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How to Immigrate to the US as a Medical Technologist

Hi everybody, and welcome. It's Friday. So it must be Connetics USA weekly show onwards and upwards. Everything that a healthcare worker needs to know about coming to live and work in the United States. I am your host, Tanya Freedman. And we have an exciting show for you today. We had a few Friday gremlins. So unfortunately, we're not able to stream on stream yard, which is what we typically do every Friday, but we will be using zoom. So unfortunately, I'm not going to be able to take questions in the chat. But we have an expert panel that will be joining us today. And we're very excited to talk about our topic. med techs made medical technologists coming to the United States. So we are very excited to get started today. And I am joined by our guests, and we are going to be joined by Elissa Scotland. Hi, Alisa. Welcome. You are new to Elissa. Elissa, you unmute.

Good morning, everyone. Oh goody. Well, good morning. Good evening, wherever you are in the world. Welcome. Welcome. We are also joined by Paul welcome, Paul. Hello, good morning. Morning, Paul. May be wherever everybody is in the world. And we are joined by Ali. Welcome, Ali. Hi, Good day. Good morning. Good evening, wherever you are in the world right now. Thank you for joining us, Ali. And we also have a few guests that will be joining us later in the show. So if you are watching today, and you're interested in coming to the United States, please apply to Connetics USA, we would love to help you if you are a registered nurse, if you are maitake if you are a CNA, a nurse aide or lots of different positions available throughout the United States. And we would love to have you join us in the United States. So we're gonna get started on the show. I'm going to try and juggle back and forth and see if I can take some questions in the chat as well. Because this is not typically how we do things. And go we're doing the show on Zoom. And but I'm gonna get started now and we're going to start with some introductions. So, Elissa, do you want to go ahead and introduce yourself?

Certainly. Well, thanks for having me here. Today. I'm an International Healthcare recruitment consultant, formerly a physician, and I've lived worked and studied on three continents, and I'm delighted to now be living my USAA dream. Okay, well, we excited to have you here. Alyssa, as a physician, I think you bring an interesting perspective. But I know that you've been working with allied health care workers for some time now. So a lot of pointers and tips that Elissa is going to be able to share with everybody. And Paul, do you want to go ahead and introduce yourself? Sure. My name is Paul, I am a I'm a licensed clinical laboratory scientists medical technologist, whichever you prefer. I have been in the field since the early 90s. I'm a bit different than most clinical laboratory scientists. My background is in it. I do have experience in the lab on the bench, obviously. But my primary background is information technology.

Okay, so interesting background. And Paul is going to give us his perspective from the employers side. And last but not least, Ali, do you want to go ahead and introduce yourself, Ani. Thank you. Hi, Good day. Good evening, everybody. So I'm Ali Brian. And I am a medical technologist here in New York, USA. And I've been in the practice for seven years, more or less seven years in the Philippines. And in that span of years, I've been practicing as an academic and at the same time working in the hospital setup. So I would say that on my years of experience, I have both worlds of the academia and the actual practice. Okay, great. Arisa. We look forward to learning more about your journey of coming to the United States and seeing what that was like for you. So Elissa, let's start off with you. And just let's give a definition. Paul was talking about medical technologist clinical lab scientist. I know there are lots of terms that can be bandied around like historic technologist, medical lab technician. When we speak about med techs, what are we actually speaking about? So these are all clinical laboratory professionals that prepare and analyze a variety of biological specimen specimens.

So the terms are technologists and scientists, and medical and clinical, these terms are interchangeable with each other. So a technologist is or a scientist performs more complex tasks and tests and laboratory procedures than a technician. And then you mentioned about a hysto technologist. Well, history has to do with tissue. So someone working in histology deals with the thin slices of human tissue, whereas the other what we would normally call med techs deal with other bodily fluids and blood, urine and bodily connect like this. So that's the main difference. Okay, well, thank you for clarifying that, that for us. So today's show is going to be specifically about medical med techs. And Ali, did you always want to become a med tech tell us about that?

Well, frankly speaking or Honestly speaking, I would say that being a medical technologist was not really my first choice when I was planning my future when I was still in high school. But I would say that there are no regrets as to my position as a medical technologist now here, and actually practicing what I have learned in the school, I would say that I have learned to love my profession. And I have embraced all its difficulties and all its challenges. And I would say, based on my years of experience, as a medical technologist, I would say that I love the challenge. I love the adrenaline of the profession. The pressure is what keeps me energetic and enthusiastic every time I go to work.

Okay, good. So the love evolved it. Yeah, you did. Paul, did you always want to become a med tech? Because it sounds like you had a varied background as well.

