Nurses seeking immigrant visas (“green cards”) operate under
an easier system and get their green cards much faster than many of the other
professions. Registered Nurses (RNs) are treated in very special ways by U.S.
immigration laws. Some requirements highly favor foreign nurses; however,
others impose additional documentation and examination requirements on RNs. This
article pertains solely to Registered Nurses --- not Licensed Practical Nurses
(LPN) and Certified Nursing Assistants (CNA).
Unlike many of the other employment based immigrant visa
categories, the labor certification requirement does not apply to RNs. This is
because the occupation is a “Schedule A” occupation, meaning it has already
been certified by the Department of Labor. This makes
the process much shorter than for categories that do require a labor
Is there a cap or numerical limitation?
Nurses fit into a green card category with a limited quota. During early
2005, the category for nationals of the Philippines, India and China was
backlogged by several years and many nurses were affected. As a result,
Congress signed a bill in May 2005 that created
50,000 additional visas for RNs, physical therapists, and their spouses and
children. The additional 50,000 visas were only expected last to the end of
2006, and unless more visas are made available, the backlogs are expected to
return. Accordingly, employers are urged to act quickly.
“Schedule A” Occupations
“Schedule A” is a list of occupations, set forth
at 20 CFR 656.15, for which the Department of Labor has determined there are
not sufficient U.S. workers who are able, willing, qualified and available. In
addition, “Schedule A” establishes that the employment of foreign workers in
such occupations will not adversely affect the wages and working conditions of
U.S. workers similarly employed. On the “Schedule A” list RNs are defined as
Professional Nurses - the
alien (i) has a Commission on Graduates in Foreign Nursing Schools (CGFNS)
Certificate, (ii) the alien has passed the National Council Licensure
Examination for Registered Nurses (NCLEX—RN) exam, or (iii) the alien
holds a full and unrestricted (permanent) license to practice nursing in the
state of intended employment.
Note that this pre-certification is limited in
scope. It only applies to “Professional Nurses”. “Schedule A” is not available
to Licensed Practical Nurses, Nurse Assistants, or other nursing aides.
Professional Nursing is defined as a course of study in professional nursing
resulting in a diploma, certificate, baccalaureate degree, or associate degree.
More specifically, an acceptable course of study for professional nurses
generally includes theory and practice in clinical areas such as obstetrics,
surgery, pediatrics, psychiatry, and medicine. Whatever training the nurse has
received should result in licensure in the country in which the training
occurred. This coursework may have been completed at a U.S. nursing school or
an approved foreign nursing program. For an immigrant visa, it is not required
that a nurse have a bachelor’s degree in nursing, only that he or she completed
a professional program in nursing and have subsequently been licensed.
are the requirements that the foreign nurses must meet?
For a foreign nurse to obtain permanent residency through the “Schedule A”
category, the applicant must meet the following requirements:
- He or she must have a diploma
from a nursing school in his or her country;
- Have a RN license in his or
her country; and
- Have a full and unrestricted
license to practice professional nursing in the state of intended
employment, or a certification that she has passed the examination given
by the Commission on Graduates of Foreign Nursing Schools (CGFNS), or
evidence that she has passed the NCLEX-RN licensing examination but cannot
obtain a license because she lacks a social security number.
Although some states require that foreign nurses pass the
CGFNS examination before taking the state RN licensing (NCLEX) examination, the
number of such states is on the decline. This is because, it now possible to
take the NCLEX abroad. The examination is offered in Australia (Sydney), Canada
(Montreal, Toronto and Vancouver), Great Britain (London), Hong Kong, India
(Bangalore, Chennai, Hyderabad, Mumbai and New Delhi), Japan (Chiyoda-ku and
Yokohama), Korea (Seoul), Germany (Frankfurt), Mexico (Mexico City) and Taiwan
(Taipei). In addition, RNs may take the NCLEX in Guam, Puerto Rico and Saipan.
As of February 9, 2007, RNs may take the NCLEX in Manila, Philippines. (More information about NCLEX-RN can be
found at the NCSBN Web site: www.ncsbn.org
Nurses are also required to adhere to licensing requirements
of the state in which they intend to work. Licensing requirements for
registered nurses are maintained on a state-by-state basis, and each state has
slightly different requirements for licensing. To demonstrate eligibility and
preparedness for the NCLEX exam, most states require a combination of materials
be submitted with the license application. The documents may include CGFNS
certification, copies of foreign academic credentials with certified translations,
an education/credentials evaluation and a demonstration of proficiency in
English (e.g. TOEFL exam results).
All states permit an individual to obtain a license through examination, and
some state permit licensing by endorsement, or acceptance of a registered nurse
license from another state or country as evidence of the person's credentials.
For more information on requirements in each of the states visit the National Counsel of State Boards of Nursing
In addition, unless the nurse was educated in an
English-speaking country (U.S., Australia, New Zealand, Ireland, United Kingdom
or Canada — except Quebec), the nurse must achieve a certain 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 TOEIC (Test of English in International Communications.)
