How do Nurses Get Green Cards?

How do Nurses Get Green Cards?
By: Attorneys Robert L. Reeves and Joseph I. Elias

The single most important thing an RN interested in U.S. employment should do is begin processing his or her Visa Screen. This is a process that takes a minimum of 6 months to complete and is a prerequisite to obtaining a U.S. immigrant visa.

The United States has an acute shortage of nurses that is so severe that the U.S. Department of Labor pre-certified the registered nursing occupation as a shortage occupation several years ago. This pre-certification allows foreign nurses to quickly immigrate to the United States.

Because of pre-certification, Employers may petition the United States Citizenship and Immigration Services (“USCIS”, formerly known as the INS) directly for an immigrant visa and bypass the laborious Labor Certification process. This shaves off years of processing for permanent residency status also known as the green card. Essentially, RNs are only required to show that they are qualified for the nursing position.

This qualification is demonstrated through a process called the Visa Screen. The Untied States requires that immigrating RN’s obtain a certificate known as the Visa Screen issued by the Commission on Graduates of Foreign Nursing Schools (“CGFNS”). The CGFNS conducts an assessment of an applicant’s foreign education to ensure that it is comparable to that of a U.S. graduate in the same profession. It also verifies that the applicant’s licenses are valid and unencumbered, and determines the applicant’s English language proficiency. Finally it verifies that the nurse has either earned a CGFNS Certificate or passed the National Counsel Licensure Examination for Registered Nurses (“NCLEX-RN”). Applicants must successfully complete all three parts of the Certification Program in order to earn the CGFNS Visa Screen.

Nurses who successfully pass the CGFNS’s nursing knowledge exam are awarded the CGFNS Certificate. This exam is administered at select locations worldwide and is a prerequisite for sitting for some state licensing exams. The NCLEX-RN exam is given only in the U.S. and its territories which include Guam and American Samoa. Since all states require passing the NCLEX exam, it is the preferred exam to take.

The U.S. Consulate in Manila is notorious for being one of the most difficult consulates in the world to obtain a tourist visa to visit the U.S. But, the Consulate will usually grant RN’s tourist visas to Guam in order to sit for the NCLEX exam. For those thinking of taking this exam, it is well worth the extra expense to travel to a U.S. territory to take the exam. The NCLEX also makes RN’s more marketable because employers can use them right away.

For example, a hospital in California cannot employ RNs who are not licensed in California. A Filipino RN who sits for the NCLEX in Saipan and designates California as the licensing state on the exam, will be in higher demand once the RN passes the exam. The RN will be allowed to be employed as an RN by the hospital immediately.

RNs who pass the CGFNS exam will still have to take the NCLEX at some point in order to obtain state licensing. So, nurses who have a choice should take the NCLEX exam. The NCLEX Board is currently considering offering the exam overseas. But, this will probably not occur for at least a few years. Until then, if a RN has the option of traveling to the U.S or its territories to take the NCLEX exam, the nurse should take this option over sitting for the CGFNS exam.

The CGFNS Visa Screen also requires an assessment of the RN’s spoken and written English knowledge. The three English tests currently accepted are the TOEFL, the Test for English in International Communication, and the International English Language Testing System. RNs who have obtained their nursing degrees in the United States, Australia, New Zealand, United Kingdom, and Canada (except for Quebec) are exempted from the English language requirement.

The CGFNS takes several months to issue a Visa Screen once all the exam results are submitted to it. Therefore, it is important for RNs to begin this process as soon as possible. Once a Visa Screen is issued by the CGFNS, it may then be submitted to the U.S. Consulate along with an approved immigrant visa petition. RN’s already in the U.S. may use the Visa Screen to adjust their status to that of legal permanent resident with the USCIS.

Armed with a Visa Screen, foreign nurses are able to immigrate to the U.S. much faster than most other occupations being sponsored for legal permanent residency. The USCIS process for obtaining a green card is sufficiently complex that it is best for the layperson to obtain professional representation in the matter. For more information please visit