International Students -Things to know

What are the educational requirements to become an RN/LPN in the U.S.?

There are three general requirements:
  1. You need to have completed nursing school from an accredited nursing program.
  2. Being a licensed RN/LPN.
  3. Having practiced as an RN for at least 2 years.

Can I work as a registered nurse in the U.S. without any previous working experience?

If you have not worked for a minimum of two years after you have graduated from your nursing school, most state boards will not license you until you complete an FEN (Foreign Educated Nurses) refresher course. You need to check with the Board of Nursing (BON) of the state where you are planning to work to verify if the course is required.

What does an FEN refresher course consist of?

This course consists of 120 classroom hours and 120 clinical practice hours under the supervision of an RN.

How can I find an FEN refresher course?

You can find a Foreign Educated Nurses review course through an online search.

How can I find an FEN refresher course?

You can find a Foreign Educated Nurses review course through an online search.

What is the purpose of the TOEFL exam?

This test is used as an evaluation of English proficiency and readiness for academic programs. You can visit for more information.

Is there any chance I might be excused from taking the English exam?

You may be excused from taking the TOEFL exam if satisfy the following:
  1. You attended nursing school in the U.K., Australia, New Zealand, Canada (except Quebec) or the Republic of Ireland.
  2. The spoken language of your nursing school was English
  3. Your nursing school textbooks were written in English

What steps do I need to take to get my nursing license in the U.S.?

Step 1: Contact the BON of the state you want to practice to find out requirements and specific documents needed. These requirements vary state by state.
Request an application packet for licensure for nurses trained outside the U.S.
Step 2: Complete the Credentials Evaluation Service (CES) request form through the Commission on Graduates of Foreign Nursing Schools (CGFNS). Visit to download the form.
Step 3: Pass the TOEFL exam (if required).
Step 4: Submit your complete application (from step 1) to the Board of Nursing.
Step 5: The BON will determine your eligibility to take the NCLEX RN/LPN exam once all required documents are reviewed (CGFNS report, TOEFL test results and completed application packet).
Step 6: Register and pay $200 with Pearson VUE via the internet, telephone or regular mail. You will receive an Authorization to Test (ATT) by email or regular mail.
Step 7: Schedule the date and location of your NCLEX exam. If for any reason you cannot attend your scheduled date of exam, you will be required to re-register without a refund.
Note: The name with which you register for the test will be printed on your authorization to test (ATT) and must match the name on your identification you bring to the Pearson Center.

Do I need to take an NCLEX preparation course before registering for my NCLEX exam?

It is highly recommended that you take a comprehensive NCLEX review course that will address you learning style and needs to increase your chances of passing the exam.

What documents do I need to get an RN immigrant visa green card?

To get an RN immigrant visa card you will need evidence of a US based employer who will be the petitioner (I.e. A Hospital or recruiting agency) and a Visa Screen Certificate (VSC) by the international commission on Health Care Professionals (ICHP)

Can I take HESI A2 anytime, or only on certain dates?

The HESI A2 is a proctored exam, which means it has to be administered under supervision. Sometimes that supervision can be arranged at the school’s testing center or with nursing faculty, but sometimes it might require you to go to a professional testing center like you will when you’re ready to take NCLEX. Some schools might allow students to take HESI A2 on any date that’s convenient, others require all applicants to take the entrance exam at the same time. Know what to expect from your school so that you can plan accordingly.

How many times am I allowed to take HESI A2?

All schools are going to have a different requirement. Some give you an unlimited amount of attempts, although there may be a waiting period, which I’ll talk about in a moment. Other schools might only let you take it once or twice. Check with the nursing school you’re applying to in order to find out what their policy is.

If I am allowed to retake the exam, is there a waiting period between attempts?

