But on the other hand, this 'shortage' is being used as a political tool to depress engineering salaries, even though if you applied the same logic to other professions you would find there are worse shortages there. Clearly it would be useful from a healthcare cost perspective if we had more doctors but we aren't expanding visa quotas there. Salary is a huge issue and most jobs want to pay engineers as little as possible. Of course they will rant about how competitive their pay is but if it was so competitive they would probably advertise it, instead of trying to use information asymmetry so they can negotiate them down lower. Then of course, they only hire the best, but salary negotiations inevitably revert to 'market wages', then after all this they can't hire people so they need more immigrants who get deported if they fire them.
For some reason, if you can't afford an accountant, you don't get an accountant, if you can't afford a private lawyer, you don't get a private lawyer, but if you can't afford a programmer, there is a talent shortage and we need more skilled immigrants and to subsidize more STEM graduates.
New Employment must be the "same or similar" classification
Form I-140 has been approved or is approvable when filed with I-485
Form I-485 has been pending for at least 180 days
The employee needs to file a Form I-129 and will need to provide their new employer their original I-94, passport, and Form I-129 filing receipt to properly document work authorization.Most HR departments fuck this up and many immigration attorneys fuck this up but it's completely possible.
And yes, skilled immigrants create wealth. But the same reasonable arguments that can be made for bringing in skilled tech immigigrants (NOT on indebtured servant visas) could be made for bringing in skilled healthcare immigrants. The reason the former happens a lot more than the latter is because of political representation. Doctors have the AMA carefully controlling the supply of doctors, tech workers have Google and Microsoft doing the opposite.