F.A.Q.

Frequently Asked Questions

The following is a list of frequently asked questions about the Alliance for Ethical International Recruitment Practices (Alliance), divided into subject areas. We are continually updating this section so please check back. If you have a question that is not listed, please feel free to send us an email.

About the Alliance

  1. Who is the Alliance?
  2. Why does the Alliance exist?
  3. How does it plan to promote ethical recruitment?
  4. When was the Alliance created?
  5. How is the Alliance governed?
  6. How is the Alliance funded?

About the Health Care Code

  1. What is the Health Care Code?
  2. What does the Health Care Code cover?
  3. Why was the Health Care Code developed?
  4. Who authored the Health Care Code?
  5. How were these organizations selected?
  6. Who uses the Health Care Code?
  7. How was the Health Care Code developed?
  8. Who funded this work?
  9. How is compliance with the Health Care Code monitored?
  10. What is the difference between endorsers and Certified Ethical Recruiters?
  11. What is the WHO Code of Practice on the International Recruitment of Health Personnel and how does it compare to the Alliance’s Health Care Code?

About the Teachers’ Code

  1. What is the Teachers’ Code?
  2. What does the Teachers’ Code cover?
  3. Why was the Teachers’ Code developed?
  4. Who authored the Teachers’ Code?
  5. How were these organizations selected?
  6. Who uses the Teachers’ Code?
  7. How was the Teachers’ Code developed?
  8. Who funded this work?
  9. How is compliance with the Teachers’ Code monitored?

Alliance Certified Ethical Recruiters

  1. Who should become certified by the Alliance?
  2. Why do organizations decide to become certified?
  3. How difficult is it to become a CER?
  4. How is a CER’s compliance with the code monitored?
  5. What happens when a report of non-compliance is received?
  6. What is the cost to be a CER?
  7. How can a CER cancel their certification?
  8. Does the Alliance plan to rely exclusively on Certification fees in order to operate?

Foreign-Educated Health Professionals (FEHPs)

  1. Why should I work with an Ethical Recruiter (CER)?
  2. What types of reported problems can the Alliance address?
  3. How will reported problems be handled by the Alliance?
  4. How long will the remediation take?
  5. What happens if the remediation is unsuccessful?
  6. Why should I participate in the survey?
  7. Are the surveys anonymous and confidential?
  8. Can I take the survey if I do not work for a CER?
  9. How can I access the survey?
  10. Can I submit an open report if I am participating in the Alliance Survey Monitoring Program?
  11. Can I submit an open report if I have submitted the same report to another organization?
  12. Whom should I contact with questions about the survey?

About the Alliance

Who is the Alliance?

The Alliance for Ethical International Recruitment Practices is a non-profit organization that aims to promote an underlying system of voluntary Codes of Ethical Conduct for the recruitment practices of foreign-educated professionals to the U.S.

Why does the Alliance exist?

Regulatory guidelines of labor standards concerning the recruitment practices of professionals obtaining employment over international waters are absent. In order to mitigate the exploitation faced in health care and education sectors in the U.S., the Alliance aims to facilitate adoption, awareness and advancement of voluntary codes for ethical recruitment practices.

How does it plan to promote ethical recruitment?

The Alliance’s proactive response to the issue of unethical recruitment has advanced the international policy agenda since 2008. Our mission is to create Codes of Ethical Conduct in international recruitment partnering with stakeholders who address the application and monitoring of organizations to provide an overall evaluation of their practices. Foreign professional are ensured that Alliance-certified recruiters uphold ethical recruitment and transparent practice as a priority when conducting business.

When was the Alliance created?

The Alliance for Ethical International Recruitment Practices was created in 2009 to implement the Voluntary Code of Conduct for the Ethical Recruitment of Foreign-Educated Health Professionals to the United States. This Health Care Code was created in 2008. The Teachers’ Code for Ethical International Recruitment and Employment Practices was later launched in 2015.

How is the Alliance governed?

The Alliance Governing Board is currently comprised of 17 members representing six stakeholder groups: unions, professional associations, U.S.-based foreign-educated professional associations, employers, staffing/placement agencies, and certification and licensure bodies. A Steering Committee composed of stakeholders from the education sector report to the Alliance Governing Board.

How is the Alliance funded?

The Alliance is a non-profit organization that is funded by a combination of grants, certification fees and organizational support.

About the Health Care Code

What is the Health Care Code?

The Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Health Professionals to the United States (HC Code) provides voluntary standards that aim to ensure that the practice of recruiting foreign-educated health professionals (FEHPs) to the United States is done in a responsible and transparent manner.

What does the Health Care Code cover?

