Foreign-Educated Nurses: An Overview of Migration and Credentialing Issues

Tanya Bieski, BSN, RN


Nurs Econ. 2007;25(1):20-23, 34. 

In This Article

Credentialing Requirements for Migration

Prior to a foreign-educated nurse's arrival in the United States, a mandatory review is completed by the CGFNS. This includes a comprehensive credential review, documented English proficiency, and success on the NCLEX-RN or CGFNS exam. All aspects of the review are an integral part of the licensure process (CGFNS, 2006). This review ensures that foreign-educated nurses have at least the minimal educational equivalent required for RN licensure in the United States (CGFNS, 2006). Licensure requirements vary by state and are governed by the board of nursing of the receiving state. Foreign-educated nurses are required to contact the board of nursing in their desired destination state to ensure that they have met all requirements (CGFNS, 2006).

Another integral part of the review includes passing the NCLEX-RN or CGFNS exam. The CGFNS exam is a predictor for passing the NCLEX-RN but is not a substitute for the NCLEX-RN. Foreign-educated nurses must take and pass the NCLEX-RN just as U.S. nurses to be eligible for licensure even if they have passed the CGFNS exam. The NCLEX-RN may not be available in all countries; therefore, many take the CGFNS exam to obtain their credentials certificate prior to arriving in the United States. Once in the United States, they take the NCLEX-RN.

To meet credentialing requirements, foreign-educated nurses must pass approved English language-proficiency exams. Four tests or combination of tests are approved by the Departments of Education and Health and Human Services (CGFNS, 2006): (a) Test of English as a Foreign Language (TOEFL), Test of Written English (TWE), and Test of Spoken English (TSE); (b) Test for International Communications (TOEIC) and TWE; (c) International English Language Testing System (IELTS); and (d) Internet Based Test of English as a Foreign Language (TOEFL) (CGFNS, 2006). English-proficiency exam scores are valid for 2 years. Foreign students who have graduated from a nursing program in Australia, Ireland, New Zealand, the United King dom, or Canada (except Quebec) are exempt from the English-proficiency exam as long the program's language of instruction and textbooks were in English (CGFNS, 2006). The CGFNS exam and English language proficiency exam must be taken within 2 years of each other to be considered valid (CGFNS, 2006).


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