FREQUENTLY ASKED QUESTIONS (FAQ)In general, what type of visas do foreign health professionals apply for?1. A Permanent (immigrant) visa, also known as a “green card” (Alien Registration Receipt Card). 2. A Temporary (non-immigrant) visa: H-1B, H-1C and TN (Trade NAFTA). What is the first step to obtaining a green card?I-140 applicationCurrent regulations have preserved Registered Nurses (RNs) on Schedule A, Group I, as pre-certified by the DOL as a shortage occupation. RNs are exempt from the individual labor certification process. The immigration process
begins when an employer submits an immigrant visa petition (Form I-140) to the office of the Immigration and Naturalization Service (INS) having jurisdiction over the nurse’s place of intended employment. The petition must be accompanied by Labor Department forms ETA-750A and B and proof of the employer’s ability to pay the prevailing wage offered to the employee. When submitting the I-140 the RN must be in
possession of: a) A diploma from a nursing school in his/her country;
b) An RN license in his/her country; and
c) A full and unrestricted license to practice professional nursing in the State of intended employment or a certification that she has passed the examination given by the Commission on Graduates of Foreign Nursing Schools (CGFNS) which includes a
credential review, a nursing examination, and the TOEFL. The regulations governing this process state that the nurse must have the CGFNS certificate or be fully licensed in the state of intended employment in order to file an immigrant petition. The INS, however, has indicated a willingness to accept the NCLEX in place of the CGFNS certificate. It is most common for nurses to
obtain the CGFNS certificate prior to taking the NCLEX for several reasons. The first and foremost reason is that many states require that foreign nurses pass the CGFNS examination before taking the state RN licensing (NCLEX) examination. The following states impose this requirement: Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, District of Columbia, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota,
Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Vermont, Virginia, Washington, West Virginia and Wyoming. (Please refer to the section on licensing for further details.) Under new INS regulations, the Adjustment of Status application can be filed concurrently
with the I-140 for those aliens who are eligible to file such an application. The process is described below. What is the final step in obtaining a green card?Consular Processing (For Nurses located outside of the United States)The INS
first sends the approved visa petition to the National Visa Center (NVC) in Portsmouth, New Hampshire. If there is no backlog for immigrant visas from the RN’s native country (her “priority date” is “current”), the NVC forwards a packet to the nurse or his/her attorney containing biographical information forms to be completed by his/her and his/her family members, and a list of documents which must be presented at his/her interview for permanent residence. Generally, the forms are submitted
directly to the U.S. consulate. For individuals from certain countries, forms are submitted to the National Visa Center for preliminary processing. The NVC completes preliminary processing for cases for persons from, among others, the Philippines, Canada and China. Upon completion of preliminary processing, the NVC will forward the case to the appropriate U.S. Consulate for final processing. The U.S. consulate where the nurse will have his/her interview for permanent residence will review specific forms and documentation. At this interview, the nurse must present various documents including the following: a. Application for Immigrant Visa b. Police Clearance c. Birth Certificate d. Marriage Certificate, if any e. Divorce or Death Certificate of Spouse, if any f. Valid Passport g. Medical Examination h. Photographs. Recent job offer letter (or employment contract) j. Financial information regarding employer k. Government filing fee l. Visa Screen Certificate If I am an international nurse currently located in the United States, is it possible to adjust my visa status?1. Adjustment of Status to Legal Permanent Resident (for those health care professionals in valid visa status present in the U.S.)
Currently, all employment based visa categories are current. Nurses can apply for adjustment of status concurrently with the I-140 filing or immediately upon its approval. The adjustment of status for a nurse will not be granted unless and until Visa Screen is submitted. The adjustment of status package needs to include:
a. Form I-485, Application to Register Permanent Residence or Adjust Status (with two immigration-style photos) b. Form I-765, Application for Employment Authorization (with two immigration-style photos) c. Form G-325A, Biographic Information d. Form I-131, Application for Advance Parole (if travel permission is being requested)(with two immigration-style photos) e. Medical Examination sealed original f. Birth Certificate with certified English translation g. Marriage Certificate with certified English translation, if any h. Divorce or Death Certificate of Spouse with certified English translation, if any i. Verification offer of employment or employment contract
j. Necessary filing fees and fingerprinting fee k. Copies of valid passport l. Valid I-94 card m. I-140 approval notice, receipt notice or concurrent filing. Dependents will need to submit separate packages which can be filed concurrently with the principle’s application.
