dismissed EB-2 NIW Case: Pediatric Nursing

U.S. Citizenship 
and Immigration 
Services 
Non-Precedent Decision of the
Administrative Appeals Office 
Date: WL. 07, 2023 In Re: 27032668 
Appeal of Nebraska Service Center Decision 
Form 1-140, Immigrant Petition for Alien Workers (National Interest Waiver) 
The Petitioner, a pediatrician who intends to work in the United States as a registered nurse, seeks 
employment-based second preference (EB-2) immigrant classification as a member of the professions 
holding an advanced degree or as an individual of exceptional ability in the arts, sciences or business. 
In addition, she seeks a national interest waiver of the job offer requirement attached to the EB-2 
classification. See Immigration and Nationality Act (the Act) section 203(b )(2), 8 U.S.C. § 1153(b )(2). 
The Director of the Nebraska Service Center denied the petition, concluding that the record did not 
establish the Petitioner's eligibility for a national interest waiver under the Dhanasar framework. The 
matter is now before us on appeal. 8 C.F.R. § 103.3. 
The Petitioner bears the burden of proof to demonstrate eligibility by a preponderance of the evidence. 
Matter ofChawathe, 25 I&N Dec. 369, 375-76 (AAO 2010). We review the questions in this matter 
de novo. Matter of Christo 's, Inc., 26 l&N Dec. 537, 537 n.2 (AAO 2015). Upon de novo review, 
we will dismiss the appeal. 
I. LAW 
To establish eligibility for a national interest waiver, a petitioner must first demonstrate qualification 
for the underlying EB-2 visa classification, as either an advanced degree professional or an individual 
of exceptional ability in the sciences, arts, or business. Section 203(b )(2)(B)(i) of the Act. 
Once a petitioner demonstrates eligibility as either a member of the professions holding an advanced 
degree or an individual of exceptional ability, they must then establish that they merit a discretionary 
waiver of the job offer requirement "in the national interest." Section 203(b )(2)(B)(i) of the Act. 
While neither the statute nor the pertinent regulations define the term "national interest," Matter of 
Dhanasar, 26 I&N Dec. 884, 889 (AAO 2016), provides the framework for adjudicating national 
interest waiver petitions. Dhanasar states that U.S. Citizenship and Immigration Services (USCIS) 
may, as matter of discretion, 1 grant a national interest waiver if the petitioner demonstrates that: 
1 See also Poursina v. USCIS, 936 F.3d 868 (9th Cir. 2019) (finding USCIS' decision to grant or deny a national interest 
waiver to be discretionary in nature) . 
• The proposed endeavor has both substantial merit and national importance; 
• The individual is well-positioned to advance their proposed endeavor; and 
• On balance, waiving the job offer requirement would benefit the United States. 
II. ANALYSIS 
The Director determined that the Petitioner is eligible for EB-2 classification as a member of the 
professions holding an advanced degree. 2 The remaining issue to be determined is whether the 
Petitioner qualifies for a national interest waiver under the Dhanasar framework. 
Prior to her admission to the United States in 2018, the Petitioner worked as a pediatric resident and 
pediatrician in Brazil for over 15 years. The Petitioner's proposed endeavor, as described in her 
statements and a five-year personal plan, is to work as a registered nurse in pediatric healthcare 
settings. 3 She also indicates her intent to enroll in a master's program which would allow her to obtain 
certification as a pediatric nurse practitioner. The Petitioner stated that she will "focus on pediatric 
nursing, providing nursing training, and providing high-quality healthcare services to the Latin 
population." 
The Director concluded that, although the Petitioner established the substantial merit of her proposed 
endeavor, she had not demonstrated its national importance, that she is well-positioned to advance her 
proposed endeavor, or that, on balance, it would be beneficial to the United States to waive the 
requirements of a job offer, and thus of the labor certification. 
On appeal, the Petitioner asserts that the Director ignored or mischaracterized credible and probative 
evidence, misapplied established legal standards for adjudicating national interest waiver petitions, 
and inflated the standard of review above the preponderance of the evidence standard. For the reasons 
provided below, we agree with the Director's determination that the Petitioner did not establish the 
national importance of her proposed endeavor. While we do not discuss each piece of evidence 
individually, we have reviewed and considered the record in its entirety. 
The first prong of the Dhanasar analytical framework, substantial merit and national importance, 
focuses on the specific endeavor that the individual proposes to undertake. The endeavor's merit may 
be demonstrated in a range of areas such as business, entrepreneurialism, science, technology, culture, 
health, or education. In determining whether the proposed endeavor has national importance, we 
consider its potential prospective impact. Dhanasar, 26 I&N Dec. at 889. In Dhanasar, we further 
noted that "we look for broader implications" of the proposed endeavor and that "[a]n undertaking 
may have national importance for example, because it has national or even global implications within 
a particular field." Id. We determined in Dhanasar that the petitioner's teaching activities did not rise 
2 Because the Director found the Petitioner eligible for classification as a member of the professions possessing an 
advanced degree, the decision does not evaluate the Petitioner's alternative claim that she also qualifies for EB-2 
classification as an individual of exceptional ability. The record demonstrates that the Petitioner earned a medical degree 
(Titula<;ao de Medico) from a Brazilian university that is the foreign equivalent of a U.S. advanced degree. See 8 C.F.R. 
