From Manila to Manhattan: A Physical Therapist’s H1B Visa Journey
By Naila Trani, PT, MSPT
Physical Therapist, New York
It started with an ad in our local newspaper in Manila, Philippines. My friend and classmate of 8 years, Telly, brought it to my attention. A Philippine-based agency that had partnered with a United States-based employment service was looking for physical therapists interested in working for Health and Hospitals Corporation in one of their many hospitals in New York City!
Telly and I were part of a class of 40 who graduated from the University of Santo Tomas, one of my country’s pre-eminent tertiary schools. We had all passed our PT Licensing Exams in Manila. By then, many of my classmates had already left Manila for Texas on working visas. Telly and I were essentially laggards in this exodus BUT now we were going to NYC! We received brochures of the hospitals under the HHC umbrella—and there were many hospitals in the brochure. How big was NYC that it needed all these hospitals? Little did we know, NYC really was THAT BIG, and HHC represented only a few of the hospitals serving the city.
The Call to Migrate
What makes the mindset of a migrant? Who could leave their family, friends, and everything familiar behind to go across the earth? To a new world with a different lifestyle, culture, and people? Even the weather was different! Everything about NYC and the US was a new experience in all aspects of life. I guess it helps that even while young, the idea of leaving the Philippines was inculcated in our minds. I have many cousins (all nurses) who left for the US, Canada, and Australia. I had friends and even my brother who sought employment in the Middle East. It has been said that the biggest export of the Philippines is its people. The economics of migrating to better afford to support our families, the boundless opportunities for personal and professional development and growth, the call for adventure, and a new life are typical reasons to leave. I was a typical immigrant. I am thankful I did not have to include escaping danger or risking death as part of the reasons that compelled me to depart from the comforts of home.
The Road to New York
The process to work abroad was long and detailed. Many documents and various papers needed to be put together: resume, recommendation letters, official school transcripts, diplomas, licensure—and some needed to be translated. There were Philippine government employment clearances, credentialing of my courses and grades by the NY State Education Department’s Board of Physical Therapy, applying for a US Visa, and medical clearance. It was a long process that began in January.
The final piece I needed to complete was to disclose my decision and plans to my parents. While the idea of migration is pervasive in the Philippines, the decision to act on it is still a personal one. It is not uncommon for a household to have 3 generations under one roof, so the ties that bound us were tight! I was leaving my country…and my family. To my relief, my parents supported my choice.
In July, I received a letter of understanding from HHC of their intent to employ me as a nonimmigrant PT on a limited permit to practice in the State of NY. In September, I was included in a Visa petition filed with the Immigration and Naturalization Services in NY. Ten months after I started, all the preparations were complete. Contracts with the recruitment agency and HHC were signed, and I purchased my plane ticket to New York.
Arriving in New York City
December 8 is an auspicious day as it marks the feast day of the Immaculate Conception of Mary, the Patron Saint of the Philippines. When things were uncertain or unknown, I clung to my faith. Therefore, December 8 for me, was a harbinger of good things to come. I flew to NY that day.
There were 5 of us from different Philippine PT schools who met for the first time on that plane. Together, my instant friends and I embarked on our adventure to the strange new world of NYC and the rest of our lives. We arrived in NYC at night, the best time to see the city for the first time. In the darkness of the night sky, the concentrated myriads of lights were an astounding sight to behold, a Queen’s jewel on the ground, a pulsing sea creature, a steady beacon of life! We landed at JFK Airport and were met by staff from HHC, then driven to our lodgings.
My first observations of NYC on the ground: orange lights gave the streets a strange glow and I lost count of how many bridges and overpasses we drove under. Finally, we got to Draper Hall, a dormitory for the staff of Metropolitan Hospital. It was my stop. I had a room there. The others were brought to a dormitory serving Goldwater Memorial Hospital. I phoned my cousins in Detroit so they could call long distance to let my parents know that I had arrived safely. I spent my first night in tears, thanking God for His blessings and already missing home.
Settling into New York Life
I was assigned to Bird S. Coler Memorial Hospital, an LTC on Roosevelt Island. The next morning, a staff member from Coler arrived at Draper Hall to show me how to navigate the subway there. The underground was a complicated maze of unbelievably big spaces connected by endless tunnels in all directions. How was it possible that there seemed to be as many people underground as there were above ground? How do people know where to go? And all in a hurry? The cool thing about getting to Roosevelt Island (before there was ever a subway there) was the tram! Suspended in the Manhattan skyline, I gawked at the spread of skyscrapers up and down my line of sight, cars looking like blood cells flowing through the vessels of the streets and avenues of the city.