CGFNSWho is CGFNS?The Commission on Graduates of Foreign Nursing Schools (CGFNS) is a
non-profit, internationally recognized leader in the education, registration and licensure of healthcare professionals worldwide. CGFNS protects the public in relation to evolving healthcare policies and standards of professional practice for migrating healthcare professionals. As a foreign-educated nurse, how can CGFNS help me to practice in the United States?CGFNS offers a Certification Program and Qualifying Exam, which most U.S. State Boards of Nursing require in order to be eligible to apply for licensure within that state. What is the CGFNS Certification Program?The CGFNS Certification Program is a three-part program designed to predict an applicant’s likelihood of passing the NCLEX-RN examination and becoming licensed as a
registered nurse in the United States. The three parts of the program include: 1. Credentials Review (Conducted by Credential Evaluation Service) 2. Qualifying Examination of nursing knowledge 3. English Language Proficiency Examinations Applicants must successfully complete all three parts of the Certification Program in order to earn the CGFNS Certification. Who is eligible to take the CGFNS Qualifying Exam?The CGFNS Qualifying Exam is open to first-level, general (registered) nurses ONLY. 1. Must hold an initial and current registration/licensure as a first level general nurse in their country. 2. Must have obtained theoretical instruction and clinical experience in a variety of nursing areas. How often and where is the CGFNS Qualifying Exam offered?The CGFNS Qualifying Exam is offered three times per year in
more than 40 locations throughout the world. A list of exam centers around the world can be found here. Exam | Deadline | March 13, 2003 | December 11, 2002 | July 9, 2003 | April 9, 2003 | November 12, 2003 | August 13, 20003
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In addition to the examinations listed above, CGFNS has announced that it will provide a Special Administration of the CGFNS Qualifying Exam at limited exam centers in 2003. The exam will be held September 10, 2003 at the following exam centers:
Center No. | Exam Location | 501 | Chicago, USA
| 540 | New York City, USA | 823 | Manila, Philippines | 907 | Cebu City, Philippines | 850 | Bangalore, India | 851 | Cochin, India |
What is the VisaScreen?The VisaScreen Certificate requirement was imposed by §343, a last-minute amendment to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA). It added “uncertified health-care workers” to the list of persons who are inadmissible to the U.S. See §212(a)(5)(C), INA. Those medical
occupations currently covered include nurses, physical therapists, occupational therapists, speech-language pathologists, medical technologists, medical technicians and physician assistants. A VisaScreen Certificate is issued only after the RN has demonstrated that (1) his/her education, license and training in his/her country are equivalent to
education, licensure and training in the U.S. and that (2) his/her level of competence in oral and written English are appropriate to practice professional nursing in the U.S. At present the INS regulations provide that the only organization authorized to issue VisaScreen Certificates to RNs is the Commission on Graduates of Foreign
Nursing Schools (CGFNS), the organization which is listed in §343. As an international nurse located outside the United States, do I need to obtain VisaScreen Certification?The INS interim VisaScreen regulations (8 C.F.R. §212.15) provide that all foreign-born nurses applying for permanent residence based on employment as a
nurse, even if educated, licensed and trained in the U.S., must obtain a VisaScreen Certificate or a Certified Statement. (Obtaining the Certified Statement from the ICHP is a somewhat streamlined process available only to nurses who completed nursing education in English in certain designated countries. The nurse must also be licensed in the state of intended employment and have passed the NCLEX to qualify for the Certified Statement.) Visa Screen Certification is required for those
nurses that do not qualify for the Certified Statement. In addition, unless the nurse was educated in an English-speaking country (U.S., Australia, New Zealand, Ireland, United Kingdom or Canada – all provinces except Quebec), she must achieve a certain score on tests in written and spoken English administered by TOEFL (Test Of English As A Foreign Language) or
MELAB (Michigan English Language Assessment Battery) in order to qualify for a VisaScreen Certificate.
