NCLEX Requirements for Foreign Nurses in the US (2025 Guide)

For foreign-educated nurses who dream of practicing in the United States, one of the most important steps is meeting the NCLEX requirements for foreign nurses in the US. Passing the NCLEX-RN is not just about proving clinical knowledge—it is also about meeting the specific eligibility, credentialing, and documentation requirements set by U.S. boards of nursing and agencies like the CGFNS (Commission on Graduates of Foreign Nursing Schools).

In 2025, the process remains thorough but structured, ensuring that internationally educated nurses are fully prepared to provide safe and competent care in the U.S. healthcare system. This guide breaks down the key requirements, documents, and steps you must complete before registering and sitting for the NCLEX in the United States.

Foreign nurses often face additional hurdles compared to U.S.-educated candidates, such as language proficiency exams, credential verification, and immigration-related processes. While these may feel overwhelming at first, understanding the exact NCLEX requirements will make your journey smoother and far less confusing. Whether you are from the Philippines, India, Nigeria, the UK, or any other country, the U.S. has standardized steps that every foreign nurse must follow before becoming eligible to test. By 2025, states continue to uphold strict licensing criteria, but with the right preparation, international nurses can confidently navigate the system.

The first step usually involves a credentials evaluation through CGFNS or a similar agency. This ensures that your nursing education abroad matches the minimum standards required in the U.S. Once verified, you may need to complete the VisaScreen certificate, a federal requirement for foreign-educated healthcare professionals who plan to work in the United States. English proficiency testing, such as IELTS or TOEFL, may also be required unless you graduated from an English-speaking nursing program. These are critical parts of the NCLEX eligibility pathway that foreign nurses cannot overlook.

Another essential requirement is applying through the State Board of Nursing where you plan to practice. Each state has slightly different criteria, application fees, and processing times. Some states mandate CGFNS certification before granting NCLEX eligibility, while others directly evaluate your documents. Understanding state-specific requirements in 2025 is vital, as applying to the wrong board or submitting incomplete documentation can delay your application for months.

Foreign nurses should also be aware that the NCLEX-RN exam itself has evolved over the years. With the introduction of the Next Generation NCLEX (NGN), the test now places more emphasis on clinical judgment and decision-making. This makes proper preparation essential, especially for internationally educated nurses who may be unfamiliar with the U.S. style of patient care and exam format. Alongside meeting all paperwork requirements, investing in structured NCLEX prep courses and practice exams is strongly recommended.

Ultimately, the NCLEX requirements for foreign nurses in the USA are designed to protect patients, standardize nursing skills, and ensure that every nurse—regardless of where they trained—meets the same high standards of American healthcare. By following the right steps in 2025, from credential verification to exam preparation, international nurses can successfully bridge the gap between their training abroad and a rewarding career in the U.S.

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Step-by-Step NCLEX Requirements for Foreign Nurses in the US (2025)

To qualify for the NCLEX-RN in 2025, foreign-educated nurses must meet several eligibility and documentation requirements before registering for the exam.

Below is a clear, step-by-step breakdown of what you’ll need to complete:

1. Educational Credential Evaluation

The first requirement is verifying your nursing education to ensure it aligns with U.S. nursing standards. Most states require this to be done through an approved organization such as the Commission on Graduates of Foreign Nursing Schools (CGFNS).

• Submit transcripts directly from your nursing school.

• Provide proof of nursing licenses held in your home country.

• Ensure documents are in English (or translated by a certified translator).

2. English Language Proficiency

If your nursing program was not conducted in English, you will need to demonstrate proficiency through exams such as:

• IELTS Academic (minimum overall score usually 6.5–7.0, depending on state)

• TOEFL iBT (minimum scores vary by state, often 83–90+)

Some states waive this requirement if you graduated from an English-speaking country.

3. VisaScreen Certificate

For nurses planning to work in the U.S., obtaining a VisaScreen certificate is mandatory. This process, managed by CGFNS, verifies your credentials and English proficiency to meet U.S. immigration requirements. Without this, foreign nurses cannot be issued a work visa.

