sustained EB-2 NIW Case: Medicine

U.S. Citizenship 
and Immigration 
Services 
MATTER OF E-A-A-
Non-Precedent Decision of the 
Administrative Appeals Office 
DATE: DEC. 27,2016 
APPEAL OF NEBRASKA SERVICE CENTER DECISION 
PETITION: FORM I-140, IMMIGRANT PETITION FOR ALIEN WORKER 
The Petitioner seeks second preference immigrant classification as a member of the professions 
holding an advanced degree, as well as a national interest waiver of the job offer requirement 
attached to this EB-2 classification. See Immigration and Nationality Act (the Act) 
section 203(b)(2), 8 U.S.C. ~ 1153(b)(2). After the petitioner has established eligibility for EB-2 
classification, U.S. Citizenship and Immigration Services (USCIS) may, as matter of discretion. 
grant a national interest waiver if the petitioner demonstrates: (I) that the foreign national's proposed 
endeavor has both substantial merit and national importance: (2) that the foreign national is well 
positioned to advance the proposed endeavor: and (3) that, on balance. it would be beneficial to the 
United States to waive the requirements of a job offer and thus of a labor certification. 1\lfot/er of 
Dhanasar, 26 I&N Dec. 884 (AAO 2016). 
The Director of USCIS's Nebraska Service Center denied the petition. The Director found that the 
Petitioner qualified for classification as a member of the professions holding an advanced degree, 
but that he had not established that a waiver of a job offer would be in the national interest. 
The matter is now before us on appeal. In his appeaL the Petitioner contends that he is eligible for a 
national interest waiver based on his work developing guidelines to improve physicians· ability to 
determine the correct prognoses and treatments for individuals with cancer. The Petitioner maintains 
that the Director did not properly consider his past record of achievement. 
Upon de novo review, we will sustain 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. Because this classification 
requires that the individual's services be sought by a U.S. employer, a separate showing is required 
to establish that a waiver of the job offer requirement is in the national interest. 
Section 203(b) of the Act sets out this sequential framework: 
Matter qf E-A-A-
(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 ofjob offer-
(i) National interest waiver. ... 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. 
While neither the statute nor the pertinent regulations define the term ··national interest." we recently 
set forth a new framework for adjudicating national interest waiver petitions. S'ee Dhanasar. 26 I&N 
Dec. 884. 1 Dhanasar clarifies that. after EB-2 eligibility as an advanced degree professional or 
individual of exceptional ability has been established, USCIS may grant a national interest waiver if 
the petitioner demonstrates by a preponderance of the evidence: (1) that the foreign national's 
proposed endeavor has both substantial merit and national importance: (2) that the foreign national is 
well positioned to advance the proposed endeavor: and (3) that. on balance. it would he beneficial to 
the United States to waive the requirements of a job offer and thus of a labor certification. If these 
three elements are satisfied. USCIS may approve the national interest waiver as a matter of 
discretion. 
The first prong, substantial merit and national importance. focuses on the specific endeavor that the 
foreign national proposes to undertake. The endeavor's merit may he 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. 
The second prong shifts the focus from the proposed endeavor to the foreign national. To determine 
whether he or she is well positioned to advance the proposed endeavor, we consider factors 
including, but not limited to: the individual's education. skills. knowledge and record of success in 
related or similar efforts; a model or plan for future activities: any progress towards achieving the 
proposed endeavor; and the interest of potential customers. users. investors. or other relevant entities 
or individuals. 
1 
In announcing this new framework. we vacated our prior precedent decision. Matter of NeH· York State Department of 
Transportation, 22I&N Dec. 215 (Act. Assoc. Comm·r 1998) (lVYSf)Ol). 
2 
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Matter of E-A-A-
The third prong requires the petitioner to demonstrate that, on balance, it would be beneficial to the 
United States to waive the requirements of a job offer and thus of a labor certification. In 
performing this analysis, USC IS may evaluate factors such as: whether, in light of the nature of the 
foreign national's qualifications or the proposed endeavor. it would be impractical either for the 
foreign national to secure a job offer or for the petitioner to obtain a labor certification; whether. 
even assuming that other qualified U.S. workers are available, the United States would still benelit 
from the foreign national's contributions ; and whether the national interest in the foreign national"s 
contributions is sufficiently urgent to warrant forgoing the labor certification process. In each case, 
the factor(s) considered must, taken together, indicate that on balance, it would be beneficial to the 
United States to waive the requirements of a job offer and thus of a labor certi tication. 2 
II. ANALYSIS 
The Petitioner received a medical degree from in 201 0 and a 
master of science degree from in 2015. Accordingly. the Director found that 
the Petitioner qualified 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 otler requirement and thus a 
labor certification, is in the national interest. 
