; users may evaluate the content of those letters as to whether they support 
the alien's eligibility. See id. at 795-796; see also Matter ofV-K-, 24 I&N Dec. 500, n.2 (BIA 2008) 
(noting that expert opinion testimony does not purport to be evidence as to "fact"). Thus, the content 
of the references' statements and how they became aware of the petitioner's reputation are important 
considerations. Even when written by independent experts, letters solicited by an alien in support of 
an immigration petition are of less weight than preexisting, independent evidence that one would 
expect of a physician or surgeon who has made original contributions of major significance in the 
field. Without additional, specific evidence showing that the petitioner's original work has been 
unusually influential, widely implemented throughout his field, or has otherwise risen to the level of 
contributions of major significance, the petitioner has not established that he meets this regulatory 
criterion. See Visinscaia, 2013 WL 6571822, at *6. 
Evidence of the alien's authorship of scholarly articles in the field, in professional or 
major trade publications or other major media. 
The petitioner has documented his authorship of scholarly articles in professional publications and, thus, 
has submitted qualifying evidence pursuant to 8 C.P.R. § 204.5(h)(3)(vi). Accordingly, the director's 
finding that the petitioner's evidence meets this regulatory criterion is affirmed. 
Evidence that the alien has performed in a leading or critical role for organizations or 
establishments that have a distinguished reputation. 
The director discussed the evidence submitted for this regulatory criterion and found that the 
petitioner failed to establish his eligibility. On appeal, the petitioner does not contest the director's 
findings for this criterion or offer additional arguments. When an appellant fails to offer argument 
on an issue, that issue is abandoned. Sepulveda v. U.S. Att'y Gen., 401 F.3d 1226, 1228 n. 2 (11th 
Cir. 2005); Hristov v. Roark, No. 09-CV-27312011, 2011 WL 4711885 at *1, *9 (E.D.N.Y. Sept. 
30, 2011) (plaintiffs claims abandoned when not raised on appeal). Accordingly, the petitioner has 
not established that he meets this regulatory criterion. 
B. Summary 
The petitioner has failed to satisfy the antecedent regulatory requirement of three categories of 
evidence. 
III. CONCLUSION 
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. 
Even if the petitioner had submitted the requisite evidence under at least three evidentiary categories, in 
accordance with the Kazarian opinion, the next step would be a final merits determination that 
considers all of the evidence in the context of whether or not the petitioner has demonstrated: (1) a 
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Pag e 13 
"level of expertise indicating that the individual is one of that small percentage who have risen to the 
very top of the[ir] field of endeavor" and (2) "that the alien has sustained national or international 
acclaim and that his or her achievements have been recognized in the field of expertise." 8 C.F.R. 
§ 204.5(h)(2) and (3); see also Kazarian, 596 F.3d at 1119-20. Although we conclude that the evidence 
is not indicative of a level of expertise consistent with the small percentage at the very top of the field or 
sustained national or international acclaim, we need not explain that conclusion in a final merits 
determination.3 Rather, the proper conclusion is that the petitioner has failed to satisfy the antecedent 
regulatory requirement of three categories of evidence. /d. at 1122. 
The petitioner has not established eligibility pursuant to section 203(b )(1 )(A) of the Act and the petition 
may not be approved. 
In visa petition proceedings , it is the petitioner's burden to establish eligibility for the immigration 
benefit sought. Section 291 of the Act, 8 U.S.C. § 1361; Matter of Otiende, 26 I&N Dec. 127, 128 
(BIA 2013). Here, that 
burden has not been met. 
ORDER: The appeal is dismissed. 
3 The AAO conducts appellate review on a de novo basis. See Siddiqui v. Holder, 670 F.3d 736, 741 (7th Cir. 2012); 
Soltane v. DOl, 381 F.3d 143, 145 (3d Cir. 2004); Dar v. INS, 891 F.2d 997, 1002 n. 9 (2d Cir. 1989). In any future 
proceeding, the AAO maintains the jurisdiction to conduct a final merits determination as the office that made the last 
decision in this matter. 8 C.F.R. § 103.5(a)(1)(ii). See also section 103(a)(1) of the Act; section 204(b) of the Act; DHS 
Delegation Number 0150.1 (effective March 1, 2003); 8 C.F.R. § 2.1 (2003); 8 C.F.R. § 103.1(f)(3)(iii) (2003); Matter of 
Aurelio, 19 I&N Dec. 458, 460 (BIA 1987) (holding that legacy INS, now USCIS, is the sole authority with the 
jurisdiction to decide visa petitions).