An Oregon physician is suing Department of Homeland Security officials after her application for a green card was denied.
Nikhila Palle, MD, an internal medicine physician practicing at Providence Medford (Ore.) Medical Center, filed a lawsuit against Secretary of Homeland Security Kristi Noem, Citizenship and Immigration Services Director Joseph Edlow and Deputy Associate Director for the Service Center Operations Directorate John Allen Dec. 4, according to court documents acquired by Becker’s.
Dr. Palle, an Indian-born Canadian citizen, began practicing as a full-time hospitalist at Providence in August 2024 under an H-1B visa. The region surrounding the hospital is a federally designated Health Professional Shortage area. A program called the Physician National Interest Waiver allows applicants to apply for a green card so long as they agree to work for a period of time in one of these areas, according to the U.S. Citizenship and Immigration Services website.
In January 2025, Dr. Palle applied for the national interest waiver and agreed to continue practicing medicine full-time in underserved areas of Oregon for five years. The state health authority submitted a letter verifying her certifications and stating that it is in the nation’s interest to keep her working there, FOX affiliate KOIN reported Dec. 8. The publication also reported that the hospital’s medical director confirmed that it intended to keep Dr. Palle on staff for at least the five full years.
Dr. Palle’s application was denied in July, despite documentation from state and hospital officials. According to court documents, the decision said “the petitioner did not establish that she has agreed to work full-time (40 hours per week) in a clinical practice for an aggregate of five(5) years.”
Dr. Palle’s lawsuit argues that immigration officials ignored evidence in issuing their decision. While publicly available statistics on green card denials do not disaggregate by profession, the most recently available data suggests that the government rejects approximately 9% of all employment-based applications.
The decision comes at a time when a new wave of restrictive visa regulations and fees have disrupted international recruiting at healthcare systems across the nation while, simultaneously, those same systems battle a mounting shortage of physicians overall. Immigrants make up 27% of physicians and surgeons, 22% of nursing assistants and 16% of registered nurses in the U.S.
In October, the White House confirmed a policy that instituted a $100,000 fee for H-1B visa petitions. Some hospitals and health systems, including Seattle-based Fred Hutchinson Cancer Center and UW Medicine, paused H-1B petitions due to the new cost. Others said they were awaiting further guidance and evaluating the potential effects on their workforce pipelines.
“The U.S., and in particular our rural areas, are experiencing crisis-level shortages of the physicians and nurses needed to deliver high-quality care, and this shortage is only projected to become more acute in the decade ahead,” Ryan Miller, chief human resources officer at Trinity Health in Minot, N.D., told Becker’s regarding the new regulations’ impact on healthcare overall. “The communities we serve, and those like ours all throughout the nation, rely on attracting physicians who have completed their training in the U.S. medical system and hope to legally immigrate in order to build their practices and lives in the United States.”
In a statement shared with Becker’s USCIS said it does not comment on pending litigation.
