Wednesday, February 26, 2014

Hiring an Associate Dentist Who Requires Visa Sponsorship

Long a part of medical doctor staffing, dentists requiring visa sponsorship have come to represent a much larger segment of the available work force. Often these associate candidates bring extensive training and geographic flexibility that is not easily found in the domestic applicant pool. Also, they often offer a longer-term associate solution, as the visa process discourages the kind of “job-hopping” that is more routine with traditional early career dentists.
Whether a practice is considering sponsoring a new Visa or transferring an existing Visa, the process is not as intimidating as it may appear. Our friend Ken Gauvey of The Law Practice of Ken C. Gauvey ( provides the following overview of the Visa sponsorship process from the employer’s perspective. For more information or to consult with an immigration lawyer, please contact Ken Gauvey at

Hiring Doctors in the Era of Health Care Shortages
The U.S. faces a national shortage of doctors. In fact, the Association of American Medical Colleges released a report indicating that the U.S. shortage of qualified physicians is at 20,000 now with half of the nation’s doctors being over the age of 50. As a result, that shortage, even before the introduction of the Affordable Care Act, is expected to grow exponentially in the coming years. A study in the Annals of Family Medicine projects that the country will need 52,000 more primary care physicians by 2025. According to the Journal of the American Medical Association, only one in five graduating medical residents plan to go into primary care. In the face of this shortage, it is clear that hospitals in the U.S. will have to rely more on qualified foreign doctors to fill this gap.

Unfortunately, the means to hire foreign nationals are limited and complex. In general, when hiring a foreign national doctor, the immigration timeline follows a predetermined schedule. In many cases, a doctor will need a J-1 waiver, followed by an H-1B visa, followed by some form of permanent residency sponsorship. Doctors who come to the U.S. to finish their studies commit to a two-year period of practicing medicine in their home country. The J-1 waiver is required to waive that two-year commitment. In exchange, those doctors agree to work for three years in the U.S. in a medically underserved area. However, once the waiver is approved, the doctor still needs an H-1B visa to actually work in the U.S.

The J-1 Waivers are limited. At present, each state only gets 30 of them. Moreover, each state has its own processes and procedures developed by the state department of health in place to determine who gets one of the waivers. Some states require the putative employer to demonstrate six months of recruiting efforts. Other states have few actually requirements outside of an application. Some states process the waivers at no cost to the employer; others have large fees associated with waiver requests. Having knowledgeable counsel who is familiar with the requirements for multiple states is of significant benefit to the employer. Once the state approves the request, the U.S. Department of State has to approve it. This process generally takes six to ten weeks. Following this, the Department of Homeland Security (DHS), through USCIS provides the final approval.

Concurrent with the review, the employer can file for the H-1B, which is the visa that actually allows the doctor to work. With premium processing, the H-1B can be approved, along with the final waiver, two to three weeks after the Department of State issues its approval. The H-1B is valid for three years, and permits one three year extension. During this period, the employer has to make a determination on whether to sponsor the employee for permanent residency.

There are many ways to obtain permanent residency through an employment relationship. The two most prominent ways are the National Interest Waiver (NIW), and Labor Certification. If a doctor subject agrees to work for five years (two in addition to the typical J-1 service requirement) in a medically underserved area, the doctor can immediately apply for a NIW. Additionally, assuming an immigrant visa is immediately available; the physician can also file for permanent residence, though the final approval of permanent residence is granted only upon proof of five years of service. An additional benefit afforded by the NIW and concurrent application for permanent residence is that the immediate family of the physician may apply for work authorization. Moreover, this process avoids the Labor Certification process which is time consuming and expensive.

The Labor Certification process requires the employer to conduct a specific test of the labor market to determine whether there are any qualified, ready, willing and able U.S. physicians to fill the position. The employer must conduct, at minimum, a two month recruiting effort using methods dictated by the U.S. Department of Labor. The employer must conduct a good faith recruiting campaign using five different types of recruitment efforts such as newspaper advertisements, web advertisements, etc. The employer has to interview minimally qualified candidates and if one candidate meets the qualifications the Labor Certification process fails. Therefore, this process requires an in depth review of the job description, and strict adherence to the regulatory requirements for the recruiting campaign. At the end of the recruiting effort, assuming no minimally qualified candidates are found, the employer, through their attorney, can file the Labor Certification application asking the DOL to certify the position. The DOL can request an audit, approve or deny the application, or have the employer redo the recruitment process under DOL supervision. Once approved, the employer can file the employment-based visa application. Following approval of the visa, and the completion of the three-year waiver requirement, the doctor can then file for permanent residency, subject only to the per country limitations in this process.

The process for hiring foreign national doctors is complex, but manageable with competent legal counsel. Employers should not shy away from engaging in this process especially as the shortage of doctors in this country continues to grow. However, employers do need to know the options when seeking to hire doctors who are subject to the J visa requirements. Competent legal counsel can manage the J waiver process and the H-1B process; and provide legal guidance throughout the Labor Certification process; and can prepare the remaining immigration filings. Therefore, while hiring doctors can be complex, employers cannot afford to shy away from the process in this era of health care shortage.

