Licensing Guide for Internationally Educated Nurses
If you trained as a nurse outside the United States and want to work as an RN or LPN in any of MyShyft’s operating states, there’s a defined path but it’s neither short nor cheap. Most internationally educated nurses complete the full process in 12 to 24 months, longer if visa processing is involved. Understanding every step before you start is the best way to avoid costly delays.
The Five-Step Path to U.S. Nursing Licensure
Credential evaluation
Your first step is having your nursing education formally evaluated by an approved credential evaluation service. This process verifies that your nursing program, clinical hours, and licensure are substantially equivalent to a U.S. nursing degree. The evaluation agency requests documents directly from your nursing school and your home country’s licensing authority, both of which must send them directly to the evaluator, not through you. How quickly those institutions respond is the primary factor in how long this step takes.
English proficiency (if required)
If your nursing education was not conducted in English, most state boards require you to demonstrate English proficiency through an approved exam. Accepted exams include TOEFL iBT, IELTS Academic, PTE Academic, and OET (Occupational English Test). Each state sets its own minimum scores verify with your specific destination state’s board, not just with CGFNS, because the requirements differ.
NCLEX-RN or NCLEX-PN
All U.S. RNs and LPNs must pass NCLEX, regardless of where they trained. Once your credential evaluation is approved and your state application is deemed eligible, the Board of Nursing issues an Authorization to Test (ATT) that allows you to schedule the exam. NCLEX is administered internationally at Pearson VUE centers in many countries check availability in your country at pearsonvue.com. The ATT has a limited validity window; schedule promptly after receiving it.
Visa and work authorization
This is the step most often misunderstood. Passing NCLEX and receiving a U.S. nursing license does not give you the right to work in the United States that requires valid work authorization through a visa. Most internationally educated nurses come through employer-sponsored EB-3 immigrant visas. Many large hospital systems, long-term care operators, and international recruiting agencies actively sponsor nurses. The VisaScreen certificate (issued by CGFNS) is also required for most work visa applications for nurses.
Apply for state licensure
With your credential evaluation, NCLEX pass, English proficiency score (if required), and background check completed, apply to the Board of Nursing in your intended state of practice. Processing times vary from as little as 4 weeks (Texas can process in about 15 days once all requirements are met) to 4 months or more in states with higher application volume. Most states also require a U.S. Social Security Number for licensure confirm the requirement with your destination state.
Credential Evaluation Services: Which one to Use
Not all evaluation services are equal and not all are accepted by all states. Always verify which service your destination state’s Board of Nursing requires before paying. Using the wrong evaluator can mean starting over.
Accepted by some state boards. Used more commonly for academic credit evaluation than nursing licensure. Verify acceptance with your specific state board before submitting.
The CES Professional Report evaluates your credentials only. The full Certification Program adds a qualifying exam and English proficiency components. Some states require the full Certification Program; others accept only the CES report. Check your destination state’s requirements carefully.
Issues the CES Professional Report (for licensure) and the full CGFNS Certification Program (required by about two-thirds of state boards). Also issues the VisaScreen certificate required for most work visa applications.
Standard fee ~$425–$485; expedited review available. Timeline: 4–8 months typical. Also recently rebranded as TruMerit.
Accepted by some state boards as an alternative to CGFNS CES. Verify acceptance with your specific destination state before paying. Faster processing in some cases.
Always confirm the required evaluator with your specific destination state board before paying any evaluation fee. CGFNS is the most widely accepted, but some states have specific requirements. Using the wrong evaluator, even a reputable one can result in your application being rejected and requiring you to pay for a new evaluation.
English Proficiency: Who Needs It and Who’s Exempt
If your nursing education was conducted entirely in English at an institution in a country recognized by your state board as English-medium, you may be exempt from English proficiency testing. The exemption list varies by state verify with your destination state’s Board of Nursing before assuming exemption applies.
| Exam | Details for healthcare licensure |
|---|---|
| TOEFL iBT | Widely accepted; minimum scores vary by state and by CGFNS requirements. Scores are valid for 2 years. CGFNS does not accept at-home versions of TOEFL. |
| IELTS Academic | Widely accepted; the Academic module is required (not General Training). Minimum scores vary by state, typically around 6.0–7.0 overall. Scores are valid for 2 years. |
| PTE Academic | Accepted by CGFNS and many state boards. Speaking score minimums recently returned to 50. Scores are valid for 2 years. |
| OET (Occupational English Test) | Healthcare-specific English exam accepted by some states and CGFNS. Minimum grade requirements vary. Particularly useful for nurses because the exam content is clinically focused. |
Note: Philippines-educated nurses typically qualify for exemption due to English-medium education but verify with each state board individually as requirements differ. Some states also exempt nurses from specific English-medium programs in non-predominantly-English countries.
