Navigating the CGFNS Maze for Nurses
Posted Nov 01, 2002

In earlier articles the MurthyBulletin has focused on the basics of entering the U.S., either temporarily or permanently, as a registered nurse. Available on MurthyDotCom, our November 23, 2001 article, entitled Nurses – Shortages and Options, mainly covers temporary visa possibilities. Published October 11, 2002, Nursing as a Route to the Green Card shares details on obtaining permanent resident status. This supplement to that October article plots a course for navigating the various services offered by the Commission on Graduates of Foreign Nursing Schools (CGFNS), in order to obtain the proper proof of training and education necessary for the green card approval.

The CGFNS is an immigration-neutral service that determines which nurses with foreign educations or licenses are qualified to practice as registered nurses in the United States. In order to gain immigration as a nurse it is necessary to obtain the Visa Screen certificate through the International Commission on Healthcare Professions (ICHP), a division of CGFNS*.

International Commission on Healthcare Professions - Visa Screen

Foreign-born nurses, even those educated in the United States, must complete the Visa Screen certification in order to qualify for permanent resident status. The ICHP may conduct a final credentials review and will look for the CGFNS certificate (explained below) and/or evidence that the applicant passed the NCLEX-RN (also explained below). Additionally, ICHP will check results of the English language tests*, known as TOEFL, TWE, and TSE or, alternatively, the MELAB and MELAB (oral) test results. After making the determination that an applicant has satisfied the requirements, ICHP will issue the Visa Screen Certificate to enable that nurse to complete the consular processing or adjustment of status application. CGFNS' fee for the Visa Screen process is $325.00 U.S. as of October 2002.

CGFNS Certification Program

As indicated above, prior to applying for the Visa Screen, it is necessary to obtain the CGFNS certificate or pass the NCLEX-RN examination. For the CGFNS certificate, it is necessary to apply to the CGFNS Certification Program (CGFNS-CP). CGFNS-CP first evaluates the would-be immigrant's documentation to determine whether s/he has completed the minimum number of hours in theoretical and clinical training in Adult Medical / Surgical Nursing, Maternal / Infant Nursing (Obstetrics, but not Gynecology), Care of Children (Pediatrics), and Psychiatric / Mental Health (but not Neurology) Nursing. If the person has not met all of these requirements, s/he is required to complete theoretical and clinical training in the deficient area at a government-approved nursing school. Once this requirement is met, CGFNS-CP checks whether the applicant was a registered nurse in his/her country of education. It should be noted that this requirement relates to the country of education, not the country of origin. In addition, the applicant must provide any current licenses. Both the initial and current license, as applicable, must be sent to CGFNS directly from the licensing authorities.

Once the educational and licensing documentation is complete and verified, the applicant must successfully complete the CGFNS qualifying exam and the TOEFL*. If the applicant passes both parts of this exam, s/he is issued a CGFNS Certificate. CGFNS' fee for this process is $295.00 U.S., and includes a study guide for the CGFNS qualifying exam.

For applicants planning to take the test in 2003, the CGFNS exam will be given on March 12, 2003 (application deadline December 11, 2002); July 9, 2003 (deadline April 9, 2003); and November 12, 2003 (deadline August 13, 2003). Locations are listed on the CGFNS WebSite.

CGFNS Credentials Evaluation Service

For those considering taking the NCLEX-RN, evaluation of an applicant's credentials to determine eligibility for taking that examination is done by CGFNS' Credentials Evaluation Service (CES). The NCLEX-RN is only administered in the United States and its territories but is required in most states in order for one to be licensed as a registered nurse. Some applicants may want to consider obtaining a visitor's visa to take the NCLEX-RN in Guam rather than taking both the CGFNS qualifying exam and the NCLEX-RN. However, statistics compiled by the CGFNS show that applicants who take CGFNS qualifying exam first have a higher passage rate on the NCLEX-RN. Furthermore, some states require foreign nurses to pass the CGFNS qualifying exam in order to be eligible for a license even if they have already passed the NCLEX-RN. An applicant will want to weigh the costs and benefits of each option.

Documents Needed

For each part of the process one needs a completed application for that process; a full transcript mailed to CGFNS directly from the nursing school; a copy of the license from the country of education and the current license mailed directly from each licensing authority; and a copy of the secondary school diploma or, if not available, an official letter with the school seal which is signed by the principal and forwarded directly to CGFNS by the school. This letter must verify dates of attendance and completion of secondary school.

Pointers

Other considerations in starting the CGFNS process are that CGFNS will not count any nursing classes taken during secondary school in their evaluation of the applicant's credentials. Therefore, it is important to ensure that all potentially qualifying nursing classes were taken as part of a post-secondary educational program. To meet the Visa Screen requirements, applicants must have completed both a secondary school education and a government-approved healthcare program that was at least two years in duration.

Completion of the CGFNS requirements does not guarantee that an applicant has met an individual state's registration requirements. It is possible that, once in the United States, one who is a registered nurse in another country may need to undergo additional testing to become a registered nurse in the particular state where s/he intends to work. It is worthwhile researching any additional requirements that may exist in the state where one plans to work and live prior to entering the U.S.

Finally, the CGFNS is a credentials and testing service, not a place to seek legal advice. If you have any legal questions regarding any stage of the process, you should contact a qualified immigration attorney. If you do not have an attorney, you can contact The Law Office of Sheela Murthy at <law@murthy.com>. Information on paid consultations is available on our WebSite.

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*These subjects, among others, are described in more detail in our October 11, 2002 article, Nursing as a Route to the Green Card.