Yeah, I know, that was not my first choice. My first choice was engineering. And I found that that didn't quite agree with me. In the long run, and I basically I fell into medical technology, kind of as a secondary option. But, you know, like, all the, over the years, this is it has been very good to me. I mean, obviously, I'm here with you guys talking about. So yeah, it has changed over the last 25 years. It's become very interesting. And we can get more into that later. But yeah, I would agree that was not my first choice. But it was a good choice. It was the choice that was that I was meant for. We don't always know what's best for us. And sometimes the best comes for us.

Sometimes it's a little bit of a zigzag. It's you kind of move in one direction. And in another even unless there's not your head there being a physician and now working as an allied recruitment, probably something you didn't anticipate either Elissa. Correct. So, Paul, what made Methodist le bonheur decide to look at hiring international med techs? Well, obviously, we have a difficult time finding local, clinical laboratory scientists. We have we have some local schools, or a local school. However, we have many, many hospitals, several systems in the area. And we're only graduating, if I remember correctly, somewhere between eight and 12 scientists here. So that's difficult to compete with particularly when, you know, they're not necessarily planning to stay in the area. And I have experience previously with international Associates, and a very positive so, you know, in discussions with our senior leadership in the system, that was what kind of pushed us into considering this, and it has been a very good process so far.

Okay. And I think, Paul, you probably would agree that this is very, very common for most healthcare facilities in the United States right now. Yeah, I would absolutely. I think very much across the entire country. There is a shortage of clinical laboratory scientists, and it is very difficult to compete for a really good med tech. Yeah. And that really is a problem in the United States, but also an opportunity for international med techs who want to come to the United States like Ali. Ali, did you always want to come to the United States? Um, I would say at first, when I first graduated as a medical laboratory scientist, I did not really have any plans in migrating in the United States. But then as Time passes by, I been aware of the opportunities of a medical technologist here in the United States. And I would say that compared to any other countries, indeed, the United States opens the doors to its medical laboratory scientists not only inside the four corners of the laboratory, but also outside what is happening in the laboratory. What is good in the United States is that it offers a lot of opportunities for medical technologists here, med techs can practice beyond their profession. Some can become directors, some can become a sales associate some with work in the crime scene and all of those things. So the opportunity is limitless here in the United States, when it comes to our profession as medical laboratory scientists,

lots and lots of opportunities. So if you are med tech now watching anywhere around the world, this is an opportunity. As Paul said, there are many healthcare facilities like Methodist le bonheur, amazing organization and many other opportunities around the United States. And as Ali said, there's more opportunity here in the United States, and probably there's ever been. So now is the time to become to come to America, if that's something that you've been considering. And I feel so cut off this morning. And because we are usually on stream yard, and I can take questions in the chat, and we can show pictures and slides and videos. So today, unfortunately, we're a little bit more limited because of a technical hitch with stream yard. And I know only we had some great pictures that you had shared of life in America. So we're going to post those into the chat. Because I think it's really fun for everybody to see the  life and the experience that you have been, you know, that you have had here in the United States. And I see that we also have Don Hudson joining us. Hi, Don, welcome. Oh, Don is no stranger to onwards and upwards. So welcome back, Don. And we have a few technical hitches, but Don, do you want to go ahead and introduce yourself?

Absolutely. I'm Don Hudson, and I am the chief talent officer for Metalist the Bonner healthcare. And, you know, we are a amazing organization here in Memphis, Tennessee. And our role is to serve our community. And we do that through great health care, but also just really caring about the people that come here. And, and that's our associates, you know, we can't treat our patients any better than we treat each other. So our organizational culture is really important to us. And, and it will be to you too, right. It's not just what you do in life, but it's who you do it with that matters most. And so we try to be a great place to work and we are recognized as a great place to work. And then we tried to serve our community about being at our best so we can help them be better too.

Thank you, Don, and we love Methodist Levana, we have placed hundreds of nurses at the facility and many med takes as well. So really an awesome place to work. And if anyone is interested in Methodist Levana, please check out the showcase that we did on metallers Levana. Don, I don't know how long ago it was I think it was quite a few months ago already. The year has flown a year yeah, maybe a year ago. Yeah, they did back in the spring. Yeah, might have been the spring. So a few months back. So please check that out on the Connetics USA website. And if you want to learn more about Methodist Levana and what an awesome organization it is. And so if we move forward now, Elissa and start talking about the process of coming to the United States. Obviously, there are the immigration requirements. They are the occupational requirements. And then there's the institutional requirements. So if we talk about the success path of coming to the United States, and we talk about oh, there we go, we be able to show some slides, which is great. And Elissa, do you want to talk us through just how does it may take know if they are eligible, those first few steps on that success path that need to be taken in order to come and live and work in the United States.