The Code sets standards for ensuring that the rights of FEHPs are protected, clinical and cultural orientation programs are adequate, and the practice of recruitment is not harmful to source countries.

Why was the Health Care Code developed?

The Code was developed in response to widespread recognition that international recruitment of health professionals needs to be conducted in an ethical way that balances diverse stakeholder interests. There is general acknowledgement that there is currently no mechanism for preventing or reporting unethical conduct in international recruitment.

Who authored the Health Care Code?

The Code was authored by a diverse group of stakeholders representing unions, health care organizations, educational and licensure bodies, and recruiters. A full list of authors is included with the Code.

How were these organizations selected?

Participating organizations were identified through a study on the structure and practices of the U.S.-based international health professional recruitment industry conducted by AcademyHealth. They include both stakeholders and experts on the process of international recruitment.

Who uses the Health Care Code?

Our goal is that all employers and recruiters will use the Code to influence their recruitment practices. Both employers and recruiters can apply to become certified by the Alliance as being in compliance with the Code’s standards. In addition, the Alliance uses the Code as a guiding tool when assessing applications for certification.

FEHPs are encouraged to use the Code to learn about their rights to seeking employment in the U.S. The Code’s standards should outline basic recruitment practices oh recruiters and employers with whom they choose to work. .

How was the Health Care Code developed?

AcademyHealth convened a diverse group of stakeholders for a year-long consensus-building process. The group developed the Code with technical assistance from the O’Neill Institute for National and Global Health Law at Georgetown University.

Who funded this work?

The research and consensus building process were funded by the John D. and Catherine T. MacArthur Foundation.

How is compliance with the Health Care Code monitored?

A full description of the Alliance’s monitoring program can be viewed here.

What is the difference between endorsers and Certified Ethical Recruiters?

An endorser is an organization that does not engage in the recruitment of FEHPs, but would like to show their support of the Code and the mission of the Alliance. Examples include unions, foreign health professional associations, and non-governmental organizations (NGOs). Endorsers are not subject to monitoring by the Alliance.

An organization that has been certified by the Alliance is directly involved in the recruitment of health professionals. In addition, their compliance with Code standards are monitored through the Alliance Survey Monitoring Program.

If you are interested in becoming an endorser, please download and submit the endorsement form. A list of endorsers can be viewed here.

What is the WHO Code of Practice on the International Recruitment of Health Personnel and how does it compare to the Alliance’s Health Care Code?

The World Health Organization’s (WHO) Code of Practice on the International Recruitment of Health Personnel aims to promote a balance of the interests of health workers, source countries and destination countries, while mitigating the negative effects of recruitment of international migration on countries experiencing health workforce crises. Signatories of the WHO Code are member states.

The Alliance Code, which pre-dates the WHO Code, is a market-based tool that is adopted and implemented by recruiting companies and employers. The Alliance believes that its goals and those of the WHO Code are in alignment and the two initiatives are complementary (See position statement).

About the Teachers’ Code

What is the Teachers’ Code?

The Teachers’ Code for Ethical International Recruitment and Employment Practices provides voluntary standards that aim to ensure that the practice of recruiting foreign-educated teachers to the United States is done in a responsible and transparent manner.

What does the Teachers’ Code cover?

The Teachers’ Code sets standards for ensuring that the rights of teachers are protected, that school and administration orientation programs are adequate, and that the practice of recruitment is not harmful to source countries.

Why was the Teachers’ Code developed?

The Teachers’ Code was developed in response to widespread recognition that international recruitment of teachers needs to be conducted in an ethical way that balances diverse stakeholder interests. There is general acknowledgement that there is currently no mechanism for preventing or reporting unethical conduct in international recruitment.

Who authored the Teachers’ Code?

The Teachers’ Code was authored by a diverse group of stakeholders representing unions, teacher organizations, state boards, and recruiters. A full list of authors is included with the Teachers’ Code.

How were these organizations selected?

Participating organizations were identified through a study on the structure and practices of the U.S.-based international health professional recruitment industry conducted by AcademyHealth. They include both stakeholders in, and experts on, the process of international recruitment.

In 2009, an interesting American Federation of Teachers (AFT) landmark study shed light to similar recruitment challenges in the education sector as well. With input from leading experts, a Steering Committee was formed to create the Teachers’ Code.

Who uses the Teachers’ Code?

Our goal is that all employers and recruiters will use the Code to influence their recruitment practices. Both employers and recruiters can apply to become certified by the Alliance as being in compliance with the Code’s standards. In addition, the Alliance uses the Code as a guiding tool when assessing applications for certification.

Foreign-educated teachers are encouraged to use the Code to learn about their rights and to identify how recruiters and employers should be treating them during the recruitment process.

How was the Teachers’ Code developed?