The next days were spent in orientation, signing up for benefits like medical insurance (a dizzying number of choices, to say the least.) These days served as my introduction to some of the Filipino staff at the hospital. While PTs from the Philippines were new as a group of immigrants, there have been scores of previous Filipino immigrants: nurses, doctors, and many others who paved the way for me. These pioneers showed me how to maneuver the intricacies of the layout of the building, scheduling, documentation, and interpreting social behavior. One showed me how to open a bank account. Another eventually offered to be roommates, so I could walk to work instead of riding the subway. They were my angels as I learned how to traverse the milieu that is NY life.
None of us newbies were socially isolated. Most weekends were spent attending birthday parties. Remember “6 Degrees of Kevin Bacon?” That’s how we got invited to these parties. We didn’t need to “know” the celebrant. It was enough to know someone who knew a friend of a friend of the celebrant.
With my limited permit, I was able to practice PT under supervision. Eventually, there were 5 of us Filipino PTs serving at Coler. I believe we could not have been blessed with a better guardian than Milton Bailey, the Chief of the Physical Therapy Department. While I knew but was unsure about providing therapeutic services, he and Ann Sullivan, my Senior PT, taught me the art of applying them, in thinking beyond the application of physical therapy techniques and interventions, and in seeing the person in front of me. They planted this seed of love that I have for the patients who have trusted us—trusted me—with their care.
Earning My New York PT License
I spent many, many sleepless nights preparing for my NY State Licensure Exam. Under the limited permit, I had 2 chances to pass it. I know this will reveal my age, but I took the exams when taking the tests in person was the norm… and appearing at another site on another day, for the practical exam was the second, the most daunting and scary part of the exams. Fortunately, my school, UST, prepared me well for this type of examination. With great pride and relief, I passed my NYS PT exams in 1 take! With my license, I could stay at Coler or apply at any other healthcare facility. I could also ask the hospital to sponsor my green card application—my golden ticket to legalize my stay in the US. If the hospital sponsored my papers, I would be committed to working there for 5 years, the shortest amount of time between getting a green card and being able to apply for US citizenship.
Mr. Bailey counseled that we owe our first loyalty to ourselves. Keeping that in mind, I left Coler for Kingsbrook Jewish Medical Center. I asked Kingsbrook to sponsor me for my green card application. While I was there, I worked on and finished my master’s degree in PT at LIU. In the settings I chose to work in afterward, I felt increasingly more comfortable working with the older adult population. I should probably have realized way before then that I had found my niche and my passion for serving this age group. I love to hear the stories of their lives, their families, and their experiences. It helped me form a vision of how they moved in their environment. It helped me understand better what drives them and how I can help them. It’s been a long journey, but I am not done because here I am now, 14 years with FOX Rehabilitation!
Finding My Place at FOX Rehabilitation
White FOX, I found a group of colleagues who are dedicated to our craft and focused on helping each other be the best clinicians we can be. We are unified in a goal to help our patients achieve their highest level of function so they can experience the fullest life they can have. It’s not just the clinicians that I feel this support from, but every level of person who makes up our organization.
I started with FOX when there were only four of us in Brooklyn. I saw patients who lived below Prospect Park. I did not realize how BIG South Brooklyn is until then. Six months after I started, I had my first patient at Sunrise ALF in Sheepshead Bay. Working closely with the nurses, care managers, and families, I ensured that our care was comprehensive and collaborative.
The service I provided did not end with direct care to that patient. I gave updates on that patient to their family and the nurses at Sunrise. I spoke to the Care Managers who provided care to this patient and asked them about their difficulties in providing this care and suggested ideas of how to make their work easier and safer. When my patient made gains, I went back to them to let them know so they could further ease their workload. I ensured they knew they were as important in my work with this patient as this patient was. In due time, I got more referrals. I am sure that Nicholas Lampiasi’s work, as my supervisor, was critical in procuring those referrals. It helped us that the Director of Nursing at the ALF saw the difference in the care that we provided.
While I started as the only FOX clinician there, our presence grew to include occupational therapy, group classes with exercise physiologists, and speech-language pathology. I learned how to lead group exercises for residents on the regular floor and those in the Memory Unit. There have been many in-services to the ALF staff conducted as part of a care plan for specific residents but also to the larger staff as well. Going above and beyond is a trait we all share at FOX.
A Journey of Growth
I have grown in my work life in so many ways and levels that have enriched my personal life. Saying yes to applying for the working visa, that H1B visa, started it all. It helped me appreciate more the drive that pushes a person to migrate. It helped me appreciate and love the United States which welcomed me and people like me, willing to work hard and harder, and that made it possible to strive for, achieve, and live in the American Dream. I now have a husband I love and two sons I adore. I believe every person I meet and the opportunities I am presented with are gifts from God. When I say yes to them, then I am fulfilling God’s vision of me.