To practice here, international nurses generally need to have graduated from an accredited nursing program in their home country, hold an RN license in that country, and have at least two years of RN experience. Your exact path depends on the state you move to, but the core steps are the same everywhere.
Five steps to a U.S. nursing license
1. Pass an English-proficiency test. Most programs require the TOEFL, though some accept the IELTS. You need at least an 83 overall and 26 on the spoken section of the TOEFL, or a 6.5 overall and 7.0 on the spoken section of the IELTS. Scores stay valid for two years. Nurses who trained in English-speaking countries can skip this step, including RNs from the United Kingdom, Canada (except Quebec), New Zealand, and Australia.
2. Get your credentials evaluated. The Commission on Graduates of Foreign Nursing Schools (CGFNS) verifies international nursing credentials. Submit your documents in English (or pay for translation), including high school transcripts, licenses, diplomas, and education records. For a fee, CGFNS produces a Credentials Evaluation Service academic report, which some states require for licensure.
3. Obtain a visa. You will need an RN immigrant visa or an H-1B visa, both of which require a federal screening program. The Department of Homeland Security authorizes CGFNS to conduct that screening.
4. Pass the licensure exam and meet state requirements. Some states require the CGFNS qualifying exam before you can sit for the NCLEX-RN. Then check with the state board of nursing, which will typically have you pass the NCLEX-RN, submit fingerprints, and complete an application.
5. Apply for a job. A recruiter can act as your U.S.-based employer, which you need for the visa application.
Requirements shift and vary by situation, so build your plan around the specific state you are targeting. Contacting CGFNS early is worth the fee. Their expertise is what gets you through the complicated parts.
Frequently Asked Questions
Can I practice nursing in the U.S. with a license from another country? Not directly. You keep your home-country credentials, but you have to earn a U.S. RN license in the state where you plan to work, which means meeting that state board's requirements and passing the NCLEX-RN (NCSBN).
Do I have to take an English-proficiency test? Usually, unless you trained in an approved English-speaking country (the United Kingdom, Canada outside Quebec, Ireland, Australia, or New Zealand). Common minimums are a TOEFL internet-based score around 83 with 26 on speaking, or an IELTS 6.5 overall with 7.0 on speaking. Scores are valid for two years, and exact thresholds vary by state.
What does CGFNS do? The Commission on Graduates of Foreign Nursing Schools verifies international nursing credentials, issues the Credentials Evaluation Service report that many states require, and runs the federal screening tied to your visa. Contact CGFNS early in the process.
Which visa do internationally educated nurses use? Most use an RN immigrant visa or an H-1B visa. Both require a federal screening program, which the Department of Homeland Security authorizes CGFNS to conduct.
How long does the whole process take? It varies widely by country, state, and visa type. Plan for months, not weeks. Knowing your destination state before you start lets you research its specific board requirements and avoid repeating steps.
Bottom line
Transferring a foreign nursing license into the United States is an involved but achievable process. Know your destination state before you start so you can research its requirements, and lean on CGFNS for credential verification, qualifying exams, and pre-visa screening.