Canadian Travel Therapy: Can Canadian Therapists Work in the US?

So… you’re Canadian… but you can work as a physical therapist in the U.S… but you don’t live here… ?

—These are the inevitable follow up questions I get from patients, colleagues, Canadians and Americans alike. The answer is “yes,” and I’ll tell you how I did it! 

Guest Post Written for Travel Therapy Mentor by Eni Kader, Canadian PT working in the US as a Travel PT

Licensing & Education

The Canadian and U.S. physical therapy (or physiotherapy) licenses are unfortunately not equivalent. In order to work in the US, a Canadian-trained physiotherapist would have to choose a state to become licensed in, then go through the process of applying for and writing (taking) the NPTE, prior to attempting working and travelling in the U.S. 

I personally went to PT school at D’Youville College in Buffalo, NY. I decided to continue living in Canada and commute over the border for school instead of living in the U.S. To make this process easier, I applied for my Nexus Trusted Traveller pass, which expedited the border process significantly. In fact, some of my Buffalonian classmates had a longer commute to school than I did!

I went to school under an F-1 Visa, which meant that I was approved to commute over the border to school while maintaining my residence in Canada. In order to be approved for the F-1 Visa, I had to first be accepted to the school, then for each year of study, I had to have the immigration officer at my school sign off on my I-20 which I brought to the border for approval. More info on this here.

After completing my Doctor of Physical Therapy degree in the United States, I wrote the NPTE and went through the licensing process for NY physical therapy licensure. Unless you are a dual citizen, this still does not allow you to legally be employed in the U.S. See the Work Visa section below to learn more about the next steps.

For those who went to PT school in Canada, you would need to check the state-specific guidelines for internationally-educated applicants, but for the most part, the NPTE eligibility criteria is your first hurdle to overcome. In order to be eligible for the NPTE, you must have been educated by a CAPTE accredited institution, and some Canadian physiotherapy schools are listed in their Previously Accredited Foreign Programs. Some states may require you to show proof of eligibility to work in the U.S. (see work visa info below), and an equivalent education.

Work Visa 

If you are a Canadian who has gone to school in the U.S., F-1 students are eligible for the Optional Practical Training (OPT) Visa, which allows you to work in your field of study in the US for up to 12 months after graduation. There are some restrictions around this Visa, and you can find out more about it here. I personally chose not to go this route because I was late for the application process and wasn’t sure what my moves were going to be when applications were due. I did have Canadian classmates go this route and the immigration officer at my school was an excellent resource for information. 

As a skilled healthcare worker and Canadian citizen, I was eligible for a TN Visa under NAFTA, which is what I work under now. The TN visa is different from the H1B because it does not allow you to work permanently in the U.S. as a resident, however it can be renewed indefinitely. It tends to be a little more cost-effective and time-efficient if you don’t plan on settling in the United States permanently. More about H1B visas here.

The TN visa is specific to the travel company you are working with. This means if you plan on working with multiple recruiters, each one would have to sponsor you for a separate TN visa once you sign a travel contract and are ready to work with them (more on the TN visa process below). 

The licensing and work visa process can take a lot of time, especially if you miss any steps or paperwork. Thankfully, I work with a large travel recruiting company with an immigration department that was very knowledgable about the whole process and helped guide me through it. I used the Department of Homeland Security websites, travel therapy and immigration forums to answer my questions. I didn’t personally go this route, but some people choose to consult with an immigration lawyer to make sure the process goes smoothly. 

TN Visa

The TN visa requires a Visa Screen for approval, so you can start the Visa Screen process before you plan on working, and once you have the Visa Screen in-hand, you can actively look for travel contracts without the TN. Once you have a contract, you’d take the Visa Screen with all the things (see below) to the border for TN approval and then you can officially work! 

As I mentioned before, I found it very helpful woking with a larger travel company that was familiar with the TN Visa process. I prioritized looking for a recruiter and travel company that was experienced working with Canadian Citizens because I wanted to make sure I didn’t make costly mistakes in the process. Thankfully, my recruiter and travel company had tons of experience and access to immigration specialists that answered any questions that arose. 

Visa Screen

In order to be approved for a TN visa, all applicants are now required to produce a Visa Screen. The Visa screen is a tool that allows border officers to verify an applicant’s credentials when they apply for approval. 

There are two main companies that do the Visa Screen: CGFNS and FCCPT.  I opted to go with CGFNS due to cost and my recruiter’s experience with them.

Visa Screen process:

• CGFNS: https://www.cgfns.org/faq/visascreen/applying-for-visascreen-visascreen-credentials-assessment/
• FCCPT: https://www.fccpt.org/Requirements/How-to-Apply/Application-Fee-Schedule 

When I was ready for my contract, I took the Visa Screen, letter of employment + contract dates from my company, my US (New York) PT license, PT school diploma & Canadian passport to the border for validation, and then I was eligible to begin work in the US!

More Info Here: https://www.uscis.gov/working-in-the-united-states/temporary-workers/tn-nafta-professionals

Note, this is simply what I did for my situation. Each individual should take their own situation into consideration and contact immigration services in the respective countries for accurate, up to date info. 

Other Considerations

In addition to getting your license and work visa taken care of to be allowed to work in the US, there are some other logistical considerations for working and living temporarily in the US:

Banking 

• As a Canadian Citizen, I had to apply for a SSN with my TN visa in order to be able to open a US bank account and be put on payroll. I found it easiest to go with my Canadian bank’s U.S. Branch and have my U.S. credit card through them too. 
• Exchange rate: consider when paying Canadian bills such as your rent or loan payments. 
• US credit card: to save on exchanging rates and fees that a Canadian credit card would place on you.
  • I also applied for this low-limit credit card to begin building my credit score in the U.S. which has come in helpful when doing background checks for landlords

Health Insurance 

• Go through your travel company as anybody would normally because Canadian health insurance doesn’t typically cover your expenses when you’re abroad. 
• I make sure I get appointments scheduled in between contracts and travel home for those.
• At the time of writing this, some people may also need to consider a 14 day mandatory quarantine coming into Canada, so take that time into consideration as well and call ahead to your border crossing as regulations are constantly changing.

Taxes 

• Travel tax & tax home are the same as for U.S. travellers but you claim your tax home in Canada instead. I used TravelTax.com for their expertise, and they helped me when it came time to filing taxes as well. 
• As my tax home is in Canada still, I pay my taxes to the U.S. first then pay the difference to Canada (since Canadian taxes are higher). As I mentioned, I used a tax professional to avoid mistakes. 

Tips for Canadian Travel Therapists

• Give yourself lots of time to get through the process from start to finish 
• Keep documents with you at all times during your travel assignment, especially if you will be travelling via airplane or crossing the border. I keep an electronic scanned copy of my documents on my phone using the Genius Scan app so I can access things quickly. 
• Try and get your healthcare check ups done in between assignments as mentioned earlier. This is typical of any traveller, though! 

Summary

If you’re a Canadian looking to travel the U.S., learn a ton, and have greater flexibility with your career, don’t let the process stop you from going after it! I’d highly recommend beginning the process as soon as you can and just taking it one step at a time. I’ve been grateful to take advantage of the flexibility of my travel therapy career, live in some amazing places, and connect with other incredible professionals as well. If given the opportunity, I hope you do too!

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We would like to thank Eni for this educational guest post! If you have further questions specifically about traveling in the US as a Canadian citizen, please contact Eni via the links above. If you’d like help getting started with travel therapy in general or getting connected with travel therapy recruiters, please contact us here.