dismissed EB-2 NIW Case: Medicine

U.S. Citizenship 
and Immigration 
Services 
MATTER OF K-B-T-
APPEAL OF TEXAS SERVICE CENTER DECISION 
Non-Precedent Decision of the 
Administrative Appeals Office 
DATE: DEC. 4, 2015 
PETITION: FORM I-140, IMMIGRANT PETITION FOR ALIEN WORKER 
The Petitioner, a physician specializing in hematology and oncology, seeks classification as a 
member of the professions holding an advanced degree. See Immigration and Nationality Act (the 
Act) § 203(b)(2), 8 U.S.C. § 1153(b)(2). The Director, Texas Service Center, denied the petition. 
The matter is now before us on appeal. The appeal will be dismissed. 
The Petitioner asserts that an exemption from the requirement of a job offer, and thus of a labor 
certification, is in the national interest of the United States. The Director found that the Petitioner 
qualifies for classification as a member of the professions holding an advanced degree, but that the 
Petitioner has not established that a waiver of a job offer would be in the national interest. On 
appeal, the Petitioner submits a brief and additional evidence. 
I. LAW 
Section 203(b) of the Act states, in pertinent part: 
(2) Aliens Who Are Members of the Professions Holding Advanced Degrees or Aliens of 
Exceptional Ability. -
(A) In General. - Visas shall be made available ... to qualified immigrants who are 
members of the professions holding advanced degrees or their equivalent or who 
because of their exceptional ability in the sciences, arts, or business, will substantially 
benefit prospectively the national economy, cultural or educational interests, or welfare 
of the United States, and whose services in the sciences, arts, professions, or business 
are sought by an employer in the United States. 
(B) Waiver of Job Offer-
(i) ... the Attorney General may, when the Attorney General deems it to be in 
the national interest, waive the requirements of subparagraph (A) that an alien's 
services in the sciences, arts, professions, or business be sought by an employer 
in the United States. 
(b)(6)
Matter of K-B-T-
II. ISSUES 
The Petitioner received a Master of Public Health degree (2009) from the 
at and holds the foreign equivalent of a Doctor of Medicine degree. Accordingly, the Petitioner 
qualifies as a member of the professions holding an advanced degree. The sole issue in contention is 
whether the Petitioner has established that a waiver of the job offer requirement, and thus a labor 
certification, is in the national interest. 
Neither the statute nor the pertinent regulations define the term "national interest." Additionally, 
Congress did not provide a specific definition of "in the national interest." Matter of New York State 
Dep't ofTransp. (NYSDOT), 22 I&N Dec. 215, 217-18 (Act. Assoc. Comm'r 1998), set forth several 
factors which must be considered when evaluating a request for a national interest waiver. First, a 
petitioner must establish that he seeks employment in an area of substantial intrinsic merit. !d. at 217. 
Next, a petitioner must demonstrate that the proposed benefit will be national in scope. !d. Finally, the 
petitioner seeking the waiver must show that he will serve the national interest to a substantially greater 
degree than would an available U.S. worker having the same minimum qualifications. !d. at 217-18. 
The Petitioner has established that his work as a physician is in an area of substantial intrinsic merit 
and that the proposed benefits of his hematology and oncology research would be national in scope. 
It remains, then, to determine whether the Petitioner will benefit the national interest to a greater 
extent than an available U.S. worker with the same minimum qualifications. 
Although the national interest waiver hinges on prospective national benefit, the petitioner must show 
that his past record justifies projections of future benefit to the national interest. !d. at 219. The 
petitioner's subjective assurance that he will, in the future, serve the national interest cannot suffice to 
establish prospective national benefit. The inclusion of the term "prospective" is used here to require 
future contributions by the petitioner, rather than to facilitate the entry of an individual with no 
demonstrable prior achievements, and whose benefit to the national interest would thus be entirely 
speculative. !d. 
Furthermore, eligibility for the waiver must rest with the petitioner's own qualifications rather than 
with the position sought. Assertions regarding the overall importance of a petitioner's area of 
expertise cannot suffice to establish eligibility for a national interest waiver. !d. at 220. At iss~e is 
whether the petitioner's contributions in the field are of such significance that he merits the special 
benefit of a national interest waiver, a benefit separate and distinct from the visa classification he 
seeks. A petitioner must exhibit a past history of achievement with some degree of influence on the 
field as a whole. !d. at 219, n. 6. In evaluating the petitioner's achievements, original innovation, 
such as demonstrated by a patent, is insufficient by itself. Whether the specific innovation serves the 
national interest must be decided on a case-by-case basis. !d. at 221, n. 7. 
