Permanent US residence for nurses

With certain limited exceptions detailed below, petitioning for a foreign-born registered nurse (RN) to work in the United States involves sponsoring her for permanent residence. can help you through this process of getting a nurse you wish to hire a US visa.

US permanent residence for nurses in the US

If the RN is in the United States, the nurse will be able to start working for the employer more expeditiously than if she resides abroad, usually within 5 to 6 months.

  • The RN is required to present to the United States Citizenshp and Immigration Services many of the same documents as stated later in this article. However, since the nurse is already in the U.S., he or she can take the RN licensing examination (officially known as the National Council Licensure Examination for Registered Nurses or the "NCLEX-RN") in any state. The NCLEX-RN is administered by the National Council of State Boards of Nursing.
  • The employer must submit an immigrant visa petition to the appropriate United States Citizenshp and Immigration Service Center on behalf of the nurse. In order for the visa petition to be approved, the RN must have passed either the CGFNS exam or the NCLEX exam, or be in possession of a "full and unrestricted license" as a registered nurse in the state of intended employment.
  • Along with the submission of the visa petition, the RN and any accompanying family members may apply for adjustment of status to permanent residence, for work permits, and in most cases, for travel permits. A nurse need not be in possession of a VisaScreen certificate in order to apply for permanent residence. However, he or she cannot obtain permanent residence without being in possession of a VisaScreen certificate (See below).

US permanent residence for nurses living overseas

If the RN resides abroad, the following steps must be completed before the nurse may be employed in the U.S.:

1. The RN must have:

  • A diploma from a nursing school in her country;
  • An RN license in her country; and
  • A full and unrestricted license to practice professional nursing in the state of intended employment, or a certification issued by the Commission on Graduates of Foreign Nursing Schools (CGFNS), or evidence that she has passed the NCLEX-RN licensing examination but cannot obtain a license because she lacks a social security number.

    Although some states require that foreign nurses pass the CGFNS examination before taking the state RN licensing (NCLEX) examination, the number of such states is on the decline. This is because, as of January 2005, it became possible to take the NCLEX abroad in (1) Hong Kong; (2) London, England; or (3) Seoul, Korea. On January 24, 2006, the National Council of State Boards of Nursing (NCSBN) announced that within the next year, it will be possible to take the NCLEX in Australia, India, Japan, Mexico, Canada, Germany and Taiwan as well as the three locations named above. In addition, RNs residing abroad may take the NCLEX in Guam and Saipan.

2. RNs together with physical therapists are listed as shortage, or "Schedule A", occupations in regulations issued by the Department of Labor. An employer who wishes to immigrate an RN is exempt from having to submit a PERM application to the Department of Labor.

The immigration process begins when an employer submits an immigrant visa petition (Form I-140) to the service center of the US Citizenship and Immigration Services having jurisdiction over the nurse's place of intended employment. The petition must be accompanied by Labor Department form ETA-9089, by a posting notice, a prevailing wage determination and by various other documents. The petition should also be accompanied by a check for filing fees.

3. US Citizenship and Immigration Services sends the approved visa petition to the National Visa Center (NVC) in Portsmouth, New Hampshire. The nurse (or her attorney) receives a "fee bill" asking for all government processing fees to be paid in advance of processing her application and those of her immediate family members. After the fees are paid, the NVC forwards a packet to the nurse or her attorney containing biographical information forms to be completed by her and her family members, and a list of documents which must be submitted.

4. The RN, or her attorney, sends the signed and completed forms and documents to the NVC which then schedules an appointment for an Immigrant Visa for the RN and her family at the U.S. Consulate or Embassy where they will have their interviews for permanent residence. At this interview, the government will examine various documents including:

  • Applications for Immigrant Visas
  • Police Clearances
  • Birth Certificates
  • Marriage Certificate, if any
  • Divorce or Death Certificate of Spouse, if any
  • Valid Passports
  • Medical Examinations
  • Photographs
  • Recent job offer letter (or employment contract)
  • Financial information regarding employer
  • Government filing fees
  • VisaScreen Certificate

A VisaScreen Certificate is issued only after the RN has demonstrated that (1) her education, license and training in her country are equivalent to education, licensure and training in the U.S. and that (2) her level of competence in oral and written English are appropriate to practice professional nursing in the U.S.

The CIS 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. The CGFNS is located at 3600 Market Street, Philadelphia, PA, 19104-2651; telephone: (215) 349-8767; fax: (215) 349-0026; e-mail:

The CIS's VisaScreen regulations provide that even if a foreign-born RN is educated, licensed and trained in the U.S., she still must obtain a VisaScreen certificate. However, such RNs may be able to obtain a certificate on a streamlined basis. Obtaining such a certificate requires a significant expenditure of time, effort and money (over $300) on the part of the nurse.

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 minimum score on tests in written and spoken English administered by TOEFL (Test Of English As A Foreign Language), IELTS (International English Language Testing Service) or the TOEIC (Test of English in International Communications). Also, if the RN registered for the MELAB (Michigan English Language Assessment Battery) before November 27, 2002, this result may be sent to the CGFNS for VisaScreen purposes.

Passing scores for RNs on English exams are as follows:

IELTS: Academic Module or the General Training Module 6.5, Overall Band Score, 7.0 Speaking

TOEFL: Paper-Based 540; TOEFL Computer-Based 207; Test of Written English (TWE) 4.0; Test of Spoken English (TSE) 50.

TOEIC: 725; plus TWE: 4.0 and TSE: 50

Passing scores for the MELAB were as follows: Final Score 79+; Oral Interview 3+.

Generally, the process of obtaining permanent residence may take between 12 to 18 months assuming that the immigrant visa quota from the RN's country of birth is not backlogged.