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When recruiting IMGs and INGs, healthcare leaders must consider the ethical implication of the rights of the workers themselves and the domestic staffing shortage in America. According to Fried and Fottler, America does not have rules on the practice of recruiting international healthcare workers (Fried and Fottler, 2008). This could pose issues with the healthcare leaders because what is ethically right in recruitment is not officially stated. Healthcare leaders will have to be careful how they go about recruiting because of the potential of not recruiting ethically. Healthcare leaders also need to take into consideration the rights international workers have when recruiting them. Since the U.S. has not officially stated these rights, employers must make their own judgment on how to implement the same rights to both international and domestic healthcare employees. They also need to take into consideration the domestic staff that could be losing jobs to international employees. There is a shortage of domestic staff that is leading to an increase in international staff; however, since international staff is willing to work in certain conditions some domestic employees are not getting jobs in the healthcare field. This could cause an even bigger domestic staff shortage. Leaders need to also start training more domestic staff to be self-sufficient in order to combat the domestic staff shortage and rely less on international staff (Fried and Fottler, 2008). These issues would be easier to solve ethically if the United States would create policies on IMG and ING recruitment. It is difficult for leaders in healthcare settings to judge what is ethically right without a basis to go off of. Nevertheless, if healthcare leaders increase their empathy and cultural awareness training they will be able to be more ethical in their decisions. By being culturally aware of the issues that international employees may go through, a leader can make sure that IMGs and INGs are getting treated fairly and right in their company. If leaders develop better empathy they can also make more ethical decisions that will positively impact their company. 


Sampson, C. J., & Fried, B. J. (2008). Chapter 3. In Human Resources in Healthcare: Managing for Success (3rd ed., pp. 58–65). essay, Health Administration Press.

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Healthcare leaders and managers must face ethical issues when recruiting IMGs and INGs within their receiving countries. When a health worker leaves his or her country to work in a place that is more desirable, the sending country is left without a worker that could positively impact the overall health of the population. Over time, if more and more, workers are sent without the proper infrastructure to ensure the home population is healthy, the sending country may face shortages. The US is facing possible repercussions due to a lack of steps taken to prevent negative impacts of international recruitment (Fried & Fottler, 2014, p. 65). While some managers’ main worries may lie within the supply chains of its migrant health workers, these managers should also think about the possible damage they are causing to the sending country’s health systems.

Leaders must also face the ethical dilemma of placing IMGs and INGs in organizations that are not ideal for a migrant health worker. Khan-Gokkaya and Mosko (2020) state that some of the main challenges that IMGs or INGs face are language barriers, discrimination, and exploitation. An argument can be made that the US and its health leaders have a duty to prepare their organizations to properly receive and help orient refugee health workers to eliminate the barriers they face. This is an ethical issue because no worker should experience negative treatment because of their culture, and leaders can implement policies and initiatives to directly attack these barriers that IMGs and INGs face.

One of the ways that health managers have tried to combat discrimination and exploitation is through empathy and cultural awareness training. This type of training may teach native workers learn how to help migrant health workers adapt to their different organizational culture. Through increased awareness of the challenges that IMGs and INGs face, organizations will hopefully become a more refugee worker-friendly environment.



Fried. B. J. & Fottler. M. D. (2014). Human Resources in Healthcare: Managing for Success. Health Administration Press.

Khan-Gokkaya. S. & Mosko. M. (2020). Labour Market Integration of Refugee Health Professionals in Germany: Challenges and Strategies. International Organization for Migration. 


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