Site logo

A Comprehensive Guide on How to Become a Foreign Nurse in the United States of America

International nurses who wish to work in the United States of America (USA) must be a holder of a nursing degree and an active nursing license. They must also apply to the CGFNS certification program, and must pass any English language proficiency test, as well as the NCLEX-RN.  Their credentials are also assessed through the credentials evaluation service professional report. Despite the number of requirements needed to qualify to become a nurse in the USA, many nurses prefer to migrate and work in the United States due to the competitive salary and benefits offered. There is also a great number of employment opportunities for the nurses who aspire to work in the country. 

About the Country

The United States of America is a country located in North America. It is a federal republic with 50 states, and there are no two states that are the same. There is a wide range of beliefs, values, and customs as a great number of people in the United States (U.S.) come from diverse origins and cultures. In fact, there is no such thing as a typical American, which is part of what makes the country so fascinating. Customs are different from one location to the next, as well as from one person to another. 

There are a great number of national parks across the country. If you choose to work in the country, you could take a breath of fresh air as you visit these magnificent sceneries, which range from the soaring mountains to vibrant forests. Aside from the landscapes, the food in the country is also delicious, and they are often served in big food portions. This is because of the stereotype, in which Americans tend to eat in massive food portions. 

If you are uncomfortable being in the country alone, there are many Filipino nurses in the U.S., wherein since 1960, about 150,000 Filipino nurses have settled in the USA. As of 2019, approximately one out of every 20 registered nurses in the U.S. acquired their nursing education in the Philippines. Despite the U.S. and the Philippines being 13215.51 kilometers apart, it is likely that you could meet other Filipinos in the country when you choose to work there. In addition to this, the Philippine Nurses Association of America (PNAA) was also established in response to the rising need for a collaborative effort to address difficulties and concerns of Filipino nurses working in the U.S..

Types of Nurses

As an aspiring nurse in the U.S,, there is a wide-range of nursing pathways you could choose from in the country. The most common nursing jobs are US Registered Nurses, Licensed Vocational Nurses or Licensed Practical Nurses, and Certified Nursing Assistants. 

US Registered Nurse (USRN). US Registered Nurses (USRN) are nurses who have obtained a nursing degree that complies with the standards of the particular state they work in, and have passed the NCLEX-RN. Patients’ requirements are assessed and identified by RNs, who subsequently execute and monitor the patient’s medical plan and therapy. They also guarantee that patient care is carried out in accordance with their employer’s regulations and standards, whether that employer is a hospital or another institution.

Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). LVN or LPN is a nurse who acquired a short course of study. They offer hands-on care to patients under the supervision of RNs. Most of them offer basic bedside care. Their job entails recording the patient’s vital signs, such as the temperature, blood pressure, pulse, and respiration. They also treat bedsores, prepare and administer injections and enemas, provide alcohol rubs and massages, apply cold packs and hot water bottles, keep an eye on catheters and repair wounds.

Certified Nursing Assistant (CNA). A CNA is responsible for the daily care and healthcare needs of patients under the supervision of an RN or an LPN. They are often in charge of feeding, bathing and fulfilling other general tasks for patients. 

Demand for Nurses

The number of registered nurses is predicted to increase by 221,900, or 7%, from 3 million in 2019 to 3.3 million in 2029. When nurse retirements and employment exits are added into the number of nurses needed in the United States, the Bureau predicts 175,900 opportunities for RNs each year through 2029.


The salary of nurses working in the United States greatly varies based on the state that their workplace is located in, as well as their respective qualifications and experiences. According to the U.S. Bureau of Labor Statistics, the mean salary of USRN in the country is $82,750, and a median salary of $77,600. As of May 2021, California is the state with the highest paid RN, with an average salary of $124,000. The second highest paying state in the United States is Hawaii, with an average salary of $106,530. 


According to the American Hospital Association, there are a total of 6,093 hospitals in the United States. 5,139 of which are community hospitals; 207 are federal government hospitals and 635 are non-federal psychiatric hospitals.

Community Hospitals. Most hospitals in the United States are categorized as community hospitals. These establishments provide general care, with some focusing on specialty care. Community Hospitals in the country are divided into three: nongovernment not-for-profit community hospitals, investor-owned (for-profit) community hospitals, and state and local government community hospitals. Some community hospitals include Edward Hospital, Saint Mary’s Hospital, Elmhurst Hospital, and Mercy Hospital Oklahoma City

Federal Government Hospitals. Federal government hospitals provide care for specific patients that have routine medical and surgical problems. Their patients include the military personnel. These hospitals are monitored by the Department of Defense, Department of Health and Human Services, and the Veterans Health Administration. Some federal government hospitals include the Air Force Hospital, Army Hospital, VA Hospital, and Navy Hospital. 

Non-Federal Psychiatric Hospitals. Non-Federal psychiatric hospitals are private hospitals, which aim to provide for the needs of patients with mental health illnesses that require acute hospital care. These hospitals deal with conditions like severe depression  and substance abuse. 

