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The latest immigration and visa news for the USA, Canada, Australia, New Zealand, Ireland, and select European countries - straight from the leading immigrant advocates in the Philippines.

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Primer for Foreign RNs intending to Practice in the U.S. - 2018

Could an Internationally-educated, licensed RN qualify for a work visa? If applying for an immigrant visa, how long would be the wait? Are the procedures the same or different for both visas?

Crispin Aranda, Jennifer ArandaOriginally posted on May 26, 2018; updated December 17, 2017

Primer for Foreign RNs intending to Practice in the U.S. - 2018


Nurses educated outside of the United States must complete the following steps to practice their profession whether on a temporary work (H-1B) or permanent resident visa (EB3).

1.  Apply for a license with a state board of nursing. All state boards require the NCLEX® examination. Each state will have specific requirements to determine comparability of those educated outside of the United States. Each state board may require certain services to determine if you will be able to practice in the United States. All required services can be provided by CGFNS International prior to authorizing nurses educated outside of the United States to take the NCLEX® exam.

2.  Register with Pearson VUE to schedule your NCLEX location and date. Registration costs $200, plus additional fees if you are taking the NCLEX outside of the U.S.  The NCSBN website lists the countries and non-member board territories that currently administer the NCLEX examinations:  Australia, Canada, England, Germany, Hong Kong, India, Japan, Mexico, Philippines, Puerto Rico and Taiwan.”

3.  CGFNS Qualifying Exam. In many countries where the NCLEX is not currently offered locally, visa requirements for first level (RN) nurses may be fulfilled by an alternate examination, the CGFNS Qualifying Exam.  Although this exam is a predictor for passage of the NCLEX-RN and satisfies the immigration requirement, it is not accepted for licensure purposes. Applicants who successfully complete the CGFNS Qualifying Exam will still be required to successfully complete the NCLEX-RN in jurisdictions that require it. – (NCSBN Resource Manual on the Licensure of Internationally Educated Nurses, p 8.)  CGFNS explains as well that “the exam is requiredfor CGFNS’s Certification Program and satisfies the nursing exam component for the VisaScreen®: Visa Credentials Assessment. “

4.  Have your credentials assessed. Credential evaluation means that specific institutions would have to determine that your nursing school transcripts and education history from your home country meets the NCSBN requirements and ensure you’re qualified to even take the NCLEX. The NCSBN has accredited and accepts credential evaluation from several entities, although CGFNS is the most popular and well-known.

5.  Take – and pass the NCLEX exam in your country of residence or practice – if available.  NCLEX exam is being administered and given in the Philippines. Arrive for the appointment with sufficient time before start and bring the required or accepted identification documents.

Social Security Numbers (SSN) NCSBN explains this legislative requirement.  “Some jurisdictions have legislative language in place requiring an SSN before a license can be issued. Because a visa, and therefore an SSN, cannot be issued without a nurse license, this presents an impossible situation for IENs desiring licensure in these jurisdictions. The following solutions have been utilized by various boards:

  1. In some states, their legal counsel has interpreted that an International Tax Identification
  2. Number (ITIN) can be used for initial licensure.
  3. Some BONS issue a letter to applicants to be taken to the social security office, stating that the nurse has completed all requirements and that the statutes require an SSN for licensure.
  4. Certain states ask applicants without an SSN to fill out an affidavit or a” request for exception” to the SSN requirement.
  5. In New York, an applicant who does not have an SSN is assigned a random nine-digit number to be the identifier for their licensure records.”

The following states or jurisdictions will only accept a U.S. SSN on an application for nurse

  1. Alabama
  2. Arkansas
  3. California
  4. Connecticut
  5. Florida
  6. Guam
  7. Hawaii
  8. Idaho
  9. Illinois
  10. Indiana
  11. Kansas
  12. Kentucky
  13. Louisiana
  14. Maine
  15. Massachusetts
  16. Michigan
  17. Minnesota
  18. Mississippi
  19. Montana
  20. Nevada
  21. New Hampshire
  22. North Carolina
  23. North Dakota
  24. Northern Mariana Islands
  25. Oklahoma
  26. Oregon
  27. Rhode Island
  28. South Dakota
  29. Utah
  30. Vermont
  31. West Virginia
  32. Wyoming

6. Receive notice from BON about results of your NCLEX exam up to six (6) to eight (8) weeks from taking it.

. Alternatives to CGFNS Credential Evaluation Services:

  • International Education Research Foundation (IERF) ($350 per report, see states that accept IERF)
  • Educational Records Evaluation Services (ERES) ($375 basic fee)
  • Josef Silny & Associates, Inc. ($300 per report)

VisaScreen Certificate

Foreign-educated RNs intending to work or migrate (permanently reside) in the U.S. are required to obtain the VisaScreen Certificate issued by the International Commission on Healthcare Professionals (ICHP) a division of the CGFNS. 

The VisaScreen is a requirement under Section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act (the IIRIRA) of 1996 requires specific health care professionals, born outside of the United States, to successfully complete a screening program before they can receive either a permanent or temporary occupational visa, including Trade NAFTA status.

This screening includes: (a)  an assessment of an applicant’s education to ensure that it is comparable to that of a U.S. graduate in the same profession; (b) a verification that all professional health care licenses that an applicant ever held are valid and without restrictions (c) an English language proficiency examination (d) for registered nurses, a verification of passing either the CGFNS Qualifying Exam®, the National Council Licensure Examination for Registered Nurses (NCLEX-RN®) or its predecessor, the State Board Test Pool Examination (SBTPE)

Other Requirements

  1. Fingerprints: Some states require students to get fingerprints, which can be a complication if you’re currently in another country.
  2. English Proficiency Test: Many states require you to take either the TOEFL or IELTS test to make sure your English is fluent enough. This is usually a part of your NCLEX exam requirements for your CGFNS report. Again, follow instructions that are listed for each state and feel free to contact them for specific details.

