How to Work in the US as a Foreign-Educated Nurse (2023)

While there is a well-known shortage of registered nurses and healthcare professionals, current U.S. immigration laws can make it difficult for foreign nurses in the US to obtain jobs. It is important for those interested in pursuing this avenue to obtain the proper visas and paperwork from the U.S. Citizenship and Immigration Services department.

How to Work in the U.S. as a Nurse From Another Country

There are eight key steps foreign-educated nurses will need to take in order to obtain a position as an RN in a U.S. hospital.

  1. Meet the educational requirements
  2. Complete a foreign-educated nurses (FEN) course
  3. Take and pass an English language proficiency test, if mandated
  4. Pass your National Council Licensing Examination-Registered Nurse (NCLEX – RN)
  5. Obtain credential evaluation
  6. Find a nursing recruiting agency or US-based employer
  7. Apply and obtain an RN immigrant visa/green card
  8. Accept an RN position

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How to Work in the US as a Foreign-Educated Nurse (1)

Step 1. Meet the US Education Requirements for Nurses

First and foremost, internationally educated nurses must meet basic education requirements. These include:

  • Graduation from an accredited Registered Nursing program: Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN)
  • Licensing as a Registered Nurse (RN)
  • Experience practicing as an RN for at least two years

Step 2. Complete a Foreign-Educated Nurses (FEN) Course

While the aforementioned are required, most states also require foreign-educated nurses to complete a Foreign-Educated Nurses (FEN) refresher course.

The course consists of 120 hours in the classroom and 120 hours of clinical practice under the supervision of a licensed Registered Nurse.

Step 3. Pass English Language Proficiency Tests

After meeting the initial education requirements, some foreign-educated nurses must take and pass the Test of English as a Foreign Language (TOEFL), the Test of English for International Communication (TOEIC) or the International English Language Testing System (IELTS). This will vary depending on the country of origin and results are sent directly to the state nursing board.

Nurses who went to nursing school in the United Kingdom, Australia, New Zealand, Canada (except Quebec), or Ireland are exempt as are those whose spoken language in nursing school was English and/or the nursing school textbooks were written in English.

Step 4. Pass the NCLEX-RN Examination

After ensuring you meet the education and language requirements it’s time to apply for the NCLEX in the state of intended employment. Registration with Pearson Vue is required and costs $200 plus additional foreign fees.

According to the webpage, NCLEX examinations are currently administered in Australia, Canada, England, Germany, Hong Kong, India, Japan, Mexico, Philippines, Puerto Rico, and Taiwan.

Step 5. Have the CGFNS or Another Credentialing Organization Evaluate Your Credentials

The Commission on Graduates of Foreign Nursing Schools (CGFNS) is a company that is employed by State Boards of Nursing to ensure that applicants meet the basic requirements and are fit to take the NCLEX.

Established in 1977 after a thorough investigation of the immigration of foreign-born and educated registered nurses, the U.S. Department of State and Labor developed the Commission with a dual purpose: to ensure safe patient care to Americans and to help prevent the exploitation of graduates from foreign nursing schools who are employed in the United States to practice.

This company specifically will go through all nursing school transcripts and education history from your home country. While this company is the most popular and most well known - it is expensive and each state requires different levels of credentialing.

There are three main credentialing reports:

  1. Credentials Evaluation Service Professional Report
  2. CGFNS Certification Program
  3. Visa Credentials Assessment

Credentials Evaluation Service Professional Report

This report is less involved and cheaper than the Certificate Program or VisaScreen. It provides the basic information for the State Board of Nursing and only a handful of states accept this.

Below are the requirements you’ll need to meet:

  • English Requirement
  • Secondary School Documents
  • Licensure Documents from your Home Country
  • Nursing Education Documents from your Home Country
  • $350 Fee

CGFNS Certification Program

This evaluation is the same as above but requires the applicant to take the CGFNS Qualifying Exam.

Here are some specifics:

  • Everything in a Credentials Evaluation Service Professional Report
  • CGFNS Qualifying Exam
  • $445 Fee

The CGFNS Qualifying Exam helps states determine if foreign-educated nurses are well suited to care for patients in America. According to the CGFNS web page, individuals must possess a wide variety of nursing knowledge.

Applicants are required to have a minimum number of classroom and clinical hours in required fields such as pediatric nursing, psychiatric nursing, neonatal nursing, and adult medical/surgical nursing.

The examination is held three times a year at over 40 testing centers across the globe. Individuals may travel to other countries, if needed, in order to take the exam.

