Qualify for an Overseas Nursing Career

Qualify for an Overseas Nursing Career
30 July 2019

The professional success of even the most competent specialist doctor often requires the support and assistance of skilled nurses and paramedical personnel. Nurses from India have made their mark at the global level in matter of competence and dedication to duty. There is a large demand for good nurses in the western countries, especially the US. The remuneration is handsome. However, those with a basic nursing qualification obtained in India cannot straightaway join the nursing service there. In the US, you have to prove your competence by passing the registered nurse licensing exam NCLEX-RN. On the lines of NCLEX-RN, the CGFNS Certificate examination has been evolved. Both CGFNS and NCLEX can now be taken in India. 

Another important factor that you should keep in mind is the need for furnishing evidence of your proficiency in the English language, through scores secured in globally accepted tests, such as the TOEFL or the IELTS. Though the medium of instruction in our nursing colleges and nursing schools is English, many of our graduates cannot gracefully communicate through that language to people from countries like the US. It is, therefore, imperative that our nursing students who desire to practice in the west should plan ahead in developing their English language skills to meet the practical demands of working abroad. 



The CGFNS International (formerly known as the Commission on Graduates of Foreign Nursing Schools) is an authority on credentials evaluation pertaining to the education, registration, and licensure of nurses and other health care professionals worldwide. It conducts predictive testing and evaluation for nurses trained in different countries, for ensuring their competence to work effectively as nursing professionals and confirming their eligibility for licensure as registered nurses in the United States.. You have to look into the following three elements for obtaining CGFNS certification: 

(1) VisaScreen: Visa Credentials Assessment 

(2) Certification Program 

(3) Credentials Evaluation Service 


Applicants must have completed 'plus two' and passed a government-approved nursing program of at least two years in length. The 4-year B.Sc. Nursing degree obtained through Nursing Colleges or the 31/2-year GNM (General Nursing and Midwifery) diploma obtained through nursing schools/recognised hospitals in India is adequate nursing qualification for appearance in CGFNS exam/ NCLEX-RN. Also, she should have obtained registration from the nursing council. CGFNS requires the nursing diploma/certificate sent directly from the Nursing College/School. So also, the registration details should go directly from the Nursing Council, and not through the candidate. 


The Qualifying Examination measures an applicant's nursing knowledge based on what nurses must know and do when they practice nursing in the United States. The foundations of the Qualifying Exam are based on client (patient) needs. The traditional clinical areas of nursing practice listed below are covered: 

• Nursing care of the adult 

• Nursing care of children, maternal/infant nursing 

â–ª Psychiatric/mental health nursing 

• Community health nursing 

The exam ensures that an applicant has the same level of understanding of nursing with various client groups, in various settings, as graduates of US schools of nursing. 


The International Commission on Healthcare Professions (ICHP), a division of CGFNS, administers the Visa Credentials Assessment Program for registered nurses who are not US citizens. This certification is essential for applying for a nurses visa. 

The process comprises four elements: 

(1) An education analysis 

(2) Licensure validation 

(3) English language proficiency assessment 

(4) An exam of nursing knowledge 


There are two examinations for confirming nursing knowledge for registered nurses—the CGFNS Qualifying Examination, and the NCLEX-RN (National Council Licensure Examination for Registered Nurses). You must secure passing score in one of these for the purpose of Visa. You can prove your English language proficiency by securing the required score in one of the following examinations: 

(a) Test of English as a Foreign Language, internet-based version (TOEFL iBT) at least a score of 83 

(b) International English Language Testing System (IELTS): at least a score of 6.5 in the Academic Module 


Application procedure for VisaScreen 

1. You complete a Visa Credentials Assessment Application Form and submit it along with full payment and your full academic records to CGFNS/ICHP. 

2. CGFNS/ICHP sends you a permanent identification number. 

3. You prepare and send a 'Request for Academic Records' form to the nursing school where you studied. 

4. Your school completes the 'Request' form and returns it by mail to CGFNS/ ICHP with your full academic records. 

5. CGFNS/ICHP notifies your eligibility. 

6. You prepare and send a 'Request for Validation of Registration/License form' to the licensing authority that issued you a registration, including the 

7. US Board of Nursing where you passed the NCLEX-RN. The licensing authority completes the 'Request' form and sends it by mail to CGFNS/ICHR 

8. CGFNS/ICI- IP notifies if any. you of insufficient or outstanding documentation, if any.

9. you register for TOEFL or IELTS, indicate CGFNS/ICHP as the score recipient, and pass the English proficiency test. 

