This summer, Alex Alvarez plans to relocate from Anchorage, Alaska, to Nanaimo, British Columbia, Canada, along with her husband, young son, and Boston Terrier. Alvarez, a registered nurse, is making this significant 3,500-kilometer move to pursue opportunities in a province she has never visited. She is among numerous American healthcare workers who are migrating to B.C. seeking better stability amidst the ongoing "uncertainty and chaos" in the United States.
Alvarez expressed the urgency of this move for her family's future, highlighting issues in the U.S. healthcare system, escalating living costs, and a lack of social safety nets as factors behind their decision. The province has responded to this trend by implementing a streamlined credential registration process for U.S. nurses, which has led to a substantial increase in approved registrations. Between April of last year and January of this year, the BC College of Nurses and Midwives approved the registration of 1,028 U.S. nurses, indicating a potential tenfold increase compared to previous years.
In 2023, the college approved 112 applicants, and the following year saw an increase to 127 approvals. However, the college was unable to provide specific figures on how many of these nurses have successfully relocated to Canada, as many complete their registration before beginning their job search. To further attract healthcare professionals, B.C. launched a $5 million advertising campaign targeting nurses and doctors in Washington, Oregon, and California, focusing on areas close to healthcare facilities and through various media platforms, including podcasts and Netflix shows.
According to Health Minister Josie Osborne, these recruitment efforts are a strategic response to the unrest following the election of President Donald Trump. Alvarez noted her desire to leave the U.S. predates Trump’s presidency, although his re-election did play a role in her decision. She stated, "It feels more dangerous to stay than it does to leave," reiterating her concerns regarding the current state of healthcare in the U.S.
Another nurse, Ken Swartz, who moved from California to Prince George about two months ago, echoed these sentiments. He attributed his relocation decision to the dramatic cultural and political changes in the U.S. Both Alvarez and Swartz utilized the expedited registration process, finding it easy to navigate. Data from the Ministry of Health indicated that 1,800 U.S. health workers applied to join B.C.'s healthcare system between May and September 2025, but only 174 had accepted job offers, which included 104 nurses, 41 physicians, 19 nurse practitioners, and 10 allied health professionals.
While Island Health reported recruiting 64 U.S.-trained nurses between April 2025 and early February of this year, four of B.C.'s five regional health authorities did not disclose how many U.S. nurses they have hired since April, deferring to the Ministry of Health for further information. Alvarez acknowledged seeing the recruitment ads online, whereas Swartz applied before the campaign commenced.
The BC Nurses’ Union president, Adriane Gear, pointed out that while the influx of U.S. workers is a positive development, it still falls short of the province’s requirements for minimum nurse-to-patient ratios. She emphasized the need for B.C. to not only hire internationally educated nurses but also increase funding for nursing education and focus on retaining current nurses within the province.
Alvarez and Swartz are attracted to B.C. partly due to its cultural and linguistic similarities to the U.S. Swartz, now a resident of Prince George, noted differences in cultural behaviors, such as Canadians being more polite and patient. The recent Tumbler Ridge mass shooting, which occurred shortly after his arrival, further underscored the violence he was trying to escape from in the U.S., where such incidents have become an alarming norm. Swartz reflected on the overwhelming tension he felt as an American, saying, "You don’t even realize the level of tension that you constantly live under." Alvarez shared her positive experiences with the Canadians she has met thus far, who have been "kind and welcoming." She plans to visit Nanaimo for the first time in May before making the move in July, expressing optimism throughout the transition by affirming, "It's gonna work out, it’ll be great."
