In order to obtain licensure as a nurse (RN or LPN/LVN) in the United States, it is important to note that licensure requirements differ from state to state. Therefore, be sure to contact the Board of Nursing in the state where you wish to practice in order to verify the respective and current licensure requirements. Please visit the web site of the National Council of State Boards of Nursing (www.ncsbn.org) for a listing of each U.S. State Board of Nursing and licensing jurisdiction, with appropriate contact information. Also keep in mind that endorsing (transferring) licensure to another state will also have different procedures depending on the respective state.

It is also necessary to obtain a visa in order to legally work in the U.S., whether that be a temporary or permanent visa; however, detailed information regarding visa application and policy should be obtained from INS. You may wish to check out their web site at http://www.ins.usdoj.gov/.

CGFNS is an independent, not-for-profit and immigration-neutral organization committed to protecting the public by ensuring that foreign-educated healthcare professionals are eligible and qualified to meet licensure and other U.S. practice requirements. CGFNS is not a government organization, nor does it recruit international professionals for employment in the U.S.

The two main programs that CGFNS offers that are required by the majority of the U.S.Boards of Nursing in order to obtain registration/licensure as a nurse in the United States are the

CGFNS Certification Program (CP) and the

CGFNS Credentials Evaluation Service (CES).

INS requires the VisaScreen certificate from CGFNS for healthcare professionals seeking permanent occupational visas in order to work in the U.S.

The CGFNS Certification Program (CP)

The CGFNS Certification Program (CP) is designed specifically for first-level general (Registered) nurses educated outside the United States who wish to pursue a career in the U.S. as registered nurses. The program is comprised of three parts: a credentials review of your nursing education, registration and licensure; the CGFNS Qualifying Exam testing nursing knowledge (offered three times a year in over 40 test sites worldwide); and an English language proficiency examination. In order to be eligible for the CGFNS Qualifying Exam, you must have completed a minimum number of hours of both classroom instruction and clinical practice in Adult Medical/Surgical Nursing, Maternal/Infant Nursing (Obstetrics), excluding Gynecology, Care of Children (Pediatrics), and Psychiatric/Mental Health Nursing, excluding Neurology. If you have not completed any and/or a sufficient number of hours in each of the above areas, you will be ineligible to take the CGFNS Qualifying Examination until you complete an entire course (both theory and clinical) in the deficient area from a government-approved nursing school. You must also have been registered (1) as a first-level (Registered) nurse in your country of education, and (2) currently hold a registration/license as a Registered Nurse in some jurisdiction, and verification of both registrations must be sent to CGFNS directly from the licensing body(ies).

The English proficiency examination is the Test of English as a Foreign Language (TOEFL), and is administered by the Educational Testing Service (ETS), to which you must apply directly in order to schedule an examination date.

You may contact ETS by writing to:

Educational Testing Service (ETS),

 PO Box 6151, Princeton,

New Jersey 08541-6151.

You may also call ETS at (609) 771-7100,

or visit their website at http://www.ets.org/.

The minimum passing score for the TOEFL examination is 540 (paper and pencil version) or 207 (computerized version); that score must also be forwarded from ETS directly to CGFNS. All English language proficiency scores are valid for up to two years from the date of administration. Passing scores on both the CGFNS Qualifying Examination and the TOEFL examination must be attained within two years of each other in order for both scores to be accepted as successful completion of the Certification Program. After successfully completing all three parts of the Certification Program, an applicant is awarded a CGFNS Certificate.

The Credentials Evaluation Service (CES)

The CGFNS Credentials Evaluation Service (CES) is a report prepared by CGFNS for a Board of Nursing, university, immigration office, employer, etc. This report analyzes the education and licensure earned outside of the United States in terms of how it compares with U.S. standards and expectations. There is no examination included in this program; once all documentation, fees and a completed application are received, a report will be prepared and submitted to the recipient (i.e., Board of Nursing, U.S. college/university [if applying for academic admission], an employer, etc.) as well as a copy to you,

at which time the Board will determine whether or not you are eligible to take the national licensing examination for nurses in the United States--the NCLEX-RN® or NCLEX-PN® examination--which is required for all nurses in order to practice in the U.S.

The ICHP VisaScreen: Visa Credentials Assessment

If you are also interested in obtaining permanent residency in the United States as a registered or licensed practical/vocational nuirse (i.e. obtain a "Green Card"), you are also required, by virtue of the 1996 immigration laws, to obtain a VisaScreen certificate. The VisaScreen Certificate is issued after a complete evaluation of a professional’s credentials to verify that he or she meets the minimum federal requirements. The Certificate must be received before INS will issue an occupational visa to the applicant to live and work as a professional in their field in the U.S.

The International Commission on Healthcare Professions (ICHP), a division of CGFNS, administers this screening process, which is called the "VisaScreen: Visa Credentials Assessment".

The VisaScreen program is comprised of three parts:

a credentials review of your entire nursing education (educational requirements same as those for the Certification Program) and all registration/licensure that you have held and currently hold, successful completion of either the CGFNS Certification Program or the NCLEX-RN® (for registered nurses), and successful completion of a group of English language proficiency examinations. Either the TOEFL, TWE and TSE administered by the Educational Testing Service (ETS), OR the MELAB and MELAB (oral) administered by the Michigan English Language Assessment Battery (MELAB) will qualify. Passing scores for these examinations are as follows:

Passing English Language Proficiency Examination Scores

Healthcare Profession	TOEFL (Test of English as a foreign Language)	TWE (Test of written English)	TSE (Test of spoken E nglish)		MELAB (Michigan English Language Assessment Battery)	MELAB (Oral Interview)
Registered Nurse	540 (207)	4.0	50		79	3+
Licensed Practical/Vocational Nurse	530 (197)	4.0	50		77	3+

Upon successful completion of all parts of the VisaScreen Program, you will obtain the VisaScreen Certificate, which you must present to INS at your final consular interview.