Many schools might allow you to attempt the HESI A2 multiple times, but require a waiting period between attempts. For example, a school might say that you can only take the entrance exam once every six months! Although it can be frustrating for a student who wants another chance, there’s actually several very good reasons for the schools to require this.First, there are only a limited number of versions of the HESI A2. Even if your school has access to all versions of the exam (most don’t), eventually you might have to retake a version you’ve already taken, so you’d be familiar with the questions already. Obviously, that could skew your exam results. A waiting period makes it less likely that you’ll take the exam that many times, and also makes it more likely the even if you get the same test versions that you’ll forget the exact questions that you saw previously. This last point is especially important for the schools that only have access to one version of the HESI A2 exam!
Another reason that a waiting period is often required is because it gives you adequate time to study before retaking the exam. If you were to retake the exam the next day, or even a week after your first attempt, that’s really not enough time to do the preparation you need to improve your score.
A final reason for a waiting period is money. The HESI A2 exam is not free! The Nursing school has to purchase it from the company that created it, and they have to purchase one test for each student. Usually, these tests must be purchased in “packages” in order to get a better deal. This is one reason why some schools may have several different versions of the HESI A2 available, while another school only has one. Each version is a separate purchase for the school, so they can’t afford to pay for students to retake the entrance exam over and over again. Of course, many schools pass part or all of that expense on to the student, which leads me to the next question…

Do I have to pay to take the exam?

Some schools allow you to make your first HESI A2 attempt for free, while many others make the student pay part or all of the cost. If your school lets you take it for free, consider yourself lucky! After all, high school students are expected to pay for their own SAT tests, so having a school pick up the tab for an admission exam is actually unusual. Most often, you will be required to pay to take the exam, and I’ve seen the cost range anywhere from $25 on up to $90, depending on the school.
If you do happen to be one of the lucky students who gets to take HESI A2 for free, just keep in mind that if you end up having to retake it then you will most likely be required to pay out-of-pocket for any additional attempts.

Are all sections of the exam required?

The HESI A2 actually consists of eight sections: Mathematics, Reading Comprehension, Vocabulary, Grammar, Biology, Chemistry, Anatomy and Physiology, and Physics. Don’t freak out yet, though, because not all schools require all sections. It’s pretty much a guarantee that every school will want to see your Reading Comprehension and Math scores, but almost every other section is up for grabs. And many (but not all) also require an Anatomy and Physiology score. The other sections are really up for grabs depending on the school, so make sure you find out exactly what you should be studying for.

Do I have to take HESI A2 for every nursing school that I apply to?

Nope! Since HESI A2 is a standardized test, you can use the same score to apply to several different schools. But if you choose to go that route, you need to be careful to make sure that you still meet the requirements for each school.
So make sure that you find out which sections of the HESI A2 each school requires so that you can take a version of the entrance exam that uses all of the sections that are needed. It would be a huge bummer to have to retake the entire exam simply because you only took the Reading Comprehension and Math sections, then found out that one of your schools requires Anatomy and Physiology!
Also be aware that each school has a time limit for how old the HESI A2 score can be in order to count for your current application. This is similar to the guidelines that many nursing schools use in order to decide if your science prerequisites were taken recently enough. So if you want to apply to a school using your HESI A2 score from last year, don’t just assume it’s okay…make sure you find out what their time limits are.

Will poor English skills keep me from a nursing program?

It is critical to have strong English language skills, particularly if you wish to enroll in an advanced degree program, such as a Master’s in Nursing (MSN) program. Poor English skills may jeopardize your ability to excel at the required NCLEX examination.
If you need additional preparation, several options exist. If you are admitted to a U.S. college or university, it may offer part- or full-time intensive English as a Second Language (ESL) courses for international students. There are also many private language institutions in the U.S., but approach these with caution: Some universities may not accept credits from institutions that are not accredited by a national accreditation organization like the Commission on English Language Program Accreditation.

With a degree from my home country, can I enter an MSN program or practice international nursing in the U.S.?

Because nursing requirements differ from country to country, you may be required to go back to school for additional international nursing training. The most important thing to do is to contact schools and universities to find out who evaluates international nursing student applications. Some schools have hired staff members with special training to evaluate academic credentials of overseas applicants, and others refer students to outside agencies like the American Association of Collegiate Registrars and Admissions’ Officers.
Some international nursing schools prefer to have credentials evaluated by the Commission on Graduates of Foreign Nursing Schools. Check with the admissions department to find out if the school accepts CGFNS evaluations, or if you need to have other organizations review your transcripts as well.
If you received training at the secondary level, like many programs in Russia and Latin America, you will not be eligible to be a licensed nurse in the U.S. You can be admitted to school nursing programs, however, and your experience may enable you to fulfill some degree requirements. You may need to complete the Foreign Educated Nurses (FEN) course, which consists of 120 classroom hours as well as 120 clinical hours under the supervision of a licensed RN.

