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Question: I earned my nursing license outside of the U.S. What steps do I need to take to practice in the United States?
Answer: Trying to move your license into the United States is possible, though it will take some planning, time, and patience.
International nurses must meet specific eligibility requirements to practice in the U.S.:
- Graduate from an accredited nursing program in your origin country,
- Have a license to practice as a registered nurse (RN) in that country; and
- Possess at least two years of experience working as an RN.
To further complicate matters, your exact steps will be determined by the state where you want to move. However, there are several common steps, regardless of the state.
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5 Steps to Receiving a U.S. Nursing License
1. Take the English-language proficiency test.
Schools most commonly require the Test of English as a Foreign Language (TOEFL), though some institutions will also accept the International English Language Testing System (IELTS). You will need to score at least an 83 overall and 26 on the spoken section of the TOEFL, or a 6.5 overall and a 7.0 on the spoken section of the IELTS.
While taking this test is a great starting point, your scores remain "good" for up to two years. You may want to verify that your educational and professional experiences are acceptable and that you are ready to make the move.
Nurses who completed English-speaking programs may be exempt from these tests. RNs who attended school in the United Kingdom, Canada (except Quebec), New Zealand, and Australia can skip this step.
2. Have your credentials evaluated.
The Commission on Graduates of Foreign Nursing Schools (CGFNS) is a nonprofit organization dedicated to verifying the credentials for nurses and other allied health professionals to help them live and work in the country of their choice. They will help you complete the steps needed to practice in the United States (or wherever else you may move).
You'll need to submit your documents (in English, or pay a fee for translation into English), including high school transcripts, licenses, diplomas, and professional education information. For a fee, CGFNS will provide a detailed Credentials Evaluation Service Academic Report. Some states require this report for licensure.
3. Obtain a visa.
The United States requires a screening program to get an RN immigrant visa or H-1B visa. This process seems intimidating, but the U.S. Department of Homeland Security qualifies the CGFNS to conduct these screening requirements.
4. Pass the licensure exam and meet state requirements.
Licensure requirements vary from state to state. Some states require that you take the CGFNS qualifying exam before receiving eligibility to take the National Council Licensure Examination for RNs (NCLEX-RN). The exam also fulfills screening requirements by the federal government needed to receive an occupational visa.
Finally, you'll need to check in with the state board of nursing to determine their licensure requirements. This will likely include taking the NCLEX-RN, submitting fingerprints, and completing the application process.
5. Apply for a job.
Finally! It can help to look for a recruiter to act as your U.S.-based employer, which is needed for the visa application.
Phew! Keep in mind that these requirements may change or vary, depending on your situation or needs. It is best to speak with a professional to develop a more individualized plan based on where you plan to move.
The bottom line?
Contact the CGFNS for assistance. While they charge a fee for their services, their expertise is priceless in navigating these complicated situations.
- Transferring a nursing license into the United States is possible but requires an involved process.
- Make sure to know what state you plan to move to ahead of time so that you can research their requirements before starting.
- Contact the Commission on Graduates of Foreign Nursing Schools for assistance with verifying credentials, taking qualifying exams, or completing your pre-visa screening.
Nicole Galan, RN, MSN
Nicole Galan is a registered nurse who earned a master's degree in nursing education from Capella University and currently works as a full-time freelance writer. Throughout her nursing career, Galan worked in a general medical/surgical care unit and then in infertility care. She has also worked for over 13 years as a freelance writer specializing in consumer health sites and educational materials for nursing students.
Galan is a paid member of our Healthcare Review Partner Network. Learn more about our review partners.
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