§ 204.5(k)(3)(i)(A). 
3 At the time of filing in June 2021, the Petitioner was qualified as a Certified Nursing Assistant in Utah and enrolled in a 
bachelor's program for nursing, which she completed in August 2022. She received her registered nurse professional 
license in November 2022. 
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to the level of having national importance because they would not impact his field more broadly. Id. 
at 893. We also stated that "[a]n endeavor that has significant potential to employ U.S. workers or 
has other substantial positive economic effects, particularly in an economically depressed area, for 
instance, may well be understood to have national importance." Id. at 890. 
In addressing the national importance of her endeavor, the Petitioner stated in her personal plan that 
she "will contribute to the improvement of the Hospitals Industry in the U.S., as nursing is considered 
such an important component of a functional healthcare system." In this regard, she notes that her 
engagement as a nurse at U.S. hospitals and other settings will have numerous benefits including "an 
increase in the number of patients putting their confidence in the institution, increased patient loyalty 
and improved patient relationships." The Petitioner has also emphasized that most full-time nurses 
see "three or more patients per hour" and thus a single nurse can "potentially impact millions of 
Americans in need of care." 
The Petitioner provided numerous industry reports and articles addressing the nursing and nurse 
practitioner occupations, the pediatrics field, the healthcare industry, and labor shortages in the 
industry. The Petitioner also submitted an expert opinion letter from a professor at the I II lwho similarly discusses the healthcare industry as a driver of the U.S. economy, the growing 
demand for nurses, and their critical role in the industry. Further, the professor states that due to the 
national shortage of healthcare workers, a situation which the COVID-19 pandemic has exacerbated, 
the Petitioner's proposed endeavor is nationally important. We recognize that the COVID-19 
pandemic and a pre-existing nursing shortage places the Petitioner's nursing work in high demand. 
We further acknowledge the Petitioner's arguments that nursing is important for the nation's quality 
of life, productivity, societal well-being, and the U.S. economy. However, in determining national 
importance, the relevant question is not the importance of the industry or profession in which the 
individual will work; instead, we focus on the "the specific endeavor that the foreign national proposes 
to undertake." Dhanasar, 26 I&N Dec. at 889. 
While we agree with the Director that the Petitioner established the substantial merit of her proposed 
endeavor, she did not elaborate on how her proposed employment as a nurse providing patient care 
would have broader implications for the field of nursing, how it would specifically contribute to the 
improvement of the "the Hospitals Industry," or how it would impact the U.S. healthcare field more 
broadly. She has not suggested that her work will resolve the national nursing shortage, nor has she 
explained what specific impact her work would have on reducing such a shortage. Her suggestion that 
she could broadly impact the field by single-handedly providing clinical nursing care for "millions of 
Americans" is not adequately supported in the record. The Petitioner has not submitted sufficient 
evidence to demonstrate how her proposed endeavor's impact would extend beyond her workplaces 
and patients to the broader field of nursing or the healthcare industry. 
The Petitioner has indicated that, in addition to her clinical duties, she would be involved in training 
other nurses and providing workshops and educational classes for parents to improve their healthcare 
literacy. However, she did not sufficiently elaborate on these aspects of her endeavor in her personal 
statements or five-year personal plan. She also indicates that she would be "leading by example 
regarding the adoption of new methodologies that will be reflected in the increased efficiency and 
quality of patient nursing care." The submitted advisory opinion letter similarly refers to the 
Petitioner's "significant potential to teach and train other U.S. professionals in the field" and to 
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"implement her healthcare methods and strategies to ... healthcare facilities." However, the submitted 
evidence offers no additional insight into the Petitioner's "new methodologies" or "health care 
methods and strategies," how she proposes to implement them, or how they would have benefits or 
other implications for the broader nursing or healthcare field. Accordingly, the record does not 
establish that she will be transferring clinical knowledge or innovative methods on a scale that would 
have the potential for national implications in the field of nursing or otherwise rise to the level of 
national importance. 
