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If you are a foreign medical graduate coming to the US and only a small amount of patient care is involved, you will have to show that you have received a medical education and are licensed in your home country. The H-1B requirements of the 1990 Act also require a physician to show that he or she possesses a state license “or other authorization” in order to perform patient care as well as a full and unrestricted license to practice in a foreign country or proof of graduation from a foreign medical school.
Note that some states will not issue a license without proof of the issuance of a visa. The Catch-22 can be avoided by getting a letter from the state licensing board documenting that the only thing standing in the way of issuing a license is the visa itself. Usually this letter will satisfy USCIS.