Educational Requirement 

In order to work as a nurse in the country, you must hold a four-year bachelor’s degree in nursing from any accredited nursing education program in your country of education. You must also have an active registered nursing license, which could be acquired from your home country. If you obtained your nursing degree and license outside of the United States, you must contact and verify with the Commission on Graduates of Foreign Nursing Schools (CGFNS) to determine if you are eligible to work in the country.


As a foreign-educated nurse, you must have practiced as a registered nurse for at least two years before your application in the country.

Certifications & Examinations 

An international nurse must apply for the following certifications and examinations, and must acquire at least the minimum passing score to be qualified to work in the USA.

Commission on Graduates of Foreign Nursing Schools (CGFNS) Certification Program

Foreign educated nurses could apply to the CGFNS Certification Program. The CGFNS will determine if you have obtained a high school education, and a nursing education. This program contains a credentials evaluation, the CGFNS Qualifying Exam, and an English Language Proficiency Exam. This program requires a fee of $445.

Credentials Evaluation Service (CES)

The CGFNS Credentials Evaluation Service (CES) Academic Report examines the nursing education taken outside of the country in depth. This report is utilized for academic entrance, and healthcare professionals and report recipients who want a full education analysis. 

Secondary School Information. Applicants are required to present a photocopy of their highest level of secondary education diploma or external exam certificate. If the applicant has completed secondary school more than ten years ago, this criterion is waived.

License/Registration/Diploma Information. Applicants must have a valid, unrestricted nursing license from their home country. The licensing organization must provide the license verification straight to CGFNS. In case the license has already expired, the applicant must request that the licensing authority that they acquired their license from, provide CGFNS with a direct proof of that license. Any relevant papers received and approved by CGFNS in the last three years may be used to meet these requirements.

Professional Education Information. Applicants must request that CGFNS get a comprehensive academic record or transcript from each educational institution attended for the profession being assessed from their nursing school. A comprehensive academic transcript is defined by CGFNS as a record of an applicant’s courses taken, as well as clock hours for clinical hours obtained for each course.

Individual Photos (Passport-format). Applicants must submit a passport-formatted photograph of themselves. Background of the photo must be white or off-white.

CGFNS Qualifying Exam

The CGFNS Qualifying Exam is required by certain state boards prior to being able to take the NCLEX-RN. This exam may also determine how well you will do in the NCLEX-RN. This exam is also essential if you will apply for an occupational visa.

English Language Proficiency Test

The CGFNS requires international nurses to take any English Proficiency Test to test your proficiency in the English language. The International English Language Testing System (IELTS), Test of English as a Foreign Language (TOEFL), and Test of English for International Communication (TOEIC) are accepted as proof of English proficiency for healthcare registration in the United States. Exemptions are made, depending on your home country.

International English Language Testing System (IELTS) – Academic. The IELTS is widely accepted as proof of English proficiency for healthcare registration, as well as visa applications in the USA. There are four parts: listening, reading, writing, and speaking sections. To be eligible to obtain a visa in the country, a minimum overall score of 6.5 is required. However, a score of 7.0 in the speaking section is necessary to meet the standards. You may learn more about the test on the IELTS website. Keep in mind that the validity of this exam is only two years. 

Test of English as a Foreign Language (TOEFL). A total score of 83 is required for international nurses to work in the country. However, a minimum score of 26 must be obtained from the speaking section. You may learn more about the test on the TOEFL website.

Test of English for International Communication (TOEIC). The TOEIC is a test taken with the use of a paper and pencil. It consists of 200 multiple choice questions with two parts: Listening Comprehension and Reading Comprehension. A total of two hours is given to complete the exam. For aspiring nurses in the country, the score requirement is 725. You may learn more about the test on the TOEIC website.

Credentials Evaluation Service Professional Report 

This report is similar to the CGFNS Certification Program, except it does not require the CGFNS Qualifying Exam. However, only some states accept this. This report is less involved and is cheaper as compared to the certification program, as the report only costs $350.

National Council Licensure Exam for Registered Nurses (NCLEX-RN)

The NCLEX-RN is a registered nurse licensing exam in the USA. It is required that all nurses who would want to work in the country have a nursing license issued in the country. This test also aims to determine whether you are fit to work in the country or not. The exam is often taken in the USA, however, it could be scheduled outside the country through a telephone call. The exam is taken in the form of a Computer Adaptive Test (CAT). In order to take the exam, a fee of $200 must be paid. 

Prior to taking the exam, you must first apply to your specific board of nursing, and register with Pearson VUE. Afterwards, you must complete the Authorization to Test (ATT), before you will be permitted to take the exam. 

Leave a Comment

We use cookies to improve your experience on our website. By browsing this website, you agree to our use of cookies.

Sign in

Sign Up

Forgotten Password

Job Quick Search