Are there application tips for international nursing students?

There are several things you can do:
  • Plan to contact prospective nursing schools for international students approximately one year before you intend to apply.
  • Apply to several institutions, including a few where you feel fairly certain that you will be accepted.
  • Apply to international nursing schools in different locations—applying to several in the same area may make the U.S. consulate in your country think that you are coming to America for reasons other than education.
  • Find out what range of test scores each school prefers and take all required exams well ahead of time.
  • Be sure to have documentation that proves you will be able to fund the duration of your stay in the U.S.
  • If you are accepted, send in your deposit immediately to contend for nursing school financial aid packages and on-campus housing.

Will I need to take the Test of English as a Foreign Language (TOEFL)?

Yes—whether you are an entering freshman or a nurse who wants to receive additional education, the TOEFL will be required by almost all international nursing colleges and universities. Your TOEFL scores are valid for two years. You may take the TOEIC or IELTS exam instead though most nurse recruiters prefer you take either the TOEFL or IELTS. Nurses who plan to become practicing residents in the U.S. will also need to take the TSE and TWE, which test written and spoken English, or the MELAB battery, another English language proficiency test.

What if I graduated from a non-American secondary school?

You will need to send original copies of your secondary school diploma and transcripts, as well as any university-level academic records. These need to be accompanied by word-for-word English translations that follow the format of the original document.
Some nursing schools for international students may also require you to have your school send an explanation of their grading system. If there is a branch in your country, you can contact the United States Information Services (USIS) for additional advice.

My school closed. What can I do?

If your school closed, you need to contact the institution or agency (like the ministry of health) authorized to hold documents for your school. You must find out who has the authority to validate your records, since many schools will not accept copies of school transcripts, only official documents.

I have been accepted! What steps should I take to obtain a visa?

As a full time international nursing college or university student, you need to apply for an F-1 visa. Upon acceptance, your school should send you an I-20 application form. You should take this and your passport to a United States Embassy or Consulate, where an official who oversees non-immigrant visas will assist you. At this point, you will need to fill out the “Affidavit of Support” form to prove that you have the finances to fund the length of your stay in the U.S. After you submit all of these forms, your visa application will be processed.
To avoid any problems, fill out your paperwork as soon as you are accepted. Many nursing school admissions offices have confirmed that they will work with international students to adjust to new deadlines and requirements as the government enacts additional security measures.

Can I fund part of my education by working in the U.S.?

Working in the U.S. can be challenging. If you arrive on an F-1 student visa, you are NOT allowed to accept any employment outside the campus for a period of 9 months. Moreover, you will not be allowed to work more than 20 hours per week if you have a job on-campus. In most cases, you will not be able to work full time during your initial year.

Will my status as an international nursing student affect financial aid eligibility?

International nursing students are ineligible for United States government funded loans, grants, or aid programs. Your selected schools will be able to tell you if there are any loans or aid packages open to international students. You should consult with individual school financial aid offices to determine what financial information needs to be provided: requirements for non-citizens often differ from those of citizens.

What types of housing options can I expect to find?

Most nursing schools for international students have a housing office that addresses student living concerns. Graduate students often have several housing options, including graduate dormitories and graduate floors within dorms.
You can also choose to live off campus, although finding an apartment, room, or shared housing arrangement may require greater preparation ahead of your arrival. Again, talk to each individual school to determine what options best fits your needs. Many admissions offices have staff members who can assist you during the transition to an American university.

Can I work in the U.S. after completing my degree?

Yes. All foreign nursing students must apply for a Visa Screen Certificate, which is issued by The International Commission on Healthcare Professionals, under section 343 of the Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA), if they plan to work permanently in the United States of America. You must also take a medical exam and a visa interview and take an accredited Advanced Cardiac Life Support, Basic Life Support, or a Pediatric Life Support course in order to earn your certificate.