Green Card Clinical Psychiatrist Jobs
Clinical Psychiatrist roles qualify for EB-2 and EB-3 green card sponsorship through the PERM labor certification process. Hospitals, community mental health centers, and academic medical centers routinely sponsor foreign psychiatrists for permanent residency. Your J-1 visa or H-1B visa status doesn't prevent you from pursuing a concurrent PERM filing with a willing employer.
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Get Access To All JobsINTRODUCTION
Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.
Functional Title: Psychiatrist V - Medical Director
Job Title: Psychiatrist V
Agency: Health & Human Services Comm
Department: General Admin
Posting Number: 21226
Closing Date: 11/09/2026
Posting Audience: Internal and External
Occupational Category: Healthcare Support
Salary Range: $25,374.89 - $27,975.83
Pay Frequency: Monthly
Salary Group: TEXAS-B-36
Shift: Day
Additional Shift: Days (First)
Telework: Eligible for Telework
Travel: Up to 10%
Regular/Temporary: Regular
Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Exempt
Facility Location: Panhandle State Hospital
Job Location City: AMARILLO
Job Location Address: 6610 W AMARILLO BLVD
Other Locations: Amarillo
MOS Codes: 210X, 44PX, 60W, SEI12
BRIEF JOB DESCRIPTION:
Would you thrive in an environment where you learn and grow personally and professionally all while helping make a positive impact on people’s lives? Do you appreciate being around others like yourself who are dependable, trustworthy, hard workers who believe in the value of teamwork? HSCS is dedicated to building an atmosphere where employees feel valued and supported while providing specialized care for Texans in need. HSCS is comprised of ten psychiatric hospitals, two youth residential treatment facilities, and thirteen state supported living centers. Psychiatric hospitals are a hub of excellence for forensic mental health and complex psychiatric care, with all facilities accredited by The Joint Commission. They provide state-of-the-art treatment that is recovery-oriented and science-based. If providing hope and healing through compassionate, innovative, and individualized care interests you, we welcome your application for the position below.
The state of Texas offers many benefits to employees. HHSC is a qualifying organization for the Federal Public Service Loan Forgiveness Program, which forgives the remaining balance on college student Direct Loans after making 120 qualifying monthly payments. We also offer excellent health benefits, a lifetime monthly retirement annuity as well as 401(k) and 457 Programs under the Employees Retirement System of Texas.
The Psychiatrist V performs managerial (senior level) work for the State Hospitals. Provides clinical leadership that involves directing, overseeing, and/or coordinating psychiatric, mental, and behavioral health, medical treatment and other clinical activities in the state hospital. Monitors trends, oversees the diagnosing and treatment plans of all patients, and develops policies and procedures to admit, access, and administer specialized psychiatric and medical treatments and determines when patient should be discharged. The Psychiatrist V directs clinical quality assurance and performance improvement projects and initiative at the hospital level and supervises the work of employees at the state hospital. Works under minimal supervision with extensive latitude for the use of initiative and independent judgment. Work involves directing psychiatric activities in the state hospital, monitoring trends and activities, has oversight of subordinate psychiatrists and nurse practitioners who diagnose and treat patients, and administers specialized psychiatric treatments and perform procedures. When required, this position may take on patients as primary doctor such as times when attending doctor is unavailable. Represents clinical services as a member of the hospital governing body, Executive Committee, and other HHSC or agency-wide committees.
Performs other duties as assigned. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.
ESSENTIAL JOB FUNCTIONS (EJFs):
Attends work on a regular basis and may be required to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned. May serve in an on-call or on-duty status on a rotating schedule to meet operational needs of the facility.
Develops and implements psychiatric recovery plans documenting how supports and interventions are customized for the individuals’ psychiatric needs as well as their strengths and preferences. Documents how recovery plans are person centered and least-restrictive interventions based on risk vs. benefit analysis and treatment history, and how psychiatric supports and interventions are integrated with the supports and interventions from other disciplines. Develops and organizes implementation time frames and provides guidance to the recovery team, and direct care staff while following HHSC and local policies and procedures, TJC standards, CMS conditions of participation, TAC and other state statutes.
