The United States has a very large number of nursing job ads. But getting there from abroad takes a state licence, an English and credentials check, and usually a green card that an employer must file for you. This guide explains each step in plain words, using official US sources. Fees and scores were checked in October 2026.
The honest picture first
Most US hospital job ads are written for nurses who can already work in the US. In early October 2026 we read a sample of about 190 registered nurse ads from US hospital career sites. None of them offered visa sponsorship.
A few US health systems do run programmes for international nurses. Their ads usually say so in the title or the first lines, with words like “international nurse” or “visa sponsorship”. On this board, check the visa sponsorship jobs page and the jobs you can apply for from abroad. If an ad does not mention sponsorship, assume it does not offer it.
The four steps in short
| Step | What it is | Who runs it |
|---|---|---|
| 1. State licence | Credentials evaluation, English test and the NCLEX-RN | The state board of nursing where you will work |
| 2. VisaScreen | A federal check of your education, licences and English | TruMerit (formerly CGFNS) |
| 3. Immigrant petition | Form I-140 under EB-3, Schedule A Group I | Your US employer files it with USCIS |
| 4. Green card | Immigrant visa when your priority date is current in the Visa Bulletin | US State Department |
Step 1: a state licence and the NCLEX-RN
There is no national nursing licence in the US. NCSBN says each state is responsible for licensing nurses in that state, and all US boards of nursing use the NCLEX-RN exam (NCSBN).
For internationally educated nurses, NCSBN says state requirements include (Nurse Licensure Guidance):
- A credentials evaluation, to compare your education with US nursing education
- An English proficiency exam
- Social Security Number requirements
- The board’s own application forms and checks
Rules differ from state to state. Use NCSBN’s Nurse Licensure Guidance tool and the website of the state board where you want to work.
The NCLEX-RN fee for US licensure is USD 200 now and USD 350 from 1 February 2027. Testing at an international centre adds a USD 150 international scheduling fee, plus VAT where it applies (NCLEX fees). Read our NCLEX-RN guide for registration, exam format and test centres.
Step 2: VisaScreen
US federal law (Section 343 of the 1996 Illegal Immigration Reform and Immigrant Responsibility Act) requires a health care worker screening for nurses who come to work on an occupational visa. TruMerit, formerly CGFNS, runs this check as VisaScreen (TruMerit). It is needed for permanent and temporary occupational visas, including TN status.
VisaScreen checks that:
- your education is comparable to a US graduate’s
- all your past and present nursing licences are valid
- your English is good enough
- you passed the NCLEX-RN or TruMerit’s Nurse Qualifying Exam
TruMerit says 90% of certificates are issued within 3.5 business days after it has all your documents. Check the current fee on TruMerit’s fee schedule.
VisaScreen English scores for registered nurses (checked October 2026)
New minimum scores apply to English tests taken after 12 May 2026. These are the scores for “Registered Nurses and other B.S. level health care workers” (TruMerit):
| Test | Minimum scores |
|---|---|
| IELTS Academic | 6.5 overall, 7 speaking |
| OET | Speaking 360, Reading 340, Writing 350, Listening 320 |
| TOEFL iBT | 4.5 overall, 4.5 speaking, 3.5 reading, listening and writing |
| PTE Academic | 55 overall, 76 speaking, 62 reading, writing and listening |
| Cambridge English (B2 First, C1 Advanced, C2) | 169 overall, 194 speaking |
| Michigan English Test (MET) | 58 overall, 59 speaking |
If you took your test before 12 May 2026, TruMerit applies the older scores, which are on its website.
You may not need a test. TruMerit says you can be exempt if your nursing education was in the United Kingdom, Australia, Canada (except Quebec), New Zealand, Ireland or the United States, and English was the language of teaching and textbooks.
Step 3: the green card petition (EB-3, Schedule A)
For registered nurses, the main route is a green card (permanent residence) in the EB-3 category for professionals and skilled workers. Nurses are on a special list called Schedule A, and typical staff nurse jobs do not qualify for the H-1B work visa (see Other visas).
Registered nurses are a Schedule A, Group I occupation. USCIS says “Group I includes professional nurses and physical therapists”, and Schedule A petitions do not need a labor certification approved by the Department of Labor (USCIS EB-3). This saves a long step.
What the employer does (USCIS Policy Manual):
- Files Form I-140 with USCIS, together with an uncertified labor certification form (ETA-9089).
- Gets a prevailing wage determination from the Department of Labor. The offered pay must be at least 100% of the prevailing wage.
- Posts a notice of the job at the workplace for at least 10 consecutive business days, between 30 and 180 days before filing.
What you must show, as of the filing date, is one of these (20 CFR 656.15; USCIS):
- a full, unrestricted, permanent licence to practise nursing in the state where you will work, or
- a TruMerit (CGFNS) certificate, or
- a pass in the NCLEX-RN.
Your spouse and unmarried children under 21 may be able to apply with you or after you (USCIS EB-3).
Step 4: waiting for your priority date
An approved I-140 does not give you a visa at once. Each year only a limited number of EB-3 green cards are available, so you wait until your priority date is “current” in the monthly Visa Bulletin of the US State Department. Waits can be long and change from month to month.
We could not load the State Department’s Visa Bulletin page when we checked in October 2026, so this guide gives no dates. Check the current bulletin for “EB-3” and your country of birth, and ask your employer’s immigration lawyer.
Other visas
- H-1B. H-1B is for “specialty occupations” that need a degree. USCIS guidance says typical registered nurse positions generally do not qualify for H-1B, while some advanced practice nurse roles may (USCIS memo). Do not expect an H-1B for a staff nurse job.
- TN status. TN is only for citizens of Canada and Mexico under the USMCA (USCIS). Nurses who use it also need VisaScreen.
Protect yourself
- Apply on the employer’s own career site. Every job on this board links to the employer’s own page.
- Read every contract carefully before you sign, and keep a copy.
- This board never charges nurses anything. Read our guide on ethical recruitment and how to spot scams.
Frequently asked questions
Do US hospitals sponsor visas for foreign nurses?
Some do, but most US job ads do not. In a sample of about 190 US registered nurse ads we read in October 2026, none offered sponsorship. A few health systems run international nurse programmes and say so in the ad. If an ad does not mention sponsorship, assume it does not offer it.
What visa do foreign nurses use to work in the US?
The main route is a green card in the EB-3 category. Registered nurses are a Schedule A, Group I occupation, so the employer files Form I-140 with USCIS without a Department of Labor labor certification. The employer must still pay at least the prevailing wage and post a notice of the job.
Can a registered nurse get an H-1B visa?
Usually not. USCIS guidance says typical registered nurse positions generally do not meet the H-1B “specialty occupation” rules. Some advanced practice nurse roles may qualify. TN status is a different route and is only for citizens of Canada and Mexico.
What IELTS or OET score do I need for VisaScreen?
For tests taken after 12 May 2026, registered nurses need IELTS Academic 6.5 overall with 7 in speaking. For OET they need speaking 360, reading 340, writing 350 and listening 320. Nurses educated in English in the UK, Australia, Canada (except Quebec), New Zealand, Ireland or the US may be exempt.
Do I need to pass the NCLEX before my employer files the I-140?
Not always. For a Schedule A nurse petition you must show one of three things on the filing date: a full permanent licence in the state where you will work, a TruMerit (CGFNS) certificate, or an NCLEX-RN pass. You will still need a state licence to work as a nurse.