My background and some details
I am a postdoc in NYC. I obtained my MD and PHD dergree in China and came here five years ago. I am working on a project funded by NIH and published two papers in 2002. I used seven recommendation letters. Three from my institute, two from US, but somewhere else, one from Europe, and one from China. In my experience, the letters are the most important. You have to convince the official, a layman of science. Of course, luck is also crucial. One of my friend submitted one month later than I and got his NIW approved last Dec.