sustained EB-1A Case: Pediatric Cardiology

U.S. Department of Homeland Security 
20 Mass. Ave., N.W., Rm. 3000 
Washington, DC 20529 
U.S. Citizenship 
and Immigration 
Services 
FILE: LIN 07 055 52503 Office: NEBRASKA SERVICE CENTER ~ate%JN I 1 2008 
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. tj 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. 
AIU~~IQ~~YL~' 
- ft- 
Robert P. Wlemann, Chief 
Administrative Appeals Office 
LIN 07 055 52503 
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DISCUSSION: The employment-based immigrant visa petition was denied by the Director, Nebraska Service 
Center, and is now before the Administrative Appeals Office (AAO) on appeal. The appeal will be sustained and 
the petition will be approved. 
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 established the sustained national or 
international acclaim necessary to qualifj for classification as an alien of extraordinary ability. The director also 
determined the petitioner had not submitted clear evidence that he would continue work in his area of expertise in 
the United States. 
On appeal, counsel argues that the petitioner meets at least three of the regulatory criteria at 8 C.F.R. 
5 204.5(h)(3) and that he will continue working in his area of extraordinary ability in the United States. 
Section 203(b) of the Act states, in pertinent part, that: 
(1) Pnority 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, 60898-99 (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. tj 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, filed on December 15, 2006, seeks to classify the petitioner as an alien with extraordinary 
ability as a pediatric cardiologist. At the time of filing, the petitioner was serving as Chief of Cardiac Surgery 
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Service for Hospital San Juan de Dios, Director and Chief of Pediatric Cardiac Surgery for the Cardioamigos 
Foundation, Cardiovascular Surgeon at both the Hospital de Clinicas Caracas and the Medical Center of 
Caracas, and Consulting Surgeon at the University Hospital of Caracas. 
The regulation at 8 C.F.R. $ 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, internationally recognized 
award). Barring the alien's receipt of a major internationally recognized award, the regulation at 8 C.F.R. 
5 204.5(h)(3) 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. We find that the petitioner's 
evidence meets at least three of the regulatory criteria. 
Documentation of the alien's receipt of lesser nationally or internationally recognizedprizes or 
awards for excellence in the jield of endeavor. 
The petitioner submitted evidence showing that he received the Luis Razetti Prize (1984) for his research 
pertaining to vascular cerebral extracranial illness. The petitioner also submitted evidence (such as media 
coverage) showing the national significance of this prize. The record also includes evidence showing that the 
Venezuelan Surgical Society awarded the petitioner the Dr. Francisco Montbrun prize' (1997) and two Dr. 
Miguel Perez Carreno Prizes (1997 and 1999). As such, the petitioner has established that he meets 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 classiJication is sought. Such evidence 
shall include the title, date, and author of the material, and any necessaly translation. 
The petitioner submitted articles about him in Venezuelan newspapers such as El Universal an El Nacional. 
The director's decision stated that there was no evidence showing these articles had national or international 
circulation. On appeal, the petitioner submits material printed from the British Broadcasting Corporation's 
internet site stating that these "leading newspapers in Venezuela" are "two of the largest circulation dailies" in 
the country. In light of the evidence submitted on appeal, the petitioner has established that he meets this 
criterion. 
Evidence that the alien has peforrned in a leading or critical role for organizations or 
establishments that have a distinguished reputation. 
In addressing the petitioner's evidence for this regulatory criterion, the director's decision stated: 
The criterion is claimed primarily on the basis of the petitioner's role as founder of the Cardioamigos 
Foundation. - indicates that the petitioner founded this non-profit organization in 
2000, and that he is responsible not only for providing surgical services care but also for quality of 
patient care and administration. Two published articles independently report on the Foundation and 
' The petitioner's Dr. Fancisco Montbrun Award was for his use of a cell-saving surgery technique eliminating the need 
for blood transhsions. 
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the additional evidence includes website information. Upon consideration, the evidence is sufficient 
to establish both the petitioner's individual role and the distinguished nature of the Foundation's 
reputation in Venezuela. 
We concur with the director's observations. In addition, the petitioner submitted reference letters discussing 
his work for the University Hospital of Caracas, Hospital de Clinicas Caracas, and the Venezuelan Society of 
Cardiology. The record adequately demonstrates that these organizations have distinguished reputations. 
As it relates to the petitioner's leading or critical role within these latter organizations, -chief 
of Service and Chair of Cardiovascular Surgery, University Hospital of Caracas, states: 
In 2000, [the petitioner] was put in charge of implementing the pediatric cardiac surgery program of 
the University Hospital of Caracas, reconstructing the infrastructure that is the paradigm in the 
specialty of pediatric cardiac surgery in Venezuela. 
