How International Nurses Move to USA: The Complete Roadmap
Every year, thousands of nurses from the Philippines, India, Nigeria, Ghana, Jamaica, and dozens of other countries successfully make the move to work in the United States. The US is facing one of the worst nursing shortages in its history — hospitals are actively recruiting internationally trained nurses, and the visa pathways exist to make it happen. But the process is long, specific, and full of steps nobody tells you about upfront. This guide walks you through exactly how international nurses move to USA — the visas, licensing, credential evaluation, English tests, the full timeline, and the traps to avoid.
open across the USA
from start to US arrival
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Why the USA Is Actively Recruiting International Nurses Right Now
The US Bureau of Labor Statistics projects the country will need over 275,000 additional nurses in the coming years. The domestic pipeline cannot fill that gap alone. Hospitals in California, Texas, New York, Florida, and Massachusetts are turning to international recruitment as a structural solution, not a temporary patch.
This is genuinely good news if you are an internationally trained nurse. The demand is real, the salaries are high by global standards, and employers are more willing than ever to sponsor visas and cover relocation costs. That said, you still need to meet every licensing and immigration requirement — and those requirements are non-negotiable regardless of how badly a hospital wants to fill beds.
Understanding how international nurses move to USA starts with one truth: this is not a quick process. The nurses who make it are the ones who start early, stay organised, and do not try to skip steps. The process has a specific order. Get that order wrong and you can lose months of progress.
Top 10 Steps: How International Nurses Move to USA
The path from your home country to working as a registered nurse in the USA follows a defined sequence. Every step matters, and most must be completed in order. Below is the full ranked process — from your first credential check to your first US shift.
| # | Step | Who Handles It | Timeline | Key Requirement |
|---|---|---|---|---|
| 1 | Credential Evaluation (CGFNS) | CGFNS International | 3–6 months | Degree + transcripts + license verification |
| 2 | English Proficiency Test (IELTS / OET) | Individual nurse | 1–3 months | IELTS 7.0+ overall OR OET B in all bands |
| 3 | NCLEX-RN Examination | NCSBN / State Board | 1–6 months prep | Pass at international Pearson VUE center |
| 4 | State Nursing License Application | State Board of Nursing | 1–4 months | NCLEX pass + credential eval + background check |
| 5 | VisaScreen Certificate (CGFNS) | CGFNS International | 4–8 months | Required by US immigration law for all HCWs |
| 6 | Employer Sponsorship / Job Offer | US Hospital / Agency | 1–6 months | Signed offer; employer willing to file petition |
| 7 | PERM Labor Certification (EB-3) | Employer\'s attorney | 6–18 months | Employer must advertise role domestically first |
| 8 | I-140 Immigrant Petition Filing | Employer + USCIS | 4–12 months | Approved I-140 sets your priority date |
| 9 | Visa Number Availability + DS-260 | US Dept of State | 6 months–4+ years | Depends on country of birth + visa bulletin |
| 10 | Consular Interview + Arrival in USA | US Embassy / Consulate | 2–6 months | Medical exam, police clearance, interview, travel |
5 Things That Determine Whether Your USA Move Succeeds or Stalls
Your Country of Birth — Not Your Citizenship or Passport
Your CGFNS Credential Evaluation Quality
English Test Scores — Specific Exam and Specific Scores
Choosing the Right Employer Sponsor
Nurses Who Move During a Shortage Get the Best Packages — Here Is Why This Matters Right Now
How to Actually Start Your USA Nursing Move — Practical Steps
Starting the process can feel overwhelming when you look at the full picture. The key is to break it into phases and start the ones you can control immediately, without waiting for other steps to finish first.
What You Can Start Right Now — Before You Have a Job Offer
Your CGFNS credential evaluation, your English language test, and your NCLEX preparation can all begin in parallel. None of these require an employer or visa petition. Most serious international nursing candidates are well into NCLEX prep and have English scores ready before they approach a US employer — because employers are far more likely to commit to sponsorship when you already hold a passing NCLEX score.
Finding a US Employer Who Will Actually Sponsor Your Visa
The most reliable routes to employer sponsorship are through international nursing staffing agencies, direct hospital international recruitment programs, and nursing job boards that specifically list visa-sponsored positions. Look for postings that state “EB-3 sponsorship available.” Do not apply to roles that say “must be authorized to work in the US” — that employer will not sponsor you. Major agencies with proven track records include AMN Healthcare, Cross Country International, Aya Healthcare, and Avant Healthcare Professionals.