Find CCNE-Accredited RN Programs

VisaScreen: Visa Credentials Assessment

The same requirements as the CGFNS Certification Program but will qualify the individual for a Work Visa after successful completion of the NCLEX.

You’ll also need to pay a $540 fee.

Other credentialing services could potentially be cheaper and still accepted by the State Boards of Nursing. It is important to check with the State Board before using a different credential service. Alternatives to CGFNS include:

  • International Education Research Foundation
  • Educational Records Evaluation Service

Step 6: Find a Nursing Recruiting Agency or US-Based Employer

The next step is to obtain an employment visa. There are several options for these nurses but nurses must have sponsorship from a staffing agency. It is easier for foreign nurses to work with an independent staffing recruiter and agency than directly with a hospital.

Agencies are well versed in helping nurses work in the U.S. and have systems in place in order to ensure all information and paperwork is completed accurately.

Step 7. Obtain Your Nursing Employment Visa or “Work Visa”

Types of Work Visas for Nurses

Mexican And Canadian Nurses - TN Visa

Mexican and Canadian nurses may work in the United States with a special TN visa if the individual has an offer of employment, a license to practice in their home country, and pass the NCLEX and state licensure requirements.

H-1B Temporary Work Visa

Nurses who hold a four-year degree and fulfill a specialized nursing role may qualify for an H-1B temporary work visa and then apply for a green card once stateside. These specialized roles include critical care nurses, emergency room nurses, and/or cardiology nurses.

It is important to note that there is a very limited number of H-1C visas available to nurses who want to work in very specific hospitals in underserved communities.

Permanent Work Visa

The majority of foreign-trained nurses will need to obtain a permanent work visa, otherwise known as a green card. This application needs to be completed prior to travel to the United States and the visa must be obtained before immigrating legally.

Step 8. Find a Registered Nursing Job in the US

Many career experts advise nurses to conduct targeted job searches through job boards specific to their area of expertise. You can start by checking out the available positions on the job board. If there is a particular hospital you’re interested in, you may want to look on their site to see if they have any openings.

Can I Work in the U.S. as an LPN From Another Country?

Many LPNs from foreign countries want to know if they can practice in the U.S.Unfortunately, U.S. work visas are only issued to foreign RNs and APRNs. Licensed Vocational Nurses (LVNs) and Licensed Practical Nurses (LPNs) are not eligible for work visas in the U.S.

According to CGFNS International, a non-profit organization that helps foreign-educated healthcare professionals live and work in their country of choice, only nurses with a first-level degree or RN credentials (as defined by the International Council of Nurses) have nursing license transferability in the US. Per CGFNS, at this time, practical and vocational nurses are unfortunately ineligible for licensure in the U.S.

CGFNS reports that the minimum requirements needed to work in the U.S. as a nurse are graduation from an accredited RN program, an unencumbered RN licensure, and two years of working experience in the profession.

Foreign Educated LPN Requirements by State

However, some US state nursing websites have varying degrees of information on how LPNs can obtain work if they are licensed in a foreign country and living in the U.S. with a non-work visa. Unfortunately, much of the information is unclear.

The New York State Education Department (NYSED) website states there is an option for obtaining licensure as a foreign-trained LPN in New York, however, the Nursing Board Office at the New York State Education Department was unable to confirm that, and instead advised LPNs to see the requirements to apply for a NYS license and to take the NCLEX via email message.

Per the NYSED website, these are the instructions to apply for licensure as an LPN who graduated from a nursing school in a foreign country (outside of the U.S. and U.S. territories).

STEP 1: Complete New York State’s infection control coursework requirement.

You can find an NYSED-approved infection control course here.

STEP 2: Submit an online application for LPNnlicensure.

There is also a limited permit application option for those who have not taken the NCEX-PN.

STEP 3: Have your foreign nursing credentials verified.

There are two options:

  • Arrange to have the Commission on Graduates of Foreign Nursing Schools (CGFNS) verify your nursing education credentials to the NYSED using CGFNS’ Credential Verification Service for New York State. You must also arrange for NYSED to receive verification of your nursing license from the licensing authority that issued it using a Verification of Foreign Professional Licensure/Certification form.

  • You must arrange to have your credentials verified by your foreign nursing school using a Certification of Professional Education form.

STEP 4: Pass the NCLEX if you haven’t already.

If you haven’t passed NCLEX-PN, you must register to take the NCLEX-PN with Pearson VUE.

The California Department of Consumer Affairs website offers applications for vocational nurse licensure by endorsement for foreign-educated LPNs. However, eligibility appears to be for LVNs with Special Immigrant Visas or those who are refugees and asylum seekers.