Documents required for any CGFNS Program

In order for CGFNS to complete an evaluation of your credentials for CP, CES or VisaScreen, the following documents are required:

• A completed application form and full payment for the program/service to which you are applying.

You can obtain application forms for any of our services by contacting our Customer Service Department by:

⇒ Telephone: (215) 349-8767, Monday-Thursday 9:00AM--5:00PM, & Fridays 9:00AM--4:30PM (ET)

⇒ Fax: (215) 349-0026

⇒ Email: support@cgfns.org

Or, download the CGFNS Certification Program, Credentials Evaluation Service (CES) and ICHP VisaScreen:

Visa Credentials Assessment application forms directly from the CGFNS website at http://www.cgfns.org

• A FULL transcript with an official school seal/stamp, mailed to CGFNS directly from your nursing school, verifying the total number of hours of classroom instruction (theory) and hours/days of clinical practice you completed in each of the courses you completed during your professional training/nursing program. Work experience CAN NOT be accepted as an alternative to lack of instruction/training undertaken during your educational program. For the Certification Program, your transcripts must be accompanied by a completed “Nursing Education Form”. For both the CES and VisaScreen, your transcripts must be accompanied by a completed “Request for Academic Records” form.

• A validation of your original registration/license as a nurse mailed to CGFNS directly from the authority which issues registrations/licensure in your original country of education (if applicable).

• A validation from any other licensing authority where you hold a license as a registered and/or practical nurse (if applicable).

• A photocopy of your secondary school diploma (high school); OR, if you no longer have your original diploma, an official letter with the school seal/stamp and signed by the principal, sent to CGFNS directly from your secondary school verifying your full dates of attendance and date of completion/graduation.

All documentation must be sent to CGFNS via mail/courier; CGFNS will not accept any official documentation sent either by fax or email. Our mailing address is:

Commission on Graduates of Foreign Nursing Schools (CGFNS)

3600 Market Street, Suite 400

Philadelphia, Pennsylvania 19104-2651 (USA)

And be sure to visit our website at http://www.cgfns.org for further information and updates

PLEASE NOTE: Successful completion of any CGFNS program does not in any way guarantee that you will be granted registration/licensure, academic admission, employment, etc. in the United States. It is the jurisdiction of the particular Board of Nursing, academic institution, employer, etc .to which you are applying as to whether or not your application will be accepted and registration, employment or admission will be granted.

Entry into the United States:

Occupational Visa Categories

Commission on Graduates of Foreign Nursing Schools

I. Temporary visa

a. H-1B

               i. A baccalaureate or higher degree is normally the minimum entry

                  requirement for the position; or the employer normally requires a

                  baccalaureate or higher degree for the position.

              ii. The beneficiary must possess a license or a temporary license, if

                   available

              iii. The beneficiary must be able to fully engage in the occupation upon

                   admittance

              iv. The employer must file a Labor Condition Application with the DOL

               v. Currently capped at 195,000 annually

              vi. Duration of three years with a three year extension

b. H-1C

                i. Created by the Nursing relief for Disadvantaged Areas Act of 1999

                ii. Capped at 500 foreign educated nurses annually

               iii. Hospitals limited to those within health professional shortage areas with

                    less than 190 beds and at least 35 % Medicare and 28% Medicaid beds

II. Permanent visa

a. Multiple visa categories (11)

b. 1996 Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA)

                i. Requires 21 named healthcare professionals educated outside the U.S.

                   who wish to apply for the occupational visas to go through a screening

                   program. Rules written for nine of the categories.

               ii. Screening established in Section 343 of IIRIRA. The alien’s education,

                    training, license and experience must:

                            1. meet all applicable statutory and regulatory requirements for

                                entry into the U.S. under the classification specified in the

                                application;

                            2. be comparable to that required for an American healthcare

                                worker of the same type;

                            3. be authentic and, in the case of a license, unencumbered.

             iii. The alien must be competent in oral and written English.

             iv. The alien must have either passed the state licensing exam or predictor

                   exam. (currently applies to RNs only)

c. 212 (r) of the Immigration and Nationality Act

             i. Alternative, streamlined process that exempts foreign-educated nurses

                from section 343.

            ii. An alien must demonstrate that he or she:

                   1. has a valid and unencumbered license as a registered                      nurse in a state where the alien intends to be employed and such state                  verifies that the foreign licenses are authentic and                                 unencumbered (states that satisfy this requirement include                                 Florida, Georgia, Illinois and New York);

                   2. has passed the NCLEX-RN;

                  3. is a graduate of a nursing program

    (a) in which the language of instruction was English,

    (b) located in a country designated by GFNS,                                                 (currently includes, Australia,Canada, Ireland, New Zealand, South Africa, the United Kingdom, and the United States) and

     (c) in operation before Nov. 12, 1999, or that is subsequently designated by CGFNS and

           any equivalent organizations approved for the credentialing of nurses.

III. Trade NAFTA

       a. Canadian citizens

            i. Streamlined application procedures at ports of entry

            ii. No numerical restrictions, limits on extensions of stay or applications for readmission

       b. Mexican Citizens

           i. Labor Conditions application and full application process

           ii. 5,500 numerical cap

           iii. No limit on readmissions

 Healthcare Staffing Firms