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Skilled immigrants are actively recruited by developed countries in Europe and North America to address health force labour shortages. Although recruitment and selection processes are subject to strict regulations in Canada, internationally educated nurses continue to experience major difficulties with foreign credential recognition and obtaining employment. This study explores the different ways in which English or French, the official language requirements, intersects with immigrants’ ethnocultural background and integration. Key factors such as the timing of migration, age and professional English language competency, and pre-migration experiences were found to have a combined impact on employment success. Nurses with high levels of language proficiency acquired during the pre-immigration period and enhanced following migration had higher levels of economic integration. This study illustrated that current immigration policies would benefit from a closer examination of the match between pre-migration experiences and the required professional skills of the host country.