With one of the world's most comprehensive universal healthcare systems, medical tourism in Costa Rica has increased significantly over the past few decades. American tourists save up to 80% of comparative costs for procedures, from heart surgery to root canal treatment. Although many Costa Rican healthcare professionals receive training in North America or Europe, there can be differences when compared to the same professionals in foreign countries. This paper examines the educational and role differences between counselors in the United States and Costa Rica. Implications for tourists in need of psychotherapeutic services while abroad or counseling professionals seeking foreign work experiences are discussed.