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In General
The U.S. is currently experiencing a severe shortage of nurses. This shortage is opening up opportunities for foreign educated and trained nurses to immigrate to the US on Green Cards.

Under the present law, H-1B visas can only be done for specialized nurses such as Head Nurse, Case Plan Coordinators or nurses with additional training necessary to do advanced procedures.
In order work as a registered nurse in the US and be eligible for a Green Card, the foreign nurse must have the following qualifications:

i) A degree from a nursing school;

ii) A license to work as a registered nurse;

iii) A license to work as a registered nurse in the US or a certificate that the foreign nurse has passed the exam given by the Commission on Graduates of Foreign Nursing Schools (CGFNS).

Green Cards for nurses are currently being done on the fast track. The Department of Labor has listed Registered Nurses along with Physical Therapists as shortage occupations; Green Cards for Registered Nurses are exempt from the Alien Labor Certification requirements. The Alien Labor Certification Processing in some states in the US can take in excess of two years.

In order to start the Green Card process, an Immigration Application is filed with the USCIS in respect of the foreign registered nurse. Upon approval of the Immigration Application; the USCIS forwards the Approved Petition to the National Visa Center at Portsmouth, New Hampshire. The National Visa Center in turn will forward the Approved Petition to the US consulate where the foreign registered nurse will be interviewed for the Green Card.

The Process:

1. Visa Screen Certificate : apply for the candidate’s Visa Screen Certificate; once scores from the TOEFL, TSE or IELTS have been submitted to the Commission of Graduates of Foreign Nursing Schools (CGFNS), along with education and license requirements are satisfied, the Visa Screen Certificate will be issued. The Visa Screen Certificate is required by the U.S. Consulate at the time of the interview.

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 USCIS regulations provide that the only organization authorized to issue VisaScreen certificates to RNs is the Commission on Graduates of Foreign Nursing Schools (CGFNS). The USCIS'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

MELAB: Passing scores for the MELAB were as follows: Final Score 79+; Oral Interview 3+.
2. Immigrant Visa Petition : file the immigrant visa petition with the USCIS and obtain a case number. When USCIS processes the petition, it will either approve the petition or request additional information if necessary.

3. National Visa Center : will then complete and file the required forms and supporting documents with the National Visa Center.

4. Consular Interview : Once the National Visa Center forwards the completed file to the local U.S. Consulate, you will then receive an appointment for the visa interview, and the issuance of the immigrant visa (“green card”) to be admitted into the United States.


If the Registered Nurse (RN) is in the United States, he or she will be able to start working more expeditiously than if he or she resides abroad, usually within 5 to 6 months.

The RN is required to present to the USCIS many of the same documents as stated later in this article. However, since he or she is in the U.S., she may 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. For more information regarding the exam, see http://www.ncsbn.org. This web site contains contact information for nurse licensing boards in each state.

An immigrant visa petition to the appropriate USCIS Service Center will be submitted 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 an RN in the state of intended employment.


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

1. The immigration process begins when employer submits an immigrant visa petition (Form I-140) to the service center of the U.S. Citizenship and Immigration Services (USCIS) having jurisdiction over the nurse’s place of intended employment.

2. The USCIS sends the approved visa petition to the National Visa Center (NVC) in Portsmouth, New Hampshire. The NVC send a "fee bill" to you requesting all government processing fees to be paid in advance of processing the visa application and those of the candidate’s immediate family members. After the fees are paid, the NVC forwards a packet to you requesting the immigrant visa application and other supporting documentation which must be executed by you.

3. Once the signed and completed forms and documents are received by the NVC, the NVC then sends the file to the local U.S. consulate. The candidate and his or her immediate family members will then be scheduled for an appointment for an Immigrant Visa 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:

a. Applications for Immigrant Visas

b. Police Clearances

c. Birth Certificates

d. Marriage Certificate, if any

e. Divorce or Death Certificate of Spouse, if any

f. Valid Passports

g. Medical Examinations

h. Photographs

i. Offer of employment

j. Financial information regarding employer

k. Government filing fees

l. VisaScreen Certificate

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.


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