Does passing the NCLEX let me work as a nurse in the US?

No. Passing the NCLEX and holding a state license make you eligible to practice, but they do not authorize you to work in the US. Work authorization is a separate immigration matter, typically employer-sponsored. The licensure path and the immigration path are two different processes.

What is the difference between CES, the CGFNS Certification Program, and VisaScreen?

They are three distinct CGFNS programs. The Credentials Evaluation Service (CES) is an education-comparability report many state boards require for licensure. The CGFNS Certification Program is a credentials assessment plus a qualifying exam plus English proficiency, required by roughly two-thirds of state boards as a criterion for NCLEX approval. VisaScreen is a federal immigration screen required for an occupational visa, not for licensure. Do not conflate them.

What is VisaScreen and why do I need it?

VisaScreen (the Visa Credentials Assessment) is a federally required certificate for foreign health-care workers seeking certain U.S. occupational visas. It rests on Section 343 of the 1996 immigration reform law (codified at 8 U.S.C. 1182(a)(5)(C)), which makes a foreign health-care worker inadmissible without a certificate verifying their education, license, and English are comparable to a U.S. worker's. It is part of the immigration process, separate from your state license.

How do foreign nurses usually get a green card?

The most common route for RNs is the EB-3 employment-based immigrant visa, which requires a permanent, full-time job offer from a U.S. employer who petitions on your behalf. Registered nurses are a 'Schedule A' occupation, which is exempt from the standard labor-certification step. Immigrant visa numbers are capped and subject to per-country waiting lists, so timing can be long and uncertain. Consult a licensed immigration attorney.

Do requirements differ by state?

Yes, significantly. Each state board of nursing sets its own rules for internationally-educated nurses, including which credential evaluators it accepts, which English exams it requires, and whether a Social Security number is needed. Multistate (compact) licensure has its own eligibility requirements. Always confirm with the specific state board where you intend to practice.

Becoming a nurse in the US from abroad

Reviewed by Keegan, RN · ER & NICU travel nurse

Updated June 19, 2026

If you trained as a nurse outside the United States, two separate processes stand between you and a U.S. nursing job. The licensure path makes you eligible to practice: a credentials evaluation, English proficiency, the NCLEX-RN, and a state license. The immigration path, entirely separate, makes you authorized to work. Here is how each one works, and why a license alone does not let you work.

Licensure and immigration are two different things. Passing the NCLEX and holding a state license mean you are eligible to practice. They do not grant the right to work in the US, which is a separate immigration process, usually employer-sponsored. This page is general information, not legal advice. Always confirm with the specific state board of nursing and a licensed immigration attorney.

The licensure path (eligibility to practice)

Get a credentials evaluation of your nursing education

State boards commonly require an independent review of foreign nursing education before you can sit the NCLEX. The CGFNS Credentials Evaluation Service (CES) report compares your education against U.S. nursing standards. The specific evaluator a board accepts varies by state.

Meet English-language proficiency, where required

If your nursing program was not taught in English, or English is not your native language, many boards require an English exam (TOEFL, IELTS, PTE, or OET). Each board sets its own accepted exams and passing scores; graduates of some English-speaking countries are often exempt.

Pass the NCLEX-RN

Internationally-educated nurses take the same NCLEX-RN that U.S.-educated nurses take. There is no separate exam. All boards require passing it for licensure by examination.

Apply to a state board for licensure

Each state licenses nurses within that state and sets its own rules (accepted evaluators, English exams, Social Security requirements). Apply for licensure by examination to the board where you intend to practice.

Sourced to NCSBN and CGFNS International (now TruMerit). The accepted evaluator and English exam vary by state board.

CES, the Certification Program, and VisaScreen

CGFNS International (now branded TruMerit) runs three programs that are easy to confuse. They serve different purposes, and only one is about immigration.

Program	Purpose	What it is for
CES report	Education evaluation	A comparability report many state boards require for licensure
Certification Program	Gateway to NCLEX approval	Credentials assessment, a qualifying exam, and English; required by about two-thirds of state boards
VisaScreen	Federal immigration screen	Required for an occupational visa, not for licensure

The "two-thirds of state boards" figure belongs to the Certification Program, not CES. VisaScreen is the only one of the three tied to a visa rather than a license.