VISA SCREENWho is ICHP?The International Commission on Health Care Professions is a division of CGFNS. CGFNS launched ICHP in 1996 to administer its VisaScreen program,
which is a federally approved screening program for foreign healthcare workers seeking an occupational visa in the United States. VisaScreen enables healthcare professionals to meet this requirement by verifying and evaluating their credentials to ensure that they meet the government’s minimum eligibility standards. Applicants who successfully complete VisaScreen receive a VisaScreen Certificate.
What does VisaScreen require for certification?International nurses must satisfy the screening requirements of Section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act that include: - An assessment of an applicant’s foreign education to ensure that it is
comparable to that of a U.S. graduate in the same profession
- Verification that the applicant’s licenses are valid and unencumbered
- Determination of English language proficiency
- Verification that the nurse has CGFNS Certification or passed the NCLEX-RN
Applicants who successfully complete VisaScreen will receive a VisaScreen Certificate, which can be presented to a consular office or, in the case of adjustment of status, the Attorney General as part of a visa application. As a
result, we suggest that you proceed with the Visa Screen Application as soon as your I-140 (green card) application has been filed with INS. What examinations are needed for the VisaScreen?You only need to successfully complete either the CGFNS Qualifying Examination or the NCLEX-RN.
If I already have CGFNS Certification do I still need the Visa Screen in order to obtain an immigrant visa (green card)?The VisaScreen Certificate is required for international nurses that are seeking a permanent visa (green card) or a change in status to permanent residency. You only need to successfully complete either the CGFNS Qualifying Examination or
the NCLEX-RN, not both. As a result, you have satisfied the examination requirement for the Visa Screen. How can I obtain additional information about the VisaScreen?International Commission on Healthcare Professions 3600 Market Street, Suite 400
Philadelphia, PA 19104-2665 USA Phone: 1-(215) 349-8767 E-mail: support@ichp.org Applications for the Visa Screen can be down loaded from the CGFNS site: www.cgfns.org When is the Visa Screen Issued?A visa screen certificate is issued only after the RN has demonstrated the
equivalency of education, licensure and training; and the level of competence in oral and written English. The only organization authorized to issue the Visa Screen is the CGFNS. The visa screen is needed after the I-140 is approved, at the Consular interview -or the AOS if in the US. So yes, you still need CGFNS certification for the visa screen- the countries listed
above are exempt from the additional testing. For Schedule A I-140’s you need to have the full unrestricted license in the state of intended employment OR a certification that you passed CGFNS certification. Do not confuse the visa screen requirements with this. ENGLISH PROFICIENCY REQUIREMENTWhat are the English Proficiency requirements for CGFNS?All applicants are required to submit a passing score on either the TOEFL,TWE and TSE or the MELAB, Parts 1,2, and 3 and the Speaking Test. For the TOEFL, TWE, and TSE, registered nurses must submit a score of 540 on the written TOEFL or 207 on the computer based TOEFL, 4.0 on the TWE and 50 on the TSE.