VisaScreen, What It Is and When You Need It
The VisaScreen certificate is a federal requirement separate from state licensure. It’s required for nurses and certain other healthcare workers applying for occupational visas (EB-3, H-1B, and others) under Section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act. It’s issued by CGFNS and serves as a federal verification that your credentials are authentic and comparable to U.S. standards.
| Component | What it verifies |
|---|---|
| Education review | Confirms that your nursing education is substantially comparable to a U.S. nursing degree program. |
| License verification | Verifies that you hold a current, valid nursing license in your home country and in any other country where you’ve been licensed. |
| English proficiency | Confirms passing scores on an approved English proficiency exam or verifies eligibility for an approved exemption. |
| Nursing knowledge | Verified through a passing score on the CGFNS Qualifying Exam or by passing the NCLEX-RN, which satisfies this requirement. |
The CGFNS full Certification Program (Qualifying Exam + credentials review + English proficiency) satisfies the nursing knowledge component of VisaScreen. If you’ve already passed NCLEX-RN, that also satisfies the nursing knowledge requirement. You don’t need to take the CGFNS Qualifying Exam if you’ve passed NCLEX.
What The Full Process Costs
- CGFNS CES Professional Report: $425–$485 (+ expedited option)
- English proficiency exam: $200–$300 per attempt
- NCLEX registration fee: $200
- NCLEX international scheduling fee: $150
- State Board of Nursing application: $100–$250
- Fingerprint background check: $40–$80
- Document translation, courier, notarization: $100–$400 (varies widely)
- VisaScreen certificate (if visa required): Additional CGFNS fee
- Conservative DIY total (pre-licensure): $1,500–$2,500
Many U.S. hospital systems and international recruitment agencies cover or reimburse some or all of these costs for nurses they are sponsoring. If you’re working with an employer sponsor, ask which costs they cover before paying out of pocket for any phase of this process.
State-Specific Notes for MyShyft Operating States
| State | Accepted evaluator | English proficiency | Additional notes |
|---|---|---|---|
| Illinois | CGFNS CES report accepted by IDFPR | Required for non-English-medium graduates | Full CGFNS Certification Program or CES report may be required depending on pathway. Apply through the IDFPR portal. |
| Texas | CGFNS CES accepted by Texas BON | Required (IELTS or OET accepted); may be waived for English-medium graduates | Texas also requires the Nursing Jurisprudence Exam (NJE) before ATT is issued. VisaScreen required for visa applicants. Processing can take as little as 15 days once the file is complete. |
| Michigan | CGFNS CES and other LARA-approved evaluators | Required for non-English-medium graduates | Both MSP and FBI fingerprints required. Apply through the LARA / MiPLUS portal. |
| Indiana | CGFNS CES and other IPLA-accepted evaluators | Required for non-English-medium graduates | Full NLC compact state. Indiana residents receive multistate licenses. Apply through the IPLA portal. |
| Ohio | CGFNS CES and other OBN-accepted evaluators | Required for non-English-medium graduates | Full NLC compact state. Category A CE required at first renewal. Apply through Ohio eLicense. |
| Tennessee | CGFNS CES and TN BON-accepted evaluators | Required for non-English-medium graduates | Full NLC compact state. Apply through the LARS portal. Typical processing time: ~4–6 weeks once complete. |
| Florida | CGFNS CES and Florida DOH-accepted evaluators | Required for non-English-medium graduates | Full NLC compact state. Level 2 background screening (Livescan) required. Apply through MQA Online Services. Endorsement applicants must also show active practice for 2 of the last 3 years. |
If You’re an Internationally Educated CNA (Not RN/LPN)
International CNA credentials are handled differently from nursing licenses and the news is less straightforward. Most U.S. states do not grant CNA reciprocity from international credentials. Even if you worked as a nursing assistant in another country for years, you’ll typically need to complete a U.S. state-approved CNA training program and pass the state competency exam from the beginning.
| Situation | What’s typically required |
|---|---|
| International CNA training, no U.S. training | Complete a U.S. state-approved CNA training program (typically 75–120 hours depending on the state) and pass the state competency exam. In most cases, full U.S. training is required. |
| RN/LPN trained internationally, want to work as CNA while pursuing licensure | Some states may grant partial credit toward CNA training requirements for documented international nursing education. Always verify directly with the specific state’s nurse aide registry. |
| Already completed U.S. CNA training in one state, moving to another | Standard CNA reciprocity rules generally apply. Contact the new state’s registry directly. Processing typically takes 2–8 weeks and may include an additional competency evaluation. |
Licensed and authorized to work in the U.S.? Start finding shifts.
Once your U.S. nursing license is active and your work authorization is in place, MyShyft connects you with shifts at licensed facilities across all our operating states without the delays of traditional job searching.
- Automatic credential verification as part of onboarding
- Shifts across multiple facility types and settings
- Flexible scheduling as you build your U.S. clinical experience
Frequently Asked Questions
Licensing Information Disclaimer:
Licensing requirements, fees, examination details, renewal standards, and Nurse Licensure Compact participation may change over time. While we strive to keep this information current and accurate, MyShyft does not guarantee the completeness or accuracy of the information provided. Always verify licensing requirements directly with the State Board of Nursing before making educational, licensing, employment, or relocation decisions. Reliance on information contained on this page is at the reader’s own risk.