Initial efforts for the ethical recruitment studies in the education sector stemmed from the work by Polly Pittman from George Washington University School of Public Health.

Who funded this work?

The research and consensus building process were funded by the John D. and Catherine T. MacArthur Foundation.

How is compliance with the Teachers’ Code monitored?

There is no formal certification process for the Teachers’ Code at this time. We are working with our Steering Committee to propose a compliance system similar to that of the Health Care Code.

Alliance Certified Ethical Recruiters

Who should become certified by the Alliance?

Organizations that engage in any phase of the recruitment process should consider becoming certified by the Alliance. Whether your organization participates in the process directly or indirectly, the Alliance welcomes your application and your commitment to the standards set forth in the Code. Remember, the certification process is only applicable for the Health Care Code at this time.

Eligible organizations include:

  • Recruiting organizations that contract with health professionals or teachers in a source country to facilitate migration to the United States and placement in employment;
  • Staffing agencies that recruit and employ health professionals or teachers and assign them to either sectors in the United States; and
  • Healthcare and education organizations who employ FEHPs (either recruited directly or through recruiters or agencies)

Why do organizations decide to become certified?

Organizations that seek certification by the Alliance demonstrate a commitment to self-regulation and recognize the benefits that stem from conducting business within a framework of social responsibility. Becoming a certified ethical recruiter (CER) indicates leadership and innovation in the field. It also provides your organization with the unique opportunity to provide valuable insights, expertise, and recommendations to the Alliance.

How difficult is it to become a CER?

Becoming a CER requires completing the application process. Each organization is required to:

  • Submit the online application;
  • Submit the Compliance Report;
  • Schedule an interview;
  • Demonstrate compliance with the Alliance Survey Monitoring Program; and
  • Submit CER Agreement.

For more details, please view Apply for Certification.

How is a CER’s compliance with the Code monitored?

The primary mechanism for monitoring Code compliance is the Alliance Survey Monitoring Program, a confidential survey that is completed by health professionals who have or are currently moving through the recruitment process.

The Alliance also accepts “open reports” via a portal on the Alliance Web site. Open reports are secure; comments on recruitment practices are kept confidential unless otherwise requested by its author.

What happens when a report of non-compliance is received?

As part of our mission, the Alliance encourages all CERs to contract with other organizations that have also been certified. We recognize that organizations engaging in international recruitment often partner with multiple entities, both in the United States and abroad. Therefore, recruitment activities of certified companies are only monitored insofar as they relate to the provisions of the Code.

Certified Companies

The Alliance only investigates and addresses reports of non-compliance related to the Code. Activities that are outside the scope of the Code are not monitored. Certified companies are not held accountable for parts of the recruitment process they did not facilitate directly.

The Alliance investigates all credible reports of non-compliance. Reports of non-compliance are validated by speaking directly with the individual who provides the information, and reviewing all other potential sources of data. Certified companies will participate in mediation and/or remediation to address compliance issues that arise. If companies fail to maintain compliance with the Code, they may be removed with an opportunity for recertification after revalidation.

As a rule, the Alliance compiles information provided by surveyed health professionals in a way that does not identify them. Therefore, the Alliance requires the express consent of individuals who provide information in order to disclose their identity during the mediation and/or remediation process.

Non-Certified Companies

For reports concerning organizations that are not certified, the Alliance may provide the party filing the report with contacts and information on resources available to them. In addition, the Alliance contacts the non-certified organization with information about the Code, steps they can take to become compliant with the Code, and information on becoming certified by the Alliance.

The Alliance is still currently accepting applications from organizations interested in becoming certified. Any organization that engages in the recruitment of foreign-educated health professionals (FEHPs) or teachers, directly or indirectly, are welcome to apply to become an Alliance Certified Recruiter by submitting our Web-based application form and completing the application process.

What is the cost to be a CER?

The Alliance Board developed a fee schedule based on

  1. number of in the case of employers and
  2. revenue in the case of placement and staffing companies
  • Hospitals (based on number of beds) : $500 – $1,500
  • Health systems (based on number of beds) : $500 – $2,500
  • Placement agencies: $500 – $1,500
  • Staffing Agencies (based on annual earning): $500 – $2,000

CERs in the education sector is yet to be defined.

How can a CER cancel their certification?

CERs have the right to cancel their certification at any time. Cancellation requests must be received in writing. Certification is non-transferable and no refunds will be issued after 30 days. Upon cancellation, the CERs shall be immediately removed from the Alliance Web site. The CERs shall immediately remove the Alliance certification seal from any and all Web sites and materials produced by the CER.

Does the Alliance plan to rely exclusively on Certification fees in order to operate?