For the MELAB, Parts 1, 2, and 3 and the Speaking Test, nurses must submit a combined score of 79, with at least a 3+ on the Speaking Test. Is there a new policy regarding the MELAB?Those applicants that are considering registering for the MELAB after November 27, 2002, should be aware that the English Language Institute will not send their
scores to CGFNS. Healthcare workers that have already taken the MELAB or who have already scheduled a particular test date will not be affected by this policy change. I attended nursing school in an English speaking country. Do I need to fulfill the English Proficiency Component of the CGFNS and Visa Screen?Nurses from the following countries may qualify for an exemption from the
English Proficiency component of the CGFNS: Canada (except Quebec), UK, Ireland, Australia, South Africa, and New Zealand. Nurses from Trinidad and Tobago may also be eligible for this exemption. To qualify for the exemption the nurse’s native language has to be English, the language of instruction has to be English, and the language of all texts had to be in English. Nurses from all other countries will be required to comply with the English Proficiency Requirements How do I apply to sit for the TOEFL, TSE and TWE?These examinations are offered by the Educational Testing Services. For more details about these examinations you should contact them directly: Educational Testing Services P.O. Box 6151 Princeton, N.J. 08541-6151 USA Telephone: (609) 771-7100 Email: toefl@ets.org Applicants must apply directly to the English Language Institute in order to take the MELAB. For further information or an application, contact: MELABEnglish Language Institute 3020 North University Building Ann Arbor, MI 48109-1057 USA Telephone: (313) 763-3452
Where are these examinations offered?Unlike the TOEFL, TWE and TSE which are offered worldwide, the MELAB is only offered in the U.S. and Canada. How many years is TOEFL good for?TOEFL scores are only valid for two years. Also, the CGFNS Qualifying Exam and
TOEFL examination must be taken within two years of each other for both scores to be valid for certification purposes. What are the Certification and Examination Fees?Program | Fee USD | Certification program (CGFNS Qualifying Exam) | $295.00 | Re-application for Certification Program | $250.00 | Credentials Evaluation Service | | General Report | $155.00
| Healthcare Profession & Science Course-by-Course Report | $225.00 | Full Education Course-by-Course Report | $265.00 | VisaScreenTM | $325.00 |
TOEFL Testing & Services Fees | | (Fees in effect until June 30, 2003) | Fee USD | TOEFL Computer-Based Test |
$110.00 | TOEFL Paper-Based Test | $110.00 | Test of Spoken English (TSE) | $125.00 |
CHILDREN AND SPOUSE
I am a nurse that is applying for an I-140 visa and I want to be able to bring my spouse and children with me to the United States. How should I proceed?
If the I-140 applicant is outside the U.S., their dependents (spouse and children under 21) will be eligible to enter the United States as permanent residents once the I-140 is approved and the family undergoes consular processing. As a result, the spouse and children under 21 would also receive a green card, and would be
entitled to work. If in the United States, and eligible to apply for an adjustment of status (I-485) then the dependents are eligible to file I-485 concurrently with the principle’s application. I am a nurse that will be entering the United States under either a H-2B, H-1B, or an H-1C Visa. Will I be able to bring my spouse and children with me to the United States?The children and spouse may enter as H-4 derivatives, but will not be authorized to work until they convert to permanent resident status.
Nurses from Canada and Mexico
Do I qualify for a TN Visa if I am from either Canada or Mexico?Canadian citizens who are licensed RNs in a province or state or who have an
interim permit to practice in the state of intended employment can enter the United States with a TN visa under the North American Free Trade Agreement (NAFTA). A TN visa is only valid for one year and, while there are no limits on the number of years a TN can be renewed, each renewal is valid only for one year. The nurses need not be born in Canada only possess Canadian citizenship, however, the TN visa requires that a Canadian nurse receive his/her nursing
education in Canada or the United States. Mexican citizens also may enter the United States with a TN visa as a RN. However, Mexican citizens are required to obtain advance approval of a TN visa prior to entering the US. Canadian citizens are not required to obtain advance approval and may apply for a TN visa at a land border or airport. Do I need a VisaScreen Certificate if I am a Canadian entering the United States on a “TN” visa?Currently the INS is waiving the VisaScreen requirements for healthcare workers entering the United States on a temporary or “non-immigrant” visa, including the TN (Trade NAFTA) category. The State Department also continues to waive the application of § 343 for RN’s who are employed in the U.S. on temporary visas. However, the INS has recently publish propose regulations, which if finalized in
