Healthcare Apprenticeships Help Refugees Overcome Career Barriers

The Problem with Standalone Healthcare Vocational Training

Before fleeing the Democratic Republic of Congo with her husband and infant son, Veronicah had a decade-long career as a nurse. Like many refugees, Veronicah was forced to leave suddenly, and she did not pack her diploma or transcript, the necessary documentation to verify her professional history. In the U.S., Veronicah’s employment specialist helped connect her and her husband to a full-time entry-level job at a manufacturing plant. The couple works a split shift to provide child care. Veronicah would like to return to her field and pursue an Associate Degree in Nursing (ADN), but her local community college does not offer nursing classes when she’s free in the evenings. Even if they did, the cost of hiring a nanny is prohibitive, and quitting her job is not an option due to expenses and the added cost of tuition.  

This set of barriers is all too common for refugees and other low-income populations. Too often, the cost and inconvenience of vocational training can derail professional development rather than act as a vehicle for upward mobility. The apprenticeship career pathway model can address many of these barriers and help refugees connect to rewarding career pathways in healthcare. 

What is a Registered Apprenticeship?

In the registered apprenticeship model, employers develop and prepare their workforce with paid, on-the-job training, supplemental education based on the employer’s unique training needs, and progressive wages tied to skill advancement. Apprentices also earn industry-recognized credentials during their training that certify them at the full performance level of their desired education. 

Benefits of Apprenticeships for ORR Populations

Apprenticeship programs can help refugees like Veronicah avoid many of the barriers encountered in career development activities. The earn-as-you-learn model eliminates or largely subsidizes the financial burden of tuition costs refugee clients face when enrolling in post-secondary education or registering for private vocational training opportunities. Apprenticeships often accommodate the schedules of working immigrant adults who may have child care duties or other responsibilities that prevent them from seeking training during their non-working hours. 

Furthermore, research suggests that apprenticeships can reduce occupational segregation by ensuring that marginalized groups have access to the individualized mentorship, employer-recognized training, professional contacts, real-world job experience, and other forms of support needed for promotion and upward mobility. In 2021, the Department of Labor reported that 93% of apprentices find employment after completing their training, and the average wages for those who complete their apprenticeship are over $70,000. Check out this article about an environmental services pre-apprenticeship jointly offered by the International Rescue Committee and the College of Western Iowa for an example model. 

Beyond Skilled Trades: A Look at Healthcare Apprenticeships

While many people associate apprenticeship opportunities with construction and the skilled trades, the apprenticeship model is increasingly being used in a wide range of sectors.  Healthcare is the fastest growing industry sector in the United States. According to the Bureau of Labor Statistics, employment in healthcare occupations is projected to grow 13% through 2031 and add about 2 million new jobs. The healthcare industry is fast becoming a major player in the apprenticeship space. The healthcare sector trained 13,882 registered apprentices in 2021 to meet the demand for healthcare workers. While this number is impressive, over 300,000 healthcare workers resigned in 2021, suggesting that healthcare employers have an ongoing critical need to find and train incumbent workers, and many will rely on apprenticeships to fulfill the need. 

Registered Healthcare Apprenticeship Occupations

The Department of Labor recognizes over 60 registered healthcare apprenticeship occupations. A full list of these nationally recognized healthcare apprenticeship occupations can be found here, and additional healthcare apprenticeships may be approved in State Apprenticeship Agencies. These training opportunities typically last a year or more, though some may be as short as six months. The bulleted list below represents apprenticeships with national-level workforce shortages and training programs that typically do not require prior post-secondary education. 

  • Central Sterile Processing Technician 
  • Certified Nursing Assistant 
  • Community Health Worker (CHW) 
  • Dental Assistant 
  • Environmental Services Technician 
  • Home Health Aide + Specialties 
  • Hospital Coder 
  • Medical Assistant 
  • Patient Care Technician 
  • Phlebotomist 
  • Pharmacy Technician 
  • Surgical Technologist 

Service providers looking to find the healthcare occupations with the most job openings and highest wages in their service area can rely on data from the healthcare page of the Occupational Outlook Handbook, as well as information published in their state or local WIOA plan.  

Tips for Connecting Clients to Healthcare Apprenticeship Programs

  • Rely on the Apprenticeship Program Finder. ApprenticeshipUSA has a helpful search function that will allow service providers to search by apprenticeship position or program title in their service area. Apprenticeship applications are linked in the search results, and providers can filter programs that are closest to the clients’ homes and that are actively recruiting candidates. 
  • Become a trusted referral provider. Most registered apprenticeships rely on community-based organizations to locate and pre-screen potential apprenticeship talent. Typically, employers are seeking apprentices with a strong understanding of the program commitments, punctuality, soft skills, and an eagerness to work in healthcare long term. ORR service providers can contact apprenticeship programs and offer this recruitment support. This collaboration may improve the acceptance rate for ORR populations, and service providers engaged in pre-screening and referral work will learn the competencies and skills most valued by the employer partner for better pre-apprenticeship program delivery. 
  • Consider a pre-apprenticeship first. Refugee-serving staff can create contextualized pre-apprenticeships to educate clients on the types of healthcare occupations available to them and prepare clients with the skills and education needed for acceptance into a registered apprenticeship. For example, a hospital coding pre-apprenticeship might choose to teach digital literacy skills for refugees unfamiliar with American keyboards or Microsoft Office products. Before creating a pre-apprenticeship, service providers should check with the apprenticeship employer along with their local American Job Center (AJC) and community college(s) to see if a pre-apprenticeship already exists and could be tailored to the needs of refugee learners. 


Encouraging Healthcare Providers to Create a Registered Apprenticeship

ORR service providers with strong partnerships in the healthcare sector may wish to “pitch” the value of apprenticeships to employer partners. The talking points below represent benefits apprenticeship employers can expect after implementation: 

  • Opportunities for additional funding, tax credits, and free-of-cost technical assistance 
  • Less time and money spent recruiting for hard-to-fill positions 
  • Access to previously untapped talent pools 
  • Talent with real-world job experience tailored to the employer’s specific context 
  • A more diverse workforce with lower turnover rates 

How the Healthcare Career Advancement Program Can Help

Service providers can also connect employer partners interested in forming a healthcare apprenticeship with the Healthcare Career Advancement Program (H-CAP). H-CAP is a national labor management organization that works directly with healthcare employer partners to create healthcare apprenticeship programs and build equity in healthcare. H-CAP has created an employer-facing Healthcare Apprenticeship Toolkit to educate employers on the components of a healthcare apprenticeship and provide the resources needed to implement a new program. For more information on H-CAP or for guidance on how to connect employer partners with these resources, reach out to for additional information.  

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