At the time of tiling the petition, the Petitioner indicated he was employed as an instructor at the 
in addition to holding a two-year position as a 
clinical scholar in residence for the and the 
The record retlects that the Petitioner has f{.)Cused his research on 
"cancer staging and developing survival prognostic calculators for various types of cancer.'' He 
indicates his intent to pursue a surgical oncology fellowship and writes that he wishes to continue his 
work collaborating with statisticians and data analysts to '·analyze large databases" to develop 
guidelines about "treatment sequencing'' and types of therapies to administer to patients with different 
types of cancer. 
A. Substantial Merit and National Importance of the Proposed Endeavor 
The Petitioner states that he intends to continue clinical practice and research , concentrating on cancer 
outcome research . He anticipates "working closely with tumor boards and cancer registrars " to improve 
the quality of cancer registry data. He writes that his "ultimate goal"' is to ·'work at an academic 
institution in the department of surgery where I will combine my clinical and research expertise to help 
improve the care of patients with cancer.'' The Petitioner provided letters from colleagues and 
professors discussing the critical need t()r advancements in cancer surveillance and the use of cancer 
registry data in the staging of adult and pediatric solid malignancy. lie also submitted research reports 
from the American Cancer Society outlining the death rates from individual cancers and explaining the 
cancer staging process . We tind that the Petitioner's proposed research and clinical work has 
2 See Dhanasar, 26 l&N Dec. at 888-91, for further elaboration on these three prong s. 
(b)(6)
Maller of E-A-A-
substantial merit because it aims to improve cancer staging data, treatment protocols, and ultimately, 
outcomes for patients with 
cancer. 
The record also demonstrates that the Petitioner's proposed endeavor is of national importance. The 
Petitioner submitted expert letters from professors working in the field of cancer staging, along with 
members of the discussing how clinicians and rcsL~archcr s rely upon comprchcn si\c 
evidence-based anatomic staging data as the critical l~1ctor to understanding cancer and treating 
patients. In addition . the Petitioner submitted research !"rom the National ( 'anccr Society reportin g 
cancer diagnoses. treatment. and death rates along \Vith the formidable cost of the disease to 
individuals and the economy as a whole. 
B. Well Positioned to Advance the Proposed Endeavor 
The Petitioner submitted his resume, documentation of his published and presented work, peer 
review activities , medical training credentials, along with reference letters discussing his work in the 
field, and evidencing his leadership in developing cancer staging tools. The record also includes 
evidence that the Petitioner is being recruited for fellowship positions at several leading hospitals 
including and 
As discussed below, we find that the Petitioner's notable experience on high-proiile 
projects in this area and his past success in perfom1ing influential original research render him well 
positioned to advance the proposed endeavor. 
For example, 
executive director of 
medical director, and 
notes that the Petitioner is "playing a vital role in the production of the 
of the which defines the classifications used to assess a 
cancer's severity and is scheduled for publication in late 2016. The Petitioner was selected as the tirst 
clinical scholar in residence tasked with detining and updating the cancer staging systems in the 
of the manual. It is utilized by clinicians throughout the country to enhance physicians' 
abilities "to make accurate prognoses for patients with cancer by integrating multiple pertinent factors, 
such as the type of cancer, the patient's age and gender. the type of treatment received, and 
characteristics of the cancer such as histology and size." chair, Department of 
Surgery , describes the manual as the .. gold standard" reference tor 
cancer staging, used by surgical , medical , and radiation oncologists. He states that it is ''crucial to the 
development of a patient's personalized treatment program to have unif<.mn, evidenced-based criteria." 
professor, agrees that the Petitioner's 
contributions to the publication of the are ''vital and necessary.'' and ''will have far-reaching 
implications for cancer care in the United States for decades to come." The Editor-in-Chief of the 
manual, professor, chairman and medical director, 
writes: 
[The Petitioner 's] prior knowledge of cancer staging, as well as his clinical background 
and work in cancer surveillance allowed him to engage fully with the in1ormation 
architects we consulted with to critically review the cuJTent cancer staging system and 
offer us critical lessons for adapting the cancer staging system to the modern era. 