4. State Board of Nursing Application

Every nurse must apply to the Board of Nursing (BON) in the state where they intend to practice. Each state has its own criteria, fees, and processing times. Some examples:

• Texas BON: Requires a full CGFNS credentials evaluation.

• New York BON: Allows direct NCLEX eligibility application without CGFNS certification.

• California BON: Has unique education evaluation requirements, often stricter for foreign graduates.

It’s critical to review the BON website of your chosen state before applying.

5. Authorization to Test (ATT)

Once your documents are approved by the Board of Nursing, you will receive an Authorization to Test (ATT) from Pearson VUE. This allows you to schedule your NCLEX-RN exam.

• ATT is usually valid for 90 days.

• Testing centers are available worldwide, but availability may vary depending on your country.

6. Prepare for the Next Generation NCLEX (NGN)

Since 2023, the NCLEX-RN includes Next Generation NCLEX (NGN) case studies and new question formats that test clinical judgment. Foreign nurses should use updated NCLEX review materials, practice test banks, and simulation-based learning to prepare effectively.

7. Take and Pass the NCLEX-RN

Finally, schedule and take your NCLEX exam at a Pearson VUE testing center. Passing scores are determined by computer adaptive testing (CAT), which adjusts the difficulty of questions based on your answers.

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Detailed Breakdown of NCLEX Requirements for Foreign Nurses (2025)

While the step-by-step outline gives you a quick overview, it’s important to fully understand each requirement so you can avoid costly mistakes and delays.

Below is a deeper dive into the major NCLEX requirements for internationally educated nurses in 2025:

1. Educational Credential Evaluation

One of the most critical requirements for foreign nurses is proving that your nursing education is equivalent to U.S. standards. This is usually handled through CGFNS or another board-approved credentialing agency.

• What you need to submit: Official transcripts from your nursing school, your course syllabus or curriculum, and verification of your current license.

• Translation requirement: If your documents are not in English, they must be translated by a certified translator.

• Processing time: This step can take 4–6 months, so start early.

 Incomplete or incorrectly translated documents are one of the top reasons applications are delayed. Double-check requirements with your state board before submitting.

2. Proof of English Proficiency

Since communication is vital in U.S. healthcare, most states require proof of English proficiency for non-English educated nurses.

• Accepted exams: TOEFL iBT, IELTS Academic, and in some cases, OET (Occupational English Test).

• Scores needed (average range):

  • IELTS: 6.5–7.0 overall, with no band lower than 6.0.

  • TOEFL iBT: 83–90 minimum total score.

• Exemptions: Nurses from English-speaking countries (like the UK, Canada, or Australia) are often exempt.

Book your English test early. Scores are valid for two years, so time your test with your application process.

3. VisaScreen Certificate

If your ultimate goal is to work in the USA, the VisaScreen certificate is mandatory under federal immigration law. It ensures your education, license, and English proficiency meet U.S. standards.

• Issued by: CGFNS International.

• Cost (2025): Around $665 plus additional document fees.

• Validity: 5 years, renewable.

• Key documents: Transcripts, license verification, English exam results.

Apply for the VisaScreen while waiting for your Board of Nursing application to save time.

4. State Board of Nursing Application

Each U.S. state has its own Board of Nursing (BON), and you must apply to the state where you want to practice.

• Different rules:

  • Some states (like New York) allow direct NCLEX application without CGFNS certification.

  • Others (like Texas or Illinois) require full CGFNS evaluation.

  • California has its own evaluation rules that may not accept CGFNS.

• Fees: Application fees range from $100–$350 depending on the state.

• Timeline: Processing can take 3–9 months depending on the state and your documentation.

Always check the BON website before applying—requirements change frequently.

5. Authorization to Test (ATT)

Once your Board of Nursing application is approved, you’ll receive an Authorization to Test (ATT) from Pearson VUE.

• Validity: ATT is valid for 90 days (some states allow 6 months).

• Where you can test: Pearson VUE centers exist worldwide—in countries like the Philippines, India, Nigeria, the UK, and the Middle East.

Book your NCLEX exam early. Testing slots outside the U.S. fill up quickly.