Right. So if we look at this chart here, this path we can see all the way on the left side. Step one, it's  referring to the ASEP. And this is the American Society for Clinical Pathology. We've just got a different slide. Let's think we're having an issue. Yeah. Like Gremlins are at us this morning. I have my own version here. So this is this is really the first step is passing the appropriate exams. So usually it's the medical laboratory scientist examination through this organization. And we mentioned earlier about histo technologists, they have a slightly different exam, to take through the ASEP. So that's the very first step. And the ASEP has their own eligibility criteria. And all of that can be found on their website. The next step is passing an English proficiency exam. And so this is the same exam that the nurses take as well and other healthcare professionals, they're the main two things to be doing. And as well as that there are some occupational, excuse me some institutional requirements, and all these can be done at the same time, you know, while you're working you, you learn and you learn on the job, and you're revising for the exam, you have colleagues around you to support that and to speak English to as well to practice with the proficiency exam. And those two are the key elements for obtaining the visa screen certificate. And this is really, this forms the foundation or the base of being able to come here in the USA. And then of course, the institutions have their own minimum and different criteria, depending on the laboratory, or the department within the lab, the bench. Yeah,

thank you, Alyssa. So that gives a really great roadmap of the steps from a licensing credentialing perspective, the exams that need to be taken by a may take in order to come and live in the United States. Ollie, can you share your journey of going through that process? What it was like for you? The asipi, or the English exam? The visa screen? Yeah, um, well, income, unlike in me, other applicants for my application, I had to break it down into several years for financial reasons, because I think any other medical technologist will agree with me that these requirements are actually expensive. So I first started my ASCP examination around 2014. And after that, I really did not have any plan of using my CPA examination to work in the United States, I simply took that examination for you know, credential purposes, and just to have the experience of, you know, taking the examination, because at that time, I was a fresh graduate.

Now, after two years or so I took my IELTS examination. And that was around 2016. And then after that, still, I wasn't 100% sure to use my English examination to apply here in the United States, when finally he came out 2018, where I decided to take up the visa screen application and pursue a career him here in the United States. So 2018 was the time where I really decided myself to apply here in the United States. So I compiled all the requirements as what Ellie mentioned, and applied for a visa screen certification. And once I received my visa screening certification, we took our which took around three months or so at that time, I started applying to different facilities until 2019, where an employer actually took notice of my application. And they patiently until I arrived, I arrived here in the United States come 2022. So it was really a long journey for me, a long journey, my goodness. And as I was saying, how it is possible to do it quite quickly. But you know, it just depends on your circumstances. And as you mentioned earlier, it's expensive.

It really is expensive to go through that process. One thing just to mention is that as a Connetics may take your place to Connetics, if you have passed the ACPI, and you get a job through a Connetics employer, like a Methodist Levana, for example, Connetics pay for the course for you to do your initial exam. This is part of the Connetics care package. It's our way of paying it forward for healthcare workers. And we've seen enormous benefits to healthcare workers are getting that that costs paid for. Because as Ali as you know, passing the initial exam can be very sometimes more stressful than the ASEP are you nodding your head, right. Okay. And so it's a long journey to get to that point. Paul, when you and evaluate a med tech from overseas, what are you looking for from an education and experience perspective?

Well, you know, that's a difficult question. education and experience, obviously, the tax are well equipped in that area, they've gotten their certification from the ASEP. I like to see excitement. I, from a technical perspective, like I said, it's going to cover but from a personal perspective, that's, that's really different. These days, we're looking more for people who can, who can work with others, we want someone who fits in with the team is a is a is a team player, and they're very personable. Because you know, you live with these people for at least eight hours a day, sometimes 10, sometimes 12, depending on that shift. And, you know, it really is difficult if there's someone in the bunch that that makes the toxic environment. So we really focus on the teamwork aspect. More so in my opinion, more so than the technical aspects, because that really has been proven already with their certification.

Okay, so that's interesting to hear that perspective poll. So it sounds like those. The behavioral piece is the part that is really important for you, when you interview looking at that, you know, Is this person a team player? Can they use their initiative, just some of those behaviors, that would make them a good fit for the team, done when a and may take interviews? And I think, you know, and I know, we've spoken about this on previous shows, as well. And many facilities use the behavioral based interviews to be able to evaluate, as Paula said, looking at some of those behaviors of what they want to have in the lab. Can you talk a little bit about the S.T.A.R method, the behavioral based technique that will enable healthcare workers to be able to evaluate if nurse if there's if med techs meet the right criteria?