4 
(b)(6)
Matter of E-A-A-
[The Petitioner] has come to understand the vision of the and has been 
collaborating with members of the expe11 panels convened for the staging 
system to ensure that our vision of a comprehensive. relevant and user-tl-iendly staging 
system is realized . 
Additionally commending the Petitioner's work on the manager of the 
states that the Petitioner provided "indispensable clinical insight as a subject matter expe11:· and 
that his opinion is "often solicited from some of the most accomplished oncologists in the \Vorld:· 
medical director of cancer data services, indicates that 
the Petitioner has also contributed significantly to the primary cancer registry in the United States, the 
writes that the Petitioner's work "has allowed for the 
development of quality benchmarks in cancer care now used by the and 
the He further explains that "[the Petitioner's] knowledge base and 
experience are possessed by very tew and make him extremely valuable to the medical community in 
the U.S." 
The Petitioner has also held a leadership role in the revision of the 
manual, which is the standard in the United States by which cancer registrars code 
all cancer cases and collect data entered into the serves as the chair f(x this project 
and describes how the Petitioner's "training as a physician. expertise in cancer staging and 
make him "invaluable to this endeavor." He comments that the Petitioner has been 
"instrumental" to the project and that he is the "lead author of an article outlining the fundamentals of 
this revision that was published in the journal Cancer, in 2015." 
Finally, several experts attest to the positive impact of the Petitioner's work proposing a new staging 
system for adrenocortical carcinoma which was pub! ished in the peer-reviewed journaL In this 
project, the Petitioner assimilated the largest dataset to date on patients with adrenocortical carcinoma. 
which the record ret1ects is being used by clinicians in the tield. For example, 
clinical professor of surgery, writes that the Petitioner's work in this 
area has been 
"informative to my clinical practice:' He comments 
that due to the Petitioner's work on 
staging adrenocortical carcinoma, he can '·confidently counsel my patients with adrenoco11ical 
carcinoma about their prognosis," and "estimate how long patients with adrenocortical carcinoma may 
live and therefore decide whether to pursue aggressive treatment or palliative care:' 
Thus, the significance of the Petitioner's research in his field is corroborated by evidence that 
physicians are modifying their treatment approaches based upon his research and publications. We lind 
that the Petitioner's education, experience, and expertise in his field the significance of his role in 
research projects, as well as his leadership in developing cancer staging tools. position him well to 
continue to advance his proposed endeavor of cancer staging research . 
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Maller of E-A-A-
C. Balancing Factors to Dete1mine Waiver"s Benefit to the United States 
Third and finally , we conclude that, on balance, it would be beneficial to the United States to waive 
the requirements of a job offer and thus of a labor certification. As noted above, the Petitioner holds a 
medical degree and a master of science degree in health services and outcomes research , along with 
considerable experience and expertise in the highly specialized field of cancer staging. The evidence 
also shows that compreh ensive evidence-based anatomic staging data is a critical l:lCtor to 
understanding cancer and treating patient s. The Petitioner has document ed his past success 
advancing high-profile projects such as spearheading the revisions of the of the 
and leading the revisions of the and the primar y cancer 
registry in the United States , the Experts in the field con sistently appl auded the Petitioner's 
contributions as critical to the ''development of quality benchmarks in cancer care," and testified to their 
use of the Petitioner's work in their own clinical practic e and research. For these reaso ns. we find the 
Petitioner has established that the United States will benefit ti·om his contributions even assuming 
that other qualified U.S. workers were available to perform these critical functions. Therefore, we 
conclude that , on balance , it would be beneficial to the United States to waive the requirements of a 
job offer and thus of a labor certification. 
III. CONCLUSION 
The Petitioner has met the requisite three prongs set forth in the Dhanasar analytical framework. We 
find that he has established eligibility for and otherwi se merits a national inter est waiver as a matter 
of discretion . Accordingly, the Petitioner has met his burden to establish eligibility for the 
immigration benefit sought. Section 291 ofthe Act, 8 U.S.C. ~ 136 1. 
ORDER: The appeal is sustained . 
Cite as Matter (dE-A-A-, 10# 77902 (AAO Dec. 27, 20 16)