Welcome Internationally Educated Nurses

Answers to some of your most frequently asked questions

Frequently Asked Questions

What are the educational requirements to become an RN/LPN in the U.S.?

There are three general requirements:

     1. You need to have completed nursing school from an accredited nursing program.
     2. Being a licensed RN/LPN.
     3. Having practiced as an RN for at least 2 years.

For more information, you may visit the NCSBN website U.S. Nursing Licensure for Internationally Educated Nurses | NCSBN

Can I work as a registered nurse in the U.S. without any previous working experience?

If you have not worked for a minimum of two years after you have graduated from your nursing school, most state boards will not license you until you complete an FEN (Foreign Educated Nurses) refresher course. You need to check with the Board of Nursing (BON) of the state where you are planning to work to verify if the course is required.

How can I find an FEN refresher course?

You can find a Foreign Educated Nurses review course through an online search.

Will I need to pass an English test?

Depending on which country you are from, you will be required to take one of the following tests:

     1. TOEFL (Test of English as a Foreign Language) *Most commonly required
     2. TOEIC (Test of English for International Communication)
     3. IELTS (International English Language Testing System)

What is the purpose of the TOEFL exam?

This test is used as an evaluation of English proficiency and readiness for academic programs. You can visit www.TOEFL.org for more information.

Is there any chance I might be excused from taking the English exam?

You may be excused from taking the TOEFL exam if:
     1. You attended nursing school in the U.K., Australia, New Zealand, Canada (except Quebec), or the Republic of Ireland.
     2. The spoken language of your nursing school was English
     3. Your nursing school textbooks were written in English

What steps do I need to take to get my nursing license in the U.S.?

Step 1. Meet the Basic Requirements
Step 2. CGFNS Evaluates your Credentials
Step 3. Pass a Licensure Exam

To practice nursing in the United States, you must have a professional license from the state where you plan to work. State Boards of Nursing regulate registered Nurse licenses with varying requirements.

You will likely need to pass a licensure exam to be registered as a nurse by your state board. Before taking the licensure exam, first-level, general nurses educated outside the U.S. may choose to apply to the CGFNS Certification Program®, which consists of:
     – a credentials evaluation
     – the CGFNS Qualifying Exam®, and
     – an English language proficiency component.

The CGFNS Qualifying Exam® is a requirement by some state boards before you can sit for the NCLEX-RN, but it is an excellent predictor for how any nurse will do on that exam. The Qualifying Exam may help gauge your readiness before committing to the licensure exam.

The Qualifying Exam also fulfills the U.S. federal government’s screening requirement for an occupational visa.
View the requirements for the board of nursing in the state where you seek to practice >>

Source: How to Work as a Nurse in the U.S. – CGFNS International, Inc.

Do I need to take an NCLEX preparation course before registering for my NCLEX exam?

It is highly recommended that you take a comprehensive NCLEX review course that will address you learning style and needs to increase your chances of passing the exam.

What documents do I need to get an RN immigrant visa green card?

To get an RN immigrant visa card you will need evidence of a US based employer who will be the petitioner (I.e. A Hospital or recruiting agency) and a Visa Screen Certificate (VSC) by the international commission on Health Care Professionals (ICHP)


International Educated Nurses

Feuer Nursing Review has a long history of preparing internationally educated nurses for the NCLEX. As a matter of fact, Angelica Feuer, FNR’s President, is a nurse who studied nursing in Chile before enrolling in a Feuer review and passing the NCLEX with Dr. Helen Feuer in 1981.

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

International nurses 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). They 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 divided into four sections: Listening, 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. 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:

The U.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 professionals 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

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 eligibility and readiness for the NCLEX licensure examination. The Qualifying Exam is an additional cost.

Pass the NCLEX Exam

Students who meet the above requirements can apply for the NCLEX (National Council Licensure Examination.) Applicants must apply in the states where they seek employment. Applicants should be aware that there is a $200 fee plus an additional international scheduling fee of $150 to foreign takers to apply to take the NCLEX (source: Fees & Payment | 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?
Candidates can retake the NCLEX if they do not pass on their first attempt. However, they will have to pay the fee again.

Repeat, U.S.-educated test taker’s pass rate is 48.12%, and Repeat, Internationally Educated test taker’s pass rate is 36.18% (Based on the 2023 YTD stats. Source: 2023 NCLEX Pass Rates | NCSBN)

Many NCLEX review courses are available for nurses preparing for the NCLEX. Most focus on practice questions, test-taking strategies, or a combination of those. Little attention to content which is essential for a good foundation is insufficient to pass the NCLEX.

Feuer Nursing Review provides a comprehensive content-based NCLEX review course that has been helping students pass the NCLEX since 1971. The review courses offered are Live Online, Self-Paced Online, and Home-Study Courses, allowing students to choose the course that best fits their learning needs and style.

Our study program is designed to decrease test anxiety and boost self-confidence while providing a solid curriculum, test-taking skills, and effective study plans to fully prepare for the NCLEX.

Finding a Job
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.

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, between 200,000 and 450,000 nursing jobs could be available. This creates an excellent opportunity for nurses to immigrate to the United States.

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