Short Guide for Foreign Trained Healthcare Professionals in the US

May 19, 2014


Foreign trained healthcare professionals make up 15% or more of the US healthcare workforce, based on a 2005 American Communities Survey report. Immigrants in the workforce are particularly common in US urban centers. Job outlooks for a great number of careers in the health industry show that there will be many new openings in the next ten years. Some analysts believe that a worker shortage is imminent in the growing industry, and that more and more healthcare providers will need to actively pursue foreign-born candidates.  An issue arises, though, when state law requires specific types of certification and licensure; foreign-born workers must demonstrate equivalency in their training and education. In this process, there are a number of steps that need to be taken, and some barriers that may arise.


Shortages of nursing and allied health professionals drastically alter quality of care, as well as the strain placed on current healthcare workers.





Proving English Language Competency

One of the first steps to working in the US healthcare system will be proving your ability to use the English language effectively. If you attended school in an English-speaking country, this is usually not a requirement. Otherwise, you will most likely need to take the TOEFL or IELTS, international English language competency tests. They are meant to test your ability to listen, read, speak, and write in English. Seek guidance and resources online if successfully taking this test is a concern.

Collection & Translation of Documents

In order for your credentials to be approved, governing bodies need to be able to understand and process them. These often must begin with the last year of secondary school, through to certificates of graduation at any other level of education. An academic transcript or grade report is necessary alongside any credential transmitted. Sometimes copies of transcripts and grade reports must be official, at other times a photocopy is acceptable, depending on the evaluator.

Credential Evaluation & USCIS Credentialing

Submitting credentials for evaluation is an important step to prove your competency for most positions. A professional evaluator will look at the documents you've gathered that prove your academic history and find the US equivalent. The National Association of Credential Evaluation Services lists a number of organizations that are highly qualified to provide top-rate evaluation services.

US Citizenship and Immigration Services requires adequate health care worker certification in order for foreign-born workers to prove proficiency in their field. This involves demonstrating competency in oral and written English, as well as passing either a predictor test (should the profession require licensure in a majority of states) or the actual exam for licensing or certification. USCIS certification is valid for 5 years, after which a renewal is required. This is referred to as the VisaScreen requirement.

Credentials in nursing are recognized through the Commission on Graduates of Foreign Nursing Schools (CGFNS), an internationally recognized authority dealing with evaluating credentials and verification of nurses and some other healthcare professionals' education, registration, or licensure.

Employer Backing 



A permanent resident "green" card is the more difficult to obtain than a temporary H-1B visa.





Most applicants will need employer backing in order to successfully petition U.S. Citizenship and Immigration Services. The I-140 petition form to USCIS displays the employer's willingness to back a candidate for an immigration visa. Once the I-140 is approved, the employer and candidate work with the National Visa Center to move forward on the Visa issuing process, including a visa interview at the home country consulate. Some immigration law firms provide assistance with the I-140 process, be sure to look for support resources on the web as needed.

Temporary H-1B visas can also be used to obtain legal status in the US. They typically only are active for three years, and also require employer sponsorship and the VisaScreen. They require a four-year/ Baccalaureate degree or higher, and the job must require the same level of degree or higher.

For more information about legal and immigration requirements, please visit USCIS or contact a legal professional.