Absolutely, you know, I think I like to start off by echoing what Paul just said, it's not just what you do, that matters most, it's who you do it with, right. And so think about jobs that you've had, you can look up your schedule, and you can see, okay, this is when I'm going to work, but what you really want to know is who you're going to be with that shift, right? Because that determines how good the chef's it's going to go when everybody's pulling their weight, and they communicate well together. And they help each other out. And all those things are so important. So that's why it's important that organizations have a feeling for how you're going to work with other people, the teamwork that Paul mentioned, is so important. And so we do behavioral based interviewing, because we know your technical skills are good. We just want to know how you behave in different situations. And the best way to predict how you're going to behave is to know how have you behaved in the past. And so what you want to do is you want to be a superstar when it comes to telling your story.

So we want to use the star model. And what I want to say is you're all stars, you're all very amazing people, you've got incredible talents, the fact that you're going to come here and be part of a journey to United States takes so much courage and, and I just admire every one of you, you're all stars, what I want you to be as a superstar, when it comes to interviewing and I'm going to share with you a framework, sometimes a framework is just a model, it's just a way of thinking. It's a way of framing your answer. And I want you to think about how you can use this framework to be really good at behavioral based interviewing. So you can go and show that graphic one more time, the first thing you want to do somebody's going to ask you a question, they're gonna say, Hey, tell me about a time when you had a conflict with a co worker. Tell me about a time when you had to advocate you had to sort of maybe take on a project that you've never been before you had to be a lead on something.

Tell us about a time when you were frustrated? How did you manage through that frustration, you know, what conversation did you have on people around you with your leader? Tell me about a time and they'll just keep what they're asking you to do is tell a story. And the story is going to help them get a sense of how you would handle these different situations. And so when you when you frame your answer, I want you to think of this star model star is S T A R A disappeared somewhere in here. But the S T is a situation or task. So start your story off and say well, there's just one time when I had this situation and you give get some background on what the situation was, like give an example. Maybe it's a task you are given by a leader or somebody there's one time where I was given this task to straighten up organize a piece of the lab or maybe to get some new equipment or do some research on a new piece of equipment. And then then tell your story about what you did your action your A right so the A is well what I did is I realized I wasn't going to be a solve this by myself.

So You know, I did some research, I called some experts, I visited some other hospitals to see what they did I, I asked my co workers, some questions, you know, talk to my leader, you know, there's a lot of things, we don't do anything by ourselves. But we get other people involved. And when you tell your story that way, you know, the people listening will see you, as somebody who's good at engaging other people, you're good at pro acting Pro, being proactive, you're good at planning. And so they're listening to your story. And they're already making a lot of assumptions about you, because they're seeing kind of how you work and how you do things. And then you always want to make sure you do the last part, which is the R, you want to make sure you're really good explained. And the result was, we had a successful implementation of this project. We, we got the equipment in and we saw our results at the lab go from increased 20%, or the accuracy increased 20%. So be very metric driven, be very clear about specifically how to do the improvement Did you see because the action, maybe the relationship with my co worker was better, we realized we were having not a conflict with each other, we were just having a conflict with a resource that we're trying to use.

And so we scheduled that resource a certain way. And then we never had that conflict again. And we got even more productive in how we use the resource. So again, yeah, Don, I love that I really love the STAR method. I think it gives. People who are interviewing you can be a great may take but might not know how to interview. So I think that's really a great tool to be able to learn how to interview with interviewing is a skill. And we're going to put that graphic into the chat for people to have a look at. Because I think that it's really important to be able to present yourself in the best way possible. Once you've got a job, we can then move on to the next step, which is looking at the immigration piece. Because when the med tech comes to the United States, it's a different process to how it might work for a nurse. I know we do many shows about immigration for nurses, but a med tech has a very different process. So we're going to be bringing in Mike Hammond, who is an immigration lawyer, a friend to the show, we've worked together for many, many years. And Mike is going to be joining us and going to be speaking about the immigration pathways. Mike, are you joining Are you here? I think we were just gonna bring Mike in real quick. And they ask the mic. Hi, Mike. Welcome.

Hey, Tanya, how are you? Good. Nice to have you on the show. Mike is a familiar face on onwards and upwards. So we'd love to have you on the show, Mike, and thank you for joining us. You want an introduction. I know most people know who you are. But go ahead and introduce yourself. I'm an immigration attorney based in Cincinnati, Ohio with offices throughout the country. I specialize in health care and it cases and our office does about four or 5000 healthcare workers a year. So Mike and I have known each other for how long Mike? A very short period of time that can be measured in decades, many, many, many years brought through many healthcare workers together. And Mike is truly an expert in immigration. So we're very honored and privileged to have him here to be able to share the immigration pathways for a med tech. So Mike, you want to share with everybody how, what is the processes or the different routes that may take and come into the United States?

