Healthcare Professional – Process

The Basics

•   You must have been trained and graduated from a recognized program from your country. Your training should have included at least a minimum of 3-4 years of theoretical instruction and clinical practice in the areas of Medical-Surgical Nursing, Pediatrics, Maternity, Obstetrics-Gynecology, Community Health and Psychiatry Nursing.

•   You must have been licensed to practice your profession in your home country. This license must be current, with no restrictions.

•   You must have at least 2 years of current working experience in a clinical/hospital setting, preferably in the acute care areas.

•   You should be able to speak, read and write English to a professional level.

•   Good patient care skills.

•   Willing to undergo all necessary prerequisite examinations.

•   Must be eligible for US visa.

Getting Started

Once you satisfy the minimum requirements outlined above, you are in a position to transition to the United States. For a nurse, trained internationally, there are some additional requirements to work and practice your profession in the United States:

A/ Must have been either credential verified to ensure that your education and training meets American standards. The licensure process may vary from state to state , but the common steps include:

•   Certification by CGFNS or
•   Passing result in the NCLEX-RN examination
•   Demonstrated ability to speak English
•   Demonstrated ability to listen, write and comprehend English in a fluent manner.

The last two steps are done by organizations such as ETS (Educational Testing Service) through their TOEFL, TWE and TSE exams or through IELTS. English language exam requirements are waived if you are a graduate of nursing programs in an English speaking country, such as United Kingdom, Ireland, Australia, New Zealand, Canada (except Quebec), etc. Please ask us about the requirements specific to your home country.

B/ Must be eligible for a US visa, e.g. no criminal record.

RN Licensure

In order for you to practice your profession in the United States, you must possess a valid, unrestricted license in the state in which you wish to practice. Each state may have its own standards to verify the equivalency of your education to those of nursing graduates of a US program in terms of their ability to deliver safe and effective care in accordance with US standards of practice. The licensure process varies from state to state. As part of its comprehensive migration program, Madison Healthcare assists, guides, and trains its nursing professionals to ensure successful and time-efficient completion of the licensure process.

In spite of the differences that may exist between various State Boards, common elements for an internationally trained nurse are:

•   Application

•   Satisfying English proficiency requirements specified by each Board of Nursing

•   Credential evaluation administered either by the Board itself or by the Board´s approved credentialing agencies (i.e. CGFNS)

•   A passing result in the National Council of Licensure Examination for Registered Nurses NCLEX-RN

Once the above requirements are met, most of the states offer you an initial licensure to practice in that state. Should you decide later on to practice your profession in a different state, you may transfer your licensure through a process called endorsement (without having to repeat the entire process all over again).

NCLEX-RN

•   NCLEX-RN examination is developed and administered by The National Council of State Boards of Nursing Incorporated in conjunction with the Pearson Professional Testing.

•   NCLEX-RN tests (a candidate) for a minimum nursing competence according to a national standard.

•   It’s a national exam. Application procedure and licensing requirements are determined by each State Board of Nursing and may differ from state to state.

•   NCLEX-RN examination is conducted in Computer Adaptive Test (CAT) format: The examination is computerized. It is called “adaptive” because the computer estimates the candidate’s ability after each question. The next question is chosen based on the candidate’s estimated ability thus far in the test. The test is therefore “adapted” for each candidate, thus the process is “customized”.

•   The test format will be a multiple-choice questions/answer format. In addition, according to the latest blueprint, some of the questions will be of alternate type. This may include: multiple correct answers, fill-up the blanks, click on the graphics, responding to a chart, etc. types of questions.

•   Number of questions: 75 – 265 including about 15 “tryout questions” which are not scored. These tryout questions, which are not identified to the test taker as such, are being field tested for use on future exam. They are not calculated in the overall score.

•   Types of questions:

The examination covers the following Nursing Process:
– Assessment
– Analysis
– Planning
– Implementation and Evaluation/Outcome Criteria.

The client needs tested include:
– Safe, Effective Care Environment
– Physiological Integrity
– Psychosocial Integrity
– Health Promotion and Maintenance.

•   Timing: Maximum time allowed for the exam is 5 hours. There is no time limit for each question. A 10-minute mandatory break will be given after 2 hours of testing and an optional 10-minute break after 3 ½ hours of testing.

•   The test will stop when the computer has made the pass/fail determination or the maximum number of questions has been exhausted or 5 hours has passed after the exam start.

•   The examination results will be communicated directly by the testing agency to the respective State Board of Nursing, which will then inform the candidate about the examination outcome. If a passing score was achieved, a certification of licensure will be issued.

The Visa Process

The second component of your transition to practice your profession in the US, is to obtain a valid work visa.
The preferred option for most of international nurses is the Immigrant Visa, also called “Green Card”. For some nurses, depending on their qualification and experience, they maybe eligible for a work visa (H1B). Since most of the international RNs prefer to stay for a longer and extended periods of time, the Green Card option seems to be the most viable choice.
Obtaining Green Card is a lengthy and complex process, but with careful, adequate planning and preparation, this process can be made a lot simpler!

At Madison, we ensure this process takes place smoothly through a step-by-step approach providing every assistance and support along the way.

Here are the essential components:


The first step in your application, in order to undergo a fast track approach, would be your eligibility to qualify as an immigrant worker. For an international nurse, this means the following:

•   Holding either the CGFNS certificate
Or
•   A valid US RN license (passing the NCLEX-RN exam) in the state of intended employment.

Once you have obtained the above certificates, you have fulfilled the requirements to complete your immigrant petition process. In order to coordinate your Green Card petition approval and your arrival in the United States, it involves 3 stages:

•   Approval by the BCIS (Bureau of Citizenship and Immigration Services)

•   Completion of the procedures at the NVC (National Visa Center) which issues a visa number

•   Consular interview. At this point, you would have received your interview date from the US consulate. Madison will work with you to get you well prepared to complete this process, providing you with all the necessary documentation (including the VISA SCREEN certificate) and support.

Upon successful completion of the interview and receiving your visa, you are ready to travel to the United States. Madison will work with you to schedule your arrival and the orientation process at the client facility.