[The petitioner] was the pioneer in this institute and in the implementation of new surgical procedures 
in pediatric cardiac surgery such as the use of the injectable bovine "contrega" valve, a bioprosthesis 
of tremendous use in the reconstruction of the exit tract of the right ventricle in pediatric cardiac 
surgery, the Ross Operation, among others. 
[The petitioner] has been an important teacher of his craft. The results obtained from his work in this 
Institute have been presented in several national and international congresses. 
-1 
 a pediatrician, neonatologist, and cardiologist at Hospital de Clinicas Caracas, states: 
[The petitioner] has been able to assemble a highly capable team of surgeons, cardiologists, 
anesthesiologists, pediatricians, and pediatric intensive care specialists. Our surgical Intensive Care 
Unit has become, through his effort, the foremost cardiac surgical ICU of the country, incorporating 
innovations such as inhaled Nitric Oxide and Extracorporeal Membrane Oxygenation for cardiac 
support. 
Society of Cardiology, state: 
The petitioner is a prominent Cardiovascular Surgeon in Venezuela and famous for his specialty in 
Pediatric Heart Surgery. 
He is the actual president of the Chapter of Cardiovascular Surgery of the Venezuelan Society of 
Cardiology. He has organized a number of seminars of Cardiovascular Surgery, in addition to 
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participating as a co-coordinator and speaker at the Annual Cardiology Congress of the Society at 
various times . . . . 
[The petitioner] . . . is . . . working as a cardiovascular surgeon in the two most prestigious private 
institutions in Venezuela: the Medical Center of Caracas and the Caracas Clinicas Hospital. 
In light of the above, we concur with the director's finding that the petitioner's evidence meets this criterion. 
In this case, we find that the petitioner's evidence satisfies at least three of the regulatory criteria 8 C.F.R. 
5 204.5(h)(3). 
The remaining issue is whether the petitioner has established that he is coming to the United States to 
continue work in his area of expertise. The regulation at 8 C.F.R. tj 204.5(h)(5) requires "clear evidence that 
the alien is coming to the United States to continue work in the area of expertise. Such evidence may include 
letter(s) from prospective employer(s), evidence of prearranged commitments such as contracts, or a 
statement from the beneficiary detailing plans on how he or she intends to continue his or her work in the 
United States." 
In an affidavit accompanying the petition, the petitioner states: "My permanent presence in the United States 
will permit me to apply my skills in some of the economically and medically neediest areas, participate in 
conferences and events in my field, and expand my research." 
The director requested further evidence "establishing details about where, when and how [the petitioner] will 
continue work in the field of pediatric cardiology in the United States." 
In response, the petitioner submitted a March 16,2007 letter stating: 
. . . I submit this letter as my statement of intent to continue work in the United States in my field of 
expertise, specifically pediatric cardiac care. 
Specifically, I intend to pursue research in the field of pediatric cardiac vascular conditions through 
my many contacts and colleagues at major American Universities, medical research firms, and 
pharmaceutical companies, including Merck. I also intend to continue to provide my services to aid 
in the development of new cardiac vascular products through companies like Medtronic USA Inc., for 
which I have been training surgeons throughout Latin America in use of the company's products and 
techniques for more than a decade. 
As the enclosed letter from Medtronic's ~r. 
 indicates, the company intends to continue 
to utilize my services when I am in the United States, specifically to train Latin American Surgeons in 
the application of new products and techniques that it releases over the next few years. I expect the 
company will also seek out my services in other ways, including for research purposes. I remain 
valuable to Medtronic because of my deep knowledge of many of its cardiac vascular products and 
techniques. 
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[I]t is reasonable to assume that working in my field of expertise, for example as a researcher and 
trainer, in the United States will provide a significant benefit to the country . . . . 
In support of his statement, the petitioner submitted material reflecting that Merck is a sponsor of his 
Cardioamigos Foundation. The petitioner also submitted a March 14, 2007 letter from - Cardiac 
Surgery Director, Latin American Operations, Medtronic USA, Inc., Miami, Florida, stating: 
[W]e really appreciate your effort in providing a very valuable evaluation, analysis and information 
for ContegraQ Pulmonary Valves conduit for Pediatric applications. 
Over the past 15 years . . . you have trained Cardiac Surgeons such for [sic] unique technique of 
implantation that has sa[v]e[d] so many children. 
As discussed in the past Medtronic recently launched Percutaneous Trans Catheter Pulmonary Valves 
Conduit technology "PTCV" in Europe, Canada and it is under investigation device in United States. 
Approximately 500 of such devices have been implanted . . . . I want to assure you that you are going 
to be one of the first physicians that will be trained in Latin America in such technique. So 
subsequently Medtronic will be able to use your experience and seek your support in training and 
education . . . . 