Sure. So the when I say the phrase most common it's not necessarily the only one. But probably the most common people think of with med techs, which is very different from nurses is med techs are eligible for h1 visas. The advantage of an h1 visa over a Green Card route is that it's simply faster. h1 visas can kind of be broken down into two kinds of categories, depending upon the type of hospital facility that you're going to work at. There are those that are called cap exempt. Those are hospitals that are nonprofits affiliated with a university. And those H ones do not have to go through the lottery, which means that if you match with one of those hospitals, and they want to hire you that in six weeks, you could be here in the US working, assuming you met all the qualifications that were already previously outlined earlier. If the standards are, you need the visa screen which has already been talked about. You need the state license or at least be immediately eligible for the state license for the states that have a license for the states that don't simply the ASEP is sufficient enough.

The hostel Little does a filing with the Department of Labor that occurs fairly quickly. The hospital then does a filing with the immigration service, which goes fairly quickly as well. And then you go to an interview at the consulate. And because you're an h1 holder and a healthcare worker, those interviews can occur fairly quickly. Right now we're seeing interviews in the Philippines, in about three weeks, sometimes even a little less than that. And in other parts of the world, we're seeing interviews within a week, 10 days, we're not seeing any h1 interviews anywhere in the world, they're taking more than 30 days to get. So beginning to end, from the time that match is made. Six weeks is not an unrealistic kind of timeframe to look at for a med tech added cap exempt facility. A second type of H one is if you're matched with a facility that's not cap exempt. So they're not nonprofit, they're not affiliated with a university. They're a for profit facility, they don't have affiliations, those h1 cases have to go through what's called the lottery. A lottery occurs once a year, that occurs in April, but you actually file cases during the window in February and March, the dates vary a little bit.

So you kind of want to line those cases up in January. So this is kind of a perfect timing. to happen. Last year, we had almost 500,000 registrations for the lottery or submissions for the lottery of those almost 500,000, they chose 125,000 due to the fact there's only 85,000 H ones, but their use of algorithms because there's obviously a lot of duplicate filings, people are filing for more than one facility. Those cases are then chosen on April 1 or the day before, and then there's a 90 day window in which the facility would file for you. And if you're approved, then you would go to the interview stage. And the interviews would occur. And then you can come in and start working on October 1. The reason why October 1 Is Magic is because that's the government's new fiscal year. And the h1 a lot man is used on a fiscal year basis. So depending upon your timing of being matched, the lottery can occur, you could be working within let's call it nine months, if you're identified in January, you get chosen in a lottery, you wouldn't be able to work in October. And obviously you get time at the mat. And as far as risks are, how often does get denied? And is it hard to get them approved?

And all those kinds of questions, the answer is gonna really no risks, you know, the facilities hiring you as a med tech, they're gonna pay you to prevailing wage that's required by the government, and you meet the qualifications licensures standards ahead of time, there's no risk, we don't go, oh, this might get approved or might not, it'll get approved. And they they're generally in this space, not a lot of issues that are raised. So that kind of is a quick overview of the h1 D. Probably the next most common route international med techs would use is what we would call like an EB three direct. And generally speaking, so that is a green card, there are a couple of advantages to you as an individual in getting a green card through the EB three program directly in that one is if you have a spouse who wants to work, then your spouse comes in as a green card holder as well. So both of your green cards at the beginning, whereas if you come in with an H one, your spouse cannot initially work your spouse could work later, but they can't work initially. As far as the timing on the green card, though, it's not like the nurse cases. med techs have to go through what's called the labor market test that requires a recruitment campaign with the Department of Labor.

And depending on the facility you're matched up with. If they already have a prevailing wage in place, that process can take seven to nine months if they don't have a prevailing wage in place, that process could take 18 months just for the labor stage. And then you go through the immigration part with the I-140. And then you go through something else with the what's called the National Visa Center and then you ultimately go for an interview. So you would be looking at a processing time. I would say best case scenario today with hospital who has a prevailing wage, 18 months hospital doesn't have a prevailing wage, we're probably looking at two plus years. Now. Some people would go why would you ever choose an EB three route? If it's going to take that long where the h one and the reason is because not every hospital is cap exempt and, you know, a nonprofit affiliated and so a lot of hospitals that are not kept exempt will choose the EB three green card route over the h1 B lottery or maybe they do both at the same time.

Simply because H won't be lottery you're out aren't very good at getting picked. So instead of trying every year and going, Oh, I didn't get picked again this year, I'll try again next year, at some point, the hospital says I just want to have a green card program, I'm gonna put you in place for that. And even though it's slow, its steady. And we will get you there. And we're gonna get you to this endpoint that we want. If we happen to get an h1, in the meantime picked in the lottery, or break, good, we'll bring you in. But if not, we at least have this steady plan. So don't I think it's a bad decision as a candidate to look at it and go, Oh, that's gonna take too long. So I don't want to do that route. I want to wait for an h1 B, I think that's probably a poor decision. So those are the two most common ways to bring people in.

