Professional Practice Guidelines for International Recruiters

AAIHR believes that the organizations that recruit and employ international healthcare professionals have a responsibility to act in a legal and ethical manner when dealing with international healthcare professionals, regulatory bodies, and client organizations. The following represent professional practice guidelines for AAIHR member organizations when dealing with international healthcare professionals.

Refrain from False Advertising and Communications – A member shall not in the course of its advertising, marketing, or other communications make any overtly false or misleading statement about, the terms of employment in the US, another member firm or its services, the competitor’s client or potential place of employment or about another organization or its services. A statement will be considered false if:​

  • it contains a material misrepresentation that violates the spirit of the Code of Ethics or omits a fact, which would make the statement as a whole misleading;
  • it is likely to create an unjustified expectation about the results the member can achieve, or states or implies that the member can achieve results that violate the Code or any applicable law; or
  • it makes a comparison of the member with another member that cannot be factually substantiated.

Provide Fair Treatment in Contracting – Members shall apply the principle of informed decision making in recruitment and employment contract negotiation with healthcare professionals. Members shall make a reasonable effort to ensure that applicants understand and have adequate opportunity to consider the material terms of their contractual obligations.

Licensing and Immigration Requirements – Members shall provide a good faith explanation of the expected licensing and immigration requirements, procedures, and timing related to immigration laws and processes.

Employment Terms and Conditions – Members shall inform healthcare professionals about the known  material conditions of employment, including the minimum required period of employment, work schedule,anticipated employer of record, clinical setting, worksite location of employment, wage rates, benefits, duties, and other material information as soon as such information is known, ideally in advance of travel to the U.S.Members shall provide a signed copy of the contract to the healthcare professional. Members shall also secure the healthcare professional’s agreement to any changes to any material contract terms or conditions of employment.

Financial Responsibilities – Members shall clearly identify the financial responsibilities of healthcare professionals, recruiters, employers, and visa sponsors and clients, as they relate to costs associated with credentialing, individual and family visa sponsorship, relocation and resettlement, transportation and housing throughout the expected period of employment, including:​i. the conditions under which the healthcare professional would be obligated to incur any expenses and the expected amounts of such expenses, and​ii.any potential financial consequences to the healthcare professional for violations of their contract; Members shall not charge recruitment or placement fees to healthcare professionals if such fees are also paid by the employer or client.

Contract Termination Rights – Members shall clearly spell out the provisions for contract termination by the employer and the healthcare professional, prior to and after arrival in the U.S.When contracts are signed in advance of visa issuance, Members shall permit the termination of contracts by healthcare professionals if:i.deployment is delayed for more than five years from the date of contract execution, and​ii. such delay is not due to the healthcare professional’s failure to meet requirements necessary to secure licensure (e.g., failure to pass an exam in a reasonable time period) or secure a visa in a reasonable time period (e.g., visa retrogression) or a material change in the regulatory environment, and​iii. all costs incurred by the recruiter, employer, and visa sponsor on the healthcare professional’s behalf have been reimbursed to the organization(s) that have incurred them.

Contract Assignment Rights – Members shall secure the right to assign the healthcare professional’s contract to another recruiter, visa sponsor, or employer at the time of contract execution or prior to the assignment of the health professional’s contractual rights and obligations to another recruiter or employer.

Provide Transition Support – Members shall make a reasonable effort to ensure foreign-trained healthcare professionals receive adequate transition support relating to living and working in the U.S., including assistance with safe initial housing, transportation, and banking solutions. Members shall either provide such support directly, or ensure that such support is provided by the client or employer. Members shall ensure that foreign-trained healthcare professionals receive at least basic orientation to working in their profession in the U.S.

Compensate Fairly – Members shall ensure that healthcare professionals are compensated consistent with federal, state, and local wage and hour laws as well as federal visa requirements regarding prevailing wage levels.It is understood that violating compensation, accounting and taxation laws to gain competitive advantage not only represents unfair competition, but also puts our key stakeholders, our clients and healthcare professionals, in serious risk of sanctions for violating labor and visa laws and IRS regulations. As experts in international healthcare recruiting and staffing, members agree that this is unacceptable and irresponsible behavior. Members shall comply with generally accepted accounting principles, wage and hour laws, and fully comply with visa and IRS regulations not limited to, and including:​

  • payment of wages that meet or exceed prevailing wages as required by visa laws in the geographic area to which the healthcare professional is employed;
  • proper usage of non-taxable per diems or lodging or meals and incidentals allowances/reimbursements;
  • proper classification of healthcare employees including classification of temporary healthcare employees as non-exempt and W2 employees;
  • abidance by all overtime laws; and
  • proper withholding of all payroll related taxes, including state income taxes