2 
(b)(6)
Matter of K-B- T-
III. FACTS AND ANALYSIS 
The Petitioner filed the Form I-140, Immigrant Petition for Alien Worker, on August 14, 2014. At the 
time of filing, the Petitioner was working as Chief of Hematology/Oncology House Staff at 
1 The Director determined 
that the Petitioner's impact and influence on his field did not satisfy the third prong of the NYSDOT 
national interest analysis. 
In addition to documentation of his presented work, authorship of three published case reports, peer 
review activities, and medical training credentials, the Petitioner submitted various reference letters 
discussing his work in the field. 
in which the Petitioner received specialty medical training, stated: 
[The Petitioner] currently is focusing his efforts on his original research, which includes 
areas such as incidence and prognosis of solid tumors in HIV patients; and an important 
placebo-controlled trial studying the efficacy and safety of 
for patients with acquired thrombotic thrombocytopenic purpura. The first 
results of this trial have just been announced and it is spectacularly successful and will 
be followed by further trials to bring this medical advance into clinical use. 
mentioned that the results of the Petitioner's placebo-controlled trial studying the efficacy 
and safety of _ were "spectacularly successful," but did not 
explain the Petitioner's role in the trial or how his work has influenced the medical field. Similarly, 
while , Distinguished Professor of Medicine and Oncology at the 
, indicated that the Petitioner's current work involves a "multi-national trial that includes 51 
participating centers focused on an improved treatment method for Thrombotic Thrombocytopenic 
Purpura," he did not discuss how the Petitioner's medical trial has affected treatment protocols or 
has otherwise had an impact on the field as a whole. In addition, asserted that the 
Petitioner has "significantly advanced Hematology research as he produced an important study 
showing the use of hormonal agents such as conjugated estrogens in treating gastrointestinal 
bleeding in hemodialysis patients," but did not provide specific examples of how the Petitioner's 
work has influenced the field. 
Chief of the Division of Hematologic Malignancies and Cellular Therapy, and 
Director of the Adult Blood and Marrow Transplant Program at 
stated: 
An example of [the Petitioner's] important research is his work treating Isolated 
Factor V deficiency in a patient with elevated PT and aPTT. Isolated Factor V 
1 As a member of house staff, the Petitioner was a physician engaged in specialty training who cares for patients 
under the direction and supervision of the attending staff. 
3 
(b)(6)
Matter of K-B-T-
deficiency (Owren 's disease, parahemophilia) is a very rare autosomal recessive 
disorder with an incidence of about 1 in 1 million .... [The Petitioner's] was one of 
the first work [sic] showing treatment of such a patient, and therefore helps provide a 
roadmap for later clinicians. 
asserted that the Petitioner's work "was orte of the first" showing treatment of Isolated 
Factor V deficiency. appears to be referencing a case report coauthored by the Petitioner 
that was published in entitled ' ' . ~ 
' The Petitioner's case 
report indicates that the disease was first described in 1943 by and that 
"approximately 150 cases" have been "reported in the literature since 1943." In addition, the case 
report concludes that fresh frozen plasma "remains the mainstay of treatment" and that "patients are 
generally treated after bleeding episodes or in preparation for surgery." While the Petitioner's case 
report affirms pre-existing 
treatment practices and adds to the general pool of knowledge in the field, 
there is no documentary evidence demonstrating that his findings have influenced the field of 
hematology as a whole. 
