Visa sponsorship for nurses in the US follows a fixed sequence, and doing the steps in the right order can save you a year. In short: get your credentials evaluated for a state board of nursing, pass the NCLEX-RN, pass an English test, obtain a VisaScreen certificate, sign with an employer who files Form I-140 under EB-3 Schedule A, wait for your priority date, then attend your immigrant visa interview. You arrive with a green card, and so do your spouse and children.
This guide is a checklist with a timeline and a cost table. It is written for registered nurses trained outside the United States. For the background on Schedule A, retrogression and other healthcare pathways, read our companion article on EB-3 healthcare jobs in the USA.
Before you start: do you meet the basic requirements?
- You completed a nursing program that included theory and clinical practice in adult medical-surgical, maternal and infant, pediatric and psychiatric nursing. Gaps in any of these areas are the most common reason credential evaluations fail.
- You hold a current, unrestricted license as a first-level (registered) nurse in your country.
- You can get transcripts and license verification sent directly from your school and regulator.
- You have recent clinical experience. There is no legal minimum, but most US employers want at least one to two years in an acute or long-term care setting.
A bachelor’s degree is preferred by many hospitals but is not a legal requirement; diploma-trained RNs can qualify if their education meets the state’s standards.
Steps 1–4: How do you get licensed and certified?
Step 1: Choose a state board of nursing and get your credentials evaluated
Nursing licenses are issued by individual states, and you take the NCLEX through one of them. Requirements differ: some boards ask for a US Social Security number before issuing a license, and each specifies which credential evaluation it accepts. Many international nurses apply first to a state that does not need an SSN to sit the exam, then transfer the license by endorsement to the state where they will work.
Most boards require a course-by-course evaluation from CGFNS International (its Credentials Evaluation Service) or another approved evaluator; New York uses its own CGFNS verification process. Order the report, have your school and regulator send documents directly, and submit the board application with its fee. Find each board’s rules through the National Council of State Boards of Nursing at ncsbn.org.
Expect three to eight months, mostly waiting for institutions at home to send documents.
Step 2: Register for and pass the NCLEX-RN
Once the board declares you eligible, you register with Pearson VUE, pay the exam fee and receive an Authorization to Test. You can sit the exam at approved international test centers in countries including the Philippines, India, the United Kingdom and South Africa, as well as in the US; an additional international scheduling fee applies.
The NCLEX is a computer-adaptive exam. Since 2023 it has used the “Next Generation” format, with case studies that test clinical judgment alongside standard items, a variable number of questions and a five-hour time limit. It tests safe entry-level US practice, so even experienced nurses need structured preparation, particularly on delegation and prioritization.
- Use a reputable question bank and plan eight to twelve weeks of steady study.
- If you fail, you can retake after a waiting period, commonly 45 days, subject to the state’s limits on attempts.
Step 3: Pass an accepted English test
You need English scores for the VisaScreen unless you were educated in English in an exempt country: the United States, the United Kingdom, Ireland, Australia, New Zealand or Canada (except Quebec), with textbooks also in English. Nurses from the Philippines, India, Nigeria, Kenya and Ghana are not exempt.
CGFNS accepts several tests, including IELTS Academic, TOEFL iBT, OET and PTE Academic. For registered nurses the IELTS requirement at the time of writing is an overall 6.5 with 7.0 in speaking; other tests have equivalent minimums. Scores are valid for two years, so time the test so it has not expired when the VisaScreen is issued. Confirm the accepted tests and current scores on cgfns.org.
Step 4: Apply for the VisaScreen certificate
The VisaScreen is a federal requirement for foreign healthcare workers. A consular officer cannot issue your immigrant visa without it. CGFNS reviews three things: that your education is comparable to a US nursing graduate’s, that your licenses are valid and unencumbered, and that you meet the English requirement. You also need an NCLEX pass or a CGFNS Certification Program certificate.
If CGFNS already holds your documents from Step 1, the file can be reused. Processing generally takes a few months, and the certificate is valid for five years.
Steps 5–7: How do the job offer, petition and visa work?
Step 5: Find an employer and sign a contract
Sponsors fall into two groups: hospitals and health systems that hire directly, and international staffing agencies that employ you and place you with client facilities.
Compare offers on more than the hourly rate:
- Location and whether you have a say in it
- Length of commitment, and whether it is counted in months or hours worked
- The breach or buy-out amount, and whether it decreases over time
- Which costs the employer pays outright, which it reimburses and which become a debt if you leave
- Support on arrival: temporary housing, family flights, license endorsement and orientation
Legitimate employers do not charge you for the job offer or for sponsorship. Be careful with agents who demand placement fees, promise an arrival date, or cannot name the US employer that will sign the petition. Our immigration tips for securing US visa sponsorship explain how to verify an employer and when to pay a US attorney to review a contract.
Step 6: The employer files Form I-140 under Schedule A
Because registered nurses are a Schedule A occupation, the employer skips the PERM recruitment campaign. It still must:
- Obtain a prevailing wage determination from the Department of Labor, which can take several months.