10. CGFNS/ICHP receives your TOEFL or IELTS scores and records it in your VisaScreen file, and reviews your eligibility. 


You should note that your school and the licensing authority have to send your documents directly by mail to CGFNS/ICHP, and not through you. It may be remembered that authorities in the US would insist on NCLEX-RN qualification for practicing as a registered nurse. The CGFNS exam is modelled on the lines of NCLEX-RN. So those who have passed the CGFNS exam can reasonably expect to pass in NCLEX-RN. The conditions for licensure vary from state to state in the US. For specific information, you may contact the board of nursing in the State where you wish to become licensed. 


VisaScreen fees for online applications 

• The application includes the ICHP VisaScreen certificate valid for five years. 

• Application -- $540 

• Reprocess an expired application — $150 

• Expedited Review Service — $500 

• Application for renewal certificate — $275 

• Certificate verification letter — $100 

• Replacement certificate — $150 

• The rates of fees for paper applications are higher. 



As mentioned above, there are some differences among the states in the US with regard to the licensure for registered nurses. In most states, internationally-educated nurses should possess CGFNS Certificate for taking NCLEX-RN. The application procedure for CGFNS Certification is as follows :: 

1 You complete an Application Form for the CGFNS Certification with appropriate fee.

2. CGFNS sends you an identification number and CGFNS Official Study Guide. 

3. You prepare and send Request for Validation of Registration/License Forms Council). to the licensing authority (Nursing Council)

4. You prepare and send a Request for Academic Records Form to your Nursing College / School. 

5. CGFNS checks your documents and notifies your eligibility. 

6. You register for TOEFL or IELTS, indicate CGFNS as the score recipient, and pass the English proficiency test. 

7. Simultaneously prepare for the CGFNS Qualifying Exam. 

8. CGFNS notifies your eligibility and the date and location of CGFNS Qualifying Exam. 

9. You take the CGFNS Qualifying Exam of nursing knowledge (administered four times a year in over 50 locations worldwide). In India, the usual test centres are Bangalore, Cochin, Delhi, and Mumbai. 

10. CGFNS notifies you Qualifying Exam results. 


Certification fees for online applications 

• The application includes the ICHP VisaScreen certificate valid for five years. 

• Application — $445 

• Reprocess an expired application — $150 

• Re-exam application — $350 

• Exam scoring — $100 

• Certificate verification letter -- $100 

• Replacement certificate — $150 

• The rates of fees for paper applications are higher. 



The Credentials Evaluation Service Report helps you to demonstrate the merits of your credentials with regard to US standards. Nearly half of the US State boards of nursing require CES Reports for foreign applicants seeking initial and endorsement licensure in their states. The report analyses your educational qualification and your registration. There is no test or examination involved. 


CGFNS furnishes two kinds of reports. 

(1) Healthcare Profession & Science Report. This is a general report 

(2) Full Education Course-by-Course Report. This gives more details. 


You can contact the recipient and confirm which kind of report is required. You can follow the steps listed below for receiving the CGFNS Credentials Evaluation Service Report: 

(1) Identify the Report recipient and the kind of report required. 

(2) You complete a CES Application Form and send it with full payment to CGFNS. 

(3) CGFNS sends you an identification number. 

(4) You prepare and send the Request for Academic Records Form to your nursing college/school asking them to send your records to CGFNS. 

(5) You send a photocopy of your secondary school certificate to CGFNS. 

(6) CGFNS reviews your higher secondary certificate. 

(7) You prepare and send the Request for Validation of Registration/License Form to the Nursing Council, requesting them to send your records to CGFNS. 

(8) CGFNS reviews the registration and validates it. 

(9) Check your status online at www.cgfns.org, and supply any missing data. 

(10) CGFNS evaluates the documents and issues a report to the designated recipient. with a copy to you. 


• Open an account to purchase CGFNS International Services 

• Submit your educational and professional information to CGFNS International for certification and/or verification 

• Choose the location and date of your Qualifying Examination 

• Check the progress of your application 

• Pay for CGFNS International services with your credit card 


Credentials Evaluation Service fees for online applications 

• Full Education Course-By-Course Report application - $385 

•Healthcare Profession & Science Report application - $335 

• Reprocess a Healthcare Profession & Science Report application - $125 

• English language proficiency report (each) - $80 

• The rates of fees for paper applications are higher. 