This requirement often does not apply if you attended nursing school in Barbados, Canada (except Quebec, the only schools approved for exemption are: McGill University, Dawson College, Vanier College, John Abbott College, and Heritage College), Ireland, Jamaica, New Zealand, South Africa, Trinidad and Tobago, United Kingdom or United States, and if your nursing school and textbooks were taught in English.

English language requirements for the Certification Program

To complete the CGFNS Certification Program, applicants must submit scores from one of four accepted English language proficiency examinations:

1. TOEFL® iBT (Test of English as a Foreign Language, Internet-based Test)

A minimum total score of 83 is required. Please reference code number 9988 on your Certification Program application form to ensure your results will be sent electronically to CGFNS

2. TOEFL® PBT (Test of English as a Foreign Language, Paper-based Test)

A minimum total test score of 540 is required on the paper-based version and a minimum total test score of 207 is required on the computer-based version.  Please reference code number 9988 on your Certification Program application form to ensure your results will be sent electronically to CGFNS

3. TOEIC® (Test of English for International Communication)

A minimum total test score of 725 is required. Please provide your Test Report Form (TRF) number on your Certification Program application form and request IELTS to have your exam scores made electronically available to CGFNS

4. IELTS (International English Language Testing System)

A minimum total test score of 6.5 is required (Academic Module only). Please provide your Test Report Form (TRF) number on your Certification Program application form and request IELTS to have your exam scores made electronically available to CGFNS.

Take note of the following when considering the English language requirements for the Certification Program:

  1. Scores must be from an English language exam taken within 2 years of the Certification Program Qualifying Exam.
  2. You are not required to submit English language test scores in advance of taking the Qualifying Exam®. However, if you pass the Qualifying Exam®, you will not receive a Certification Program Certificate until English language proficiency exam scores are received.
  3. You have 2 years to submit English language proficiency exam scores after taking the Qualifying Exam®. If you do not meet the English language proficiency requirement within 2 years of taking the Qualifying Exam®, you will be required to take the Qualifying Exam® again to receive a Certification Program Certificate.

Immigration Process: Filing petition and applying for the visa

Foreign-educate d RNs – including Filipino Nurses – who have successfully taken the NCLEX and obtained the VisaScreen Certificate are documentarily eligible for sponsorship either on a work visa (H-1B) or permanent resident visa (EB3).

Registered Nurses (RNs) and Physical Therapists (PTs) remain as occupations listed in the U.S. Department of Labor (DOL) as Schedule A Occupations. Sponsoring employers, therefore, need not obtain a Permanent Labor Certification from DOL.

Schedule A is comprised of certain occupations for which DOL has determined there are not sufficient U.S. workers who are able, willing, qualified and available. In addition, Schedule A establishes that the employment of aliens in such occupations will not adversely affect the wages and working conditions of U.S. workers similarly employed.

The occupations listed under Schedule A include:

Group I

  1. Physical Therapists - who possess all the qualifications necessary to take the physical therapist licensing examination in the state in which they propose to practice physical therapy; and
  2. Professional Nurses - the alien (i) has a Commission on Graduates in Foreign Nursing Schools (CGFNS) Certificate, (ii) the alien has passed the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam, or (iii) the alien holds a full and unrestricted (permanent) license to practice nursing in the state of intended employment.

Group II

  1. Sciences or arts (except performing arts) - Aliens (except for aliens in the performing arts) of exceptional ability in the sciences or arts including college and university teachers of exceptional ability who have been practicing their science or art during the year prior to application and who intend to practice the same science or art in the United States. For purposes of this group, the term "science or art" means any field of knowledge and/or skill with respect to which colleges and universities commonly offer specialized courses leading to a degree in the knowledge and/or skill. An alien, however, need not have studied at a college or university to qualify for the Group II occupation.
  2. Performing arts - Aliens of exceptional ability in the performing arts whose work during the past 12 months did require, and whose intended work in the United States will require, exceptional ability.

An employer must apply for a labor certification for a Schedule A occupation by filing an ETA Form 9089, in duplicate, with the appropriate USCIS Service Center, and not with DOL.

Filing the Petition

  1. The qualified U.S. Employer files the working visa petition on Form I-129 Petition for Nonimmigrant Worker or Form I-140 Immigrant Petition for Alien Worker with the U.S. Citizenship and Immigration Services (USCIS).  Note that the H-1B work visa for which most RNs with experience may qualify is done through visa lottery.  The EB3 on the other hand has a waiting period, which has considerably shortened of late (less than 2 years).
  2. Once approved, the I-129 petition is sent to the Employer and the applicant proceeds to the U.S. Embassy for the interview. 
  3. The I-140 Petition, on the other hand, is forwarded by the USCIS to the National Visa Center (NVC) for safekeeping and scheduling for interview at the specific consular post when the priority date becomes current.  The priority date is the date the I-140 petition was received and acknowledged by the USCIS.
  4. The applicant appears for the scheduled interview at the U.S. Embassy (or consular post) on the date indicated in the NVC letter.

.If you have additional concerns or need assistance, please call or text the Immigrant Visa Center at 6t3-917-529-8472

Authors & Contributors

Crispin Aranda

Crispin Aranda

Crispin R. Aranda is an established International Visa Conselor and Immigrant Advocate. He is the president of IVC and is in several migration radio programs.

Jennifer Aranda

Jennifer Aranda

Jennifer S. Aranda is the COO of IVC Immigrant Visa Center, Inc.

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