11 Step-by-Step Guide on How to Become a U.S. Registered Nurse (RN) as an International Student
Becoming a Registered Nurse (RN) in the United States as an international student or foreign-educated nurse may seem complex, but with the right guidance, it's entirely achievable.
The process involves validating your credentials, proving your English proficiency, passing the NCLEX-RN exam, and navigating licensure and immigration requirements. This blog post breaks down the journey step by step to help you transition into U.S. nursing practice with confidence.
1. Activate Your Home Country Nursing License
Your foundation starts at home. To become eligible for U.S. licensure, you must hold a valid, active nursing license in good standing from your home country. The license should be free from disciplinary actions or suspensions. This ensures the U.S. Board of Nursing can verify that you’ve practiced nursing legally and professionally.
Make sure your home country’s nursing license verification process is streamlined and updated, as this will be essential during credential evaluation.
2. Choose a U.S. State for Licensure
Not all U.S. states have the same requirements for foreign-educated nurses. Each Board of Nursing (BON) operates independently and may differ in accepted credential evaluation agencies, English language requirements, documents required for verification, application fees and processes.
Visit the official website of the state BON where you wish to practice. Make sure you fully understand their guidelines before starting your application.
Some popular states for international nurses include Texas, New York, and California.
3. Prove English Language Proficiency
Most state BONs require international applicants to demonstrate proficiency in English through standardized exams such as the IELTS Academic or TOEFL iBT. The IELTS usually requires a minimum score of 6.5 to 7.0 overall with no less than 6.0 in any module, while the TOEFL typically requires a score of 83 to 90 overall.
You may be exempt if you completed your nursing education in an English-speaking country and the medium of instruction was English. However, always check your chosen BON’s specific requirements.
4. Credential Evaluation
This is one of the most critical steps for international nurses. You will need to have your educational credentials and license evaluated to determine if they are equivalent to U.S. nursing standards.
The most commonly used agencies include CGFNS (Commission on Graduates of Foreign Nursing Schools), Josef Silny & Associates, and Educational Records Evaluation Service (ERES).
They will verify your nursing education, analyze your transcripts and coursework, verify your home country license, and ensure you meet U.S. standards.
Some states require you to use CGFNS, while others accept multiple agencies. Make sure to follow your state BON’s approved list.
5. Apply to the State Board of Nursing
Once your credential evaluation is complete, you can now apply for licensure through your selected state’s Board of Nursing.
This step may involve submitting an online application, paying application fees (usually 100 to 200 USD), sending supporting documents such as your transcript, license verification, passport copy, and credential report, and completing any required forms.
Each BON will provide a checklist of required materials. Follow instructions closely to avoid delays.
6. Background Check and Fingerprinting
To ensure public safety, most U.S. states require a criminal background check and fingerprinting. This can often be done via Live Scan for in-state applicants or ink card fingerprints for out-of-state or international applicants.
Some BONs partner with vendors like IdentoGO or Fieldprint for digital fingerprinting. Make sure to follow your BON’s specific process.
7. Receive NCLEX Eligibility
Once all documents are received and approved, the BON will grant you eligibility to take the NCLEX-RN (National Council Licensure Examination for Registered Nurses).
This is a major milestone. It means you are officially recognized as a qualified candidate to test for licensure.
You’ll receive an Authorization to Test (ATT) email, which includes instructions on how to schedule your exam.
8. Register for the NCLEX Exam
With your ATT, you can now register for the NCLEX-RN exam through Pearson VUE, the official testing service.
The registration fee is 200 USD, although it may vary with international testing locations. Choose your testing center—there are global testing sites available.
Take a NCLEX prep course or use Q-banks to study. The NCLEX tests critical thinking, clinical judgment, and application of knowledge, not just memorization.
9. Schedule and Pass the NCLEX
Schedule your test, show up prepared, and pass the NCLEX-RN exam. The test is adaptive and ranges from 85 to 150 questions. Results are usually available within a few days, but some states may take longer to update licensure status.
10. Receive Your U.S. RN License
Once you pass the NCLEX, you will be issued a Registered Nurse (RN) license from the state where you applied. Congratulations — you are now licensed to work as an RN in that state.
If you wish to work in another state, you may need to apply for a license by endorsement or check if your license qualifies for Nurse Licensure Compact (NLC) participation.
11. Visa Screening and Immigration Process
Before you can work in the U.S., you’ll need to clear immigration hurdles, including VisaScreen, a service provided by CGFNS.
VisaScreen includes educational credential review, English proficiency verification, and NCLEX-RN passing confirmation.
Once approved, you can proceed with obtaining a work visa such as an H-1B visa (for specialized occupations) or a green card via employment sponsorship (EB-3 Visa).
Most nurses are sponsored by U.S. hospitals or recruitment agencies who help with the visa application process.
Final Thoughts
While becoming a U.S. RN as an international student may feel overwhelming, each step brings you closer to a fulfilling career in American healthcare. Preparation, patience, and persistence are key. If you stay organized and seek guidance when needed, you’ll be well on your way to becoming a licensed nurse in the U.S.
Helpful Resources
CGFNS Official Website: https://www.cgfns.org/
NCSBN - NCLEX Information: https://www.ncsbn.org/nclex.htm
List of U.S. State Boards of Nursing: https://www.ncsbn.org/contact-bon.htm
