How to Get a US Nursing License as a Foreign-Trained Nurse
Important: This guide provides general information for foreign-trained professionals seeking US licensure. International licensing pathways change frequently. Always verify requirements directly with the credential evaluation agency, state licensing board, and — for visa questions — a qualified immigration attorney. LicenseMap does not provide legal or immigration advice.
This guide is for internationally educated nurses (IENs) seeking Registered Nurse (RN) licensure in the United States. Whether you trained in the Philippines, India, the United Kingdom, Nigeria, Canada, or another country, the pathway to US nursing licensure follows a consistent series of steps: CGFNS credential evaluation, English proficiency testing, the NCLEX-RN examination, VisaScreen certification, and state board licensure.
The US is one of the top destinations for international nurses, and demand for qualified RNs remains high across all 51 states we track. This guide walks through the most common pathway used by the majority of foreign-trained nurses, from initial document gathering through receiving your state license.
Pathway at a Glance
- CGFNS Credentials Evaluation Service (CES) evaluates your nursing education
- Pass an English proficiency exam (TOEFL iBT or IELTS Academic)
- Register for and pass the NCLEX-RN examination
- Obtain a VisaScreen Certificate (required for employment-based visas)
- Apply for licensure with your chosen state board of nursing
Step 1: CGFNS Credential Evaluation
The CGFNS Credentials Evaluation Service (CES) is the primary credential evaluation used for internationally educated nurses. CGFNS evaluates your nursing education against US standards to determine equivalency.
Documents you will need:
- Official nursing school transcripts (sent directly from your institution)
- Degree or diploma certificate
- License verification from your home country's nursing regulatory authority
- Copy of your passport (identity verification)
Processing time for CGFNS CES is typically 2–4 months, though this can vary depending on how quickly your institutions respond to verification requests. Start this step as early as possible, as document gathering from international institutions is often the longest part of the process.
Step 2: English Proficiency Testing
Most state boards of nursing require proof of English proficiency for internationally educated applicants. The two accepted exams are:
- TOEFL iBT — Minimum scores vary by state, but a common threshold is an overall score of 83 or higher with a minimum of 26 in the speaking section.
- IELTS Academic — An overall band score of 6.5 or higher is generally required, with a minimum of 7.0 in the speaking section. Requirements vary by state.
CGFNS accepts both TOEFL iBT and IELTS Academic scores. Some applicants from countries where English is the primary language of nursing education may be exempt from this requirement — check with your state board and CGFNS for specific exemptions.
Step 3: NCLEX-RN Examination
The NCLEX-RN is the same national licensure examination taken by US-educated nursing graduates. It is a computer-adaptive test (CAT) that assesses entry-level nursing competency. You must pass the NCLEX-RN regardless of your country of origin or years of nursing experience.
- Registration: Through Pearson VUE after receiving an Authorization to Test (ATT) from your state board
- International testing centers: The NCLEX-RN is available at Pearson VUE testing centers worldwide, including in the Philippines, India, the UK, Canada, Australia, and other countries
- Exam format: Computer-adaptive with 85–150 questions (variable length)
LicenseMap covers RN licensing requirements across all 51 states, including exam details, fees, and continuing education requirements.
Step 4: VisaScreen Certificate
The VisaScreen Certificate is required for all healthcare professionals entering the United States on employment-based immigration visas. It is issued by CGFNS International and verifies:
- Your nursing education meets US standards
- Your nursing license is valid and in good standing
- You meet English proficiency requirements
- You have passed a qualifying examination (NCLEX-RN or CGFNS Qualifying Exam)
The VisaScreen is a federal immigration requirement and is separate from state licensure. You will need it before a US employer can sponsor your work visa.
Step 5: State Licensure
Once you have passed the NCLEX-RN and completed your credential evaluation, you can apply for licensure with the board of nursing in the state where you intend to practice. Each state has its own application process, fees, and additional requirements.
LicenseMap tracks RN licensing requirements across 51 states. Visit our state-by-state RN requirements page to find specific application details, fees, and continuing education requirements for any state.
Credential Evaluation Organizations
CGFNS International is the primary credential evaluation organization for internationally educated nurses. Most state boards require or prefer a CGFNS evaluation.
CGFNS International
Credential evaluation, VisaScreen, and Certificates Program for internationally educated nurses
Some states also accept credential evaluations from World Education Services (WES), particularly for general education components. Check with your specific state board to confirm which evaluations they accept.
World Education Services (WES)
General credential evaluation for international degrees — accepted by most US state boards and institutions
Visa & Immigration Overview
International nurses pursuing US employment typically use one of the following visa categories:
- EB-3 (Skilled Worker) — The most common pathway for international nurses. This is an employment-based immigrant visa (green card) category. Processing times vary significantly by country of origin.
- H-1B (Specialty Worker) — A temporary work visa that may be available for nurses in some specialty roles. Subject to annual caps and employer sponsorship.
- TN Visa (USMCA) — Available specifically to Canadian and Mexican nurses under the United States-Mexico-Canada Agreement. A more streamlined process with no annual cap.
The VisaScreen Certificate is required for all healthcare workers entering the US on employment-based visas, regardless of visa type.
Note: Immigration law is complex and changes frequently. The information above is a general overview only. Consult a qualified immigration attorney for advice specific to your eligibility, country of origin, and circumstances.
Estimated Costs
The following table provides approximate costs for the major steps in the international RN licensure pathway. Actual fees may vary.
| Item | Estimated Cost |
|---|---|
| CGFNS CES (Credential Evaluation) | ~$350 |
| VisaScreen Certificate | ~$540 |
| NCLEX-RN Exam | $200 |
| State Licensure Application (varies by state) | Varies |
| TOEFL iBT | ~$245 |
| Visa Application Filing Fees | $190–$460+ |
Costs are approximate and subject to change. Additional expenses may include document translation, courier fees for international transcripts, and immigration attorney fees.
NCLEX-RN & CGFNS Exam Prep
Study materials for US nursing exams.
English Proficiency Test Prep
Prepare for required English exams.
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Frequently Asked Questions
How long does it take to get a US nursing license as a foreign-trained nurse?
The process typically takes 6-18 months from start to finish, depending on how quickly you gather documents, complete credential evaluation, pass the NCLEX-RN, and obtain state licensure. CGFNS credential evaluation alone can take 2-4 months.
Do I need to redo my nursing education to become an RN in the US?
No. CGFNS evaluates foreign nursing degrees against US equivalency standards. If your nursing education meets the requirements, you do not need to complete an additional US nursing program. However, some applicants may need to take bridge courses if gaps are identified.
Can I take the NCLEX-RN outside the United States?
Yes. The NCLEX-RN is available at Pearson VUE testing centers worldwide, including locations in the Philippines, India, the United Kingdom, Canada, Australia, and many other countries.
Which US states are most popular for international nurses?
States with large healthcare systems and established international recruitment pipelines are most popular. Many states accept CGFNS credential evaluation, though specific requirements vary. Check individual state board requirements before applying.
What is the VisaScreen Certificate?
The VisaScreen Certificate is a required immigration document for healthcare workers entering the US on employment-based visas. Issued by CGFNS International, it verifies that your education, licensure, English proficiency, and examination credentials meet US standards.
Related Resources
- RN License Requirements by State — Compare requirements, fees, and Nurse Licensure Compact status across all 51 states
- Registered Nurse License Cost by State — Detailed breakdown of initial licensing fees in every state
- How to Become a Registered Nurse (Domestic Guide) — The complete US-based pathway to RN licensure
- International Credential Evaluation Guide — Overview of credential evaluation for all professions