Recruiting Abroad 

HR manager at computer. 

Targeted recruitment of internationally educated nurses abroad raises complex ethical issues. If your organization is considering recruiting nurses abroad, it’s important to:

  • Investigate the standards of nursing education and practice in targeted countries 
  • Form appropriate partnerships in the target countries
  • Be aware of migration and regulation issues
  • Arrange to integrate recruits into the community, the organization and the nursing profession in Canada

Ethical issues

The International Council of Nurses (2001) and many national and regional nursing associations oppose targeted recruitment of nurses abroad, especially from developing countries and countries with significant nursing shortages.

The CNA (2005) does not support the "unethical recruitment of nurses from countries that currently are or will be experiencing a shortage" (p. 2). But it recognizes that "employment of IENs holds a number of benefits for the Canadian healthcare system such as the filling of nursing vacancies by educated, experienced and often specialized nurses" (p. 2).

Some countries – the Philippines, China and India, for example – produce a surplus of nurses to meet the demands of foreign markets (Xu & Zhang, 2005). Although there is both internal and external criticism of overseas recruitment, Canadian recruiters seeking nurses usually target these countries. 

See the resources below for more information, or visit the section on Hiring Processes to learn more about interviewing internationally educated nurses in Canada, and assessing IEN education.Or see HealthForceOntario's ethical recruitment statement for more information on recruiting nurses abroad.

Strategies from province to province

  • Ontario healthcare institutions sometimes recruit nurses abroad, but there’s little evidence for major recruitment initiatives.
  • Alberta and British Columbia have targeted nurses in the United Kingdom (UK), tapping candidates from developing countries who are licensed to practice in the UK. The ethical implications of this practice relate to bypassing the injunction against recruiting in the Third World and accepting candidates from a country that has expended resources on their education and adaptation (De Guzman, 2008; Nurse Vancouver, 2007). 

Government initiatives

These initiatives were put in place to accelerate the migration and employment of individuals with desirable skills:

  • The Foreign Credentials Referral Office (FCRO), which already offers services in the Philippines, is expanding to help immigrants from India and China (Citizenship and Immigration Canada, 2008). 
  • Alberta Health and Wellness received funding from the Ministry of Citizenship and Immigration to pilot an offshore assessment program intended to identify the adaptation needs of IENs before they migrate (FCRO, 2007). 

Organizations interested in recruiting abroad should be aware of these initiatives. 

Developing partnerships abroad

Some provinces have formed partnerships abroad to allow for temporary and permanent migration of workers. The literature agrees that bilateral agreements, such as those between some Canadian jurisdictions and the Philippines, can be frameworks for the ethical transfer of migrant nurses. Read the memorandum.

Individual applications from abroad

The majority of recruits in Ontario are already in the province, but nurses who have not yet migrated also submit applications. Accepting these applications offers advantages to both nurses and employers. However, nursing and HR managers who’ve been involved in transferring these nurses to Canada suggest that sometimes it’s a long and frustrating process.

  • Prospective employers can only hire applicants after all Canadian nationals have had the opportunity to fill the position. 
  • An application for employment authorization must be submitted to HRSDC. The only exception to this rule is US nationals who, under the NAFTA agreement, don’t require HRSDC validation. 
  • Upon approval, applicants must apply for a Canada work permit/visa. A temporary work permit may also be issued for a spouse ( 
  • Applicants must also provide evidence that they have a temporary nursing licence from the regulatory body before they can receive a work permit. For more information, see Requirements for IENs.

Useful resources

International Council of Nurses. (2011). Position Statement: Ethical Nurse Recruitment.

Memorandum of Understanding between the Department of Labor of the Republic of the Philippines and Ministry of Employment and Immigration of Alberta Concerning Cooperation in Human Resource Deployment and Development. (2008). Available at:

Sinnema, J. (2007). Nurse Recruiting Efforts Bolstered by Government.

Xu, Y., & Zhang, J. (2005). One size doesn’t fit all: Ethics of international nurse recruitment from the conceptual framework of the stakeholder interests. Nursing Ethics, 12(6), 571-581.