The immigration path (authorization to work)

A license does not authorize employment. To actually work, an internationally-educated nurse generally needs employer-sponsored work authorization plus a VisaScreen certificate.

EB-3 employer-sponsored green card. The common route for RNs. Per USCIS, it requires a permanent, full-time job offer from a U.S. employer, who files the petition (Form I-140).
RNs are "Schedule A." Registered nurses are pre-certified, which exempts the petition from the standard labor-certification (PERM) step. The regulatory basis is 20 CFR 656.15, under which a nurse qualifies via a CGFNS certificate, an unrestricted state license, or a passed NCLEX-RN.
VisaScreen is federally required. Under 8 U.S.C. 1182(a)(5)(C)(enacted by Section 343 of the 1996 immigration reform law), a foreign health-care worker is inadmissible without a certificate verifying their education, training, license, and English are comparable to a U.S. worker's.
Visa availability is limited. Immigrant visa numbers are capped with per-country limits, so cut-off dates can retrogress and waits can be long. The Department of State Visa Bulletin tracks current availability.

High-level overview only, not legal advice. Immigration law is complex and changes; consult a licensed immigration attorney for your situation.

Honest caveats

State variation is significant. Each board sets its own rules for accepted evaluators, English exams, and Social Security requirements. Confirm with the specific state board.
Compact (multistate) licensure has its own eligibility. The compact requirements fold in a credentials review, an English exam where applicable, a passed NCLEX, and a valid U.S. Social Security number.
The immigration process is long and timing is uncertain because of visa caps and retrogression.
Always consult the specific state board of nursing and a licensed immigration attorney. This page is general information, not legal or immigration advice.

General educational information, not legal or immigration advice. Licensure and immigration requirements vary by state and by federal law, and change over time. Confirm current requirements with the specific state board of nursing and a licensed immigration attorney.

Internationally-educated nurse FAQ

Does passing the NCLEX let me work as a nurse in the US?: No. Passing the NCLEX and holding a state license make you eligible to practice, but they do not authorize you to work in the US. Work authorization is a separate immigration matter, typically employer-sponsored. The licensure path and the immigration path are two different processes.
What is the difference between CES, the CGFNS Certification Program, and VisaScreen?: They are three distinct CGFNS programs. The Credentials Evaluation Service (CES) is an education-comparability report many state boards require for licensure. The CGFNS Certification Program is a credentials assessment plus a qualifying exam plus English proficiency, required by roughly two-thirds of state boards as a criterion for NCLEX approval. VisaScreen is a federal immigration screen required for an occupational visa, not for licensure. Do not conflate them.
What is VisaScreen and why do I need it?: VisaScreen (the Visa Credentials Assessment) is a federally required certificate for foreign health-care workers seeking certain U.S. occupational visas. It rests on Section 343 of the 1996 immigration reform law (codified at 8 U.S.C. 1182(a)(5)(C)), which makes a foreign health-care worker inadmissible without a certificate verifying their education, license, and English are comparable to a U.S. worker's. It is part of the immigration process, separate from your state license.
How do foreign nurses usually get a green card?: The most common route for RNs is the EB-3 employment-based immigrant visa, which requires a permanent, full-time job offer from a U.S. employer who petitions on your behalf. Registered nurses are a 'Schedule A' occupation, which is exempt from the standard labor-certification step. Immigrant visa numbers are capped and subject to per-country waiting lists, so timing can be long and uncertain. Consult a licensed immigration attorney.
Do requirements differ by state?: Yes, significantly. Each state board of nursing sets its own rules for internationally-educated nurses, including which credential evaluators it accepts, which English exams it requires, and whether a Social Security number is needed. Multistate (compact) licensure has its own eligibility requirements. Always confirm with the specific state board where you intend to practice.

Once you are licensed

License renewal and CE by state

Moving states later? License by endorsement

Nurse career guides

Once you are licensed, keep it that way

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