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The demand for foreign nurses is high in the United States, as the nation struggles to replace nurses who have retired or changed professions. If you are patient and willing to complete a multi-step process, you can find a fulfilling career in the US.

If you are a licensed nurse in another country, there are several steps to take in order to become a nurse in the United States. Should you plan to live here permanently, you need to obtain an Alien Registration Receipt Card, commonly known as a Green Card. The Immigration and Naturalization Service can help you through this process

The first thing to remember is that licensure requirements differ with each state. The state Board of Nursing will be able to tell you what prerequisites you should fulfill to be licensed. You need to know where you will be working before you arrive in order to be sure that you meet all of the criteria.

In addition to state licensing procedures, there are several additional steps to take. We have provided a list of frequently asked questions about the process, and more information is provided by the Commission on Graduates of Foreign Nursing Schools.

You need to take the TOEFL, or Test of English as a Foreign Language.

TOEFL scores are valid for two years, and you must take the CGFNS Qualifying Exam and TOEFL within two years of each other.

According to their web site, the Commission on Graduates of Foreign Nursing Schools is “a non-profit, internationally recognized leader in the education, registration and licensure of healthcare professionals worldwide. CGFNS protects the public in relation to evolving healthcare policies and standards of professional practice for migrating healthcare professionals.” CGFNS is federally-approved to certify nurses and other healthcare providers.

The program is designed for first-level general, or registered, nurses who have been educated in another country and wish to work as professional nurses in the United States.

There are three parts of the certification program: a credentials review, the CGFNS Qualifying Exam, and an English language proficiency exam. Most Boards of Nursing require foreign nurses to complete the certification program and the credentials evaluation. In addition, the Immigration and Naturalization Service (INS) requires all healthcare professionals who seek permanent occupational visas to obtain VisaScreen certificates.

The test is designed to see if nurses with international educations are qualified to practice in the United States. If you pass the exam, it means that your credentials are valid and that the educational standards of your school or institution meet those expected of nursing programs in the United States.

To be eligible for the test, foreign nurses must have significant experience in a wide range of nursing fields. A minimum number of hours in classroom instruction and clinical practice are required in the fields of Adult Medical/Surgical Nursing, Maternal/Infant Nursing (Obstetrics), Care of Children (Pediatrics), and Psychiatric/Mental Health Nursing. The CGFNS web site has specific information about the instruction and hours needed.

You also need to be a registered first-level nurse in the country where you were educated, and you must hold a current registration/license as an R.N.

Yes. You must have a license/registration from your country in order to be eligible for the exam.

The Qualifying Exam is offered three times each year in over 40 locations worldwide. To find a test center near you, contact the CGFNS Customer Service Department or consult the CGFNS Certification Program handbook. You can also visit their website.

Yes, but remember that you must sit for the TOEFL and Qualifying Exam within two years of each other in order to have valid scores.

VisaScreen is administered by the International Commission on Healthcare Professions, which is a division of CGFNS. The screening program is federally-approved and is designed for all health care workers who want occupational visas, including RNs and LPNs. The VisaScreen certificate is required by the INS and must be obtained before you can receive a residency visa. When you receive the certificate, you can present it to your consular office with the rest of your visa application.

In order to receive a VisaScreen certificate, CGFNS must conduct credential reviews of your nursing education and licensure, and an assessment of your English language skills. You must also be able to pass either the CGFNS Qualifying Exam or the NCLEX exam. According to the CGFNS, when you receive the VisaScreen packet, you should:

1. Complete the VisaScreen application.
2. Complete the enclosed forms to send to your nursing school(s). Academic transcripts must come directly from the nursing school(s).
3. Complete the enclosed forms to send to your licensing authority(ies). Validations of all licenses, past and present, must come directly from the licensing authorities.
4. You must successfully complete an English language proficiency test and have the scores directly forwarded to ICHP from the testing agency.
5. You must successfully pass either the CGFNS Qualifying Exam or the NCLEX-RN examination if you are a nurse.
6. Enclose a copy of your high school diploma or equivalent.

The credentials review looks at theoretical instruction and clinical practice in five major areas of nursing: Adult Medical Nursing, Adult Surgical Nursing, Maternal/Infant Health Nursing (Obstetrics), Care of Children/Pediatrics, and Psychiatric/Mental Health Nursing. Generally, it does not examine additional education in the sciences, humanities, or other areas of study.