With regard to the Petitioner's clinical experience in treating and caring for cancer patients, 
Professor of Medicine, , stated that the Petitioner has 
the ability "to care for an increasing number of patients by utilizing newer and more effective 
technologies and treatment modalities" and that he is "well versed in the use of the latest medicines 
and technologies" for fighting cancer. Any assertion that the petitioner possesses useful skills, or a 
"unique background" relates to whether similarly-trained workers are available .in the United States 
and is an issue under the jurisdiction of the U.S. Department of Labor through the labor certification 
process. NYSDOT, 22 I&N Dec. at 221. In addition, asserts that the Petitioner has 
"advanced scientific research through his publications and presentation" and mentions the 
Petitioner's "recently published work focusing on innovative treatment of a patient whose surgery 
was complicated by a rare blood disorder, isolated Factor V deficiency (published in 
." In regard to the Petitioner's published and presented work, there is no presumption 
that every published article or conference presentation demonstrates influence on the field as a 
whole; rather, the Petitioner must document the actual impact of his article or presentation . In this 
instance, there is no evidence showing that once disseminated through publication or presentation, 
the Petitioner's medical research has garnered a significant number of citations or that his findings 
have otherwise influenced the field as a whole. 
With respect to the documentation indicating that the Petitioner has presented his findings at various 
meetings and medical conferences, we note that 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, healthcare organizations , employers, and 
government agencies promote and sponsor these meetings and conferences. Although presentation 
of the Petitioner's work demonstrates that he shared his original findings with others, there is no 
documentary evidence showing, for instance, frequent independent citation of his work, or that his 
4 
(b)(6)
Matter of K-B-T-
findings have otherwise affected the fields of hematology or oncology at a level sufficient to waive the 
job offer requirement. 
stated that the Petitioner "has produced outstanding research innovations that 
influenced how Hematologists and Oncologists practice and treat patients nationwide" and that the 
Petitioner's work has "demonstrably benefited and advanced the national and scientific medical 
communities," but did not mention any specific innovations or explain how they have influenced the 
field as a whole. Similarly, _ 
asserted that the Petitioner "has made substantial scientific contributions to 
his specialty fields through original research, and his influence has been felt throughout this nation 
and internationally." USCIS need not rely on unsubstantiated statements. See 1756, Inc. v. US 
Att 'y Gen., 745 F. Supp. 9, 15 (D.D.C. 1990) (holding that an agency need not credit conclusory 
assertions in immigration benefits adjudications). further stated that "Isolated Factor V 
deficiency in a patient with 
elevated PT and aPTT during routine pre-operative laboratory screening" 
is "an important baseline · work that provides guidance for peri-operative management and 
monitoring for patients with Isolated Factor V deficiency," but did not provide specific examples of 
how the Petitioner 's work has affected treatment protocols at various medical centers or has 
otherwise influenced the hematology field as a whole. 
, stated: 
[The Petitioner] was selected to serve as a peer reviewer for our journal based on an 
exceptional background and expertise related to the focus of our journal. Applying 
up-to-date knowledge, [the Petitioner] provides critical feedback that helps the editors 
of our journal to identify whether an article is research worthy of publication, as well 
as feedback for the authors related to refining the study measures, study design, and 
statistical analysis, resulting in overall improvement of the article. 
With regard to the Petitioner's service as a peer reviewer for _ and 
various other journals, it is common for a publication to ask multiple 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. Thus, peer 
review is routine in the field, and there is no evidence demonstrating that the Petitioner's occasional 
participation in the widespread peer review process is an indication that he will serve the national 
interest to a substantially greater degree than would an available U.S. worker having the same minimum 
qualifications. 
In response to the Director's request for evidence, the Petitioner provided additional letters of 
support. 
, mentioned the Petitioner's research concerning "the role of alternate 
chemotherapeutic protocol for initial treatment of patients with Hodgkin lymphoma presenting with 
severe abdominal liver function." stated that she is aware of the Petitioner's research 
5 
(b)(6)
Matter of K-B-T-
and has "seen its applications frequently utilized" in her practice, but did not offer any specific 
examples of its implementation. 
, asserted that 
that the impact of the Petitioner's research has affected "the field at [a] national and international 
level" and that he and his colleagues "frequently rely on (the Petitioner's] work." Specifically, 
stated: 
An example of this is his work "Isolated Factor V deficiency in a patient with elevated 
PT and aPTT during routine pre-operative laboratory screening," (the Petitioner's] paper 
provides systematic approach to management of a very rare disease condition. The 
international recognition of his work is reflected by the invitation to present his research 
at the 
There is no documentary evidence demonstrating that "Isolated Factor V deficiency in a patient with 
elevated PT and aPTT during routine pre-operative laboratory screening" is frequently cited by 
independent researchers or that the Petitioner 's findings have otherwise influenced the field as a 
whole. Furthermore, the submitted documentation reflects that the 
was held in October 2014. Eligibility, however, must be 
established at the time of filing. 8 C.F.R. § 103.2(b)(1), (12); Matter of Katigbak, 14 I&N Dec. 45, 
49 (Reg'l Comm'r 1971). Accordingly, we cannot consider any presentations given after August 14, 
2014, the date the petition was filed, as evidence to establish the Petitioner's eligibility at the time of 
filing. 
