38. FOREIGN' MEDICAL GRADUATES: IMMTGRATTOX AXD XATIOXALTTY ACT AND RELATED PROVISIONS OF LAW

SaicnoKS 101 Ajo' 212 or The IanaGaaTioir Ilkd XainoiKaxiTS- ActAs AiKxsn>ED Bt Ttbuc Law M-4S4

iaEJTJcmoss

Smctiox 101. a' As used in this Act—

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115 , The term .;immiETfljiT" -mfHiTis every alien ,except an alien who K -within one -of the f aLiowinc classes of nonimmigrant aliens—

(A; ***

iH; an alien having a residence in a foreign coumiry m-hoch h*' has no intention of abandoning 'i) who is of disTmariusbed mem and ability and -who is coming Temporarily to the United S*aWs to perform services of an ,exceptional nature reojiiring such merit and ability, and who. m the -case erf a graduale of a medical school coming to the United States to perform services as a member of the medical profession, is coming pursuant to an invitation from a public or nonprofit privatie educational or research institution or agency in the United States to teach or conduct research, or both, at or for such institution or agency.; or ('ii > who is coming HUftrarihr to the United States to perform temporary services or labor, if unemployed persons capable of performing such service or labor cannot be found in tins country, but this clause shall not apply to graduates of medical schools oomimr to tibe United States to perform services as members of the medical professioni: or (iiil who is coming temporarily to the United States as a trainee, other than to receive graduate medical education or training: arod the alien spouse and minor children of any such aben specified in this paragraph if accompanying him or foUorring to join him. *******

(J) an alien having a residence in a foreign oountrv which he hai no intention of abandoning who is a bona fide student, scholar, trainee, teacher, professor, research assistant, specialist.. or leader in a field of specialiTed knowledge or skill, or other person of similar description, who is coming temporarily to the United States as a participant in a program designated by the Secretary of State, for the purpose of teaching, instructing oar lecturing, studying, observmg, conducting research, consultu^r, demonstrating special ikills, or receiving training a»d who, if be is coining to the United States to participate m a program under which he will receive graduate medical education or training also, meets the requirements of section 212(j) and the alien spouse and minor children of any such alien if accompanying him or following to join him.

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(41) The term "graduates of a medical school" means aliens who have graduated from a medical school or who have qualified to practice medicine in a foreign state, other than such aliens who are of national or international renown in the field of medicine.

GENERAL CLASSES OF ALIENS INELIGIBLE TO RECEIVE VISAS AND EXCLUDED FROM ADMISSION; WAIVERS OF INADMISSIBILITY

Sec. 212. (a) Except as otherwise provided in this Act, the following classes of aliens shall be ineligible to receive visas and shall be excluded from admission into the United States:

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(32) Aliens who are graduates of a medical school not accredited by a body or bodies approved for the purpose by the Commissioner of Education (regardless of whether such school of medicine is in the United States) and are coming to the United States principally to perform services as members of the medical profession, except such aliens who have passed parts I and II of the National Board of Medicine Examiners Examination (or an equivalent examination as determined by the Secretary of Health, Education, and Welfare) and who are competent in oral and written English. The exclusion of aliens under this paragraph shall apply to preference immigrant aliens described in section 203 (a) (3) and (6) and to nonpreference immigrant aliens described in section 203 (a) (8);

(e) No person admitted under section 101 (a) (15) (J) or acquiring such status after admission (i) whose participation in the program for which he came to the United States was financed in whole or in part, directly or indirectly, by an agency of the Government of the United States or by the government of the country of his nationality or his last residence, (ii) who at the time of admission or acquisition of status under section 101 (a) (15) (J) was a national or resident of a country which the Secretary of State, pursuant to regulations prescribed by him, had designated as clearly requiring the services of persons engaged in the field of specialized knowledge or skill in which the alien was engaged, or (iii), who came to the United States or acquired such status in order to receive graduate medical education or training, shall be eligible to apply for an immigrant visa, or for permanent residence, or for a nonimmigrant visa under section 101 (a) (15) (H) or section 101 (a) (15) (L) until it is established that such person has resided and been physically present in the country of his nationality or his last residence for an aggregate of a least two years following departure from the United States: Provided, That, except in the case of an alien described in clause (iii). upon the favorable recommendation of the Secretry of State, pursuant to the request of an interested United States Government agency, or of the Commissioner of Immigration and Naturalization after he has determined that departure from the United States would impose exceptional hardship upon the alienis spouse or child (if such spouse or child is a citizen of the United States or a lawfully resident alien), or that the alien cannot return to the country of his nationality or last residence because he would be subject to persecution on account of race, religion, or political opinion, the Attorney General may waive the requirement of such two-year foreign residence abroad in the case of any alien whose admission to the United States is found by the Attorney General to be in the public interest: And provided further, That the Attorney General may, upon the favorable recommendation of the Secretry of State, waive such two-year foreign residence requirement in any case in which the foreign country of the alienis nationality or last residence has furnished the Secretary of State a statement in writing that it has no objection to such waiver in the case of such alien.

