What is a foreign-educated healthcare professional?

For more than 70 years, foreign healthcare professionals have served the U.S. healthcare system. These highly motivated, well educated, skilled physicians, nurses, and allied healthcare professionals augment an often understaffed, overloaded U.S. workforce in clinical settings across the country. They come here legally to help overcome chronic worker shortages, and they accept positions in geographic locations and clinical settings that are often more difficult to fill with U.S. workers.

Before obtaining their US licenses, foreign-educated healthcare professionals must have received education that is substantially equivalent to their US-educated peers, have demonstrated English proficiency through a rigorous English proficiency exam, and have passed the same US licensure examination that is required of US-educated colleagues in their profession.  Many foreign-educated healthcare professionals have years of experience in quality healthcare facilities including Joint Commission International-accredited hospitals around the world, including the Philippines, India, the United Kingdom, or the Middle East.  Finally, they potentially have waited 6 or more years to obtain a US visa.

In 2013, of the foreign-educated nurses who sat for the NCLEX-RN exam, about 20% were Filipino.  The next largest countries were India (5%), Canada (3%), and South Korea (2%).   This percentage distribution remains similar for other allied healthcare occupations.  They come to the United States, after years of preparation and patience, motivated to excel in their professions, to meet the growing healthcare needs of U.S. patients, and to improve their lives and the lives of their families.

Few in Number

Although physicians trained outside the U.S. accounts for roughly 25 percent of the country’s physician workforce, foreign-educated healthcare professionals in nursing and allied health occupations represent a relatively small percentage of the overall healthcare workforce.  For example, foreign-educated registered nurses account for 5.4 percent[i] of total registered nurses in the United States.

The United States has immigration regulations that limit the number of visas available to foreign-educated professionals even during times of significant US worker shortages. According to the Department of Labor, Healthcare occupations are not in the Top 10 of H-1B Employment-based visas issued.  Information technology companies dominate that list.  Healthcare professionals make up just 5% of Employment-based green cards that are certified by the Department of Labor.

Quality of Care

Recent studies are pointing to the high quality of care provided by International Healthcare Professionals and the added value that they bring to the U.S. healthcare industry.  Patricia Cortes, Assistant Professor, Markets, Public Policy and Law, Boston University, authored a study in 2012, Relative Quality Of Foreign Nurses In The United States.  Ms. Cortes found that, “…foreign nurses, in particular Filipinos, tend to work in more demanding settings and maintain less desirable schedules – they are more likely to work in hospitals, work full-time, and do shift work, as compared to their native counterparts.

“Natives are more likely to work part-time and choose jobs with standard schedules – for example, they tend to work in physicians’ offices and schools, etc. In terms of educational background, the majority of foreign nurses have at least a bachelor’s degree, whereas a larger fraction of natives have an associate degree. A more educated nurse workforce (as measured by the share of nurses in a hospital holding a bachelor’s degree) has been associated with better patient outcomes and higher nurse productivity.”