Thank you, Mike. That's a very clear, very important clarification of the different routes that are available for med tech. And obviously, they're pros and cons of each of those different processes. Ali, how did you come to the United States? What was the immigration process that you went through? Well, I came here with an employment based three visa or an EB three visa or a green card visa, as they would call it. I totally agree with what they mentioned that it's a long process. For me personally, it took me around three years or so going for, it was really a test on patients at the time. Because we're the EB three visa, we have what we call as a retrogression of the visa bulletin, were in the visa bulletin, actually goes back to its older days and processes, visas that are the backlog. And unfortunately, I was one of those affected, then after that I was also affected by the Southern closure of the US embassies because of the COVID pandemic. So there, I think the embassy closed eight months or so, which cost to an additional backlog.

So it was really the best patients, because for two years, I was supposed to come here around 2020. But because of those circumstances that were anticipated, I it took me an additional two years to process my EB three. So it was really a test of patience. And considering that within those within those two years, there was no definite date as to when will I be coming here to the United States. So it was really a blind shot, and was not really expecting anything. I was already to the point of losing. You know, my, my, my, my enthusiasm, because it was really a long process. So yeah, but at the end of the day, it was worth it. I would say because I came here with a green card. And yeah, but I guess, just like what was mentioned earlier, h1, B and EB three, both will have their own pros and cons. So it's depend, it will now depend on your personal perspective on which route will you be taking?

Yeah, so you, you so correct, I mean, a taste of patients. That's an understatement, because I'm sure there were many times there, and I can see you nodding your head that you probably thought this is never gonna happen. I'm never going to get to America, done from an employer's perspective. So I know that Methodist Levana have gone through this process from an employer's perspective. Obviously, it's very frustrating as well, because you know, nobody wants to be waiting for three years for that mistake. I mean, Paul, would be, you know, really frustrated. And if we were to say it's going to take three years for the maitake to arrive. Can you share with everybody what the experience has been like from your side? And how it fits into what Mike has explained about the different routes?

Yeah, for so for med techs. What you most want to know is what would what do we do when they get here? I just want to make sure I understand the question, Tanya. Sorry, sir. So Don, I was just gonna say what has it been like for you going through the immigration process from a client's perspective from a hospital? Well, for us, it's been great. I mean, it's been a great partnership. First of all, you know, I think communication is the key. To us. I think it's the key to you to anybody on the call. I mean, what you want to know is where am I at in the process? And how's things going? And if there's any issues, you want to know that you have somebody you can go to a partner that can help you answer those questions. So some of those are process questions that Tanya and her team can help with from the nursing agency. Some of those are immigration questions that Mike and his team can answer. And so when I feel like we have it's a fantastic partnership, and those partners are your partners.

And so the good news is we all get the information we need to help us get comfortable with where we are in the process and when we're going to get to United States and what's going to happen when we get there. I think that's also where the partnership matters and where we come in as the employer. And we want to make sure that your when you get here that you're taken care of, and that those first 30 days you have the financial resources you need, until you can get started on your job and that you have helped getting access to apartments and, and getting your social security cards and all the things that happened as you become an American, just so you can get started working, we're gonna help you get on boarded and make sure all those things are taken care of. So our team becomes your team at that point, and we work together to get you started, get you working. And then Paul's team becomes, you know, when I think about the lab leaders and the laboratory, team members, they become your family, right? And so it's all those things. So it's important for us to know how you're doing. We check in with you as you get here. We want to know how you're doing Tanya's team checks with you to make sure you're doing okay after you get started. So if there's any issues or any questions, we can work on those things together and make sure that that you did you get started and that you're, you're really happy?

Yeah. And that's what that's the goal. We want everybody to be really happy, like Ali, who's now over that hump, that long torturous weight that Michael had explained of what metrics need to go through if they're coming on the Green Card route. And we're going to talk a little bit about that onboarding process. But before we do that, Elissa, do you want to maybe share a little bit about the different states? And the license aspect? Because I think, I think it was Michael maybe mentioned that some of the states require a license and some don't. That's right. So there are some states that require a license, or have licensure requirements, most do not require any additional examination, they require there's a list. They require additional documentation or paperwork at depending on the state at different times in the process, so if I were to take Louisiana on the list here, as an example, with Louisiana, there's a two part process. So a med tech coming to the USA, who has an employer in Louisiana. Firstly, it needs to start the process with the Louisiana state licensing board, and eventually get a letter that's known as deficiency statement. And that just shows that the person could and is eligible to work in Louisiana as a med tech, if only they had the right to work in the state. And if only they had a social security number, and that document then goes along with the HIV filing, and everything is fine. And then it's picked up at the other end, a little more paperwork.