- CGFNS.org — Submit credential evaluation; required for most state boards and VisaScreen
- NCSBN.org — Register for NCLEX-RN at an international Pearson VUE center near you
- IELTS Academic / OET Online — Book your English test; allow time to retest if needed
- State Board of Nursing websites — Check state-specific requirements; some process international applications faster
- US Dept of State Visa Bulletin — Monitor monthly for your country and category priority date movement
7-Step USA Immigration Action Plan for International Nurses
Collect your nursing degree transcripts, official license verification from your country\'s nursing council, and passport photos. Submit your CGFNS Credentials Evaluation Service application immediately — it takes 3 to 6 months. Do not wait. This is your longest administrative delay and runs in parallel with everything else you start.
Register for IELTS Academic or OET immediately. Study using official materials and take at least two full practice tests before sitting the exam. If you score below the required threshold, book a retest straight away — retesting windows can be 3 to 4 months apart and every delay here pushes your entire timeline back.
Enroll in a reputable NCLEX prep course — UWorld, Kaplan, and Archer Review are widely used by internationally trained nurses. The Next Generation NCLEX format focuses heavily on clinical judgment. Study daily. Most internationally trained nurses who fail NCLEX underestimate how different the question style is from their home country exams.
Once your CGFNS evaluation is complete, apply to your chosen state board for an Authorization to Test (ATT). Missouri and South Dakota historically process international applications faster than high-volume states. Once you have your ATT, book your NCLEX at the nearest Pearson VUE test center internationally.
With NCLEX passed and your license in hand, you are an extremely attractive candidate for US sponsoring employers. Approach international nursing staffing agencies with your full documentation ready. Negotiate carefully — salary, relocation support, housing, and what happens to your visa petition if employment ends early. Get the immigration attorney\'s contact details before signing.
Your employer files PERM labor certification and then the I-140 petition. Once approved, your priority date is set. Monitor the monthly Visa Bulletin closely. If you are from the Philippines or India, ask your attorney specifically about Schedule A — this allows employers to skip PERM entirely for nurses, potentially cutting 12 to 18 months from the process.
Once your visa number becomes current, complete DS-260, attend your medical exam, obtain police clearance, and attend your consular interview at the US Embassy. On approval you receive your immigrant visa and travel to the USA. Your green card arrives by mail within weeks of entry. You are now a US permanent resident nurse.
Schedule A: The Immigration Shortcut Most International Nurses Have Never Heard Of
Registered nurses qualify for Schedule A, a pre-certification under US immigration law that allows employers to skip the PERM labor certification step entirely. This can cut 12 to 18 months off the EB-3 process. Not every immigration attorney mentions it — which is exactly why it is worth asking about specifically. If your employer\'s attorney does not know what Schedule A is for nurses, find a different attorney.
Apply for a Compact Nursing License State to Maximise Flexibility on Arrival
The Nurse Licensure Compact (NLC) allows nurses to hold one multi-state license covering over 40 states and territories. If you do your initial licensure in a compact state — such as Texas, Florida, Missouri, or Tennessee — you gain the flexibility to work across those states without applying for additional licenses. This is particularly useful if you plan to explore travel nursing after your initial contract period ends.
Large Hospital Systems That Have Done This Before Sponsor Faster
Large nonprofit hospital systems — Kaiser Permanente, HCA Healthcare, Ascension Health, and CommonSpirit Health — have internal immigration teams and established processes. They have done it hundreds of times and know how to move efficiently. Smaller community hospitals may want to sponsor but often lack the legal infrastructure. Ask specifically how many international nurses they have successfully brought to the USA in the past two years.
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International Nurses Moving to USA — Your Questions Answered
The full process typically takes 2 to 4 years from start to finish — covering NCLEX, credential evaluation, visa application, and waiting for a visa number. EB-3 timelines vary significantly by country of birth. Starting early, staying organised, and using Schedule A where available can cut meaningful time from the process.
The EB-3 immigrant visa is the most common permanent route — it leads directly to a green card without needing to renew or change status later. The H-1B is temporary and lottery-based. TN visas apply to Canadian and Mexican nurses under USMCA. Most nurses targeting permanent US residency use EB-3 with full employer sponsorship.
Yes. You must pass the NCLEX-RN to legally practice as a registered nurse in the USA. Many nurses complete NCLEX at approved international Pearson VUE centers before their visa is finalised. Passing before approaching employers significantly increases your chances of securing sponsorship quickly.
Missouri and South Dakota process international nursing license applications faster than high-volume states like California or New York. Getting licensed in a Nurse Licensure Compact state is also worth considering — one license covers over 40 states, giving you far more flexibility on where you can work once you arrive.
Yes. Under the EB-3 immigrant visa, spouses and unmarried children under 21 can accompany or follow the principal applicant as derivative beneficiaries and receive the same permanent resident status. Spouses can also apply for employment authorisation independently, allowing them to work in the USA without a separate employment visa.
Are you currently going through the process of moving to the USA as an international nurse? Which step are you on — and what has been your biggest challenge so far? Drop your experience in the comments below.
Your story could help another nurse plan smarter — @nursegnn
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