Career·United States· 10 min read

NCLEX-RN and CGFNS: How Foreign-Trained Nurses Get Licensed to Work in the USA

The step-by-step US licensure pathway for internationally educated nurses: CGFNS credentials evaluation, English proficiency, the NCLEX-RN exam, state board of nursing licensure and VisaScreen for occupational visas.

Last updated 7 July 2026

Key facts

Licence granted by: The state board of nursing where you intend to work (no single national licence)
Credentials evaluation: Typically via CGFNS/TruMerit — Credentials Evaluation Service or the fuller CGFNS Certification Program, depending on the board
Licensing exam: NCLEX-RN, administered by the NCSBN; board approval required before you sit it
English proficiency: A standard requirement, with possible country-based exemptions — confirm with board and CGFNS
Occupational visa: CGFNS VisaScreen (DHS-approved) is required for an occupational visa — separate from licensure
Fees, scores & steps: Vary by state and change — verify on your board of nursing, NCSBN and CGFNS websites

Licensure vs a nursing degree — two different things

Earning a nursing degree qualifies you to practise where you trained; being licensed to work as a registered nurse in the United States is a separate process governed by individual state boards of nursing. This guide is about that licensure pathway, not about studying nursing in the US.

There is no single national nursing licence. Each US state (and territory) has its own board of nursing that grants the licence, and while they share a common exam, their exact requirements differ. You choose the state where you intend to work and follow that board's rules.

For internationally educated nurses, the pathway typically layers three things: a credentials evaluation, a national licensing exam, and — if you need a work visa — an additional screening. The order and specifics vary by state, so anchor your plan to your target state's board of nursing.

US nursing licences are granted state by state, not nationally
A degree is not a licence — licensure is a separate process
Choose your target state early; its board of nursing sets the rules

Step 1: get your credentials evaluated by CGFNS

State boards of nursing generally require internationally educated nurses to first have their academic and professional credentials evaluated. CGFNS International (now operating under the TruMerit brand) is the recognised body many boards use to authenticate your documents and compare your education to US nursing standards.

CGFNS offers more than one service, and this is where applicants often get confused. The Credentials Evaluation Service is a standalone report that verifies your documents are authentic and comparable to US standards. The broader CGFNS Certification Program bundles a credentials evaluation with a qualifying exam and an English-language component, and is required by a large share of state boards as a condition for approval to take the NCLEX-RN.

Check exactly which CGFNS service your chosen state board requires before you order one, because ordering the wrong product wastes time and money. The requirement is board-specific.

Most boards require a CGFNS credentials evaluation before licensure
Credentials Evaluation Service = a standalone document-and-education report
CGFNS Certification Program = evaluation + qualifying exam + English component

Step 2: demonstrate English proficiency

Because safe nursing depends on clear communication, English-language proficiency is a standard part of the pathway for internationally educated nurses, though some applicants may be exempt based on their country or language of education.

English requirements can appear in more than one place — as part of a CGFNS service, as a board-of-nursing requirement, and again for the occupational-visa screening. The accepted tests, minimum scores, and exemptions are set by each board and by CGFNS, so confirm precisely what your target state and service require.

Plan the English assessment early. It can be a gating item for taking the NCLEX-RN and for your visa, and rebooking a test late in the process can delay everything downstream.

English proficiency is a standard requirement, with possible country-based exemptions
Requirements may recur for CGFNS, the board and the visa screen
Confirm accepted tests and scores with your board and CGFNS

Step 3: pass the NCLEX-RN

All US boards of nursing use the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to test whether a candidate can practise safely and effectively. It is administered by the NCSBN (the National Council of State Boards of Nursing).

Before you can sit the exam, your chosen board of nursing must approve you as eligible — which is why the credentials evaluation and any required CGFNS product come first. Once approved, you register and schedule the NCLEX-RN according to the current process.

Exam content, format, registration steps and fees are published by the NCSBN and can change, so use the official NCSBN resources for the version that applies when you test. Passing the NCLEX-RN is a core requirement for RN licensure.

The NCLEX-RN is the common licensing exam, administered by the NCSBN
Your board must approve your eligibility before you can register
Verify current format, process and fees on the official NCSBN site

Step 4: obtain your state licence

The licence itself is issued by the state board of nursing once you satisfy all of its requirements — typically a satisfactory credentials evaluation, any required English proficiency, and a passing NCLEX-RN result, along with the board's own forms and checks.

Because each board differs, requirements such as background checks, additional documentation, or specific CGFNS products vary from state to state. If you later want to work in a different state, you may need to meet that state's requirements or use a licensure-by-endorsement process.

Always read your specific board's checklist directly. Two nurses with identical training can face different steps simply because they chose different states.

The state board of nursing issues the actual RN licence
Requirements (background checks, documents, CGFNS products) vary by state
Moving states later may require endorsement or additional steps

Step 5: VisaScreen for an occupational visa

Licensure lets you practise, but if you are entering the US on an occupational visa you also need a separate screening. US law requires certain healthcare workers, including registered nurses, to complete a screening programme before receiving an occupational visa, and CGFNS is approved by the US Department of Homeland Security to provide it.

CGFNS's VisaScreen verifies that your licences are valid and unrestricted, assesses your education for comparability to US graduates, confirms English proficiency, and confirms that you have passed the required licensing exam. The resulting certificate is included with the visa petition.

This is an immigration-adjacent requirement, and immigration rules change. Treat visa and work-authorisation questions as separate from licensure, and confirm current requirements on the official government and CGFNS sources. This is general information, not immigration or legal advice — verify on the official government source before acting.

An occupational-visa screening is a separate legal requirement from licensure
CGFNS VisaScreen (DHS-approved) is the standard way RNs meet it
This is general information, not immigration advice — verify on official sources

Frequently asked questions

Is there one national nursing licence in the US?

No. Each US state (and territory) has its own board of nursing that issues the licence. They share the NCLEX-RN exam, but requirements differ, so you follow the rules of the state where you plan to work.

What is the difference between the CGFNS Certification Program and Credentials Evaluation Service?

The Credentials Evaluation Service is a standalone report verifying your documents and comparing your education to US standards. The CGFNS Certification Program adds a qualifying exam and an English component and is required by many boards as a condition for taking the NCLEX-RN.

Who administers the NCLEX-RN?

The NCLEX-RN is administered by the NCSBN, the National Council of State Boards of Nursing, and is used by all US boards of nursing. Your chosen board must approve your eligibility before you can register.

What is VisaScreen and do I need it?

VisaScreen is a CGFNS screening, approved by the US Department of Homeland Security, that certain healthcare workers including RNs must complete before receiving an occupational visa. It is separate from licensure. Verify current visa requirements on official government sources.

How much does the whole process cost and how long does it take?

Costs and timelines vary by state, by which CGFNS service your board requires, and by how quickly your documents are verified. Use the official board of nursing, NCSBN and CGFNS websites for current fees and steps rather than older estimates.

Official sources

This guide explains the process and is for guidance only. Eligibility, dates, fees and rules change every year — always confirm the current details on the official site before you act.

Verified against: CGFNS/TruMerit — How to Work as a Nurse in the U.S.; CGFNS/TruMerit — VisaScreen: Visa Credentials Assessment; NCSBN — U.S. Nursing Licensure for Internationally Educated Nurses.

Last verified: 7 July 2026.