their current form will require all non-immigrant health care workers including registered nurses to obtain a visa screen before entering the United States. As a Canadian, what documentation is required to obtain a TN Visa?In order to qualify for a TN visa, the Canadian nurse must possess the necessary
credentials to practice her/his profession. Technically, under the NAFTA Treaty, Canadian nurse must have a valid state (United States) or provincial (Canada) license. However, that where a Canadian nurse possesses only a provincial license and the state where your entity intends to employ the nurse requires that he/she possess a state license, a state license will be required before the Immigration and Naturalization Service will issue a TN visa. Further, in order to
obtain a state license you may have to pass the National Council Licensure Examination (NCLEX). Some states have provisions to issue an interim license to nurses that have registered for the NCLEX. Finally, a majority of the states require that you first present a Commission on Graduates of Foreign Nursing Schools (CGFNS) Certificate How important is it to have a professional resume?It is critical that each nurse candidate create a professional resume that can be forwarded to prospective employers in the Unites States. There are several web sites that provide sample resumes and helpful guidance in preparing a resume: - http://jobstar.org/tools/resume/res-web.cfm
- http://www.nurseweek.com/features/98-5/resume 1.html
- http://www.zzpixel.com/resume-rehab-career_buil
ding_tutorials_for_nurses.html
How do I obtain a license to practice nursing in the United States?To work as a Registered Nurse in the United States, you must be licensed in the state in which you plan to practice. International nurses should contact the nursing board in the states they wish to practice to verify current requirements
because each state has its own individual requirements for licensure. Initial licensure in a state is awarded by receiving a passing grade on the National Council License Examination for Registered Nurses (NCLEX-RN). Once you pass the NCLEX-RN and are licensed in a state, you may apply to other states through a process known as endorsement. To obtain contact information on all the state nursing boards please visit the following website: www.allnurses.com
What is the NCLEX-RN?The NCLEX-RN is an application-based examination that is designed to make sure that each nurse has the knowledge to practice safely at a minimum of an entry level registered nurse. It is a computerized multiple choice examination. For more details about NCLEX visit the National Council of State Boards: http://www.ncsbn.org
To work as a Registered Nurse in the United States, you must be licensed in the state in which you plan to practice. Initial licensure in a state is awarded by receiving a passing grade on the National Council License Examination for Registered Nurses (NCLEX-RN®). Once you pass the NCLEX-RN and are licensed in a state, you may apply to other states through a process known as endorsement.
The NCLEX-RN is designed to make sure that each nurse has the knowledge to practice safely at a minimum of an entry-level registered nurse. Many nursing schools in other countries have examinations that are knowledge-based, testing you on the facts you have learned. The NCLEX-RN, however, is an application-based examination.
NON-IMMIGRANT VISAS
Should I apply for a green card or an H-1B Visa?Generally, the H-1B visas are temporary employment visas, entitling the visa holder to work in the U.S. for a particular employer, in a particular job, for a specified period of up to a total of six years. H-1B visas are available for temporary specialty occupations or professional positions. The main requirements for the H-1B visa:The job must be either in a “specialty occupation,” i.e., a professional field. A “specialty occupation” is one which requires the theoretical and practical application of a body of highly specialized knowledge to fully perform the
occupation and requires completion of a specific course of education culminating in a baccalaureate degree in a specific occupational specialty, e.g., computer scientists, architects, teachers, and engineers.
The applicant must actually have the necessary credentials, e.g., the baccalaureate degree in the particular specialty.
The job must actually require the services of someone who possesses the credentials of a professional.
The employer must pay the applicant the prevailing wage in the area, or the wage it pays other workers in its company, whichever is greater.
Employers must follow a two step process to obtain an H-1B for a professional employee:
Department of Labor - Labor Condition Application. The employer must determine the prevailing wage for the occupation and the actual wage being paid by employer to other professionals in the same field. They must pay whichever is higher. The safest way to establish the prevailing wage is to obtain an opinion from the State Workforce Agency (SWA). We can also obtain prevailing wages on-line from OES.