Okay. So there are some states that require a license, we're going to put that graphic into the chat, so that anybody who's going to those states will know which ones require that additional step. The one thing that is good news for Methodist Levana is that Methodist Levana are in Tennessee, and they don't require the state license. So Paul, can you share with us a little bit about the onboarding process when a med tech arrives in the United States? And what would be the next steps? How do you go about helping them adjust to life in the United States? Well, let me just correct something. The State of Tennessee does not require licensure, however, methods Lavon or health care does. Okay, thank you for clarifying. The State of Tennessee does not require it unless you are a supervisor, but it still does provide the licensure for employers who actually prefer that. Okay, and that's just a little extra step for us to make sure we get the highest quality med techs possible.

So, onboarding, onboarding and new international tech in the past, what we've done is we pair them up with a another tech, a more senior tech but similar age, because I think a lot of the difficulty and adjustment is social adjustment. One of the issues that I see or have seen in the past, one of the larger issues is transportation. You would think that that would be a very small thing, but many are most international tax, don't have a driver's license when they get here. It's very difficult, particularly for hospitals that are more rural than the larger ones to get around. For example, our University Hospital is in the middle of Memphis, and there are apartments within walking distance. We have a hospital in northern Mississippi that is very far from the nearest department. So that there's really no opportunity to get there through public transportation, you would have to Uber or otherwise taxi or, or have a buddy. And sometimes that's the key is to have that buddy to help you transition from the way that you your, your daily life was prior to the transition to your new your new state. And honestly, the transition, the onboarding for that technical aspect is pretty straightforward. We teach that we go through the different analyzers, we go through the different processes, policies and procedures, we make sure there's checklists, and we check everybody off to make sure they're competent. And that's all fine and good.

That's, that's standard everywhere. But I think the key is to have those people with the partnerships that can help you through the day to day, just simple questions. And you know, I don't know how to do this. You know, that's, that's very difficult. That's a big change for anyone but coming from a new job or coming from to a new job from so far away. I mean, I think that's key. Okay, yeah, a lot of a lot to, to manage when a med tech arrives in the United States. So it's not just the clinical aspect and learning a new job and a new system and new processes, but also just living in a new environment, which can be very stressful things like transportation, finding permanent housing, putting the kids in school, maybe a spouse finding a job, if they're able to work early. What was that like for you that transition? And what advice would you give to a med tech arriving in the United States?

Yeah. So before I came here to the United States, I already had a very good communication with the hospital that I will be working since 2019. So I never lost communication with them, I always update them with where I am in the process. And I also seek the help of our laboratory director with respect to transportation, housing, if they can recommend nearby apartments and so on. And they were very helpful, though we did not yet have any physical contact, still, they were very helpful and very understanding. And they were also very accommodating since the day that I arrived. So what's good is that when I arrived here in the United States, it seems like we already established that relationship, even though it was my first time meeting them face to face. And I would say for those who are planning to come here to the United States is to be in constant communication with the hospital that you are, you will be assigned to be in constant communication with the director. If you can ask their help, then that will be very great. Also be in constant communication with your future co workers, for example, ask if they have any Filipino community.

Unfortunately, for me, I am the only Filipino here in our laboratory. That's why I did not ask the help of any other Filipino. So I was the first one but and because of that experience, I am now helping future Filipino applicants in their migration here in the United States, especially here in LA, but I tell them, what an overview of what is to expect in our community. And so yeah, it's all about helping others who you know, because I have been there, and I know the feeling.

Yeah. And I love that you're paying it forward. Now Ali, and helping so many people. And I want to give Ali's group a plug on he has a book a group, I think it's on Facebook, right Ali, with 1000s of mistakes. I because of that, because of you know, I want to help the Filipino community. I put up a small group with 7000 members who are currently watching our live show. Now the main on Facebook is aspiring med tech or MLS, we do the United States. So if ever they want advice, if they seek for help, if they are, if they don't know what to expect, or if they don't know the process, someone will help you in that community of medical technology. So that group has been established to you know, help and empower medical technologists who are planning a career here in the United States. So that is a collaborative effort. I take All the credit, it's a collaborative effort for you know, med techs, who will have been staying here who have been living here sharing their own pieces of advices, to the newbies coming to the United States. So, yeah, it's a collaborative effort.