6. Preparing for the Next Generation NCLEX (NGN)

Since April 2023, the NCLEX-RN includes Next Generation NCLEX case studies that test clinical judgment.

• Question types: Case studies, bow-tie questions, and extended multiple response.

• Recommended prep: Use updated NCLEX prep books, online question banks, and simulation-based courses.

• Study time: Most foreign nurses study for 3–6 months before attempting the exam.

 Focus on U.S.-based nursing protocols and medication names—these differ from international practice.

7. Taking the NCLEX-RN

• Format: Computer Adaptive Testing (CAT) adjusts difficulty based on your answers.

• Number of questions: Minimum 85 and maximum 150 for NGN (as of 2025).

• Time limit: 5 hours, including breaks.

• Result: Pass/Fail—results are usually released within 48 hours (unofficial) or mailed by the Board.

Common Mistakes Foreign Nurses Make When Applying for the NCLEX (and How to Avoid Them)

Even though thousands of international nurses successfully apply for the NCLEX each year, many encounter unnecessary delays or rejections because of avoidable errors.

Understanding these mistakes in advance will save you both time and money during your U.S. nursing journey.

1. Submitting Incomplete or Incorrect Documents

One of the biggest issues foreign nurses face is submitting incomplete paperwork to CGFNS or their State Board of Nursing. Missing transcripts, outdated licenses, or documents without official seals often cause long delays.

• How to avoid it: Create a checklist of all required documents. Ask your nursing school to send official transcripts directly to CGFNS or the BON. Never send photocopies unless specifically requested.

2. Choosing the Wrong State Board of Nursing

Each U.S. state has its own eligibility requirements. Some states accept CGFNS certification, while others conduct their own evaluations. If you apply to a state without understanding its rules, you may waste months of waiting time.

• How to avoid it: Research each state’s BON requirements carefully. For example, New York does not require CGFNS certification, but Texas does. Match your situation to the state that best fits your credentials.

3. Delaying the English Proficiency Exam

Since English exams like IELTS or TOEFL are often mandatory, many nurses postpone them and later find their NCLEX application on hold until results are submitted.

• How to avoid it: Take your English proficiency exam early in the process. This way, your scores will be ready when you apply for VisaScreen or the BON.

4. Misunderstanding the VisaScreen Process

The VisaScreen certificate is not just a formality—it’s a federal requirement for immigration. Some nurses assume passing NCLEX is enough, only to discover later that they cannot proceed without VisaScreen.

• How to avoid it: Begin your VisaScreen application while working on your NCLEX requirements. This saves months of waiting time.

5. Not Preparing for the Next Generation NCLEX (NGN)

Many international nurses study using outdated NCLEX review books and practice questions. However, since 2023, the NCLEX now includes NGN case studies and new item formats.

• How to avoid it: Use updated NCLEX prep materials that cover NGN-style questions. Enroll in reputable online review programs that simulate U.S. clinical scenarios.

6. Ignoring Application Deadlines and ATT Validity

Your Authorization to Test (ATT) has an expiration date, and some nurses lose their chance to test because they miss scheduling within that window.

• How to avoid it: As soon as you receive your ATT, book your exam date. Remember that some test centers outside the U.S. have limited availability.

7. Underestimating Costs

The NCLEX application process for foreign nurses involves multiple fees: CGFNS evaluation, VisaScreen, BON application, English exam, and the NCLEX exam itself. Nurses sometimes underestimate the total cost and face financial stress mid-process.

• How to avoid it: Budget at least $1,000–$1,500 USD for the full process in 2025. This includes exams, application fees, and document handling charges.

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Costs and Timelines for NCLEX Requirements in 2025

Applying for the NCLEX as a foreign nurse involves multiple steps, and each comes with its own fees and processing time. Understanding the total cost and expected timeline will help you plan realistically and avoid surprises.

1. Credential Evaluation Fees

Foreign nurses must undergo an educational credentials review through CGFNS or a similar agency.

• CGFNS Credentials Evaluation Service (CES): Around $365–$450

• CGFNS Certification Program (CP): Around $445–$530

• Processing time: 4–6 months depending on how quickly your school submits documents.