further stated: 
[The Petitioner] has also published papers describing novel therapeutic regiment for 
uncommon presentation of Hodgkin's Lymphoma and use of conjugated estrogens in 
life-threatening bleeding in patients on hemodialysis. I can affirmatively state that his 
research has been exciting, novel and helpful to Hematologists and Oncologists 
throughout the United States and internationally in delivering healthcare. 
mentioned the Petitioner's research concerning a novel therapeutic regiment for uncommon 
presentation of Hodgkin's Lymphoma and use of conjugated estrogens in life-threatening bleeding in 
patients on hemodialysis, but there is no documentary evidence showing that the Petitioner 's 
findings have impacted the field as a whole. Although the Petitioner's medical research has value, 
any research must be original and likely to present some benefit if it is to receive funding and 
attention from the medical or scientific 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 hematology or oncology fellow who performs 
original research that adds to the general pool of knowledge in the field inherently serves the 
national interest to an extent that is sufficient to waive the job offer requirement. 
(b)(6)
Matter of K-B-T-
==-- · Program Leader and Senior Member, Senior Adult Oncology Program, 
stated: 
[The Petitioner] is a leader in clinical research having produced several important 
studies. His research has addressed several unique issues including a novel treatment 
protocol for Hodgkin[']s lymphoma patients with unusual presentation with liver 
involvement. [The Petitioner] also pioneered use of conjugated estrogens in patients 
with renal failure on dialysis who develop uncontrolled gastrointestinal bleed, not 
responding to standard treatment options. Also, distinct is his paper on "Isolated 
Factor V deficiency" which is a very rare condition. 
commented on the Petitioner's clinical research studies, but there is no documentary 
evidence showing that the Petitioner's findings have been frequently cited by independent 
researchers or have otherwise affected the field as a whole. In addition, asserted that he 
has seen the Petitioner 's work "being utilized frequently" in his practice and by colleagues, but did 
not offer any specific examples . 
Chair of the Department of Hematology and Hematopoietic Cell 
Transplantation, mentioned the Petitioner's article entitled "Use of conjugated 
· estrogens in life-threatening gastrointestinal bleeding in hemodialysis patients -
a review." 
indicated that the Petitioner's article offered "substantiating evidence for the use of this 
approach in management of people in renal failure who have life-threatening bleeding who are on 
dialysis, which is very common in the United States" and that the Petitioner's "research was 
important in helping the care of patients with these types of problems." While the Petitioner 's 
findings validated a treatment approach developed by others, did not explain how the 
Petitioner's findings have resulted in improved patient outcomes or provide specific examples of 
how the Petitioner 's work has influenced the field as a whole. In addition, mentioned 
the Petitioner's "research in the management of patients with atypical Hodgkin's disease and also the 
rare Isolated Factor V deficiency" and asserted that the Petitioner's "contributions are used both in 
the U.S. and around the world," but did not identify the actual contributions or explain how they 
have affected the field as a whole. 
The Director denied the petition on April 9, 2015. The Director acknowledged the Petitioner's 
submission of documentation reflecting his service a peer reviewer, published and presented work, 
and reference letters discussing his medical skills and activities in the field, but determined that they 
did not show the Petitioner's influence on the field was sufficient to demonstrate eligibility for the 
national interest waiver. 
On appeal, the Petitioner asserts that the "testimonials from peers" are "primary evidence of his elite 
clinical skills." In addition, the Petitioner mentions his "unique" and "critical" roles "within major 
academic teaching hospitals." With regard to the Petitioner's hospital duties and clinical skills as a 
hematology and oncology specialist, any objective qualifications which are necessary for the 
performance of the occupation can be articulated in an application for labor certification. NYSDOT , 22 
I&N Dec. at 220-21. The testimonial letters discussing the Petitioner's skills as a physician and 
(b)(6)
Matter of K-BcT-
research projects have already been addressed above. Again, the submitted evidence does not show 
that the Petitioner's work has affected the field as a whole as to warrant a waiver of the job offer. 