(j)(l) The additional requirements referred to in section 101 (a) (15) (J) for an alien who is coming to the United States under a program under which he will receive graduate medical education or training are:

(A) A school of medicine or of one of the other health professions, which is accredited by a body or bodies approved for the purpose by the Commissioner of Education, has agreed in writing to provide the graduate medical education or training under the program for which the alien is coming to the United States or to assume responsibility for arranging for the provision thereof by an appropriate public or nonprofit private institution or agency, except that, in the case of such an agreement by a school of medicine, any one or more of its affiliated hospitals which are to participate in the provision of the graduate medical education or training must join in the agreement;

(B) Before making such agreement, the accredited school has been satisfied that the alien (i) is a graduate of a school of medicine which is accredited by a body or bodies approved for the purpose by the Commissioner of Education (regardless of whether such school of medicine is in the United States); or (ii) has passed parts I and II of the National Board of Medical Examiners Examination (or an equivalent examination as determined by the Secretary of Health, Education, and Welfare), has competency in oral and written English, will be able to adapt to the educational and cultural environment in which he will be receiving his education or training, and has adequate prior education and training to participate satisfactorily in the program for which he is coming to the United States;

(C) The alien has made a commitmftit to return to the country of his nationality or last residence upon completion of the education or training for which he is coming to the United States (including any extension of the duration thereof under subparagraph (D)), and the government of the country of his nationality or last residence has provided a written assurance, satisfactory to the Secretary of Health, Education, and Welfare, that there is a need in that country for persons with the skills the alien will acquire in such education or training; and

(D) The duration of the alienis participation in the program for which he is coming to the United States is limited to not more than 2 years, except that such duration may be extended for one year at the written request of the government of his nationality or last residence, if (i) the accredited school providing or arranging for the provision of his education or training agrees in writing to such extension, and (ii) such extension is for the purpose of continuing the alienis education or training under the program for which he came to the United States. (2) (A) Except as provided in subparagraph (B), the requirements of subparagraphs (A) and (B) of paragraph (1) shall not apply between the effective date of this subsection and December 31, 1980, to any alien who seeks to come to the United States to participate in an accredited program of graduate medical education or training if there would be a substantial disruption in the health services provided in such program because such alien was not permitted, because of his failure to meet such requirements, to enter the United States to participate in such program.

(B) In the administration of this subsection, the Attorney General shall take such action as may be necessary to ensure that the total number of aliens participating (at any time) in programs described in subparagraph (A) does not, because of the exemption provided by such subparagraph, exceed the total number of aliens participating in such programs on the effective date of this subsection.

Section 906 Of The Health Professions Educational Assistance

Act Of 1976

(Public Law 94-484)

Labor Certification

Sec. 906. (a) The Secretary of Health, Education, and Welfare shall (not later than one year after the date of the enactment of this Act) develop sufficient data to enable the Secretary of Labor to make equitable determinations with regard to applications for labor certification by graduates of foreign medical schools.

(b) The data required under subsection (a) shall include the number of physicians (by specialty and by percent of population) in a geographic area necessary to provide adequate medical care, including such care in hospitals, nursing homes, and other health care institutions, in such area.

(c) The Secretary of Health, Education, and Welfare shall develop such data after consultation with such medical or other associations as may be necessary.

Legislative History Of P.L. 94-484

House reports: No. 94-266 (Committee on Interstate and Foreign Commerce) and No. 94-1612 (Committee of Conference).

Senate reports: No. 94-886 (Committee on Labor and Public Welfare) and No. 94-887 accompanying S. 3239 (Committee on Labor and Public Welfare). Congressional Record:

Vol. 121 (1975): July 11, considered and passed House.
Vol. 122 (1976):

July 1, considered and passed Senate, amended.
Sept. 20, Senate agreed to conference report.

Sept. 27, House receded and concurred in Senate amendment with amendment.

Sept. 30, Senate agreed to House amendment.

21. HEALTH AND NUTRITION DEMONSTRATION PROJECTS—SECTION 516 OF TITLE V OF THE APPALACHIAN REGIONAL DEVELOPMENT ACT OF 1965 (AS ADDED BY PUBLIC LAW 94-188)

HEALTH AND NUTRITION DEMONSTRATION PROJECTS

Sec. 516. (a) In order to demonstrate the value of adequate health facilities and services to the economic development of the region, the Secretary of Health, Education, and Welfare is authorized to make grants for the planning, construction, equipment, and operation of multicounty demonstration health, and nutrition projects including hospitals, regional health diagnostic and treatment centers, and other facilities and services necessary for the purpose of this section. Grants for such construction (including the acquisition of privately owned facilities not operated for profit or previously operated for profit where the acquisition of such facilities is the most cost effective means for providing increased health services, and initial equipment) shall be made after applications and plans relating to the program or project have been determined by the responsible Federal official to be compatible with the provisions and objectives of Federal laws which he administers that are not inconsistent with this title, and the regional commission has approved such program or project and determined that it will contribute to the development of the region, and shall not be incompatible with the applicable provisions of title VI of the Public Health Service Act (42 U.S.C. 291-291o), the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963 (77 Stat. 282), and other laws authorizing grants for the construction of health-related facilities,' without regard to any provisions therein relating to appropriation authorization ceilings or to allotments among the States. Grants under this section shall be made solely out of funds specifically appropriated for the purpose of carrying out this title and shall not be taken into account in the computation of the allotments among the States made pursuant to any other provision of law.

(b) No grant for the construction or equipment of any component of a demonstration health project shall exceed 80 per centum of such costs. The Federal contribution may be provided entirely from funds authorized under this title or in combination with funds provided under other Federal grant-in-aid programs for the construction or equipment of health-related facilities. Notwithstanding any provision of law limiting the Federal share in such other programs, funds authorized under this title may be used to increase Federal grants for component facilities of a demonstration health project to a maximum of 80 per centum of the costs of such facilities.