Contact your state’s individual nursing board for more information on foreign-educated LPN work if you are a foreign-educated LVN in the US with a non-work visa.

Nurses NOT Eligible To Work In The United States

Unfortunately, not all foreign-educated nurses are eligible to work in the United States. These include but are not limited to:

  • Nurses with less than two years experience
  • Nurses lacking a four-year nursing degree (state dependent)
  • Individuals who have committed a crime
  • Nurses who lack sponsorship from a reputable nursing agency

Next Steps for Nurses Who Want to Work in the U.S.

Due to ever-changing immigration laws, it is important for potential nurse immigrants to speak directly to staffing agencies or immigration lawyers to ensure all laws are followed. Most foreign-educated nurses work closely for several years prior to working in the United States as a registered nurse.

Those seeking additional information regarding specific immigration laws should search the U.S. Department of Homeland Services and U.S. Department of Labor.'s Popular Articles and Resources

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How to Work in the US as a Foreign-Educated Nurse (5)

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Can foreign trained nurses work in USA? ›

You're eligible to work in the US if you're a Registered Nurse in your home country. Contact the Commission on Graduates of Foreign Nursing Schools (CGFNS) to see if you're qualified. When you know where in the US you'd like to work, you can apply to that state's Board of Nursing and take the NCLEX-RN.

How can a foreigner become a nurse in US? ›

You will need to obtain a Registered Nurse Immigrant Visa (“Green Card”) or H-1B visa. U.S. law requires nurses to complete a screening program before they can receive an occupational visa.

Can a foreign nurse work in the US without NCLEX? ›

If you are a foreign nurse and want to work in the USA, you must pass the NCLEX.

Can a foreign nurse take the NCLEX? ›

Can a foreign nurse take the NCLEX? Yes! The NCLEX exam is open to international nurses and is a necessary step to qualify foreign nurses to work as registered nurses in the U.S.

Do hospitals sponsor green card? ›

Again, the basic requirements most hospitals will require to sponsor a nurse green card are: NCLEX RN license. Nursing degree. Healthcare skills.

How long does it take for a nurse to get a green card? ›

You can expect to receive your receipt notice in 2-3 weeks after submitting the form I-140, and it can take up to six to eight months or longer or more to receive an approval notice on an application. The entire process, from start to finish, can take anywhere between one to three years.

What are the requirements for a nurse to work in us? ›

CGFNS reports that the minimum requirements needed to work in the U.S. as a nurse are graduation from an accredited RN program, an unencumbered RN licensure, and two years of working experience in the profession.

What are the requirements to work as RN in USA? ›

Registered nurses must have a nursing license issued by the state in which they work. To become licensed, nurses must graduate from an approved nursing program and pass the National Council Licensure Examination (NCLEX-RN). Other requirements for licensing, such as passing a criminal background check, vary by state.

Can I work as a nurse in USA without experience? ›

The qualifications you need to start working as a nurse with no experience include a nursing degree and license and the skills to adapt to different healthcare environments. A registered nurse has an associate degree in nursing or a bachelor's of science in nursing degree (a BSN).

Which state is easiest to take NCLEX for foreign nurses? ›

None. There is no “easy” state to take the NCLEX. The NCLEX is a national exam administered by the National Council of State Boards of Nursing (NCSBN). Because it's national, the NCLEX will be the same regardless of what state you choose to take it in.

Can nurses get h1b visa? ›

H-1B Work Visa Eligibility Requirements for Nurses

You must be a working in a nursing position that qualifies as a “specialty occupation,” which is any occupation that typically has a minimum educational requirement of a four-year Bachelor's degree.

Can you be a nurse if you don't pass the NCLEX? ›

All nurses have to pass the NCLEX to acquire a nursing license and practice. If you fail the exam, you should reschedule and restudy as soon as possible to get closer to working as a nurse. In some states, you must inform your employer once you learn you didn't pass the NCLEX (if you're already employed).

Which state is easiest to get RN license? ›

Easiest states to become a nurse – Length of licensing process
  • Maine: 1-2 weeks.
  • Maryland: 2-3 days.
  • Missouri: 2 weeks.
  • Nevada: 1-2 weeks.
  • North Carolina: 1-2 weeks.
  • North Dakota: 1-2 weeks.
  • Texas: 2 weeks.
  • Vermont: 3-5 business days.

How many times can you fail NCLEX? ›

If they fail, they'll need to wait 45 days before retesting. After failing three times, though, they'll need to complete a board-approved remediation program before the next retake. test-takers have six attempts to pass in total.

