In Reply In our research letter, we noted that labor condition application data are not equivalent to data from the US Citizenship and Immigration Services (USCIS), which were not available at the time the study was conducted. However, through an evaluation of prior USCIS and labor condition application data, we suggested that an 80% conversion rate from labor condition applications to visa issuance would likely pertain in aggregate for 2016. Additionally, in our analyses, we tabulated the number of individuals included in each labor condition application rather than the total number of applications specifically to avoid the concern mentioned by Dr Iroegbu and colleagues. Subsequent to the publication of our research letter, the USCIS responded to a Freedom of Information Act request by providing additional information regarding the actual issuance of H-1B visas to physicians. For calendar year 2016, 7924 H-1B visas were issued by USCIS, which represents a labor condition application to H-1B visa issuance conversion rate of 75%, which is quite close to our suggested 80%.
Kahn PA, Gardin TM. H-1B Visa Applications for Physicians—Reply. JAMA. 2017;318(12):1188. doi:10.1001/jama.2017.11990
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