Healthcare employers and foreign physician employees received unexpected good news on June 12, 2026, when U.S. Citizenship and Immigration Services quietly added physicians to its list of cases eligible for hold removal under its “comprehensive review” process. The move — reported by the American College of Osteopathic Internists and confirmed by USCIS — ends a period of limbo for an unknown number of H-1B petitions and adjustment of status applications that had been frozen amid the broader USCIS enhanced screening and vetting initiative launched in late 2025.
What Changed on June 12, 2026
USCIS updated its Update on USCIS’ Strengthened Screening and Vetting alert page to include physicians as a group whose pending cases can now go through an established internal process for lifting holds. This process requires “comprehensive review by multiple offices,” but it signals that USCIS will actively adjudicate physician cases rather than leaving them in an indefinite queue.
Two categories of cases are affected:
- H-1B petitions filed by U.S. employers (hospitals, clinics, academic medical centers) for physician employees
- J-1 waiver-related adjustment of status (I-485) applications — physicians who completed a J-1 exchange visitor program, obtained a Conrad 30 or IGA waiver, and are now pursuing permanent residency
Background: Why Were Physician Cases on Hold?
Starting in late 2025, USCIS implemented a sweeping enhanced screening and vetting program that placed processing holds on benefit applications across a wide range of categories and nationalities. While the policy initially targeted nationals from countries subject to the presidential travel ban — the 39 countries named in the January 2026 proclamation — the holds also swept up cases involving applicants not on those country lists, including physicians, due to the broad nature of the internal policy guidance.
For healthcare employers, the holds created an urgent staffing crisis. Rural hospitals, underserved urban clinics, and teaching hospitals rely heavily on J-1 waiver physicians and H-1B holders to fill Conrad 30 positions in physician shortage areas (HPSAs). A frozen I-485 or stalled H-1B extension meant doctors could not continue working legally, endangering both patient care and the employer’s own compliance obligations.
| Case Type | Applicants Affected | Status as of June 12, 2026 |
|---|---|---|
| H-1B petition (physician employee) | Foreign physicians employed by U.S. hospitals / clinics | Hold eligible for removal ✓ |
| J-1 waiver AOS (I-485) | Conrad 30 / IGA waiver physicians pursuing green card | Hold eligible for removal ✓ |
| Other H-1B (non-physician) | All other specialty occupations | Case-by-case basis |
| Nationals from 39 travel-ban countries | Broad range of visa categories | Processing resumed (Dorcas order, June 11) |
What “Comprehensive Review” Means in Practice
Being added to USCIS’s list does not mean automatic or immediate approval. The agency’s language — “comprehensive review by multiple offices” — indicates a multi-step internal vetting process. In practical terms, this means:
- Cases will not be adjudicated overnight. The hold removal is a clearance to begin active adjudication, not approval itself. Normal processing queues still apply once the hold is lifted.
- Requests to expedite may be appropriate. Employers with urgent patient care needs should consider filing an expedite request under the criteria for “severe financial loss” or “urgent humanitarian” grounds — USCIS has historically granted these for physicians in shortage areas.
- Legal status must be maintained. Physicians whose H-1B status has lapsed during the hold period may face unlawful presence issues. Immigration counsel should review each case before the physician resumes or continues employment.
Key Dates and Timeline
| Date | Event |
|---|---|
| Dec 2025 – Jan 2026 | USCIS issues PM-602-0192 and PM-602-0194 — processing holds for 39 countries begin |
| May 21, 2026 | USCIS issues PM-602-0199 (AOS discretion memo) — separate policy |
| Jun 5, 2026 | D. Rhode Island vacates PM-602-0192, PM-602-0194, PA 2025-26 (Dorcas v. USCIS) |
| Jun 11, 2026 | Final judgment entered; USCIS instructed to resume processing for 39-country nationals |
| Jun 12, 2026 | USCIS adds physicians to hold-removal list; USCIS files appeal in Dorcas case |
| Ongoing | USCIS “comprehensive review” of physician cases in queue; individual holds being lifted |
J-1 Waiver Physicians: Special Considerations
J-1 physicians who received Conrad 30 or Interested Government Agency (IGA) waivers have an additional layer of complexity. Their waiver obligations — typically three years of full-time practice in a Health Professional Shortage Area (HPSA) — run concurrently with H-1B status. A processing hold that delays an H-1B extension can put a physician out of status even while they remain employed and trying to fulfill their service commitment.
For these physicians, the June 12 update is particularly significant. Pending I-485 applications tied to J-1 waivers are now within scope for hold removal, which may allow the physician to obtain an Employment Authorization Document (EAD) and Advance Parole (AP) combo card — giving them work and travel authorization while the green card is adjudicated.
What Hospitals and Healthcare Employers Should Do Now
- Audit your physician H-1B and I-485 caseload. Identify any cases submitted after late 2025 that received no action or a hold notice. These are prime candidates for the June 12 hold removal.
- Contact USCIS or your attorney to confirm hold status. The agency will not proactively notify petitioners that a hold has been lifted. Attorneys can check case status in USCIS’s online system or submit a service request.
- Prepare expedite requests for urgent cases. If a physician is currently unable to work due to an expired H-1B and a pending extension, document patient care impact and file an expedite request alongside any attorney inquiry.
- Do not assume holds are automatically lifted. The “comprehensive review” process requires USCIS to take affirmative action on each case. Cases may be prioritized differently based on case type, country of chargeability, and internal review outcomes.