U.S. immigration law now requires that healthcare
professionals, other than physicians, complete a screening program in order to
qualify for certain occupational visas. VisaScreen,
a program offered by the International Commission On Healthcare Professions
(ICHP), enables healthcare professionals to meet this requirement by verifying
and evaluating their credentials to ensure compliance with the government's
minimum eligibility standards.
A VisaScreen certificate is issued only after the
RN has demonstrated that:
education, license and training are equivalent to education, licensure and
training in the U.S., that all professional licenses are valid and unencumbered;
level of competence in oral and written English are appropriate to practice
professional nursing in the U.S.
USCIS regulations provide that the only
organization currently authorized to issue VisaScreen certificates to RNs is
the Commission on Graduates of Foreign
Nursing Schools (CGFNS). Additionally,
the regulations also require foreign-born RNs who are educated, licensed and
trained in the U.S. to obtain a VisaScreen certificate. However, such RNs may
be able to obtain a VisaScreen certificate on a streamlined basis.
For RNs outside the U.S. who will be applying for
their visas at the U.S. Consulate, the VisaScreen certificate will be submitted
at the consular interview. If the RN already has a VisaScreen certificate when
the I-140 immigrant petition is filed, include it as an attachment to the Form
I-485 (adjustment of status). Note: The
CIS will send an RFE requesting the VisaScreen before approving the I-485
application for adjustment of status.
the I-140 Immigrant Visa Petition on Behalf of a foreign RN
The initial step in a “Schedule A”
case is to file an I-140 Immigrant Visa Petition package with the appropriate
USCIS Regional Service Center. The petition is filed by a U.S. Employer
(Petitioner) on behalf of the foreign nurse (Beneficiary). NOTE: If the
Beneficiary is already in the U.S., he/she and her
accompanying family members may apply for adjustment
of status at the same time as filing the Immigrant Visa petition.
I-140 Immigrant Visa Petition package must include the following:
I-140, Petition for Alien Worker, with appropriate filing fee
- An uncertified Form
ETA-9089, Application for Permanent Employment Certification
- A Wage Determination issued
by the State Workforce Agency (SWA) having jurisdiction over the proposed
area where the job opportunity exists. Employers are required to pay 100
percent of the prevailing wage determination.
- Copy of the posted Notice and
Notice must include a job description, work hours, and rate of pay and must
be posted in the worksite for a minimum of ten consecutive business days.
addition, the employer must publish the Notice in any and all in-house
media, whether electronic or printed, in accordance with the normal
procedures used for the recruitment of similar position in the employer’s
Attestation must identify the physical location/s where the Notice was
posted and the date of publishing all in-house media
- Evidence of the employer's ability to pay the nurse.
- Copies of annual reports, federal tax returns or
audited financial statements
- If the
employer has at least 100 employees, a detailed letter from the CFO will
- Copy of the foreign nurse’s
full unrestricted permanent license to practice nursing in the state of
intended employment or CGFNS certificate issued by the Commission on
Graduates of Foreign Nursing Schools; or,
- Evidence that the foreign nurse has passed the National
Council Licensure Examination for Registered Nurses (NCLEX-RN), administered by
the National Council of State Boards of Nursing and evidence that the nurse
cannot obtain a license because he or she cannot obtain a social security
- Nursing diploma/degree
registration/licensure form the country where the degree was obtained
For RNs already in the U.S. who are filing for adjustment of status concurrently with the
immigrant visa petition, be sure to review the article entitled Adjustment of
Status for detailed information on the forms and documents to be submitted.
Additionally, see section above on “VisaScreen”.
aforementioned, RNs already in the U.S. may file for adjustment
of status at the time of filing the I-140 Immigrant Visa Petition.
If for some reason, he/she does not file for adjustment of status at that time,
he/she may apply any time after the I-140 package is submitted or approved.
the RN is outside the U.S., once the USCIS approves the I-140 Immigrant Visa
Petition they will forward the approved visa petition to the National Visa
Center (NVC) in Portsmouth, New Hampshire. The nurse (or the attorney) receives
a "fee bill" asking for all government processing fees to be paid in
advance of processing the application and those of his/her immediate family
members. After the fees are paid, the NVC forwards a packet to the RN (or the
attorney) containing biographical information forms to be completed by the RN
and his/her family members, and a list of documents which must be submitted.
The RN, or the attorney, then sends the signed and
completed forms and documents to the NVC which then schedules an appointment
for an Immigrant Visa Interview for the RN and his/her family at the U.S.
Consulate or Embassy where he/she resides. At this interview, the Consular Officer
will examine various documents including:
- Applications for Immigrant Visas
(Available at the Department of State’s website. In addition,
these forms may now be e-filed at many
- Police Clearances
(Information on obtaining these
can be found at the Department of State’s website’s section on Reciprocity Schedules)
- Birth Certificates
- Marriage Certificate, if any
- Divorce or Death Certificate of Spouse, if any
- Valid Passports
- Medical Examinations
- Recent job offer letter (or employment contract)
- Financial information regarding employer
- Government filing fees
- VisaScreen Certificate (see section above entitled “VisaScreen”)
their own interview policies and procedures regarding immigrant visa
interviews. Be sure to check the consulate’s website for their specific
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