A March 15, 2007 letter from , General Manager, Service & Medical International 
LLC, North Miami Beach, Florida, states: 
[The petitioner] has been of invaluable help in the implementation of innovative cardiac techniques, 
specifically in the field of pediatric cardiac surgery, including research and training of colleagues, 
both in the fields of cardiac surgery and perfusion techniques . . . . 
We are counting on [the petitioner] to continue his association with our enterprise in order to further 
promote research and training in pediatric cardiac surgery. 
The director's decision cited the petitioner's March 16, 2007 letter and the March 14, 2007 letter from 
of Medtronic USA. The director's decision then stated: 
Upon consideration, the record continues to lack clear evidence that the petitioner is coming to the 
United States to continue to work as a pediatric cardiologist. The Service acknowledges that 
conducting medical research and training other physicians are possible related duties. However, 
distinguishing between professions within a given field is consistent with the reasoning of the court in 
Lee v. Ziglar, 237 F. Supp.2d 914 (N.D. 111. 2002). In this case, the record reflects that the petitioner 
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is primarily a practicing cardiovascular surgeon. According to the Occupational Outlook Handbook 
(U.S. Dept. of Labor, 2002-03 Edition at p. 262), physicians and surgeons "diagnose illnesses and 
prescribe and administer treatment for people suffering from injury or disease . . . . Surgeons are 
physicians who specialize in the treatment of injury, disease, and deformity through operations . . . . 
Surgeons, like primary care and other specialist physicians, also examine patients, perform, and 
interpret diagnostic tests, and counsel patients on preventive healthcare." The record continues to 
lack clear evidence that the petitioner will continue to work as a pediatric cardiologist and the petition 
will be denied on that ground. 
The statute requires that the petitioner "seeks to enter the United States to continue work in the area of 
extraordinary ability." See section 203(b)(l)(A)(ii) of the Act, 8 U.S.C. 5 1153(b)(l)(A)(ii). As previously 
noted, the implementing regulation at 8 C.F.R. 5 204.5(h)(5) requires "clear evidence that the alien is coming 
to the United States to continue work in the area of expertise." In this case, the documentation submitted by 
the petitioner indicates that his area of expertise includes cardiovascular surgery training and research. 
Further, the documentation does not support the director's conclusion that the petitioner's plans for 
employment in the United States reflect his entry into a different profession within his field. Thus, the present 
matter is distinguishable from Lee v. I.N.S., 237 F. Supp. 2d 914 (N.D. Ill. 2002). In addition, in the cited 
matter, the alien's acclaim rested on his achievements as a baseball player. The alien in that matter had not 
demonstrated significant achievements as a baseball coach, the job he was seeking in the United States. 
Conversely, in the present case, in addition to the petitioner's acclaim as a pediatric cardiovascular surgeon, 
he has also demonstrated significant achievements as a surgical instructor and researcher, his areas of 
intended employment. For example, the record reflects that petitioner has earned nationally recognized 
awards based on his research and surgical innovations, authored research publications, lectured on his 
specialty at numerous medical conferences as a recognized national expert, trained cardiovascular surgeons at 
distinguished institutions where he has worked (such as the University Hospital of Caracas), and trained 
surgeons from foreign countries (such as those from the Institute of Pediatric Cardiology in Uruguay). With 
regard to the petitioner's training of surgeons in Venezuela, a November 7, 2006 letter from - 
, 
 Professor of Surgery, Emeritus, Harvard Medical School and Surgeon-in-Chief, 
Hospital in Boston, states: "[The petitioner] has also been central to the effort of training pediatric 
cardiac surgeons in Venezuela. His pupils are now working in different areas of the country, guaran[teeing] 
the future of pediatric cardiac surgery in Venezuela." Therefore, the petitioner's plans for training others in 
his field and pursuing research in the field of pediatric cardiac vascular conditions are consistent with his area 
of expertise. Further, the petitioner's plans to continue his work in the United States are corroborated by the 
letters from Medtronic USA, Inc. and Service & Medical International LLC. 
Pursuant to the statute and regulations, the petitioner qualifies for classification sought. While not all of the 
petitioner's evidence carries the weight imputed to it by counsel, the totality of the evidence establishes an 
overall pattern of sustained national acclaim and extraordinary ability. The petitioner has also established that 
he seeks to continue working in the same field in the United States. Therefore, the petitioner has overcome 
the stated grounds for denial and thereby established eligibility for immigrant classification under section 
203(b)(l)(A) of the Act. 
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The burden of proof in visa petition proceedings remains entirely with the petitioner. Section 291 of the Act, 
8 U.S.C. $ 1361. The petitioner has sustained that burden. Accordingly, the decision of the director denying 
the petition will be withdrawn and the petition will be approved. 
ORDER: 
 The appeal is sustained and the petition is approved.