Oversees all the psychiatric and medical treatment provided at the state hospital through direction to the state hospital staff. Provides strategic direction and leadership to the hospital staff, ensuring Patient-Centered Care Initiatives for our patients, resource optimization, and training and professional development.
Oversees the provision of examinations, diagnostic testing, treatment planning, and administration of psychiatric and general medical care through formulation of evidence-based policies and procedures in accordance with statute, rules, regulations, and hospital or behavioral health accrediting body requirements. At times, must perform as attending doctor.
Consults directly with state hospital clinical staff when patients experience difficult or refractory psychiatric problems and/or when new and investigatory psychiatric medications or treatment techniques become available; renders expert opinions in difficult clinical scenarios.
Monitors trends, oversees the diagnosing and treatment of all patients, and develops policies and procedures to admit, access, and administer specialized psychiatric and medical.
Directs clinical quality assurance and performance improvement projects and initiative at the hospital level and supervises the work of employees at the state hospital.
Directs psychiatric activities in the state hospital, monitoring trends and activities, has oversight of subordinate psychiatrists and advanced practice nurses who diagnose and treat patients, and administers specialized psychiatric treatments and procedures. Performs administrative duties such as oversight of development of Scope of Work for clinical contracts and complex clinical systems, reports.
Maintains open and regular communication with the other Medical Directors, Central Office, Superintendent, and other staff to ensure the transfer of needed information and continuity of services. Participates in various Medical Staff Committees and Sub-committees (Utilization Management, Infection Control, Pharmacy and Therapeutics, etc.) designed to ensure patients are receiving quality care.
Works as a supervising physician and liaison to resolve issues related to student rotations at the SH by initiating contact with medical schools, attending meetings, and writing statements of work for contracts.
Performs other duties as assigned. Other duties may include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
- Knowledge of psychiatric principles and methods
- Knowledge of general medicine methods and procedures
- Knowledge of principles and practices in the development, implementation, and documentation of individualized care and recovery plans
- Knowledge of statutes, regulations, and accreditation standards that apply to hospitals
- Knowledge of quality improvement and patient safety principles
- Skills in the care and treatment of patients
- Skills in the interpretation of regulatory requirements
- Skills in the development of policies and procedures
- Skills in leading and managing committees to accomplish goals
- Skills in conflict management
- Skills in conducting psychiatric research
- Skills in the use of a computer and applicable software
- Skills in the management of large, complex medical systems
- Skills in reading complex documents pertaining to regulation of medicine
- Ability to direct complex psychiatric care activities
- Ability to interpret complex medical, psychiatric, and psychological diagnostic studies and analyses
- Ability to interpret regulatory requirements and develop policies and procedures based upon those requirements
- Ability to develop Statements of Work for clinical contracts
- Ability to communicate effectively both orally and in writing
REGISTRATIONS, LICENSURE REQUIREMENTS OR CERTIFICATIONS:
Must be licensed (unrestricted) as a medical doctor by the State of Texas and be Board Certified or Board eligible in Psychiatry in the state of Texas.
Must have current registration certificate from the Drug Enforcement Agency (DEA). Must possess a National Provider Identifier (NPI#) as defined by Medicare Part B and enroll as a Medicaid and Medicare Part B provider.
INITIAL SCREENING CRITERIA:
Residency experience will not be included in the requirements below.
- At least five years of experience working as a psychiatrist is required.
- At least five years of experience working with people with psychiatric disorders is required.
- Residency trained.
ADDITIONAL INFORMATION:
Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aid, Medication Aide and Employee Misconduct, List of Excluded Individuals/Entities (LEIE). Males between the ages of 18-25 must be registered with the Selective Service.
All applicants must be at least 18 years of age to be considered for employment at a state-operated facility. Waco and Terrell Center for Youth applicants must be 21 years of age.
Flexibility in work hours may be required for this position. The position may be required to work overtime and/or extended hours.
Compliance with HHSC immunization policy and state hospital operating procedures related to immunizations is required. According to the Centers for Disease Control and Prevention, healthcare workers are considered to be at significant risk for acquiring or transmitting hepatitis B, measles, mumps, rubella, varicella (chicken pox), tetanus, diphtheria, pertussis (whooping cough), and influenza. All these diseases are vaccine preventable. As a result, state hospital policy requires employees be vaccinated according to their level of contact with individuals. In the event you choose to not be immunized for the influenza virus, you may be required to wear a mask and take other protective measures.
Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.
ACTIVE DUTY, MILITARY, RESERVISTS, GUARDSMEN, AND VETERANS:
Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.
ADA ACCOMMODATIONS:
In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.
PRE-EMPLOYMENT CHECKS AND WORK ELIGIBILITY:
Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.
HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form.
TELEWORK DISCLAIMER:
This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.
INTRODUCTION
Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.
Functional Title: Psychiatrist V - Medical Director
Job Title: Psychiatrist V
Agency: Health & Human Services Comm
Department: General Admin
Posting Number: 21226
Closing Date: 11/09/2026
Posting Audience: Internal and External
Occupational Category: Healthcare Support
Salary Range: $25,374.89 - $27,975.83
Pay Frequency: Monthly
Salary Group: TEXAS-B-36
Shift: Day
Additional Shift: Days (First)
Telework: Eligible for Telework
Travel: Up to 10%
Regular/Temporary: Regular
Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Exempt
Facility Location: Panhandle State Hospital
Job Location City: AMARILLO
Job Location Address: 6610 W AMARILLO BLVD
Other Locations: Amarillo
MOS Codes: 210X, 44PX, 60W, SEI12
BRIEF JOB DESCRIPTION:
Would you thrive in an environment where you learn and grow personally and professionally all while helping make a positive impact on people’s lives? Do you appreciate being around others like yourself who are dependable, trustworthy, hard workers who believe in the value of teamwork? HSCS is dedicated to building an atmosphere where employees feel valued and supported while providing specialized care for Texans in need. HSCS is comprised of ten psychiatric hospitals, two youth residential treatment facilities, and thirteen state supported living centers. Psychiatric hospitals are a hub of excellence for forensic mental health and complex psychiatric care, with all facilities accredited by The Joint Commission. They provide state-of-the-art treatment that is recovery-oriented and science-based. If providing hope and healing through compassionate, innovative, and individualized care interests you, we welcome your application for the position below.
The state of Texas offers many benefits to employees. HHSC is a qualifying organization for the Federal Public Service Loan Forgiveness Program, which forgives the remaining balance on college student Direct Loans after making 120 qualifying monthly payments. We also offer excellent health benefits, a lifetime monthly retirement annuity as well as 401(k) and 457 Programs under the Employees Retirement System of Texas.
The Psychiatrist V performs managerial (senior level) work for the State Hospitals. Provides clinical leadership that involves directing, overseeing, and/or coordinating psychiatric, mental, and behavioral health, medical treatment and other clinical activities in the state hospital. Monitors trends, oversees the diagnosing and treatment plans of all patients, and develops policies and procedures to admit, access, and administer specialized psychiatric and medical treatments and determines when patient should be discharged. The Psychiatrist V directs clinical quality assurance and performance improvement projects and initiative at the hospital level and supervises the work of employees at the state hospital. Works under minimal supervision with extensive latitude for the use of initiative and independent judgment. Work involves directing psychiatric activities in the state hospital, monitoring trends and activities, has oversight of subordinate psychiatrists and nurse practitioners who diagnose and treat patients, and administers specialized psychiatric treatments and perform procedures. When required, this position may take on patients as primary doctor such as times when attending doctor is unavailable. Represents clinical services as a member of the hospital governing body, Executive Committee, and other HHSC or agency-wide committees.
Performs other duties as assigned. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.
ESSENTIAL JOB FUNCTIONS (EJFs):
Attends work on a regular basis and may be required to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned. May serve in an on-call or on-duty status on a rotating schedule to meet operational needs of the facility.
Develops and implements psychiatric recovery plans documenting how supports and interventions are customized for the individuals’ psychiatric needs as well as their strengths and preferences. Documents how recovery plans are person centered and least-restrictive interventions based on risk vs. benefit analysis and treatment history, and how psychiatric supports and interventions are integrated with the supports and interventions from other disciplines. Develops and organizes implementation time frames and provides guidance to the recovery team, and direct care staff while following HHSC and local policies and procedures, TJC standards, CMS conditions of participation, TAC and other state statutes.
Oversees all the psychiatric and medical treatment provided at the state hospital through direction to the state hospital staff. Provides strategic direction and leadership to the hospital staff, ensuring Patient-Centered Care Initiatives for our patients, resource optimization, and training and professional development.
