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Nursing in the USA

We have compiled a concise guide to the process of becoming an overseas nurse in the USA. We hope this helps you on your way!


In order to work in the USA as a Registered Nurse:


u Overview of USA Nursing
u Eligibility
u    Requirements
u    CGFNS
u Language Skills
u Visa Application



The salary and benefits package that you receive as a nurse in the USA can vary significantly from state to state. Health Insurance is normally included in the benefits package, but the type of cover offered can also vary. Holiday entitlement will usually be between 2 and 4 weeks a year. 



In the USA the category of first-level of nurse is the Registered Nurse (RN). To be eligible to nurse in America you must be a registered general nurse with at least one-year postgraduate experience and have good English language skills.



Each USA state has a nursing board. Each nursing board has its own set of regulations for overseas-trained nurses.  To work in the USA as an RN, you have to be licensed by the relevant state board of nursing and the license is only valid for that particular state.


To become a  licensed nurse in the USA, most states have two main requirements:


1. CGFNS and



Most states in the USA require you to have both in order to be licensed, however regulations vary from state to state and you should contact the board of the state you wish to work in directly to find out what their requirements are.



The CGFNS Certification Program is designed for first-level, general nurses educated and licensed outside of the United States who wish to assess their chances of passing the U.S. registered nurse licensing exam, the NCLEX-RN, and attaining licensure as registered nurses within the United States.


The certification program consists of three steps.

  • a Credentials Review: CGFNS evaluates an applicant’s education and registration credentials to certify that the applicant is a first-level general nurse and meets all of the registration requirements to be licensed as a professional in that field

  • a one-day Qualifying Exam of Nursing Knowledge: The actual exam is divided into two parts with a total of 260 questions. The qualifying exam measures the applicant’s knowledge and is based on what nurses must know and do when they practice nursing in the United States. The qualifying exam is held 4 times a year in over 40 countries in the world.

  • an English language proficiency exam. The Test of English as a Foreign Language (TOEFL), the Test of English for International Communications (TOEIC) and the International English Language Testing System (IELTS) are currently being used to meet the English language proficiency requirement of the Certification Program. TOEFL and TOEIC are administered worldwide by the Educational Testing Service (ETS). IELTS is jointly managed by: British Council, and IDP: IELTS Australia.

Upon successful completion of all three elements of the Certification Program, applicants are awarded a CGFNS Certificate. The certificate helps applicants in three ways:

1. The certificate will help applicants meet state requirements for the registered nurse licensure exam. Most states require a CGFNS Certificate from nurses educated abroad before they can take the NCLEX-RN examination.

2. CGFNS certificate holders consistently have a higher rate of success on the NCLEX-RN examination than internationally educated nurses who do not hold the certificate.

3. The CGFNS Certificate helps applicants to qualify for an occupational visa. CGFNS was named in section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 as an organization qualified to administer a screening program for healthcare professionals who are seeking an occupational visa. For foreign educated nurses who have not taken the NCLEX-RN exam, passing a predictor exam such as the CGFNS Qualifying Exam fulfills one of the requirements of Section 343.

For more information,


Language Tests

Most nurses educated outside the USA must pass an approved English Language exam before practicing nursing in America. Applicants who received their nursing education in Australia, Canada (except Quebec), Ireland, New Zealand, Trinidad & Tobago or the United Kingdom, and their text books and instruction were in English, do not need to take a language test.



Up until recently (Jan 2007) you could only take the NCLEX in a USA territory. Now you can also sit the NCLEX-RN in London, Seoul and Hong Kong. World-Wide NCLEX Test Centres


For more information,


Visa Application

U.S. Immigration law now requires that healthcare professionals, other than physicians, complete a screening program in order to qualify for certain occupational visas. VisaScreen™, a program offered by The International Commission on Healthcare Professions (ICHP), a division of CGFNS, enables healthcare professionals to meet this requirement by verifying and evaluating their credentials to ensure that they meet the government’s minimum eligibility standards. CGFNS is named in Federal law as a qualified provider of such a screening program.


The VisaScreen™ Certificate is issued directly to the applicant who successfully completed all of the requirements of the program. The applicant then presents it to a consular office or attorney general (when applicable) as part of a visa application. For more information, 
















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