For more information or to consult with an immigration lawyer, please contact Ken Gauvey at

Monday, February 10, 2014

Electronic Cover Letters

Attached you will find my resume. I have 7 years of Medical Receptionist experience but no dental office experience.  I read that you need to have dental office experience and I don not have that but still feel that I would be a good choice for the job. Thank you for looking at my resume.

Writing a cover letter can be tough.  However, it is an important to getting your foot in the door.  Above is a cover letter that I recently received.  Yes, that is it, spelling error and all.  Honestly, I did not even open this individual’s resume, but it did get me thinking about what other individuals need to do to improve their chances at getting the attention of a potential employer.

In this day and time, the cover letter is especially crucial since communication is electronic.  When your resume is an attachment, this is your first chance to make an impression on a potential employer.  Unless you are copying and pasting your resume into the emails, which I do not recommend, your resume is not staring the reader in the face.

So, what can you do to stand out and get the reader’s attention?

First, address the reader.  Now, in this person’s defense, she was applying to a blind ad.  She could have, however, addressed the email to the hiring manager or with a “Dear Doctor”.

Next, let the reader know which position you are interested in.  They could have more than one opportunity available.

Then, focus on the positives.  The phrase that jumps out at me in this letter is “no dental office experience” a requirement for the position.  She even goes on to say that she read that it is a requirement.  Focus on what you have. 

A few other points to hit on in the body of this email, spell out simple numbers.  Spell check is a wonderful thing-use it.

Finally, there is no way to contact this individual in the email.  What if the attachment does not work?  Always, always, always include contact information! 

Below is a simple letter that would have made a much better impact for the job seeker.

Dear Doctor or Hiring Manager,

Attached you will find my resume for the opening you have available for a dental receptionist.  I have seven years of experience working in the medical field as a receptionist.  I am computer savvy and have strong customer service skills; I believe that my skills would transfer well into your practice and would welcome the chance to interview for your opening.  Please feel free to call me at (xxx)xxx-xxxx if you have any questions or would like to schedule a time to meet.

Thank you for your time and consideration.


Your Name

A few extra minutes and minimal work can mean the difference between your resume getting deleted or you scoring the interview.  Take your time!  Happy job hunting!

Tiffany Worstell is a nationwide Recruiter for Dental Staff at ETS Dental. She can be reached at or 540-491-9112. ETS Dental is a Dental Recruiting firm specializing in finding and placing General Dentists, Dental Specialists, and Dental Staff throughout the United States.

Friday, February 7, 2014

Recruitment in 2014 - Employers Look for Unique Ways to Compete for Top Talent

As we kick off the New Year, the candidate-driven market that MRINetwork has been observing in the executive, managerial and professional sector is projected to become an even greater challenge in 2014. The media is increasingly making note of this trend, referenced as "overwhelmingly candidate-driven" in the most recent MRINetwork Recruiter Sentiment Study, as exceptional candidates with specialized skills gain more leverage due to a shrinking talent pool. The reality is that employers must compete like never before to bring in the best people to lead their organizations into the workforce of 2020 and beyond.

FFP February 2014Click to enlarge.

"2014 has been slated as the Year of the Employee, due to global economic growth that is increasing demand for top candidates with specialized skills," says Nancy Halverson, vice president of global operations for MRINetwork. "As 'A' players gain more control over the hiring process, employers will need to develop innovative processes to recruit and retain exceptional talent."

The following are some suggestions for how employers can make themselves more attractive to the professional workforce:
  • Create an employee experience that is engaging and motivating. Confidence is growing in the economy, providing more candidates with the incentive to leave less than desirable work arrangements. As companies become more vulnerable to losing key talent in 2014, they will have to seek ways to provide an employee-centric work environment that is fun, motivating and focused on the things the employees within the organization value most.
  • Include millennials in succession planning. As succession planning and executive searches are becoming a priority for many companies who need to replace retiring baby boomer executives, employers should not forget to include millennials in these plans. Millennial professionals, who are in their mid-twenties and thirties, possess the skills and experience needed to grow into mid and senior management roles, if provided the appropriate support and guidance.
  • Provide continuing education opportunities to avert skill gaps. Finding qualified candidates that have the specialized skills that employers need is becoming a global dilemma, with skill gaps in the workplace at an all-time high. Companies that invest in their staff by providing ongoing learning opportunities, create added value to current employees while also attracting desirable talent into their organizations.
  • Keep technology simple. New human resources and recruitment technology are emerging every day. No matter what platforms or solutions your organization uses, the key is to make sure the technology facilitates a user-friendly experience that engages employees and candidates, instead of creating a frustrating or tedious process that diminishes the organization’s ability to attract and retain talent.
"The candidate-driven market in our post- recessionary economy presents some unique challenges, given mounting skill gaps in our professional workforce," states Halverson. "Companies will have to assess whether their branding and recruitment practices are attractive and engaging enough to allow them to compete for the best talent."