Registered nurses have been designated as a shortage occupation under the Department of Labor’s “Schedule A,” thereby bypassing the recruitment normally required for labor certification and earning an expedited path toward lawful permanent residence.
To qualify, the foreign-born nurse has to possess a diploma in nursing and an unrestricted and unencumbered nursing license from the nurse’s home country (if the nurse was educated outside the United States).
Nurses from foreign countries must meet one of two licensing/certification requirements
- Possession of license in the state of intended employment in the U.S., or
- Successful completion of the Commission on Graduates of Foreign Nursing Schools (CGFNS) certification program.
State nursing boards generally require a nurse to pass the National Council Licensure Exam (NCLEX-RN) exam, a frequently scheduled examination offered exclusively in the United States (and U.S. territories such as Guam).
Licensure requirements differ from state to state, and it is important to consult the state licensing authority for guidelines.
The website of the National Council of State Boards of Nursing contains contact information for the state Boards of Nursing.
Instead of directly pursuing state licensure, a nurse can complete the CGFNS certification program.
The CGFNS certification program consists of three parts:
1) a review of foreign nursing credentials;
2) the CGFNS qualifying exam (offered in all 50 states and worldwide); and
3) an English language proficiency component. CGFNS accepts qualifying results from three standard English language proficiency examinations known as TOEFL, TOEIC and IELTS.
The exams are administered by the Educational Testing Service (ETS), The Chauncey Group, and a consortium of the Cambridge ESOL Examinations, the British Council and IDP Education Australia. Native-English speaking applicants who received their nursing education in Australia, Canada (except Quebec), Ireland, New Zealand or the United Kingdom may be exempt from the English language proficiency requirement.
For those candidates already lawfully present in the United States in an appropriate nonimmigrant visa status, an Adjustment of Status application (I-485) for the nurse and family members may be filed simultaneously with the immigrant petition.
The nurse may be authorized to accept employment with the healthcare institution immediately upon approval of the employment authorization component of the Adjustment of Status track (three to four months after filing) assuming there are no state licensure issues.
In order to be eligible for the Adjustment of Status track, the individual must have been lawfully admitted to the United States in a nonimmigrant classification that does not require nonimmigrant intent.
Furthermore, the I-140 immigrant petition must have been filed before the expiration of the period of authorized U.S. stay, and the individual must not have been employed without authorization.
If the nurse is living outside the United States, the I-140 immigrant petition will request Consular Post Processing (CPP) at a U.S. consulate abroad.
Upon approval of the I-140 immigrant petition, the USCIS will notify the U.S. State Department’s National Visa Center (NVC), who will then provide instructions on how to apply for an immigrant visa at a U.S. Consulate.
The NVC conducts the initial processing of the consular packet, which is then referred to the applicable U.S. consulate for the immigrant visa interview.
After the immigration petition is filed, but before obtaining permanent residency approval (under either track), the nurse must obtain a VisaScreen Certificate.
The VisaScreen Certificate program is administered by the International Commission on Healthcare Professions (ICHP), a division of the Commission on Graduates of Foreign Nursing Schools (CGFNS).
The VisaScreen Certificate is a based on criteria very similar to the CGFNS Certificate and is composed of three parts:
1) a credentials review;
2) successful completion of either the CGFNS qualifying exam or NCLEX-RN examination; and
3) passage of an English proficiency examination.