Can I work as a nurse in USA without ielts? ›

Which test do I need to take? The IELTS offers two different exams and so it is important that you choose the right test; IELTS Academic and IELTS Professional. If you are an international registered nurse that wants to work in the USA, you will need to take the IELTS Academic.

Is USA giving green cards to nurses? ›

No more applications for green cards for foreign nurses will be accepted by the State Department this year, and only applications submitted by June 2022 will be processed until the backlog eases up and more green cards are made available, according to a bulletin issued by the department April 20.

Do hospitals sponsor h1b for nurses? ›

As a foreign nurse, you will need a sponsor as per H-1B visa requirements, and in the majority of cases, a hospital will usually be your sponsor.

Which U.S. companies sponsor green card? ›

Top 10 Green Card Sponsors in 2021
  • Microsoft Corporation.
  • Services LLC.
  • Google LLC.
  • Tata Consultancy Services Limited.
  • Apple Inc.
  • Intel Corporation.
  • Amazon Web Services Inc.
  • Capgemini America Inc.
Jan 19, 2022

Do nurses get green card faster? ›

Being a Schedule A professional means you can use an expedited process to get a green card (lawful permanent residence status in the U.S.). The process fast-tracks your application for a green card. In order to use the Schedule A process, you must have a bona fide, full-time, permanent job offer from a U.S. employer.

Which state is best for Nclex? ›

Complete List of Average NCLEX Pass Rates by State
State (including Washington D.C.)NCLEX Pass Rate Five-Year Average (2017-2021)Average Salary (2022)
West Virginia90.2%$67,640
District of Columbia90.16%$98,540
47 more rows
Apr 25, 2023

What is the fastest way to become a nurse in the US? ›

The fastest way to become an RN is through an RN diploma program, which can be completed in as little as a year. While completing this program does not lead to a degree, it does make the individual eligible to take the NCLEX and earn their RN license.

How can I sponsor a nurse to USA? ›

To obtain an H-1B visa for a foreign nurse, the U.S. employer, such as a hospital or medical clinic, would file an I-129 petition with United States Citizenship and Immigration Services (USCIS). This agency decides whether or not to approve the employer's request for H-1B status for the worker.

How long does it take to move to USA as a nurse? ›

Generally, the process of obtaining permanent residence may take between 12 to 18 months assuming that the immigrant visa quota from the RN's country of birth is not backlogged.

How hard is the NCLEX exam? ›

NCLEX Pass Rates

The second-attempt pass rate for domestically-educated students taking the test was 45.56%. These results demonstrate that it is a pretty difficult test. The questions are designed to test your critical thinking, knowledge of the nursing process, and assessment skills.

What is the minimum salary for RN in USA? ›

The average registered nurse salary in the USA is $74,773 per year or $35.95 per hour. Entry level positions start at $53,868 per year while most experienced workers make up to $117,297 per year.

What country do nurses make the most money? ›

Top Paying Countries for Nurses In the World
  • Luxembourg - $96,000 (USD) Currently topping the list as the highest-paid country in the world for nurses, this tiny country in Western Europe pays its nurses very well. ...
  • Denmark - $87,436 (USD) ...
  • Canada - $50,168 per year, $27.58 per hour (USD)
Mar 22, 2023

Is it worth it to work as a nurse in USA? ›

Nursing is an exciting profession with tremendous growth, advancement, and always being in demand. If you choose, you can earn an advanced degree and slip into another role in the world of nursing. Some examples would be earning a master's degree, becoming a nurse practitioner, or working in management.

Which state does not require Cgfns for NCLEX? ›

California. California does not require CGFNS certification or require the foreign educated nurse applicant to pass the CGFNS qualifying exam.

What is the best country for nurses to work and live in? ›

  • Luxembourg. Luxembourg is one of the top highest-paying countries for nurses. ...
  • Germany. If you are thinking about which country is best for nursing jobs, Germany is one of the highest-paying countries for nurses. ...
  • United States. ...
  • Canada. ...
  • Virgin Islands. ...
  • Australia. ...
  • Switzerland.
Jan 31, 2023

What IELTS score is required for nurses in the US? ›

Universities and other organizations in the USA accept the IELTS exam as an indicator of your English language capabilities, as do healthcare employers. In order to work as a nurse in the USA, you will need an overall score of 6.5, with a 7 in Speaking.

What state is the hardest to get a nursing license? ›

ALASKA. The Last Frontier is calling! While that may be the case, a nurse interested in working in Alaska must first go through the (on average) 8-week nursing license process. Alaska, like all the aforementioned states, requires fingerprints and a background check from nurses applying for a license.

