by large IT companies: http://www.myvisajobs.com/Reports/2012-H1B-Visa-Sponsor.aspx Guess what? H1B is the only reasonable route for educated people to immigrate legally to US (aside from marriage and family ties, and lottery.) Due to annual cap, that is mostly taken by large IT companies, other folks are out of luck. I went to school for 10 years in US, got doctorate degree, and can't just open my own clinic and practice. I am not taking anybody else's job - I'll create jobs. But current immigration system does not allow that, unless you are rich right out of school and can invest hundreds of thousands of dollars in your business in order to get E2 visa. Even then, you cannot get residency and citizenship later, ever; only renew E2, if you are lucky. So, H1B is the only reasonable option: get hired, work for several years, and then get residency through permanent employment. However, most private clinics do not want to spend time and money to start H1B paperwork in April and wait until October for the worker to start working. Immigration system is ridiculous and that's why there are so many illegals. People just cannot get through the system even when they try to do it legally.