- Post a notice of the job opportunity at the worksite for ten business days.
- File Form I-140 with USCIS together with the uncertified labor certification form, the wage determination, the notice, and evidence of your NCLEX pass, license or CGFNS certificate, and of its ability to pay the wage.
The day USCIS receives the I-140 becomes your priority date. With premium processing, USCIS decides within weeks; without it, several months. The employer normally pays these filing fees. Track the case with the receipt number on uscis.gov.
Step 7: Wait for your priority date, then complete consular processing
EB-3 visas are limited each year, and demand has exceeded supply for all countries for much of the period since 2023. Each month the State Department publishes the Visa Bulletin on travel.state.gov. When the EB-3 date for your country of birth passes your priority date, your case can move forward. This wait is the least predictable part: recently about one to three years for most countries, and longer for India and China.
Once current, the National Visa Center asks you to:
- Pay the immigrant visa fee for yourself and each family member.
- Submit Form DS-260 online.
- Upload civil documents: passports, birth and marriage certificates, police certificates, and your VisaScreen.
- Attend a medical exam with an embassy-approved panel physician, including required vaccinations.
- Attend the interview at the US embassy or consulate. Bring originals, your VisaScreen certificate and an updated job offer letter.
After approval you pay the USCIS immigrant fee online, travel before the visa expires (usually within six months of the medical), and receive your green card by mail a few weeks after arrival.
How long does the whole process take?
| Stage | Typical duration | Can it overlap? |
|---|---|---|
| Credential evaluation and board eligibility | 3–8 months | Start first |
| NCLEX preparation and exam | 2–4 months | Study while waiting for eligibility |
| English test | 1–3 months | Yes, alongside NCLEX study |
| VisaScreen | 3–6 months | Yes, after NCLEX and English results |
| Job search and contract | 1–3 months | Yes, after NCLEX |
| Prevailing wage and I-140 | 5–10 months | Runs while VisaScreen is processed |
| Wait for priority date | About 1–3 years for most countries; longer for India and China | No |
| National Visa Center, medical and interview | 4–8 months | No |
A realistic total is two and a half to five years from your first application to your first US shift. These are estimates at the time of writing; nobody can guarantee a timeline.
How much does it cost?
| Item | Approximate cost (USD) | Who usually pays |
|---|---|---|
| CGFNS credentials evaluation | $350–$700 | You; often reimbursed |
| State board application and fingerprints | $100–$400 | You; often reimbursed |
| NCLEX-RN registration | $200, plus $150 international scheduling fee | You; often reimbursed |
| NCLEX review course or question bank | $100–$500 | You |
| English test | $200–$450 per attempt | You |
| VisaScreen | Roughly $700–$750 | You or employer |
| Prevailing wage, I-140 filing and attorney fees | Several thousand dollars | Employer |
| Immigrant visa fee | $345 per person | You or employer |
| Medical exam and vaccinations | $200–$500 per person, varies by country | You |
| USCIS immigrant fee | About $235 per person | You or employer |
| Flights and first month’s living costs | $3,000–$8,000 for a family | Shared; check your contract |
Fees change regularly, so confirm each one with CGFNS, Pearson VUE, the State Department and USCIS. A single nurse paying everything personally should budget roughly $2,500–$4,000 before flights. Many agencies advance or reimburse these costs, but read how that affects your breach clause.
What should you do in your first month in the US?
- Collect your Social Security number and complete license endorsement in your work state if needed.
- Enroll in your employer’s health insurance during the onboarding window, and ask about malpractice cover.
- Open a bank account and start building credit; see how to build your credit score.
Frequently Asked Questions
Which state should I apply to for the NCLEX?
Choose based on three things: whether the board will make you eligible without a Social Security number, its English and education requirements, and processing speed. If you already have an employer, ask which state it prefers. You can endorse your license to another state later.
Can I take the NCLEX before I have an employer?
Yes, and you should. The exam is tied to a state board, not to a job offer. Employers and agencies prioritize nurses who have already passed, and the pass result is one of the documents that qualifies you for Schedule A.
What if my VisaScreen or English score expires while I wait?
The VisaScreen must be valid on the day of your visa interview. If it has expired after five years, you renew it with CGFNS. English results only need to be valid when the certificate is first issued, which is why the order of the steps matters.
Are other countries faster for nurses?
Often, yes. The UK, Australia, Canada and Germany can process nurses in months rather than years, though pay, language and settlement rules differ. Compare with our guide to Australia visa sponsorship for healthcare workers.
Bottom line
The US route for nurses is long but well mapped: credentials, NCLEX, English, VisaScreen, I-140, priority date, interview. Start the credential evaluation now, pass the NCLEX before you negotiate, read your contract’s breach clause carefully, and check the Visa Bulletin monthly rather than trusting a promised date. This article is general information, not legal advice.