Why does the AAO dismiss EB-1A appeals from medicine petitioners?

Not shown to be among the small percentage at the very top of the field (final merits) (74 of 186 merits dismissals); Original contributions not shown to be of major significance (23 of 186 merits dismissals); Membership criterion not met (no outstanding-achievement requirement) (23 of 186 merits dismissals); Awards not shown to be nationally or internationally recognized (19 of 186 merits dismissals)

Is the 89.5% dismissal rate the EB-1A approval rate for medicine?

No. These are published AAO decisions on appeals of denials, not all USCIS adjudications. Approved petitions are never appealed, so the dismissal rate on appeal is not an initial-filing approval rate. It shows which arguments the AAO rejected and which it accepted.

Can physicians get an EB-1A? What 209 AAO decisions say

Published AAO non-precedent decisions, 2001–2025 · updated 2026-10-16

Between 2001 and 2025 the AAO published 209 EB-1A appeal decisions from medicine petitioners; 13 were sustained and 160 dismissed. The most common ground for dismissal: not shown to be among the small percentage at the very top of the field (final merits) (74 of the 186 merits dismissals, 40%). Second: original contributions not shown to be of major significance (23, 12%). What the sustained decisions had: final merits: among the small percentage at the top of the field; contributions shown to be of major significance. These are appeals of denials, not all adjudications, so the dismissal rate is not an initial-filing approval rate; it shows which arguments the AAO rejected on appeal and which it accepted.

What the decisions say

Grounds for dismissal, by frequency

74 of 186 Not shown to be among the small percentage at the very top of the field (final merits)
“The evidence, including support letters from immediate colleagues and limited media coverage, was deemed insufficient to prove the petitioner had risen to the very top of the field.” AAO, 2024
23 of 186 Original contributions not shown to be of major significance
“However, the petitioner failed to establish that his work constituted original contributions of major significance, citing low citation numbers and evidence of only local influence.” AAO, 2022
23 of 186 Membership criterion not met (no outstanding-achievement requirement)
“Furthermore, his memberships did not require outstanding achievements as a condition for admission, and citations of his work were not considered published material about him.” AAO, 2006
19 of 186 Awards not shown to be nationally or internationally recognized
“The AAO affirmed the Director's finding that the petitioner's awards were not shown to be nationally or internationally recognized, appearing to be regional or a lesser level than required.” AAO, 2023

What the 13 sustained decisions had

5 of 13 Final merits: among the small percentage at the top of the field
“His research in infant care has significantly impacted international guidelines, as confirmed by numerous letters from experts at universities and international health organizations like the WHO, establishing that he is among the small percentage at the…” AAO, 2019
3 of 13 Contributions shown to be of major significance
“The appeal was sustained because the AAO found the petitioner met a third criterion, original contributions of major significance, in addition to the two criteria previously acknowledged by the Director.” AAO, 2017
1 of 13 Judging the work of others documented
“The appeal was sustained because the AAO found the evidence met three regulatory criteria: service as a manuscript reviewer (judging others' work), authorship of chapters in significant medical textbooks (original contributions), and authorship of…” AAO, 2015

Outcomes by Year

Year	Dismissed	Sustained	Remanded	Total
2025	1 (—)	0	1	2
2024	9 (—)	0	2	11
2023	6 (—)	0	3	9
2022	7 (—)	0	0	7
2021	11 (—)	2	2	15
2020	18 (—)	0	0	18
2019	14 (—)	3	0	17
2018	6 (—)	0	0	6
2017	8 (—)	1	0	9
2016	7 (—)	2	0	9
2015	8 (—)	1	0	9
2014	3 (—)	0	0	3
2013	9 (—)	0	0	9
2012	11 (—)	0	0	11
2011	7 (—)	2	0	9
2010	2 (—)	1	0	3
2009	9 (—)	0	0	9
2008	3 (—)	1	0	4
2007	2 (—)	0	0	2
2006	7 (—)	0	0	7
2005	7 (—)	0	0	7
2004	2 (—)	0	0	2
2003	1 (—)	0	0	1
2001	2 (—)	0	0	2

Criteria Breakdown

Criterion	In Dismissed	In Sustained	Total	Dismissal Rate
Judging	105	11	123	85.4%
Authorship of scholarly articles	105	10	122	86.1%
Prizes or awards	110	3	116	94.8%
Original contributions of major significance	99	7	114	86.8%
Membership in associations	90	0	94	95.7%
Leading or critical role	63	5	72	87.5%
Published material about the alien	54	5	64	84.4%
High salary or remuneration	36	0	41	87.8%
Sustained national or international acclaim	15	1	17	—
Artistic exhibitions or showcases	9	0	10	—

Example Decisions

Sustained2021-09-13The appeal was sustained because the AAO found that the petitioner successfully demonstrated he met the criterion for original scientific contributions of major significance, which the Director had initially denied. The… Sustained2019-05-08The appeal was sustained because the AAO determined that the petitioner's evidence, considered in its totality, demonstrated sustained national and international acclaim. His research in infant care has significantly… Sustained2011-12-23The director initially denied the petition, finding the petitioner had not established the requisite extraordinary ability. Upon de novo review, the AAO determined that the petitioner's evidence met at least three of… Sustained2019-04-15The appeal was sustained because the AAO, in its final merits determination, found the petitioner demonstrated sustained acclaim and had risen to the top of his field. This was evidenced by his numerous scholarly… Sustained2015-04-10The appeal was sustained because the AAO found the evidence met three regulatory criteria: service as a manuscript reviewer (judging others' work), authorship of chapters in significant medical textbooks (original… Dismissed2004-07-24The appeal was dismissed because the petitioner failed to establish the sustained national or international acclaim required for the classification. The AAO found that the evidence submitted, including a university gold… Dismissed2015-06-24The appeal was dismissed because the petitioner failed to demonstrate that the beneficiary meets the regulatory criteria. The evidence for awards, consisting of university exam rankings, was deemed a local academic… Dismissed2005-03-30The appeal was dismissed because the petitioner failed to establish the sustained national or international acclaim required. The director found that the petitioner's awards, such as a 'Resident-of-the-Year' award and… Dismissed2017-04-26The motions to reopen and reconsider were denied, upholding the previous dismissal of the appeal. The motion to reopen was denied because the new evidence was dated after the petition's original filing and could not be… Dismissed2006-04-26The appeal was dismissed because the petitioner failed to establish the sustained national or international acclaim required for the classification. The AAO found that the petitioner's awards were institutional rather…

Sample: published AAO non-precedent decisions collected from uscis.gov, 2001–2025. These are appeals, not all USCIS adjudications; approval rates here are not initial-filing approval rates. Read our full methodology.

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