Recruiting a clinician from overseas is easy. Doing it so that everyone is better off, the clinician included, is the actual job.
I named the company Ethicare for a reason. The more both countries lean on internationally trained clinicians, the more it matters where those clinicians come from, what they were promised, and how they are treated once they land. Get that wrong and no amount of process rescues the programme. Get it right and recruitment quietly compounds: people stay, and they tell their friends.
On this page
Ethical recruitment is a wider lens than the vacancy in front of you. It asks two extra questions: what does this hire do to the country someone leaves behind, and is the person themselves better off at the end of it?
Done well, it strengthens the health system and changes a family’s life. Done badly, it burns trust and people leave. This chapter won’t recite the codes. It shows what ethical recruitment looks like in the decisions you make.
The reliance is just as clear in nursing: a third of New Zealand’s nurses (33%) and almost a fifth of Australia’s (18%) trained overseas, against an OECD average of 9%. When a health system leans this heavily on international professionals, how they are recruited is not a side issue. It is a question of the system’s integrity.
Part 01Why ethics matter
Ethics aren’t a compliance add-on at the end of the process. They’re central to whether a workforce lasts.
What ethics protects
- Recruitment as a partnership, not a transaction
- The health systems of source countries
- Sustainable workforce development at home and abroad
- Trust with the candidates who place their future in your hands
- Your organisation’s reputation and standing
- Long-term retention, which begins with how people are recruited
No OECD country relies on overseas-trained nurses more than New Zealand, where a third of nurses and 42% of doctors qualified abroad. Australia is close behind, at 18% and 31%.
Choosing where to recruit
Responsible sourcing starts with a simple discipline about where and who you recruit.
The WHO Global Code of Practice and the UK’s Code of Practice for International Recruitment exist so that solving one country’s shortage never deepens another’s. They set the floor we build on. Our own test is three questions, in order: not just can we recruit, but should we, and how do we do it responsibly?
Respect the safeguards
- No active recruitment from safeguarded countries
- Government-to-government agreements only
- Transparency on source countries
Fair treatment
- No recruitment fees to candidates
- Clear, honest contracts
- No debt or tie-in traps
Mutual benefit
- Skills and remittances flow back
- Circular, not extractive
- Long-term relationships
Not every healthcare professional living in a country trained there. Many experienced clinicians are already working internationally (in the UAE, in Singapore, across the Gulf), often having qualified elsewhere years earlier.
Recruiting these already-mobile professionals lets you build a workforce ethically while minimising the impact on any one country’s domestic health system. Individual circumstances matter, and they reward looking at each person’s story rather than their passport.
Fair and transparent recruitment
Someone moving countries is often making one of the biggest decisions of their life. They deserve the full picture from the very first conversation.
Honest information (the opportunities and the challenges, not just the brochure) means people arrive with likely expectations and are far more likely to stay. That covers salary, registration requirements, immigration advice, costs, timeframes and any conditions, communicated respectfully and kept up to date.
The path
- Registration & timelines
- Immigration requirements
- Supervision requirements
The offer
- Employment conditions
- Salary & benefits
- Relocation costs
The life
- Career development
- The realities of the role
- Living in a new country
Every candidate should understand
- What is expected of them
- What support is available
- What challenges they may face
- What success looks like
Removing barriers
Every professional deserves to be assessed on what they know and what they can do, not on assumptions about where they trained, their nationality or their accent. Unconscious bias is usually unintentional, but it quietly shapes shortlisting and interviews in ways that overlook capable clinicians.
It’s easy to treat training from a familiar or “comparable” system as a proxy for quality. But once a candidate has been assessed and registered by the relevant professional board, their competence has already been independently verified against the standards of the country they’ll practise in. Some of the most capable people I worked alongside in the NHS trained in the Philippines, in parts of Africa, in India and beyond. They met the same bar, and became the backbone of their teams.
Widening opportunity, not narrowing it
- Recognise transferable experience and equivalent systems
- Look past country stereotypes
- Support people through registration and English-language requirements
- Guide candidates through complex processes
- Provide workplace readiness before day one
International recruitment should widen opportunity, not create unnecessary barriers.
Part 05Supporting people, not placements
People don’t relocate alone. A clinician arrives with a partner, perhaps children, often extended family, and a whole life to rebuild alongside a new job. Ethical recruitment treats the journey as a human one: long, sometimes anxious, and far better for regular, honest communication.
Family
- Partners & children
- Schooling & childcare
- A partner’s own career
Wellbeing
- Culture & belonging
- Mental health
- Community connection
The journey
- Long recruitment timelines
- Regular communication
- Pastoral support throughout
Four checks before any campaign starts:
- Check the WHO Safeguards List before choosing where to recruit.
- Ask should we recruit here, not just can we.
- Give candidates the full picture: costs, timelines and conditions included.
- Assess people on capability and values, never on accent or where they trained.
Building trust
Ethical recruitment compounds. Do it well and you earn long-term relationships, candidate referrals, employer partnerships and a professional reputation that quietly does your recruiting for you. Transparency and continuous communication are what turn a single placement into a lasting one, and a good experience into the next three candidates.
Regulators
- Work collaboratively, not around them
- Respect the standards they set
Reputable partners
- Shared ethical principles
- No fees ever charged to candidates
The long term
- Universities & employers
- Relationships, not transactions
Ethical recruitment is a shared responsibility
Too much of this gets left at the recruitment partner’s door. It only works when everyone involved holds the same line, from the employer signing the offer to the regulator setting the standard.
Ethical recruitment is shared across
- Employers
- Workforce planners
- Regulators
- Immigration services
- Professional bodies
- Recruitment partners
When everyone works to the same standard, nobody has to choose between filling a rota and doing right by the person who fills it.
An ethical recruitment checklist
- Is international recruitment needed?
- Have domestic workforce options been explored first?
- Are we recruiting in line with international ethical guidance?
- Are candidates receiving clear, accurate information?
- Have we been transparent about costs, registration and timelines?
- Is pastoral support available throughout the journey?
- Are hiring managers prepared to support internationally trained professionals?
- Are we measuring success through retention, not recruitment alone?
Sources
- OECD, International Migration Outlook 2025 (2023 data).
- WHO Global Code of Practice on the International Recruitment of Health Personnel.
- WHO Health Workforce Support and Safeguards List, 2023.
Building your international workforce?
We run international recruitment to this standard: ethical, prepared, supported and measured on retention. Let’s talk about doing it well.