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Recruitment In Canada: An Ideal First Place To Recruit for Healthcare Workers

by Michael F. Hammond, Esq.

As the shortage of health care workers in the United States continues to grow, many hospitals, long-term care facilities, research facilities and healthcare staffing agencies are exploring the recruitment of international workers. Because the thought of undertaking recruitment efforts on another continent, thousands of miles away can be daunting, an ideal starting place to start may be our neighbor to the north, Canada. Given its close proximity, Canada offers many practical advantages for institutions simply looking to dip their toes in the proverbial stream and begin international recruitment of health care workers. The primary advantage recruiting in Canada offers is the ability to obtain immediate employment authorization for Canadian Citizens ("TN status") under the North American Free Trade Act (NAFTA). Obtaining TN status under NAFTA is often be much faster and economical than processing a visa or green card application for an individual from anywhere else in the world. In fact, every year thousands of Canadian citizens cross the border to work in the healthcare field. 

TN status is based upon an agreement between the U.S., Canada and Mexico known as the North American Free Trade Agreement (NAFTA). To qualify for TN status, an individual must be a Canadian or Mexican citizen with a job offer from a U.S. company or organization in one of the specified occupations listed in NAFTA who meets the eligibility standards for the occupation as defined by NAFTA. Additionally, where the position requires a State license, license is required or in some circumstances, substantial progress toward attainment of the State license is acceptable. Finally, some occupations require a Healthcare Worker Certificate to be obtained prior to entry to the United States. When these criteria are met, the immigration process is both initiated and completed the same day the individual enters the United States. The application for TN status will be made simultaneously with the application for admission to the United States.

There are twelve healthcare related occupations included in NAFTA. Only individuals with offers of employment in those occupations identified below are eligible for TN status. Workers to be employed in health care occupations not listed below may be eligible for other visas such as the H-1b or green card. 

Registered Nurse: requires a state/provincial license or licenciatua degree. A registered nurse is also required to obtain a Healthcare Worker Certificate (Visa Screen).

Recreational Therapist/Physiotherapist: requires a baccalaureate or licenciatura degree or a state/provincial license for TN status.

Physical Therapist: requires a baccalaureate or licenciatura degree or a state/provincial license. Every state in the U.S. requires its physical therapists to be licensed. A physical therapist is also required to obtain a Healthcare Worker Certificate (Visa Screen).

Occupational Therapist: requires a baccalaureate or licenciatura degree. All U.S. states require occupational therapists to pass a national certification examination to be licensed to practice in the state of employment. An occupational therapist is also required to obtain a Healthcare Worker Certificate (VisaScreen).

Medical Laboratory Technologist: requires a baccalaureate or licenciatura degree or proof of a post-secondary diploma and three years experience. A medical laboratory technologist is restricted to working in a laboratory and performing chemical, biological, hematological, immunologic, microscopic or bacteriological tests and analyses for diagnosis, treatment or prevention of diseases. A medical laboratory technologist is also required to obtain a Healthcare Worker Certificate (Visa Screen).

Pharmacist: requires a baccalaureate or licenciatura degree or a state/provincial license. Every state requires a pharmacist to be licensed; to obtain the license the pharmacist may be required to complete a short-term internship under a licensed pharmacist.

Psychologist: requires a licenciatura degree or a state/provincial license. A practicing psychologist must be licensed by the state of employment.

Physician: requires an M.D. degree or state/provincial license for TN status. A physician who enters the U.S. in TN status is limited to teaching and research, he or she cannot engage in clinical patient care.

Nutritionist: requires a baccalaureate or licenciatura degree for TN status.

Dietician: requires a baccalaureate or licenciatura degree or a state/provincial license. The majority of the U.S. states require dieticians to be licensed in the state of employment.

Dentist: requires a D.D.S. or D.M.D. or state/provincial license. Every state in the U.S. requires dentists to be licensed in the state of employment. 

Veterinarian: requires a D.V.M. or D.M.V. or state/provincial license for TN status. Veterinarians are an important healthcare occupation whether they focus on the healthcare of animals or protecting humans against diseases carried by animals. All states require veterinarians to be licensed before they can practice. 

As noted above, certain healthcare workers must have their credentials evaluated and certified before they can work in the United States and Canadian citizens are no longer exempt from those certifications, which are properly labeled §343 Health Care Worker Certifications but are more commonly referred to as Visa Screen. Individuals employed in the following TN occupations will require such certification: registered nurses, physical therapists, occupational therapists and medical technologists.

This certification includes an education credentials review, licensure review, English language skills assessment and, for nurses, successful completion of the CGFNS or NCLEX examination. Healthcare workers educated in Canada (except in Quebec) are exempt from the English language assessment if the language of instruction was English and the language of textbooks was English.

Currently only three organizations are approved to issue healthcare certificates. The National Board for Certification in Occupational Therapy (NBCOT) is authorized to issue certificates for occupational therapists, the Foreign Credentialing Commission on Physical Therapy (FCCPT) is authorized to issue certificates for physical therapists. Only the Commission on Graduates of Foreign Nursing Students (CGFNS) is authorized to issue certificates (what it calls a “Visa Screen”) for all seven healthcare occupations which require a healthcare certificate for immigration purposes. 

For companies looking to explore the recruitment of international health care workers, there is no easier place to start than Canada.


About The Author

Michael F. Hammond, Esq. is Principal and founder of Hammond Law Group, a law firm that handles immigration matters exclusively, with offices in Cincinnati, San Francisco, Seattle, and Manila. Michael Hammond has personally been practicing immigration law since 1989, and specializes in primarily IT and health care related corporate matters. He can be reached at mfh@hammondlawfirm.com.


The opinions expressed in this article do not necessarily reflect the opinion of ILW.COM.


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