Recruitment of Foreign-Educated Healthcare Professionals

AAIHR and its member organizations:

Support the Basic Human Right to Immigrate – AAIHR supports the basic human right of individual healthcare professionals to exercise their freedom of choice to migrate, and to enjoy career advancement and professional opportunities, as well as improved quality of life for themselves and their families. 

Support Legal Immigration – We support lawful immigration of healthcare professionals from foreign countries to work in the U.S. provided they meet all federal and state qualifications for entry and practice. 

Understand the Link Between Availability of Qualified Staff and Safe, Quality Healthcare – We understand that safe, quality health care is directly dependent upon an adequate supply, distribution, and utilization of qualified and committed healthcare professionals and that America should be implementing a variety of methods to ensure adequate supply of such professionals, of which legal and ethical international recruitment is one such method. 

Affirm the Benefits of International Recruitment to American Patients – AAIHR member organizations affirm the many potential benefits of international recruitment to U.S. patients and American healthcare organizations, including the alleviation of chronic and growing US healthcare worker shortages and the provision of culturally sensitive healthcare for America’s growing multicultural patient population. 

Recognize the Potential Benefits of Foreign Recruitment to Source Countries – Our members recognize the potential benefits to source countries of ethical and socially responsible recruitment of healthcare professionals.  Remittances by migrating expatriate healthcare professionals often help fund the source country's healthcare system, replenish the supply of healthcare workers, and improve the quality of life for the migrating professional's family members.  

Commit to Responsible Sourcing of Foreign-Trained Healthcare Professionals – AAIHR member organizations acknowledge the potential adverse effect that international migration may have on health care quality in countries seriously depleted of their healthcare professional workforce, and commit to conducting international healthcare recruitment in a globally responsible manner. We also acknowledge the benefits of circular migration and support initiatives that encourage healthcare professionals to return to their home countries for periods of service. 

Commit to Ethical Recruitment and Employment Practices – AAIHR denounces unethical behavior by any party in the international recruitment process. Recruiters, employers, regulatory organizations, and foreign healthcare professionals each have a responsibility to protect one another from false information, misleading claims, withholding of relevant information, and exploitation. Each party has a responsibility to represent themselves accurately, to deal with the other parties honestly and forthrightly, and to honour their legal and contractual obligations. 

Call for Sensible Regulation of International Healthcare Recruitment - AAIHR calls for governments and regulatory organizations to implement fair, humane, and sensible policies and processes for international healthcare recruitment that respect the issues and concerns of the migrating healthcare professionals, their prospective U.S. employers, and the health systems in both their home countries and their destination countries (see AAIHR Position Statement on Immigration Reform). 

Proposed Executive Action on Immigration

Very few informed Americans would argue that the US immigration system should be reformed. There has been considerable debate about immigration reform over the last decade, with little legislative progress. While much of the debate centers on undocumented workers, deportations, and border security issues, few disagree that the legal system of immigration is inadequate to meet our country’s needs. 

At the same time, America faces a critical shortage for physicians, registered nurses, physical therapists, occupational therapists, and other healthcare professionals.  The current and worsening shortages are driven by a variety of factors including:

  • Demand for Healthcare Services Is Rising
    • An aging baby boomer population which is driving demand for healthcare services (10,000 Americans turning 65 each day; Medicare Board of Trustees predicts a 30% increase in enrollment between 2012 and 2020).
    • Increased participation in the US health system due to the Affordable Care Act (Million more Americans eligible for health insurance, expansion of Medicaid).
  • Demand for Certain Healthcare Professionals is Rising Rapidly
    • Registered Nurses, Physical Therapists, and Occupational Therapists are among the fastest growing occupations in America. 
    • On September 2, 2014, the American Nursing Association issued a press release that the United States will need to produce 1.1 million new Registered Nurses by 2022 to fill jobs and replace retirees. 
    • According to the Bureau of Labor Statistic (BLS), the number of therapist jobs will grow by 39 percent (or 77,400) between 2010 and 2020.  “Shortages are expected to increase for all 50 states through 2030”, according to research published in the American Academy of Physical Medicine.
    • Occupational Therapists are increasingly in demand.  The BLS reports that expected growth for Occupational Therapists between 2010 and 2022 is 33% (or (34,800).
  • Supply of Healthcare Providers is Constrained
    • An aging healthcare workforce that are likely to retire over the next 10 to 15 years (50% of physicians are 55 or older; the average age of an RN is 47 years old; both PTs and OTs have similarly aging workforces).
    • An inadequate educational infrastructure that turns away qualifying students for MD, PT, and RN programs (aging faculty, educator shortage, limited classroom and residency program capacity)
    • Increasing costs of Healthcare Professional Education due to rising cost of college education and increased levels of education required for licensure and practice in the US).
    • Shortages have largely existed for decades in many healthcare occupations, despite a range of initiatives by the private and public sectors, including myriad grants and scholarships for healthcare professionals and faculty, university-hospital partnerships, discounted student loans, tuition forgiveness programs, and advertising campaigns such as the Johnson & Johnson campaign for nursing.
    • America’s current legal immigration system constrains the supply of foreign educated healthcare professionals with US credentials (H1B visa lottery is dominated technology professionals; employment based Green Cards have been backlogged for many years).

Therefore, AAIHR has decided to support President Obama’s proposed Executive Action on Immigration. AAIHR member organizations support the recommendations and findings of the National Foundation for American Policy on ways that President Obama can address the significant and prolonged backlog of immigrant visas for skilled workers. 

In particular, we support the proposal to exclude dependents from the count of employment based immigrant visas. This would ensure that visas are available for the skilled workers America needs and would eliminate the necessity of a lottery for H1B visas.

AAIHR prefers a bipartisan Congressional solution to reform America’s immigration system. Given the decade long stalemate on immigration, and the uncertainty of a near-term solution, AAIHR applauds the President’s efforts to do whatever is within his authority to address the obvious shortcomings and constraints of the legal immigration system for skilled workers, especially for healthcare professionals. 

AAIHR believes that healthcare professionals should be given a priority over other occupations in our immigration system. Access to healthcare is a fundamental right of every American. Without adequate numbers of highly skilled healthcare professionals, many Americans are at risk of going without much needed healthcare, especially in rural communities and underserved populations. By cultivating a global workforce, AAIHR believe that the United States can more effectively meet the healthcare needs of its citizens.