Recently, in an unpublished decision, the AAO found that a nonprofit hospital that provided training to students in the medical field did not qualify for H-1B cap exemption for nonprofits affiliated with institutions of higher education. It narrowly defined affiliation as requiring either joint control or ownership. This will have an overwhelmingly deleterious effect on our health care system in light of the shortage of physicians in the US. In response, Senator Kerry from Massachusetts and several other Senators wrote letters to USCIS requesting clarification on USCIS’s policy towards nonprofit hospitals seeking cap exemption and emphasizing the dire consequences of denying such exemption. USCIS has responded by stating that it expects to issue a clarification to its policy this week. We all await with bated breath.