Healthcare Worker Guide

Hospitals across the United States are facing a full-blown staffing crisis, especially in rural and underserved areas. Nurses, physical therapists (PTs), and occupational therapists (OTs) are in critically short supply, and U.S. employers are looking north to Canada for help.

If you’re a Canadian healthcare professional considering work in the U.S., or a hospital administrator trying to fill essential roles, this guide cuts through the noise. No fluff. No scare tactics. Just the real pathways that work, especially the growing use of EB-3 green card sponsorship through rural hospital partnerships.

Why U.S. Hospitals Are Turning to Canadian Healthcare Workers

A Nationwide Shortage With No Quick Fix

The numbers don’t lie. The U.S. is facing long-term shortages of frontline healthcare workers due to:

  • An aging population requiring more care
  • Burnout and early retirements after COVID
  • Fewer new graduates entering bedside roles

Rural hospitals are hit the hardest. Many simply cannot recruit or retain enough U.S. workers to keep departments open.

Canadian professionals are an obvious solution. Training standards are comparable, English fluency is a given, and many Canadian licenses translate smoothly to U.S. credentialing requirements.

Common U.S. Visa Options for Canadian Healthcare Professionals

TN visas: fast, but temporary

Most Canadians start with a TN visa under the USMCA (formerly NAFTA). Registered Nurses, PTs, and OTs often qualify.

Pros:

  • Fast processing
  • No annual cap
  • Ideal for quick job starts

Cons:

  • Temporary and non-immigrant
  • Must be renewed regularly
  • Not designed for long-term settlement

TN status is a great entry point, but it’s not a permanent solution.

The Game-Changer: EB-3 Green Cards Through Rural Hospital Partnerships

Why EB-3 Is Gaining Momentum

With staffing pressures intensifying, more hospitals, particularly in rural areas, are sponsoring EB-3 employment-based green cards for Canadian healthcare workers.

The EB-3 category allows U.S. employers to sponsor foreign workers for lawful permanent residence when they cannot find enough U.S. workers to fill the role.

For many Canadian nurses, PTs, and OTs, this is the most stable long-term option available.

“We’re seeing a real shift,” says Rosanna Berardi, Esq., Managing Partner of Berardi Immigration Law. “Rural hospitals are stepping up with EB-3 sponsorship because they need permanent, reliable staff, not short-term fixes. For Canadian healthcare workers, this can be a clear and realistic path to a green card.”

How EB-3 Rural Hospital Sponsorship Works

Step-by-Step Overview

  1. Job offer from a qualifying U.S. hospital
    The employer must show a legitimate, ongoing need for the role.
  2. PERM labor certification
    The hospital proves it tried, and failed, to recruit U.S. workers at the required wage.
  3. Immigrant petition (I-140)
    Once PERM is approved, the employer files the green card petition.
  4. Green card processing
    The worker completes consular processing or adjustment of status (if eligible).

This is not an overnight process, but for many healthcare workers, it’s worth the wait for permanent status.

Why Rural Hospitals Are Ideal EB-3 Sponsors

Less Competition, More Opportunity

Rural and underserved hospitals often have:

  • Chronic staffing gaps
  • Fewer competing applicants
  • Greater flexibility and urgency

That combination makes them more willing to invest in long-term sponsorship.

Stability for workers and employers

Unlike temporary visas, EB-3 allows healthcare professionals to:

  • Live and work permanently in the U.S.
  • Bring immediate family members
  • Build long-term careers without constant renewals

Hospitals benefit from reduced turnover and continuity of care.

Licensing and Credentialing Still Matter

Immigration approval alone is not enough. Canadian healthcare workers must also:

  • Obtain state licensure
  • Complete credential evaluations
  • Pass required U.S. exams (if applicable)

Timing matters. Immigration strategy and licensing should be coordinated from day one to avoid delays.

Planning Ahead: TN Now, EB-3 Later

Many successful cases follow a two-step strategy:

  1. Enter the U.S. quickly on a TN visa
  2. Transition to EB-3 green card sponsorship once employed

This approach allows hospitals to fill urgent roles while building a permanent solution behind the scenes.

Opportunity Is Real But Strategy Matters

The demand for Canadian nurses, PTs, and OTs in the U.S. has never been higher. Rural hospitals, in particular, are opening doors through EB-3 green card sponsorships that simply didn’t exist at scale a few years ago.

That said, healthcare immigration is technical, highly regulated, and full of traps. The right visa, the right timing, and the right employer make all the difference.

Berardi Immigration Law works closely with healthcare professionals and medical institutions on both sides of the border to design strategies that actually hold up, on paper and at the border. Click here to schedule your consultation today.

Canadian Healthcare Worker FAQs

Can Canadian nurses apply directly for an EB-3 green card?

No. EB-3 requires employer sponsorship. You must first secure a qualifying job offer from a U.S. hospital willing to complete the process.

Are rural hospital EB-3 cases faster?

They can be. While government processing times still apply, rural hospitals often face less competition in recruitment, which can streamline the PERM stage.

Can I bring my family with me on EB-3?

Yes. Your spouse and unmarried children under 21 can receive green cards as derivatives.

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