In order to maintain independence, the Alliance Board believes that the financial support for this initiative should be shared by all interested parties. As a result, certification fees represent just one portion of the Alliance’s operating budget with the balance coming from institutional donations, including founding professional associations and unions, and public and private foundation grants.

Foreign-Educated Health Professionals (FEHPs)

Why should I work with an Ethical Recruiter (CER)?

The Alliance neither supports nor opposes the recruitment of FEHPs to the United States, but does strongly affirm that when recruitment takes place, it must be conducted in an ethical, responsible, and transparent manner. Certified ethical recruiters(CERs) recruitment practices are monitored by the Alliance to ensure they meet these standards. These standards were developed to protect FEHPs throughout the recruitment process. We depend on surveys of applicants to inform us on their experience with recruiters.

What types of reported problems can the Alliance address?

The Alliance can only address reported problems that directly relate to CERs non-compliance with the Code. In order to act upon a complaint, whether it is received through the Open Report section of the Web site or the Alliance Survey Monitoring Program, the Alliance will contact the health professional making the report to discuss the situation in more depth. After speaking with the health professional, the Alliance will contact the recruiter in an effort to resolve the problem while maintaining confidentiality,. The identity of a health professional will never be given to a recruiter without explicit permission.

How will reported problems be handled by the Alliance?

Alliance staff, in conjunction with a Compliance Committee appointed by the Alliance Governing Board, will review and investigate problems reported to the Alliance pertaining to recruiting companies. Upon a claim for non-compliance, every effort will be made to review, validate and investigate reports within 90 days of receipt. If a validated report reveals systemic problems embedded in a company’s business practices that result in non-compliance with the Code, the Alliance and said CER will enter into a remediation process to correct the problem. The Alliance will then manage the investigation, adjudication and crafting of proportional responses to unethical practices. Alliance CERs have agreed to participate in the review process, and where necessary, engage in mediation and remediation with the Alliance acting as a neutral facilitator.

If a report is received about a recruiting company that is not certified by the Alliance, the report will be documented and validated as thoroughly as possible and the recruiting company will be notified that a report is on record. The company will be invited to learn about the Code and consider becoming certified.

How long will the remediation take?

Although each situation presents unique issues and challenges, the Alliance will make every effort to complete formal remediation processes within 90 days of the close of the investigation period. As a result, the Alliance intends for reports that lead to remediation to remain “active” for no longer than a total of 180 days (90 days for the investigation and 90 days for the remediation process).

What happens if the remediation is unsuccessful?

The expectation is that organizations that are certified by the Alliance will make every effort to come into compliance with both the Code and our monitoring program. Should a company fail to successfully engage in the remediation process the Alliance will move to remove the company, revoking its status as a Certified Ethical Recruiter.

Why should I participate in the survey?

Participation in the survey is voluntary. However, all FEHPs are encouraged to share their recruitment experiences with the Alliance because it will help to ensure that the rights of all health professionals are respected.

Are the surveys anonymous and confidential?

Surveys are confidential, but not anonymous to Alliance staff. However, the Alliance will not disclose information submitted by a health professional without requesting permission.  A health professional will need to give written permission to disclose the identity to the recruiter if needed. The Alliance may be limited in both investigating and mediating/remediating if the health professional will not grant this permission.

Can I take the survey if I do not work for a CER?

Any foreign-educated health professional recruited to work in the United States is be permitted to complete the survey. They must request a survey from the Alliance. These health professionals will then receive an email from the Alliance containing a link to the survey. They may also report on recruitment practices through an open report.

While the Alliance cannot allocate resources to investigating and mediating problems with non-CERs, if requested by the FEHP the Alliance will:

  • Notify the company that the Alliance has received a report involving them and encourage them to read the Code and develop a plan to ensure compliance with its principles.
  • Refer FEHPs to relevant organizations for guidance and assistance.

How can I access the survey?

Health professionals who contract with organizations certified by the Alliance will be informed by the certified organization about the opportunity to participate in the survey. The individual FEHP will receive an email from the Alliance containing a link to begin the survey process and be prompted to complete additional parts of the survey via secure links sent by the Alliance at appropriate intervals.

Can I submit an open report if I am participating in the Alliance Survey Monitoring Program?

Yes. We invite you to submit an Open Report if you have completed a part of the survey and have additional information to share with the Alliance.

Can I submit an open report if I have submitted the same report to another organization?

Yes. If you have filed a lawsuit, submitted a complaint with a government agency, or contacted another organization for assistance/advice, please provide the Alliance with the details of your effort. Please let the Alliance know if they may follow-up with any identified organizations.

Whom should I contact with questions about the survey?

Please send all questions regarding the Alliance Survey Monitoring Program to staff@cgfnsalliance.org.