On appeal, the Petitioner contends that the Director placed undue focus on whether her proposed 
endeavor would have "substantial positive economic effects," noting that job creation and other direct 
economic impacts are only one factor that should be considered in weighing the national importance 
of a proposed endeavor. Despite downplaying the importance of economic factors, the Petitioner 
emphasizes that she will "contribute to promoting America's prosperity, noting that "[n]ursing has a 
tremendous potential to generate economic growth in the U.S" and that she will be "operating in a key 
sector of the economy." Although the Petitioner stresses the healthcare industry's importance to the 
economy, she has not sufficiently identified the potential economic impacts of her proposal to work 
as a registered nurse or nurse practitioner in clinical settings. Therefore, while we agree with her 
assertion that other factors, including non-economic factors, must also be considered, the record 
supports the Director's determination that she has not shown that the benefits to the regional or national 
economy resulting from her endeavor would reach the level of "substantial positive economic effects" 
contemplated by Dhanasar. 26 I&N Dec. at 890. 
The Petitioner maintains that she provided sufficient evidence to show that her proposed endeavor 
"will affect a large population of children in underserved areas of Utah, which are designated as Health 
Professional Shortage Areas (HPSA)," and as such will enhance societal welfare. While the Petitioner 
indicated in her five-year personal plan that her clinical placement locations to date have been in Utah 
hospitals and healthcare facilities, she did not identify the specific geographic locations. She generally 
indicates her intent to work at "U.S. hospitals" and indicates her interest in working with Portuguese 
and Spanish speaking populations, but she did not previously state an intent to work within federally 
designated HPSAs in Utah. While working in an area of designated need for primary care providers 
might relate to the substantial merit of her proposed endeavor, the shortage of providers in certain 
Utah counties or in the United States does not render the Petitioner's potential employment as a nurse 
nationally important under the Dhanasar framework. 
The Petitioner, referring to previously submitted articles, farther contends that nurses, particularly 
those who are bi-lingual, can play a vital role in improving health outcomes of children in minority 
communities who cannot obtain basic healthcare due to financial, geographic and language barriers. 
The Petitioner maintains that her work with these communities will have an "impact on matters of 
national importance designated by the government." She refers to a January 2021 White House 
Executive Order on "Advancing Racial Equity and Support for Underserved Communities Through 
the Federal government" which called for the federal government to develop plans to address barriers 
that limit foll and equal participation of underserved communities and individuals seeking to enroll in 
or access Federal benefits, services, or programs. 
While the executive order indicates the importance of engagement with members of underserved 
communities to advance racial equity and support, its focus is on the U.S. government's role in doing 
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so; it does not specifically show the government's interest in the Petitioner's proposed endeavor or 
similar endeavors. In evaluating national importance under the first prong of the Dhanasar framework, 
we will consider evidence demonstrating how a specific proposed endeavor impacts a matter that a 
government entity has described as having national importance or a matter that is the subject of 
national initiatives. However, pursuing employment in an area that is adjacent to the subject of 
national initiatives is not sufficient, in and of itself: to establish the national importance of a specific 
endeavor. The Petitioner must still demonstrate the potential prospective impact of her specific 
proposed endeavor in that area. 
Finally, to illustrate the potential impact of her proposed endeavor, the Petitioner pointed to her past 
employment experience and her qualifications as a pediatrician and registered nurse. We reviewed 
her statements and the letters of recommendation from her employers and professional contacts. The 
authors of the letters praise the Petitioner's abilities as a healthcare professional, and the personal 
attributes that make her an asset to her employers, colleagues, and patients. While the authors express 
their high opinion of the Petitioner and her work and recommend her for future nursing positions in 
the United States, they do not discuss her specific proposed endeavor or explain why it has national 
importance. As such, the letters are not probative of the Petitioner's eligibility under the first prong 
ofDhanasar. Furthermore, we note that the Petitioner's knowledge, skills, education, and experience 
are considerations under Dhanasar's second prong, which "shifts the focus from the proposed 
endeavor to the foreign national." 26 I&N Dec at 890. The issue under the first prong is whether the 
Petitioner has demonstrated the national importance of her proposed work. 
While the Petitioner's evidence establishes how her endeavor stands to positively impact her 
employers, her patients and their families, the evidence does not persuasively establish how her 
endeavor will have a broader impact consistent with national importance. Accordingly, the Petitioner 
has not established that her proposed endeavor meets the first prong of the Dhanasar framework. 
Because the identified reasons for dismissal are dispositive of the Petitioner's appeal, we decline to 
reach and hereby reserve remaining arguments concerning her eligibility under the second and third 
prongs of the Dhanasar framework. See INS v. Bagamasbad, 429 U.S. 24, 25 (1976) (stating that 
"courts and agencies are not required to make findings on issues the decision of which is unnecessary 
to the results they reach"); see also Matter ofL-A-C-, 26 I&N Dec. 516, 526 n.7 (BIA 2015) ( declining 
to reach alternative issues on appeal where an applicant is otherwise ineligible). 
III. CONCLUSION 
As the Petitioner has not met the requisite first prong of the Dhanasar analytical framework, we conclude 
that she has not established she is eligible for or otherwise merits a national interest waiver as a matter 
of discretion. The appeal will be dismissed for the above stated reason. 
ORDER: The appeal is dismissed. 
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