Once the employer has established the prevailing age it needs to submit a Labor Condition Application (LCA) to the Department of Labor (DOL). There are many attestations that the employer needs to make to the DOL when signing the LCA.Immigration and Naturalization Service. The employer then submits the petition
(Form I-129) to the INS Service Center having jurisdiction over the place of employment. The INS will review the individual credentials to fill the specialty occupation. If the application is approved and the applicant is outside the U.S. the INS will notify the Consulate abroad of the visa approval and the applicant will need to appear for an interview to review admissibility issues. At this point in time the Department of State’s Visa Screen is being waived for individuals applying for
non-immigrant visas.
To obtain an H-1B for a nurse, the petitioner must present evidence that the nurse holds a license in the state of intended employment or that the license that the nurse holds is recognized by the state of intended employment, e.g. a compact state. Some states will issue temporary or interim licenses where the nurse completes all of the necessary prerequisites to register for the NCLEX.
More specifically, the H-1b petitioner will need the following:Petition for Nonimmigrant Worker (Form I-129) and H Supplement with filing fees of $1,130.00
An approved Labor Condition Application from the Department of Labor that
confirms that the employer will pay a salary that meets or exceeds the prevailing wage for the position offered in the area of intended employment. Often the McNamara-O'Hara Service Contract Act ("SCA") determines the prevailing wages for nurses. The SCA provides protection for the employees to receive the prevailing wage and standard fringe benefits, including vacation, holiday, health and welfare.
A letter from the petitioner describing the duties and responsibilities to demonstrate that a Bachelor's Degree in the field of nursing from a U.S. university or its foreign equivalent is required. A supervisory position will meet the requirement of needing a Bachelor's Degree.
The beneficiary's degree and a foreign credentials evaluation, if the degree is from
a non-US university or college, to prove that he/she has the equivalent of a U.S. degree.
A state license in the area of intended employment or evidence that the nursing candidate has a Commission of Foreign Graduate Nursing Schools ("CGFNS") Certificate indicating that he/she has passed the CGFNS qualifying exam and the Test
of English as a foreign language ("TOEFL") and possesses a temporary state license. - H-1B visa holders may also bring their family members with them on H-4 visas. The spouse and children under 21 years of age are not permitted to work, but may attend school.
PREMIUM PROCESSINGCurrently the following INS non-immigrant visas can be expedited by paying a $1000 fee to the INS. For example, if the applicant or petitioner pays for Premium Processing Service of a petition or application, the Service will issue an approval notice, notice of intent to deny, request for evidence, or notice of an investigation for fraud or misrepresentation within 15 calendar days. Premium Processing
Service begins on the day the Service physically receives a petition or application and ends on the day the Service issues a notice or request. The following visa categories are eligible to utilize the premium processing program. (1) E-1 Treaty Trader; (2) E-2 Treaty Investor; 1. H-1B Temporary Worker with Specialty Occupation 2. H-2A Agricultural Worker 3. H-2B Temporary Worker 4. H-3 Trainee 5. L-1 Intra company Transferee 6. O-1 and O-2 Aliens of Extraordinary Ability or Achievement 7. P-1, P-2, and P-3 Athletes and Entertainers 8. Q-1 International Cultural Exchange Aliens
9. R-1 Temporary Worker in Religious Occupations 10. TN NAFTA Professional Keep in mind that if the applicant is abroad they must still undergo the consular
interview in order to have the visa issued.
H-1C VISASWhat is the H-1C visa?The H-1C visa was established to provide registered nurses with an opportunity to work in health shortage areas for a period of 3 years. This is a non-immigrant visa that is currently limited to 500 nurses annually.
Who is eligible for an H-1C visa?The Immigration and Naturalization Service (INS) will determine who receives an H-1C visa based on the following requirements. A nurse must: - have a full and unrestricted license to practice professional nursing in the
country where they obtained their nursing education or have received nursing education in the United States;
- have passed an appropriate examination (determined by the Department of Health and Human Services), or have a full and unrestricted license to practice as a registered nurse in the state of intended employment; and
- be fully qualified and eligible under the state laws and regulations of the state of intended employment to practice as a registered nurse immediately upon admission to the United States.