What is the cheapest state to take the NCLEX? ›

NCLEX New York is a single state and it doesn't require any experience. It is less hassle and the cheapest among the three states. The processing time will only take 6 to 7 months and it has lesser requirements.

What states have unlimited NCLEX attempts? ›

States With Unlimited NCLEX Attempts
  • Alabama.
  • Arizona.
  • Arkansas.
  • California.
  • Connecticut.
  • Idaho.
  • Iowa.
  • Kansas.
Mar 30, 2023

How much do H-1B nurses get paid? ›

Registered Nurse's H1B Salary 2022
30 more rows

Can I work as a nurse in the USA with a tourist visa? ›

If you are looking to work in the US as a foreign nurse on a temporary basis, you will want to apply for an H-1B visa. An H-1B is a popular temporary work visa for foreign nationals who have a job offer from a US employer to work in a “specialty occupation”, such as nursing.

Can nurses become US citizens? ›

It's true! After you become sponsored on a Green Card Visa with Medliant as a US Registered Nurse for five years you will then be eligible to apply for your US Citizenship! If you intend on staying in the USA permanently, applying for US citizenship is the appropriate next step to make this a possibility.

How many nurses fail the NCLEX the first time? ›

What Are Your Chances Of Failing NCLEX-RN On The First Attempt? The National Council of State Boards of Nursing (NCSBN) reports 13.43% of NCLEX-RN candidates fail the exam on their first attempt. The number of unsuccessful test-takers is low compared to the more than 86% who pass the exam on their first try.

Is getting 75 questions on the NCLEX good? ›

Yes, you can pass the NCLEX-RN by answering only 75 questions. Keep in mind, the number of questions you answer may be a sign you passed, but it is not a definite sign. If your questions got progressively more challenging until the test stopped, this is one of the good signs you passed NCLEX in 2023.

What happens if you don't pass the NCLEX in 3 years? ›

If you have not passed the NCLEX by the three-year anniversary of your graduation, you will have to attend a nursing education program before you may take the exam again.

How many times can I take NCLEX? ›

If you happen not to pass the exam, you can retake it after 45 days. And if you are wondering how often you can take the NCLEX, the NCSBN retake policy allows for a retake eight times a year, ensuring 45 exam-free days between each test.

What state has the least nurses? ›

California has the most severe nursing shortage, with a projected shortage of 44,500 nurses by 2030. 55% of registered nurses are over the age of 50.

How long should I study for my NCLEX? ›

HOW LONG SHOULD YOU STUDY FOR THE NCLEX? To pass the NCLEX, students should plan to spend a minimum of 1-2 months studying.

What is the pass rate for the NCLEX exam? ›

NCLEX Pass Rates by State
47 more rows
Apr 1, 2023

Can I take the NCLEX exam online? ›

You can not take the NCLEX at your home. The NCLEX is administered by Pearson VUE and can only be taken at Pearson Vue testing centers.

Can a foreigner become a nurse in USA? ›

You will need to obtain a Registered Nurse Immigrant Visa (“Green Card”) or H-1B visa. U.S. law requires nurses to complete a screening program before they can receive an occupational visa.

Can foreign nurse apply for green card? ›

However, a foreign-born RN must pass the NCLEX examination (and sometimes the CGFNS examination), pass an English examination, obtain a VisaScreen certificate and be sponsored by a US employer in order to immigrate to the United States.

How can I work as a registered nurse in USA? ›

Steps to Become a Registered Nurse
  1. Earn your Degree. In order to become a registered nurse, you will need to earn a degree from an accredited institution. ...
  2. Pass the NCLEX Exam. ...
  3. Obtain State Licensure. ...
  4. Seek Advanced Training (optional)
Feb 3, 2021

Can nurses self petition green card? ›

If you have a nursing degree, you can apply for a green card under this category. In most cases, however, you must have a professional license to practice in the U.S. To apply for EB3 green cards for nurses, you must file a Form I-140 application package with appropriate supporting documentation.

How can I convert my b1 b2 visa to green card? ›

Steps for Adjustment of Status
  1. Determine if you are eligible to apply for a Green Card. ...
  2. You or someone else must file an immigrant petition for you (if applicable) ...
  3. Check visa availability (if applicable) ...
  4. File Form I-485. ...
  5. Go to your Application Support Center appointment. ...
  6. Go to your interview (if applicable)
Dec 27, 2022

Are nurses eligible for h1b visa? ›

H-1B Work Visa Eligibility Requirements for Nurses

You must be a working in a nursing position that qualifies as a “specialty occupation,” which is any occupation that typically has a minimum educational requirement of a four-year Bachelor's degree.


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