Canadian Dermatologist on an O1 visa

My path to eventual US citizenship involves J1 and H1b visas including a 3-year return of service. Is that the only pathway? No. There are many roads to US citizenship because of different visas and personal circumstances. Today’s guest post is the story of a fellow Canadian and a practicing dermatologist in the US on an O-1 visa. If you would like to submit a guest post, reach out through the contact tab.

Undergraduate to Medical School

Born and raised a Canadian from a small town, I came to my path toward permanent residency and life in the United States unexpectedly. It was never what I thought I would do when I set out on my journey to become a doc. Like many, this meant I knew nothing regarding the ins and outs of visas and immigration. 

After graduate school I was fortunate to gain a spot in a medical school in my province where I found the love of my current specialty along with an interest in cancer surgery. I never thought I would do the second as I had not felt a love for the operating room, but I saw a lot of myself in a faculty member I had at the time. Getting people back to what they would rather be doing -- back to life -- was what drove me toward my eventual specialty.

Residency to Fellowship

A lot of anxiety, challenges, and exams later I ended up in a competitive specialty at one of the oldest programs in Canada. It was there that I found how I could blend what I loved in medical school. However, this led to another realization that I was unlikely to be able to do what I wanted in Canada. The subspecialty I wanted to pursue is hospital-based and no jobs were likely to be available near my hometown or in my home province. I also found mentors and thought leaders in the United States who I looked up to and I could not learn alongside them in my own country. This led to having to work extremely hard to complete all USMLEs in 1 year and figuring out how to compete for a highly competitive fellowship in a country where I was a complete stranger. 

It was also at this time I realized how naive I was about visa applications. Bottom line - preparation is needed, data collection on one's self is king, and an immigration lawyer is your best friend (even though a good one can be expensive).

Visa Time

Knowing I may need to stay in the US long-term I tried to keep my options open by avoiding a J1 visa for the home residency requirement and the potential need for a waiver. Not everyone has this option. H1Bs within institutions are not capped or under the usual lottery. It leaves open a 6-year period where moving toward long-term permanent residency (LPR) status is possible. I was able to obtain this and thought I was going to stay in an academic environment making it simple to carry on while I found a way toward LPR and, hopefully, eventual citizenship.   

Life is what happens when you make plans. 

With my family, we decided during fellowship that we wanted to go to a certain area of the country without a large academic institution and that academic life was not the right call for my family at that time. Leaving behind the plan was hard and caused immigration challenges. I needed to get a new visa and could not keep my H1B. An H1B transfer would not be possible as the new company would be in the lottery, which meant obtaining this would be a long shot.

In comes the O-1 visa. It is not an understatement to say this is a lot of work and I could not have done it without my intended employer, mentor, a lot of help, a lawyer, and endless hours of chronicling everything I have ever done. Literally everything. This includes proof. Proof of things I never thought to keep records of and reaching deep into the past to get copies of things I needed. It took approximately 3-4 months to prepare along with getting enough letters of recommendation writing who were unbiased or did not know me well who could vouch for my work. Once prepared, premium processing made it easy and a response was known in two weeks. Success - yay! This allowed me to transfer to my new company. At the same time I began to apply for LPR status as the processing time is significantly longer. As I went under the employment route in the eb-2 category the application was extremely long and more arduous than the O-1. Writing about yourself in the particular style that is required is hard. This is where a lawyer is most helpful - to guide and shepherd the writing. They are also able to present the evidence in a way the United States Citizenship and Immigration Services (USCIS) would like it. You could do it alone, but I did not want to take the chance of doing this incorrectly or that could cause delays. Or getting an unnecessary request for evidence.

 COVID has posed challenges and slow downs to the application process. However, the hopeful journey continues toward LPR and citizenship. I remain with fingers firmly crossed that I will go from alien to LPR in my adopted country and place where I practice in smaller communities. So far the journey has been one of intense learning and challenge, but I have found a state I love, a career I am lucky to have, and a community my family calls home. The adventure continues.

Good luck on your path.