Mode of payment Payment

Payment to CGFNS can be made by Visa/MasterCard or through international money orders or bank cheques made payable to `CGFNS' drawn on a US bank. They do not accept American Express. Payments have to be in US dollars drawn on a US bank. 




The NCLEX (National Council Licensure Examination) tests and confirms your knowledge, skills, and abilities for effectively practising as an entry level nurse. The NCLEX result is a significant factor used by boards for deciding licensure. The test follows the computer adaptive testing (CAT) style that does not give the same questions to all the candidates. The questions are offered one by one, depending on the standard of each candidate and the quality of the answers furnished till each stage. This is achieved by re-estimating the candidate's ability every time a question is answered. When the candidate answers an item, the computer recalculates the candidate's ability, based on all the previous responses. In other words, the test for each candidate is unique; it caters to his/her ability level. The score depends more on the difficulty of the items that a candidate can answer correctly rather than the number of items answered correctly. The questions are presented one at a time on a computer screen. You can view each item as long as you like, but you cannot go back to a previous item once you have selected your answer and confirmed it by pressing the NEXT button. 



(1) Identify the board of nursing where you wish to be licensed. Fulfil all of the board's eligibility norms of the board to take the NCLEX examination. You submit an application for licensure to the board. It may be noted that there are some boards of nursing which will not allow candidates without US Social Security numbers to apply for licensure. Avoid such boards. 

(2) Register with Pearson VUE for NCLEX  

(3) Receive Confirmation of Registration from Pearson VUE. 

(4) The board of nursing makes the candidate eligible to take the exam. Receive Authorisation to Test (ATT) from Pearson VUE. The ATT contains your test authorisation number, candidate's identification number, and the expiry date - varies from 60 days to 365 days depending on the board. 


You will have to pay US $200 towards the exam fee, as well as other fees required by the concerned board of nursing. You may find out the amount from the board. If you intend to take the exam in India, you have to pay an additional $150 towards international scheduling fee. You can pay by VISA/MasterCard/ American Express or money order, by a cheque drawn on a US Bank. Get the or latest instructions from the website before making any payment, since there is no refund. 

There are two options during registration—Practical Nurse (NCLEX-RN examination) or Registered Nurse (NCLEX-RN examination). 


The concerned board of nursing will mail the results to the candidates approximately one month after the examination. If the board participates in the Quick Results Service, 'unofficial' results can be received 48 hours after the examination on making a special payment. 


Contact details: 

(1) National Council of State Boards of Nursing, NCLEX Examinations Department, 111 E. Wacker, Suite 2900, Chicago, Illinois 60601-4277;  Links to all boards of nursing websites and contact information is available on this site. 

(2) NCLEX Examination Program, Pearson Professional Testing, 5601 Green Valley Drive, Room 220, Bloomington, MN 55437-1099, USA; e-mail: pvamericascustomerservice@pearson.com. 

(3) Regional Headquarters in India: NCS Pearson Inc. India Subsidiary Office, C-7, 1st Floor, Sector 3, Noida- 201301, Uttar Pradesh; Scheduling and other services by phone: 0120-4001600. 


Test Centres 

The test is conducted in 165 countries. The usual test centres in India are Chennai, Bangalore, Hyderabad, Mumbai, and New Delhi. More details and facilities for registering and scheduling are available in the Pearson VUE website www.vue.com/nclex


The Test 

You are given up to six hours to complete the NCLEX-RN examination, and five hours to complete the NCLEX-PN examination. These durations include a tutorial, two optional breaks you may take. The NCLEX-RN examination will have 75 to 265 items. Of these items, 15 are pretest items that are not scored. The NCLEX-PN examination will have 85 to 205 items. Of these items, 25 are pretest items that are not scored. 


A typical test plan for NCLEX-RN has the following structure: 

1. Safe and Effective Care Environment 

(a) Management of Care 

(b) Safety and Infection Control 

2. Health Promotion and Maintenance 

3. Psychosocial Integrity 

4. Physiological Integrity 

(a) Basic Care and Comfort 

(b) Pharmacological and Parenteral* Therapies 

(c) Reduction of Risk Potential 

(d) Physiological Adaptation (*Parenteral implies that taken into the body or administered in a manner other than through the digestive tract, as by intravenous or intramuscular injection) 


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