Request your school to send transcripts early, as this is often the biggest source of delay.

2. English Language Proficiency Exam

If your nursing program was not in English, you will need to take a language test.

• IELTS Academic: About $250–$275

• TOEFL iBT: About $235–$260

• OET (Nursing): Around $455–$500

• Processing time: Results are typically available within 1–2 weeks.

3. VisaScreen Certificate

The VisaScreen is mandatory for nurses seeking U.S. work visas.

• Application fee: About $665

• Renewal fee (after 5 years): About $325

• Processing time: 3–6 months depending on documentation speed.

4. State Board of Nursing (BON) Application

Each U.S. state has different fees and requirements.

• Application fee range: $100–$350

• Fingerprint/background check: $50–$100

• Processing time: 3–9 months depending on the state.

 Example:

• New York: $143 application fee, no CGFNS required.

• Texas: $150–$200, requires CES or CGFNS evaluation.

5. NCLEX Exam Fee

The final step is registering with Pearson VUE.

• NCLEX-RN exam fee: $200 (international scheduling may add $150 surcharge).

• Rescheduling/cancellation fees: $50–$200 depending on timing.

• Processing time: ATT (Authorization to Test) is issued within days after BON approval.

6. Total Estimated Cost (2025)

On average, foreign nurses spend between $1,000 and $1,500 USD to complete all NCLEX requirements. This does not include additional expenses such as travel, visa application fees, or study materials.

Breakdown Example:

• CGFNS Evaluation: $400

• IELTS: $270

• VisaScreen: $665

• State BON Application: $150

• NCLEX Exam: $200 (+$150 international fee if testing outside the U.S.)
  Total: ~$1,685 USD

7. Overall Timeline

From start to finish, the NCLEX application process for foreign nurses usually takes 9–12 months. This includes:

• Credential evaluation: 4–6 months

• English exam preparation & results: 1–2 months

• VisaScreen processing: 3–6 months

• State BON approval: 3–9 months

• Scheduling and taking NCLEX: Within 1–2 months after ATT issuance

Start credential evaluation and VisaScreen simultaneously to save several months.

By planning both your budget and timeline, you can avoid unexpected delays and financial stress, ensuring a smoother journey toward becoming a registered nurse in the U.S.

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Conclusion

For foreign nurses, meeting the NCLEX requirements for the USA in 2025 may feel like a long and sometimes complicated journey. Between credential evaluations, English proficiency exams, VisaScreen certification, state board applications, and finally preparing for the NCLEX itself, the process demands patience, planning, and persistence. However, every step is designed to ensure that you are fully prepared to provide safe, high-quality nursing care in the United States.

The good news is that thousands of internationally educated nurses successfully pass through this process each year and go on to build fulfilling careers in the U.S. healthcare system. By understanding the requirements, avoiding common mistakes, budgeting for costs, and using updated study strategies for the Next Generation NCLEX, you can position yourself for success.

If your dream is to work as a registered nurse in America, the NCLEX is the gateway—and with careful preparation, it is a gateway you can absolutely cross in 2025. Stay consistent, seek support from online study groups and mentors, and remember that each document you submit and each practice question you answer brings you closer to your U.S. nursing career.

Helpful Resources for Foreign Nurses

Here are reliable official links and trusted resources to guide you through the NCLEX process in 2025:

• NCLEX Official Information (NCSBN):
  https://www.ncsbn.org/nclex

• CGFNS International (Credentials & VisaScreen):
  https://www.cgfns.org

• Pearson VUE (NCLEX Registration & Testing Centers):
  https://home.pearsonvue.com/nclex

• U.S. State Boards of Nursing Directory (NCSBN):
  https://www.ncsbn.org/boards

• IELTS Official Site (English Exam Registration):
  https://www.ielts.org

• TOEFL iBT Official Site (English Proficiency Exam):
  https://www.ets.org/toefl

• OET (Occupational English Test for Healthcare):
  https://www.occupationalenglishtest.org

• UWorld NCLEX-RN (Practice QBank Updated for NGN):
  https://nursing.uworld.com