Foreign nurses often ask us, “How do I immigrate to the U.S. as an RN?”  Most RNs know that there is a shortage of nurses in the U.S. and that a fast-track process to the green card is in place for foreign RNs sponsored by U.S. employers.  It is also common knowledge that foreign RNs must obtain a Visa Screen certificate issued by CGFNS before an immigrant visa may be issued to them. 

The Visa Screen is a U.S. government immigration requirement to determine if the RN has the equivalent of a U.S. accredited nursing degree, has sufficient command of spoken and written English, has an unencumbered license (i.e., the RN has not had her license revoked), and that the RN has adequate medical knowledge.  The Visa Screen is not a nursing license.  The medical knowledge portion of the Visa Screen is determined by the RN passing either the CGFNS exam or the U.S.’s National Council of State Boards of Nursing (NCSBN) examination called the NCLEX.  Until recently, the NCLEX was offered in the U.S. and its territories only.  Most foreign RNs therefore, only had the option of taking the CGFNS exam because they had no access to the U.S. 

As a practical matter, the NCLEX exam is the far more desirable of the two exams to take.  The NCLEX exam is usually the final step in the licensing process.  Healthcare employers prefer to petition those RNs who are already licensed in the state where they will be working so that they can be put to work immediately.  With an unlicensed RN, employers run the risk that the RN may not pass the NCLEX exam and the employer is stuck with an employee that they cannot use in the RN capacity.

The NCSBN now gives the NCLEX exam in Hong Kong.  For Filipino RNs, this means a short plane ride can now make them more desirable to U.S. employers.  Foreign RNs who take the NCLEX exam can designate the state in which they wish to work as the one they want to be licensed in.  If circumstances change and the RN gets a better job in a different state, most states have licensing reciprocity laws that will allow the license to be recognized in the new state.  By taking and passing the NCLEX exam, RNs are ahead of those who take the CGFNS exam.  Those who take the CGFSN exam will also have to take the NCLEX exam once they enter the U.S.  Many test takers of the two exams find the CGFNS exam the more difficult of the two.  Whether or not this is true, simply taking the NCLEX exam removes the need to take the CGNFS exam.  Why take two exams when one will do?

RNs have many terrific opportunities to immigrate to the U.S.  Now that the NCLEX is given in Hong Kong, it has gotten easier for many.  Employers in general prefer NCLEX passers to CGFNS passers because NCLEX passers can start working right away.  Immigrating to the U.S. involves more than just passing these exams.   A competent immigration attorney can guide RNs through the process and help ensure a speedy and trouble-free immigration to the U.S.

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Author's Note:  The analysis and suggestions offered in this column do not create a lawyer-client relationship and are not a substitute for the individual legal research and personalized representation that is essential to every case.