With respect to the Petitioner's positions as Chief of Hematology/Oncology House Staff, a house 
staff physician participating in a hematology and oncology fellowship program, and a medical 
resident, there is no indication that the Petitioner 's roles had an impact beyond the patients and staff 
at his hospital. Furthermore, there is no evidence showing that the Petitioner 's work as an evaluator, 
teacher, or clinician has influenced the field as a whole. 
The Petitioner submitted letters of varying probative value. We have addressed the specific assertions 
above. Generalized conclusory assertions that do not identify specific contributions or their impact in 
the field have little probative value. See 1756, Inc. v. US Att'y Gen., 745 F. Supp. 9, 15 (D.D.C. 
1990) (holding that an agency need not credit conclusory assertions in immigration benefits 
adjudications). In addition, uncorroborated assertions are insufficient. See Visinscaia v . Beers, 4 
F.Supp.3d 126, 134-35 (D.D.C. 2013) (upholding USCIS' decision to give limited weight to 
uncorroborated assertions from practitioners in the field); Matter of Caron Int 'l, Inc., 19 I&N Dec. 
791, 795 (Comm'r 1988) (holding that an agency "may, in its discretion, use as advisory opinions 
statements . . . submitted in evidence as expert testimony," but is ultimately responsible for making 
the final determination 
regarding an alien's eligibility for the benefit sought and "is not required to 
accept or may give less weight" to evidence that is "in any way questionable"). 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 petitioner 's eligibility. Id. See 
also Matter of V-K-, 24 I&N Dec. 500, n.2 (BIA 2008) (noting that expert opinion testimony does 
not purport to be evidence as to "fact"). As the submitted reference letters did not establish that the 
Petitioner 's work has influenced the field as a whole, they do not demonstrate his eligibility for the 
national interest waiver. 
In addition, the Petitioner asserts that the Director's "mere reliance on such statistics as citation to 
gauge the influence of one's work is flawed." The Petitioner submits an article entitled 
. - - -
· While the article discusses the limitations of popular bibliometric indicators, such as the 
h-index and the impact factor, and concludes that those indicators are not reliable in making 
"accurate between-field comparisons ," it does not undermine the value of citations for assessing 
research performance . For example, the article notes that "citation analy
sis is widely used in the 
assessment of research performance in the medical sciences." Furthermore , the Director 's decision 
did not include any between-field comparisons , or rely upon the h-index or impact factor as bases for 
denial. Rather, the Director noted a lack of citations to the Petitioner 's research work. The 
aforementioned article's findings do not disprove that a high citation count in the clinical medical 
research area is a reliable indicator of significant impact in the field. It remains that a substantial 
number of favorable independent citations for an article is an indicator that other researchers are 
familiar with the work and have been influenced by it. A lack of citations, on the other hand, is 
generally not probative of an article's impact in the field. 
8 
Matter of K-B-T-
III. CONCLUSION 
Considering the letters and other evidence in the aggregate, the record does not establish that the 
Petitioner's work has influenced the field as a whole or that he will otherwise serve the national 
interest to a substantially greater degree than would an available U.S. worker having the same minimum 
qualifications. The Petitioner has not shown that his past record of achievement is at a level 
sufficient to waive the job offer requirement which, by law, normally attaches to the visa 
classification he seeks. 
A plain reading of the statute indicates that it was not the intent of Congress that every advanced degree 
professional or alien of exceptional ability should be exempt from the requirement of a job offer based 
on national interest. Although a petitioner need not demonstrate notoriety on the scale of national 
acclaim, he must have "a past history of demonstrable achievement with some degree of influence 
on the field as a whole." NYSDOT, 22 I&N Dec. at 219, n.6. On the basis ofthe evidence submitted, 
the Petitioner has not established that a waiver of the requirement of an approved labor certification will 
be in the national interest of the United States. 
The appeal will be dismissed for the above stated reasons, with each considered as an independent 
and alternate basis for the decision. 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 ofOtiende, 26 I&N Dec. 127, 128 (BIA 2013). Here, the Petitioner has not met that burden. 
ORDER: The appeal is dismissed. 
Cite as Matter ofK-B-T-, ID# 14646 (AAO Dec. 4, 2015) 
9