And we I love your big heart, Ali, and the fact that you have put that group together. And I think that speaks volumes about you as a person and being able to pay it forward and share and help fellow med techs as they come to the United States, because it is a challenge in the beginning. At Connetics, we have a circle of support. And these are a lot of different ways that we support the med techs and any other health care workers when they come in. And on the circle of support, you can see it on our website. And we were just showing a graphic of it here. These are all the different resources that we provide to the nurses when they arrive, as Paul was saying, sometimes it's you know, having getting a car and we have a lot of community resources of where you can get a car loan, how to buy a car, or lease a car, we have the Connetics Angel Network, these are, this is a mentorship program, we put you with buddies, we have a Connetics clubhouse, where we where we will help the health care workers of how to how to build your credit, or how to pay your taxes in the United States. So lots of different ways that we help support and healthcare workers. Let's I'm just looking at the clock, we have six minutes till the end of the show. And you want to very briefly just share with the matrix around the world, just what your best advice is, for med techs that are embarking on this journey.

Yeah, I think my best advice is to be able is for them to act intentionally. And to really think about what their life might look like here in the USA. Professionally, if they reflect on what they've enjoyed to date about their careers, and working in the lab, what they've learned some of the interactions they've had, sort of thinking about some of the things that Don mentioned earlier. And really then, you know, every day is a school day where we can learn from that and then think about things going forward, and then translate that into perhaps the type of environment they would really like to work in. Perhaps they're somebody who would like to be part of a really big system and a very busy hospital setting, or perhaps they would like a smaller setting. So they focus on themselves and what they would enjoy or think they would enjoy most. So act intentionally. And this can take some time to do.

Sorry, Elissa. Okay, and then go ahead. The other aspect of that is ensuring that you are as organized as possible with any files or documents, and always give them an appropriate name. So you know, what is in, in that document. So great way to have a listen, because I think being organized is really important, especially if you come on an h one. Because Mike, if you're going to be doing an EB three green card, and Adjustment of Status green card after being in the United States for a while, and it being organized and having your documents is really important to be able to file that next step. Right. Can you tell us just very, very briefly about that? Sure. So if you come to the US on an h1, and you're wanting a green card, and your employer wants to sponsor you for your green card, you would go through the EB three green card process. But instead of having the final stage at the consulate and an interview, you would have it done here in the US under what's something called adjustment of status. And that is a stage that focuses specifically on you as an individual and your entire history. You submit medical exams, they go through security clearances, and a whole series of questions they ask you about your background, and your family's background.

And there's a lot of information, a lot of documents that they look for. And so I'd certainly echo that being organized and having all your documents ready can make that process a lot smoother. And the green card process to the adjustment that Tonya mentioned is part of while you're already working on the h1 so the timing is not quite as critical for people because you already here you already live in you're already working. Your spouse is usually already working by that time too. But it is a process that you have to have to go through to ultimately get the green card. Okay, so more to come on that and if you're interested in knowing more about the adjustment of status green card process, please go to the Connetics USA website. And we have a full show that we did on that process, talking about the different steps and how that works. If you are here on an h1 and are looking to go through the adjustment of status green card, and Paul and Don I think we have like a minute or two you if you want to maybe share your advice or, or pointers or tips for med techs that are watching around the United States, let's start with you, Paul. get along with people, number one.

And number two show up. Short and simple. Yeah, I mean, really, if you can get along with people, and you can show up for work, I think those are the two main ingredients to being successful in med tech because we can teach you anything. You're smart enough, you're certified, you've obviously shown that you can you can learn what we need people to be part of the family, and actually be present as a part of the family. Thank you, Paul. And Don, final words in the last minute. you unmute done, you want me to like you, I love that if you show showing up as having success, and my mom always said, if you just get started, you're halfway there. So get started on this process. And you will be happy that you did it. And be willing to open yourself up, ask for help and accept help. That's the key thing. And we say teamwork is important. But who gets in the way of teamwork. If I don't raise my hand and let people know I need help. And if I don't accept, then I'm the one getting in the way of teamwork. So be a great team player. And let us help you. Because I've never accomplished anything in my entire life significant by myself. So we all need each other and we need you. So thank you for choosing the considering coming to the United States.

Well done. That is a perfect way to end the show. Get started and let's work together to get you to the United States. So thank you, everybody, for joining us around the world. Thank you to Elissa to Mike Paul Ali and Don for sharing your experience your advice, your pointers, your tips about this process. It's not an easy journey. It can take a long time. We don't want you to take as long as Paul Ali's journey did. For anybody who's watching today, but we are here to help and to share information to help you to live your American dream. Thank you everybody for joining us. Apologies for the technical hitches and we will see you next week. Onwards and upwards. Thank you. Thank you. Bye bye