EB-2 NIW Case Study: Venezuelan Physician Approval, No RFE Venezuela PhysicianOur client, a Venezuelan physician who secured EB-2 National Interest Waiver (NIW) approval without a Request for Evidence (RFE), has built her career around addressing one of the United States’ most urgent public-health threats: antimicrobial resistance. Antimicrobial resistance is a critical national challenge, causing millions of infections and tens of thousands of deaths each year. Bacteria, viruses, fungi, or parasites become resistant to the medications intended to treat them. Pneumonia is especially affected, with over 40% of cases now caused by strains resistant to at least one commonly used antibiotic, and resistance continuing to rise alongside antibiotic use. This trend threatens patient outcomes, forcing more complex treatment decisions, broader-spectrum antibiotics, longer hospital stays, and higher risks of complications, mortality, and hospital strain. In this context, our client received EB-2 NIW approval for her nationally significant contributions to pneumonia management and antibiotic stewardship. Her evidence-based protocols improve diagnostic precision, reduce unnecessary antibiotic use, and strengthen patient outcomes while enhancing hospital efficiency across the United States. Represented by Colombo & Hud Attorney Alexis Sein, our client presented a record that clearly demonstrated the national importance of her contributions, resulting in a strong and compelling case for approval. Check Your EB-2 NIW Eligibility Client BackgroundBuilding Expertise in Pneumonia Care and Antibiotic Stewardship EB-2 NIW VisaNearly 15 years of clinical work in hospitals in Venezuela and the United States provided this physician with the experience and expertise essential to securing her EB-2 NIW approval. She first trained in pharmacy, then completed her Medical Surgeon Degree. After she passed the required U.S. licensing exams, she obtained authorization to practice in a U.S. hospital and began a demanding internal medicine residency, treating complex pneumonia cases on a daily basis. In that role, she focused on improving pneumonia outcomes and using antibiotics more responsibly. She led a comprehensive patient chart review that tracked discharge quality, readmissions, and in-hospital mortality. Based on that analysis, she helped design clearer communication tools, structured discharge checklists, and early follow up to reduce preventable complications. She also evaluated the hospital’s pneumonia testing practices and early treatment decisions, then worked with her team to adjust workflows and training so the hospital could strengthen antibiotic stewardship for pneumonia. During the COVID-19 pandemic, she identified that many eligible hospitalized patients were not receiving indicated antiviral treatment. She addressed this gap by helping the hospital expand access to needed medications and improve the support systems clinicians rely on to ensure patients could receive appropriate therapy. She presented her findings inside her institution and at conferences and built collaborations focused on pneumonia management and antimicrobial resistance. This combination of frontline care, data driven projects and protocol development was central to her EB-2 NIW petition and the national interest arguments presented by Colombo & Hurd. The Challenge Translating Complex Medical Work into a Strong National Interest Case From the start, the legal team recognized the importance of translating highly technical medical work into a clear, compelling presentation for a non-medical officer. The client relied on specialized clinical and laboratory protocols for pneumonia and antibiotic use, so the petition needed to show, in plain language, how her methods improve care in U.S. hospitals and align with national public health priorities, while still reflecting the scientific rigor of her field. As Attorney Sein explained, “We needed to take a very niche, technical project and turn it into a roadmap that a non-medical officer could follow, see the logic and understand why her work matters for patients and for public health in the United States.” Her immigration history added another layer. Having built her career in the United States, most recently in an H-1B role, it was essential to develop a strong, coherent EB-2 NIW strategy to support her long-term goals. The petition needed to clearly show that her work advances federal goals, delivers measurable public health value, and justifies a waiver of the usual job offer and labor certification requirements. Strategic Response A Strategy Designed Around Her Proven Medical Contributions To meet these challenges, the team anchored the petition in the work the physician already carried out in her U.S. hospital. Attorney Sein and the client mapped out her main projects in clear terms, including pneumonia protocols, use of diagnostic tools, and training for clinical staff. Each piece of evidence showed specific actions she performed and how those actions improved care and antibiotic use. They highlighted concrete examples such as the extensive patient chart review, her adjustments to antibiotics based on culture results, and her efforts to improve the discharge process. This placed the focus on her record of ongoing, measurable results that she would continue to expand. The petition also emphasized strong institutional support. Her U.S. hospital confirmed its interest in her continuing research and protocol development, showing that her endeavor already has a platform in the United States and room to grow. As Attorney Sein explained, the goal was to connect what she is doing now with what she will keep doing and how that work improves pneumonia care and antibiotic use nationwide. See If you QualifyGet your free EB-2 NIW visa profile evaluation today. EVALUATE MY PROFILE The Result EB-2 NIW approval without RFE USCIS approved her EB-2 NIW petition without issuing a Request for Evidence. For a physician working in a specific area of pneumonia care and antibiotic resistance, this direct approval shows that the officer saw consistent value in her record and understood the way it was presented. The decision allows her to keep building her career in the United States, caring for hospitalized patients, contributing to research and supporting better antibiotic practices inside her institution. For her, as a Venezuelan physician who previously relied on TPS, the approval feels especially meaningful. As Attorney Sein shared, seeing her case move forward “brings a lot of happiness and hope” and highlights how dedicated professionals can continue building their futures in the United States. Case Overview Category Details Visa Classification EB-2 National Interest Waiver (NIW) Nationality Venezuela Professional Field Internal Medicine, Pneumonia Care and Antibiotic Stewardship Education Medical Surgeon Degree; U.S. licensing examinations completed and authorization to practice in a U.S. hospital Request for Evidence (RFE) No Final Outcome Approved Lead Attorneys Alexis Sein Why This Case Succeeded The petition showed how a focused medical career in pneumonia care and antibiotic stewardship directly serves U.S. public health priorities and hospital needs. Key factors included: Niche medical focus with national impact She concentrated on pneumonia management and antibiotic use; an area closely tied to antimicrobial resistance and federal public health goals. Detailed, practice-based evidence The record highlighted real projects, including a comprehensive patient chart review, antibiotic adjustments based on culture results and discharge improvement work, all described in clear, concrete terms. Strong institutional backing and a clear plan Her U.S. hospital confirmed interest in her ongoing work, and the petition presented a structured plan that connected what she already does, what she will continue to do and how this benefits patients and public health in the United States Related Resources EB-2 NIW Processing Time (2025): Realistic Timeline & How to Avoid Delays The Advantages of Self-Petitioning NIWs In Depth Look at the First Prong of Dhanasar: Substantial Merit and National Importance Attorney’s Perspective Alexis SeinImmigration AttorneyRead More “The petitioner worked in a very niche and unique area, and that is what helped her case stand out. Her focus was research on antibiotic use in pneumonia, and she was already doing this work here in the hospital, applying it in practice.”