Oversees the provision of examinations, diagnostic testing, treatment planning, and administration of psychiatric and general medical care through formulation of evidence-based policies and procedures in accordance with statute, rules, regulations, and hospital or behavioral health accrediting body requirements. At times, must perform as attending doctor.
Consults directly with state hospital clinical staff when patients experience difficult or refractory psychiatric problems and/or when new and investigatory psychiatric medications or treatment techniques become available; renders expert opinions in difficult clinical scenarios.
Monitors trends, oversees the diagnosing and treatment of all patients, and develops policies and procedures to admit, access, and administer specialized psychiatric and medical.
Directs clinical quality assurance and performance improvement projects and initiative at the hospital level and supervises the work of employees at the state hospital.
Directs psychiatric activities in the state hospital, monitoring trends and activities, has oversight of subordinate psychiatrists and advanced practice nurses who diagnose and treat patients, and administers specialized psychiatric treatments and procedures. Performs administrative duties such as oversight of development of Scope of Work for clinical contracts and complex clinical systems, reports.
Maintains open and regular communication with the other Medical Directors, Central Office, Superintendent, and other staff to ensure the transfer of needed information and continuity of services. Participates in various Medical Staff Committees and Sub-committees (Utilization Management, Infection Control, Pharmacy and Therapeutics, etc.) designed to ensure patients are receiving quality care.
Works as a supervising physician and liaison to resolve issues related to student rotations at the SH by initiating contact with medical schools, attending meetings, and writing statements of work for contracts.
Performs other duties as assigned. Other duties may include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
- Knowledge of psychiatric principles and methods
- Knowledge of general medicine methods and procedures
- Knowledge of principles and practices in the development, implementation, and documentation of individualized care and recovery plans
- Knowledge of statutes, regulations, and accreditation standards that apply to hospitals
- Knowledge of quality improvement and patient safety principles
- Skills in the care and treatment of patients
- Skills in the interpretation of regulatory requirements
- Skills in the development of policies and procedures
- Skills in leading and managing committees to accomplish goals
- Skills in conflict management
- Skills in conducting psychiatric research
- Skills in the use of a computer and applicable software
- Skills in the management of large, complex medical systems
- Skills in reading complex documents pertaining to regulation of medicine
- Ability to direct complex psychiatric care activities
- Ability to interpret complex medical, psychiatric, and psychological diagnostic studies and analyses
- Ability to interpret regulatory requirements and develop policies and procedures based upon those requirements
- Ability to develop Statements of Work for clinical contracts
- Ability to communicate effectively both orally and in writing
REGISTRATIONS, LICENSURE REQUIREMENTS OR CERTIFICATIONS:
Must be licensed (unrestricted) as a medical doctor by the State of Texas and be Board Certified or Board eligible in Psychiatry in the state of Texas.
Must have current registration certificate from the Drug Enforcement Agency (DEA). Must possess a National Provider Identifier (NPI#) as defined by Medicare Part B and enroll as a Medicaid and Medicare Part B provider.
INITIAL SCREENING CRITERIA:
Residency experience will not be included in the requirements below.
- At least five years of experience working as a psychiatrist is required.
- At least five years of experience working with people with psychiatric disorders is required.
- Residency trained.
ADDITIONAL INFORMATION:
Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aid, Medication Aide and Employee Misconduct, List of Excluded Individuals/Entities (LEIE). Males between the ages of 18-25 must be registered with the Selective Service.
All applicants must be at least 18 years of age to be considered for employment at a state-operated facility. Waco and Terrell Center for Youth applicants must be 21 years of age.
Flexibility in work hours may be required for this position. The position may be required to work overtime and/or extended hours.
Compliance with HHSC immunization policy and state hospital operating procedures related to immunizations is required. According to the Centers for Disease Control and Prevention, healthcare workers are considered to be at significant risk for acquiring or transmitting hepatitis B, measles, mumps, rubella, varicella (chicken pox), tetanus, diphtheria, pertussis (whooping cough), and influenza. All these diseases are vaccine preventable. As a result, state hospital policy requires employees be vaccinated according to their level of contact with individuals. In the event you choose to not be immunized for the influenza virus, you may be required to wear a mask and take other protective measures.
Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.
ACTIVE DUTY, MILITARY, RESERVISTS, GUARDSMEN, AND VETERANS:
Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.
ADA ACCOMMODATIONS:
In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.
PRE-EMPLOYMENT CHECKS AND WORK ELIGIBILITY:
Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.
HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form.
TELEWORK DISCLAIMER:
This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.
See all 991+ Green Card Clinical Psychiatrist Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new Green Card Clinical Psychiatrist Jobs.
Get Access To All JobsTips for Finding Green Card Sponsorship in Clinical Psychiatrist
Verify your degree meets EB-2 requirements
An M.D. or D.O. with a completed psychiatric residency satisfies the EB-2 advanced-degree requirement. Foreign medical graduates must confirm their credential equivalency through a USCIS-recognized evaluation before PERM can begin.
Target health systems with Conrad 30 experience
Employers who have navigated Conrad 30 J-1 waivers for psychiatrists already understand foreign physician sponsorship. These same health systems are far more likely to have in-house immigration infrastructure ready to manage PERM filings.
Search green card sponsors on Migrate Mate
Use Migrate Mate to filter Clinical Psychiatrist openings by employers with active EB-2 and EB-3 filing history. Targeting employers already in the PERM pipeline cuts your negotiation time and avoids educating employers from scratch.
Negotiate PERM filing into your offer letter
Confirm the employer will initiate PERM within a defined timeframe before you sign. Vague promises after onboarding are harder to enforce, and PERM preparation, including prevailing-wage determination, can take six months before DOL even receives the application.
Check prevailing wage before accepting an offer
Run your specific psychiatric role and work location through the OFLC Wage Search to confirm the offered salary meets the DOL prevailing-wage level. An offer below that threshold will fail PERM certification regardless of employer intent.
File I-140 concurrently to lock in your priority date
Once PERM is certified, USCIS allows concurrent I-140 filing with I-485 for adjustment of status if a visa number is immediately available. For EB-3 psychiatrists from most countries outside India and China, concurrent filing is often possible.
Green Card Clinical Psychiatrist: Frequently Asked Questions
Do Clinical Psychiatrist roles qualify for EB-2 or EB-3 green card sponsorship?
Clinical Psychiatrist positions qualify for both EB-2 and EB-3 sponsorship. EB-2 applies when the role requires an advanced degree, which an M.D. with residency training satisfies. EB-3 covers the same role when the employer structures the position as a skilled worker category. Most hospital employers file under EB-2 given the degree requirements, but EB-3 remains available and can sometimes offer a faster path depending on your country of birth.
How does PERM green card sponsorship differ from H-1B for psychiatrists?
H-1B is a temporary status capped at six years without extensions, tied to a specific employer, and subject to an annual lottery. PERM-based green card sponsorship leads to permanent residency with no cap concerns at the EB-3 level for most countries. The PERM process takes longer upfront, typically one to three years from PERM filing to a green card, but it removes the lottery risk entirely and lets you eventually work for any employer.
Can I start PERM while on an H-1B or J-1 waiver as a psychiatrist?
Yes. Employers can file PERM on your behalf while you hold H-1B status, and the two processes run concurrently. J-1 waiver physicians who have fulfilled their two-year home-residency requirement, or obtained a waiver through Conrad 30, can also pursue PERM. Starting PERM early matters because it locks in a priority date, which determines your place in the green card queue.
Where can I find Clinical Psychiatrist jobs with green card sponsorship?
Migrate Mate lists Clinical Psychiatrist openings filtered by employers with confirmed EB-2 and EB-3 green card filing history. Searching by sponsor type helps you avoid applying to employers who have never filed PERM and aren't prepared to start. Focusing on health systems with existing immigration infrastructure reduces delays once you have an offer.
What does the PERM labor certification process look like for a psychiatrist role?
The employer files a prevailing-wage request with DOL, then runs a recruitment campaign to show no qualified U.S. workers are available. If DOL certifies the application, the employer files an I-140 with USCIS on your behalf. For most psychiatrists born outside India and China, a visa number is available quickly, allowing concurrent I-485 adjustment of status filing. DOL processing currently averages several months, and USCIS I-140 adjudication adds additional time.