How to Work in the United States as a Foreign Trained Nurse

Nursing is the nation’s largest healthcare profession, with over 4.2 million nurses in the United States. As the nursing shortage continues to grow, new nurses are constantly needed to keep up with patient demand. Recently the United States has seen a surge in nurses from the Philippines, India, and Nigeria. But for these nurses to be able to practice in the United States, there are many requirements that they must achieve and complete before they are able to treat any patients.

Educational Requirements

A group of nursing students in a classroom

Nurses from Africa that want to work in the United States must meet specific educational criteria set forth by the Commission on Graduates of Foreign Nursing Schools (CGFNS). Nurses from Africa must have proof of graduation from an accredited nursing program, valid nursing licenses, and have worked as a registered nurse for at least two years. In some states, foreign-trained nurses must take an English Proficiency Test. The English Proficiency Test is broken up into four sections, Listening and Reading and Speaking, and Writing. The English proficiency test can take up to four hours to complete and once completed applicants must achieve a total score of 84 and a speaking score of 26. Students who are exempt from taking the test are students who completed their nursing education at a program whose education was completed in English, and the program was completed in one of the following countries:

  • Australia
  • 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
  • United States


To legally work as a nurse in the United States, you must apply for a Registered Nurse Immigrant Visa. For nurses to be considered for a work visa, they must complete the following:

  • S. law requires nurses to complete a screening program before they can receive an occupational visa.
  • The U.S. Department of Homeland Security approves CGFNS to validate the credentials of nine foreign healthcare professions for occupational visas, including registered nurses.
  • Completing CGFNS’ VisaScreen®: Visa Credentials Assessment Service will satisfy the screening program requirement.
  • You will need a “U.S.-based employer” to serve as your visa’s petitioner. Your VisaScreen® certificate must be included on every visa or green card petition filed on your behalf.

Confirmation of Credentials

verification of professional qualifications.

The Commission on Graduates of Foreign Nursing Schools (CGFNS) will evaluate transcripts and qualifications to ensure that requirements are completed before you can apply to take the licensing exam in the state where you wish to work. You may also be asked to take the CGFNS Qualifying Exam to determine if you are eligible and ready to take the NCLEX licensure examination. The Qualifying Exam is an additional cost.

Pass the NCLEX Exam

signifying success in passing the NCLEX exam

Students who meet the above requirements can apply for the NCLEX (National Council Licensure Examination.) Applicants must apply in the states that they seek employment. Applicants should be aware that there is a $200 fee to apply to take the NCLEX. Currently, applicants can take the NCLEX at an NCLEX testing center in the following countries:

  • United States
  • Canada
  • Australia
  • England
  • Germany
  • Hong Kong
  • India
  • Japan
  • Philippines
  • Puerto Rico
  • Taiwan
  • South Africa-Johannesburg

What Happens If You Don’t Pass the NCLEX?

 A distressed person sits at a desk, head in hands,

Candidates can retake the NCLEX if they do not pass on their first attempt. However, they will have to pay the fee again. For the second time NCLEX test takers, the pass rate is 39.07%. Many programs are available for nurses who struggle with the NCLEX or want tips and strategies to help them pass. Feuer NCLEX Comprehensive Content Based Review Course has been helping students prepare for the NCLEX since 1971. The review courses offered are Live Online, Self-Paced Online, and Home-Study Courses, allowing students to choose the course best for their learning needs and style. Courses like these help students after graduation hone their skills and enhance their knowledge of nursing content and test-taking strategies.

Finding a Job

Illustration of a person browsing through job listings

Due to the current nursing shortage in the United States, many hospitals, clinics, and other areas of healthcare are constantly hiring nurses. Many of these companies are offering large sign-on bonuses and tuition reimbursement. The best way for nurses to find job opportunities is to look online. Search job boards and individual hospitals’ websites for available job openings. From there, you can refine your search to find a job that fits your needs.


Finding a Conclusion

It is an exciting opportunity for foreign nurses to work in the United States of America. The nursing shortage is projected to continue for some time and by 2025 there could be between 200,000 and 450,000 nursing jobs available. This creates an excellent opportunity for nurses to immigrate to the United States.

Written by Feuer Nursing Review