How to Work in the U.S. As a Foreign-Educated Nurse

Nursing is an incredibly popular career across the globe, and many nurses consider bringing their practice to the United States. After all, working in the U.S. as a nurse has great benefits such as a variety of employers to choose from and a fair salary. According to the U.S. Bureau of Labor Statistics, the average annual salary of a nurse ranges from $59,450 to $120,250 with $77,600 being the median.

Our guide helps you understand the process of becoming a foreign-educated nurse in the United States and answers vital questions like:

• What Is the Process for Working in the U.S. As a Foreign Educated Nurse?
• How Much Does It Cost to Work as a Foreign-Educated Nurse in the U.S.?
• How Long Does It Take To Work as a Foreign-Educated Nurse in the U.S.?
• Are There Any Restrictions to Working as a Foreign-Educated Nurse in the U.S.?
• What Are the State Specific Requirements for Foreign-Educated Nurses?
• What Are the Immigration Requirements for Foreign-Educated Nurses?
• Where Can I Get a Certified Translation?

What Is the Process for Working in the U.S. As a Foreign-Educated Nurse?

The process for working in the U.S. As a foreign-educated nurse involves several steps which include:

1. Meeting the general education requirements for foreign-educated nurses, such as graduating from an accredited associate’s or bachelor’s degree nursing program. You will also need to have obtained licensure for nursing in your home country, as well as possess a minimum of two years’ work experience as a registered nurse (RN).
2. Take an English language proficiency test, if required. The two tests available are the Test of English as a Foreign Language (TOEFL) and the International English Language Testing System (IELTS), though TOEFL tends to be more common.

Exemptions from taking an English language proficiency test are granted for those who completed their foreign education in the United Kingdom, Ireland, Australia, New Zealand, or Canada (excluding Quebec), and to those whose nursing education was imparted in English using English language textbooks.

1. Become certified with the Commission on Graduates of Foreign Nursing Schools (CGFNS). The CGFNS offers a certification program for foreign-educated nurses that aims to help them easily complete the steps needed to work in the United States. This certification program includes a credential evaluation that converts foreign nursing education to the U.S. equivalent and ensures you have completed all education, licensure, and employment prerequisites, in addition to accepting and verifying your evidence of passing the TOEFL or IELTS and of passing the CGFNS qualifying exam.

If you choose not to utilize the CGFNS certification program, you will need to take the qualifying exam separately and obtain a separate credential evaluation; this can be confusing and more time-consuming than utilizing the all-encompassing certification program that CGFNS provides, but some individuals may prefer to complete each step of this process separately.

1. Pass the National Council Licensure Examination for Registered Nurses (NCLEX). This examination is required of all nurses in the United States and all individuals that wish to practice in the United States as foreign-educated nurses. You will need to register for the NCLEX and pay a fee, in addition to choosing your test date and location. The NCLEX is also administered internationally for those who wish to eventually practice nursing in the United States.
2. After you have obtained CGFNS certification and passed the NCLEX, you will need to apply for your nursing license. Nursing licensure is typically handled on a state-by-state basis, and you will need to contact the nursing license board of the state you wish to work in for more detailed information on what is required as part of your licensure application.
3. Once you have completed all educational requirements, passed your examinations, and applied for licensure in the state that you wish to work in, it’s time to start looking for jobs. You can contact facilities directly, or you can work with a staffing agency. The CGFNS does provide a list of certified recruiters. You will need a U.S. employer to serve as a petitioner on your visa application to work in the U.S.
4. Ensure you meet federal immigration requirements for those wishing to practice nursing in the United States. The visa type that you will be required to obtain is the H-1B Visa, also sometimes referred to as a Registered Nurse Immigrant Visa. An easy way to certify that you meet specific federal visa requirements and complete an essential first step of your visa application is to use the VisaScreen service provided by the CGFNS. This service reviews the credentials of registered nurses and other healthcare professionals to determine eligibility for U.S. visas, providing you with proof of eligibility that you can utilize as part of your visa application.

It’s also important to note that any foreign credentials such as degrees, transcripts, licenses, and records of foreign employment as a registered nurse will most likely require a certified English translation provided alongside it. You may be required to submit this information many times throughout this process.

How Much Does It Cost to Work as a Foreign-Educated Nurse in the U.S.?

The overall cost of working in the U.S. as a foreign-educated nurse is not inexpensive. If you utilize the CGFNS’s certification program, you will pay around $475; if you also use the CGFNS VisaScreen service, this is $700. Your H-1B visa application to the USCIS will be around $460, and it costs $200 to take the NCLEX, plus $350 to register for the exam. All of this comes up to a total of $2,185, not including any additional government application fees, testing or document fees, background check and screening costs, fees for certified translations, the cost for taking an English-language proficiency test, and national or state licensure fees. These fees vary based on your individual situation and the state you are applying to work in.

How Long Does It Take To Work as a Foreign-Educated Nurse in the U.S.?

The process for working as a foreign-educated nurse in the United States can take several years due to waiting times and limits on the number of green cards that the United States awards, and the studying periods needed for you to pass the CGFNS qualifying exam, the NCLEX, and work with licensure boards in the U.S. to obtain your nursing license. If you also need to complete the TOEFL or IELTS, this might add a few extra months to your overall timeline.

Are There Any Restrictions to Working as a Foreign-Educated Nurse in the U.S.?

There are no restrictions for foreign-educated nurses working in the United States, as long as they are able to complete each step of the process and pass the required visa screening and application processes. Once you have obtained all of the required licenses and have a prospective job with a U.S.-based employer, you will be able to apply for your visa to eventually practice as a foreign-educated nurse in the United States.

What Are the State-Specific Requirements for Foreign-Educated Nurses?

State-specific requirements for foreign-educated nurses vary based on each state’s regulations and licensure application requirements. You will need to check with the nursing license board of the specific state that you wish to practice in to learn more about what exactly is required of you to obtain your license. Most states will require proof of passing scores on the CGFNS qualifying exam, NCLEX, any applicable English language proficiency test (TOEFL or IELTS), and a credential evaluation, complete with certified translations of original documents from the country you were educated and worked in. Visit the National Council of State Boards of Nursing (NCSBN) for more information on nursing licensure and state-specific requirements.

What Are the Immigration Requirements for Foreign-Educated Nurses?

Foreign-educated nurses are required to obtain a visa to travel to the United States legally and practice nursing. The visa that the majority of foreign-educated nurses will need to apply for is the H-1B visa for specialty occupations. U.S. Citizenship and Immigration Services provides more information about the requirements for this visa, and it’s important to keep in mind that you will need a U.S.-based employer to act as a petitioner on your visa application – this means that they are verifying you will have a job once you travel to the United States.

Where Can I Get a Certified Translation?

Certified translations are a vital part of the process as you consider working in the U.S. as a foreign-educated nurse. Credential evaluation services, the CGFNS, state licensure boards, and even your visa application may all ask for original education and employment documents from your time in your home country along with a certified translation of the document. Visit our online store to obtain a certified translation of your important documents such as:

• Diplomas
• Academic transcripts
• Business licenses and certifications
• Resumes and employment records
• Birth certificates

Order Your Certified Translation