Is the CGFNS and NCLEX-RN required for the H-1C?- A nurse must obtain CGFNS Certification or certification from an
independent credentialing organization approved by either the Attorney General or the Secretary of the Department of Health and Human Services
- Must pass the NCLEX-RN Examination
What are the screening requirements for the H-1C Visa?CGFNS will be certifying that the nurse: - already possesses a valid and unencumbered licenses as a nurse in a state where the alien intends to be employed and such state verifies that the foreign license of alien nurses are authentic and unencumbered;
- has already passed the National Council Licensure Examination for registered nurses (NCLEX-RN®); and
- is a graduate of a nursing program (a) in which the language of instruction was English, (b) located in a country designated by CGFNS within 30 days of the date of enactment of P.L. 106-95
, based on CGFNS’ assessment that the quality of nursing education in that country, and the English language proficiency of those who completed English-language-medium programs in that country justify the country’s designation, and (c) if that nursing program was in operation before November 12, 1999, or is subsequently designated by CGFNS and any equivalent credentialing organizations approved for the credentialing of nurses under subsection 212(a)(5)(C).
What countries has CGFNS designated pursuant to P.L. 106-95?Australia, Canada, Ireland, New Zealand, South Africa, United Kingdom and the United States.
LICENSING REQUIREMENTSLicensure requirements vary between states. Generally, however, most states require that the nurse demonstrate eligibility and preparedness for the Nurse Comprehensive Licensure Exam (NCLEX) by presenting CGFNS certification, copies of foreign academic credentials, an education/credentials evaluation and a proficiency of English, for example TOEFL exam results. And, some states permit the nurse to take the NCLEX without the CGFNS.
Some states are part of a compact that allows a nurse to have one license (in his or her state of residency) and to practice in other states (both physical and electronic), subject to each state's practice law and regulation. Under mutual recognition, a nurse may practice across state lines unless otherwise restricted.
The number of states that are passing laws to permit entrance into the compact is increasing each year. Of course to obtain optimal processing, each state’s requirements must be ascertained as far in advance as possible. Effective October 1, 2002, the NCLEX is offered by the Pearson Professional Centers. Pearson has multiple testing sites in each state and also has sites in
Guam, Saipan, Puerto Rico, and the U.S. Virgin Islands. You can sit for the NCLEX examination an unlimited amount of times however if you do not pass it you must wait 90 days before retaking and pay new fees. If you fail the NCLEX this can have some bearing on an interim license in some states.
There is no blanket reciprocity from state to state regarding the NCLEX; each
state has different licensing requirements.
WHAT IS THE RIGHT VISA?There are many variables that need to be reviewed when deciding what type of visa a nurse will be eligible to enter and work in the U.S. on. The minimum requirements for the job offered and the prospective employee's credentials are
key in analyzing the visa type. Generally, after obtaining the correct licenses and credential evaluations, most RNs will enter the U.S. with permanent resident immigrant visas (Green cards). They will undergo Schedule A Immigrant visa processing including the visa screen and enter the U.S. through an approved sponsorship process initiated by the employer. Of course, before recommending this particular visa process, we will first determine if you qualify
for any of the limited non-immigrant visa categories. It is very important that you do not enter on the wrong visa. Occasionally, unscrupulous agencies will recommend that you apply for and enter on H-1b visa (which requires a supervisory position or highly specialized duties requiring a Bachelors degree). Often job duties are inflated and inaccurate wages are offered to obtain the visa. Applications such as these are scrutinized by the INS carefully, but
sometimes approved due to misrepresentation. Once in the U.S. the nurse finds herself in violation of the terms of his/her visa and unable to use the fast track schedule A permanent residence program. This should be avoided and competent immigration counsel utilized at all times. Legal DisclaimerThis immigration information is provided for general educational purposes only. It
is not intended to be relied on as legal advice. This information may not have been updated to reflect subsequent changes in the law, if any. Your particular facts and circumstances, and any changes in the law, must be considered to determine appropriate legal advice. Always consult with a competent immigration lawyer to discuss your particular situation. | 
