• (1) her education, license and training in her country are equivalent to education, licensure and training in the U.S., and that
• (2) her level of competence in oral and written English are appropriate to practice professional nursing in the U.S. (* some Service Centers will accept I-140/I-485 without the visa screen; however some jurisdictions will deny the I-485 if the visa screen was not submitted with the I-485. We recommend having it at the time of filing).
• (3) The CIS regulations provide that the only organization authorized to issue VisaScreen certificates to RNs is the Commission on Graduates of Foreign Nursing Schools (CGFNS), the organization which is listed in §343.
• (4)The CIS's VisaScreen regulations provide that even if a foreign-born RN is educated, licensed and trained in the U.S., she still must obtain a VisaScreen certificate. However, such RNs may be able to obtain a VisaScreen certificate on a streamlined basis.

Passing scores for RNs are as follows:

CONSULAR PROCESSING

If the RN resides abroad, the following steps must be completed before the nurse may be employed in the U.S.:

1. The RN must be in possession of:

The following states require that foreign nurses pass the CGFNS examination before taking the state RN licensing (NCLEX) examination: Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Hampshire, New Jersey, North Carolina, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Vermont, Virginia, Washington, West Virginia and Wyoming.

2. RNs together with physical therapists are listed as shortage, or “Schedule A”, occupations in regulations (20 C.F.R. §656.22) issued by the Department of Labor. An employer who wishes to immigrate an RN is exempt from having to submit an application for alien labor certification to the Department of Labor or to a State Employment Security Agency.

The immigration process begins when an employer submits an immigrant visa petition (Form I-140) to service center of the Citizenship and Immigration Services (CIS) having jurisdiction over the nurse’s place of intended employment. The petition must be accompanied by Labor Department forms ETA-9089 and by various documents including those listed above. The petition should be accompanied by a check for filing fees.

4. The RN, or her attorney, sends the signed and completed forms to the U.S. consulate where the nurse will have her interview for permanent residence. At this interview, the nurse must present various documents including the following:

ADJUSTMENT OF STATUS-IF IN THE US

5. If the RN is in the United States, the nurse may be able to start working for the employer more expeditiously than if she resides abroad (This expeditious method is no longer possible for most RNs who were born in the Philippines, India or Mainland-China due to the three-backlog for nurses from those countries.)

6. The RN is required to have the same documents as stated at the beginning of this article. However, since she is in the U.S., she may take the state licensing examination (officially known as the National Council Licensure Examination for Registered Nurses or “NCLEX-RN”). In the past, the NCLEX-RN could only be taken in the U.S., although it is also offered in Guam, Saipan, the Virgin Islands, Puerto Rico and American Samoa. Starting in January 2005, the NCLEX-RN examination became available in Hong Kong, Seoul, Korea and London, England. The NCLEX-RN is administered by the National Council of State Boards of Nursing, Inc. For more information about taking the NCLEX-RN, see National Council’s web site at http://www.ncsbn.org

This web site contains contact information for nurse licensing boards in each state.

The employer must submit an immigrant visa petition to the appropriate Immigration Service Center on behalf of the nurse. In order for the visa petition to be approved, the RN must have passed either the CGFNS exam or the NCLEX exam, or be in possession of a "full and unrestricted license" as a registered nurses in the state of intended employment.

Upon approval of her visa petition, assuming her priority date is current, the RN and her family members (spouse and unmarried children under 21 years of age) may apply for adjustment of status to permanent residence in the U.S. Simultaneously, they may apply for employment authorization cards, and possibly, travel authorization documents (“advance parole”). The number of documents which must be included with an application for adjustment of status is less than is required when one immigrates to the U.S. from abroad. However, a nurse can not qualify for permanent residence until she presents a VisaScreen* Certificate.

VISA SCREEN CERTIFICATE

A *VisaScreen Certificate is issued only after the RN has demonstrated the following:

The CIS regulations provide that the only organization authorized to issue VisaScreen certificates to RNs is the Commission on Graduates of Foreign Nursing Schools (CGFNS), the organization which is listed in §343. The CGFNS is located at 3600 Market Street, Philadelphia, PA, 19104-2651; telephone: (215) 349-8767; fax: (215) 349-0026; e-mail:support@cgfns.org

The CIS's VisaScreen regulations provide that even if a foreign-born RN is educated, licensed and trained in the U.S., she still must obtain a VisaScreen certificate. However, such RNs may be able to obtain a VisaScreen certificate on a streamlined basis. Obtaining such a certificate requires a significant expenditure of time, effort and money (over $300) on the part of the nurse.

In addition, unless the nurse was educated in an English-speaking country (U.S., Australia, New Zealand, Ireland, United Kingdom or Canada (all provinces except Quebec), she 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 the TOEIC (Test of English in International Communications. Also, if the RN registered for the MELAB (Michigan English Language Assessment Battery) before November 27, 2002, this result may be sent to the CGFNS for VisaScreen purposes.

Passing scores for RNs are as follows:
• IELTS: Academic Module or the General Training Module 6.5, Overall Band Score, 7.0 Speaking
• TOEFL: Paper-Based 540; TOEFL Computer-Based 207; Test of Written English (TWE) 4.0; Test of Spoken English (TSE) 50.
• TOEIC: 725; plus TWE: 4.0 and TSE: 50 or
• Passing scores for the MELAB were as follows: Final Score 79+; Oral Interview 3+.

LENGTH OF TIME TO GET VISA-BACKLOG

Generally, the process of obtaining permanent residence may take between 12 to 18 months assuming that the immigrant visa quota from the RN’s country of birth is not backlogged. Since January 2005, there is a two to three years backlog for RNs born in India, mainland China and the Philippines. With recent legislation granted more Nurse Visas, this may change radically in the future.

If you feel that you may qualify for consular processing or adjustment of status as a Registered Nurse or other health care professionals under Schedule A, please contact Heller Immigration Law Group, LLP at: nurses@hilglaw.com, or call us toll free at: 1-800-863-4448.