The Ultimate Guide to Becoming a Nurse in the USA: NCLEX, VisaScreen & Green Card
The pathway for Internationally Educated Nurses (IENs) to become a Registered Nurse (RN) in the United States is one of the most complex, involving state-specific licensing boards, federal immigration agencies, and third-party credentialing services.
However, the reward is massive: The ultimate goal is to obtain both the state RN License and the federal EB-3 Immigrant Visa (Green Card).
🇺🇸 USA Pathway: Licensure & Permanent Residency (EB-3 Visa)
The process is generally divided into two major phases: Credentialing/Licensure and Immigration. It is highly recommended to partner with a U.S. recruitment agency to manage the legal steps.
Phase 1: Credentialing and Examination
The first phase is focused on verifying your education and proving your competence to practice.
| Step | Action | Key Agency / Requirement |
| 1. Credential Evaluation | Submit transcripts, diploma, and home country license for review. | CGFNS International (Or ERES / Josef Silny depending on your specific State Board). |
| 2. English Proficiency | Pass a standardized English test. | IELTS Academic / TOEFL iBT / OET Requirements vary by state. Note: Nurses from UK, Canada, Aus, NZ are often exempt. |
| 3. Apply to State Board | Submit application for “Licensure by Examination” to your chosen state. | State Board of Nursing (BON) Warning: States like California have stricter concurrency rules. |
| 4. Pass the NCLEX-RN | Receive Authorization to Test (ATT) and pass the national exam. | NCLEX-RN (Pearson VUE) Passing this is the critical trigger for your Green Card petition. 💡 Pro Tip: The NCLEX is tough. Don’t risk your application fees. Guarantee your pass with our [Medical-Surgical Study Guide]. |
| 5. VisaScreen Certificate | The final federal screening for healthcare professionals. | CGFNS VisaScreen Bundles your education, license, and English scores into one certificate for USCIS. |
Phase 2: Employment and Immigration (EB-3)
Once you pass the NCLEX, you become highly marketable. The focus shifts entirely to securing permanent residency.
| Step | Action | Key Agency / Requirement |
| 6. Job Offer & Sponsor | A U.S. employer (hospital or agency) offers a permanent RN position. | EB-3 Sponsor The employer must be willing to file immigration paperwork. |
| 7. Employer Files Petition | Employer files Form I-140 (Immigrant Petition for Alien Worker). | Schedule A Designation Nurses bypass the lengthy Labor Certification (PERM) step, speeding up the process. |
| 8. Visa Interview & Green Card | Once your “Priority Date” is current, file final forms and attend embassy interview. | EB-3 Immigrant Visa Upon approval, you enter the U.S. as a Lawful Permanent Resident (Green Card holder). |
⚠️ Reality Checks: The “Waiting Game”
1. State Variability The specific order and evaluation agency required (CGFNS vs. ERES) depend entirely on the State you choose. Always check the Board of Nursing website for your target state first before paying for any reports.
2. The Visa Retrogression The EB-3 process (Step 8) is the bottleneck. While the I-140 petition is fast, the actual visa issuance is subject to backlogs based on your country of birth. This wait can range from 18 months to 5+ years depending on current “Visa Bulletin” movement.
3. Agency vs. Direct Hire Most IENs work with a Recruitment Agency (e.g., Connetics, Interstaff). They pay the legal fees and manage the paperwork in exchange for a multi-year work commitment. This makes the complex process manageable and debt-free.
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