Frequently Asked Questions

The following is a list of frequently asked questions about the Alliance for Ethical International Recruitment Practices (Alliance).

If you have a question that is not listed, please email staff@cgfnsalliance.org.

About the Code

The Health Care Code for Ethical International Recruitment and Employment Practices establishes best practices for the international recruitment of health care workers. The principles set forth in the Alliance Code aim to provide protections and benefits for all parties involved in the international recruitment process.

The Code was created in 2008 by a diverse group of stakeholders representing unions, health care organizations, educational and licensure bodies, and recruiters. It is currently overseen by the Alliance Advisory Board.

The Alliance released the 4th edition of the Code in 2023 and is committed to regularly reviewing and updating the Code to best protect the rights of immigrant health care workers and to reflect current best practices in the international recruitment landscape.

The Code is a reference for anyone who participates in the international recruitment process—foreign-educated health professionals (FEHPs), recruiters, and employers.

  • Health professionals educated outside of the United States can use the Code to learn about their rights and responsibilities as immigrant healthcare workers. FEHPs are also encouraged to refer to our list of Certified Ethical Recruiters who comply with our Code when choosing a recruiter.
  • Recruitment firms that hire FEHPs for work in the U.S. can use the Code to learn about best practices for fair, ethical, and transparent international recruitment that protects and benefits all parties involved. Recruiters are encouraged to comply with the standards set forth in the Code and apply for Alliance Certification to demonstrate their commitment to ethical recruitment.
  • Health care institutions who employ FEHPs can use the Code to learn about ethical standards in international recruitment in order to make informed decisions when choosing to partner with a recruitment firm. These institutions are also invited to endorse the Code in order to demonstrate their approval of and commitment to ethical practices.

About Certified Ethical Recruiters (CERs)

Certified Ethical Recruiters (CERs) are recruitment firms that have demonstrated compliance with the Alliance Code and have submitted their recruitment practices to additional oversight by the Alliance. A full list of Alliance CERs can be found here.

Any organization that recruits foreign-educated health professionals (FEHPs) to work in the United States is eligible for Alliance Certification. The Alliance divides international healthcare recruitment into two models based on the final employer: direct and staffing.

  • Under a direct model, the FEHP signs an employment contract directly with the healthcare provider. This recruitment can be managed solely by the provider, or it can be facilitated by a placement firm, a recruitment agency that assists during the migration process and acts as a “matchmaker” between the FEHP and the provider.
  • Under a staffing model, the FEHP signs an employment contract with a recruitment agency that has been hired to staff specific healthcare facilities. The FEHP is employed by the staffing firm and is assigned to a healthcare provider, but may be required to change providers during the contract period.

The Alliance offers additional oversight into the recruitment practices of CERs in order to ensure their compliance with the Code. CERs agree to regular survey reviews of their practices by the Alliance, allowing health professionals to confidentially share their experiences with their recruitment firms.

The Alliance also accepts inquiries and reports from health care professionals directly. If you have a question or concern about an Alliance Certified Ethical Recruiter, please contact us at staff@cgfnsalliance.org. All inquiries are confidential.

When a report of noncompliance concerning a CER is received, the Alliance will launch an investigation and bring the issue before the Advisory Board’s Compliance Committee. Following the guidance of the Compliance Committee, the Alliance will seek mediation and/or remediation with the CER to address the compliance issues. If a CER fails to maintain compliance with the Code, they may have their Alliance Certification revoked.

Recruitment firms become certified through a three-step process:

  1. Application – The recruiter completes our certification application, attesting to complying with our Code and providing a copy of their standard employment contract to demonstrate compliance.
  2. Survey – The Alliance disseminates a survey to all health professionals employed by the firm, allowing the employees to confidentially share their experiences.
  3. 30-day public comment period – The recruiter and the Alliance call for public comment on the application, allowing any other individual or organization to share support, concerns, or additional information about the firm.

More information on the Alliance Certification process can be found on the Certification page of our website.

An Alliance Certification Candidate is a recruitment firm that has completed the initial application for certification but has not completed the survey review in order to demonstrate commitment to the Code. In order to complete the survey stage of the certification process, a recruiter must have been actively recruiting FEHPs to the U.S. for over a year. Recruiters that do not meet this requirement are invited to apply as Alliance Certification Candidates as they await the required one-year commitment to the Code for final review.

A full list of Alliance Certification Candidates can be found here.

Questions from Foreign-Educated Health Professionals

Alliance Certified Ethical Recruiters (CERs) have committed to upholding the Alliance Code, which protects the rights of immigrant health care workers. CERs submit to oversight from the Alliance which ensures that they continue to practice ethical international recruitment. If a report of non-compliance is issued against a CER, the Alliance can work with the firm through mediation and/or remediation to address the complaint.

The Alliance serves as a confidential, third-party resource for migrating professionals and welcomes any questions or complaints regarding unethical international recruitment practices. You can contact us about your contract, recruitment fees or breach fees, non-compete clauses, or any other issue that arises during your recruitment process with any recruiter.

If you are making a report of non-compliance against CER, find out more here. If your concern involves an uncertified recruiter or rises to the level of legal action, the Alliance’s response may be limited. However, we are always available to answer questions and recommend additional resources to help address your specific concerns.

Please send any questions or complaints to staff@cgfnsalliance.org.

Any inquiry or complaint made to the Alliance will be kept confidential. We will never share your information or any revealing information about your situation without your express consent.

While participation in the Alliance survey is voluntary, we encourage all FEHPs to share their recruitment experiences with the Alliance. Doing so helps us to ensure that our CERs continue to uphold ethical standards and can alert us to potential issues or violations of the Code.

Alliance surveys are always confidential, and your personal responses will never be shared without your consent. If you have any questions about the survey, please contact the Alliance at staff@cgfnsalliance.org.