US Immigration for Nurses: Work Visas & Green Card Options

US immigration law favors certain types of immigrants by giving them multiple (and sometimes quicker) options for obtaining a temporary work visa as well as permanent residence in the United States (a green card). And because of a perennial shortage of medical workers in the US, one of the classes of immigrants receiving special attention is foreign nurses.

In order to encourage more foreign nurses to come to the country, the US government has introduced various procedures over time that can facilitate their ability to work and reside in this country. These are explained below. (Unfortunately, there is one visa option you may have heard about in the past called the H-1C visa, not anymore.)

As a Foreign Nurse, Can I Work in the U.S. Temporarily?

If you are a foreign nurse and wish to work in the United States temporarily (without obtaining a U.S. Green Card), you may be able to obtain an H-1B visa. An H-1B is a popular temporary work visa for foreigners who have a job offer from a US employer to work in a "specialty job."

To obtain an H-1B visa for a foreign nurse, the US employer, e.g. For example, a hospital or medical clinic, file an I-129 petition with United States Citizenship and Immigration Services (USCIS). This authority decides whether or not to approve the employer's application for H-1B status for the employee.

Your future employer must prove that you work in a nursing profession. USCIS uses a four-pronged test for this; the position must meet one of the four prongs:

- A bachelor's degree or higher, or equivalent, is usually the minimum entry requirement for the position.
- The degree requirements for the job are industry standard, or the job is so complex or unique that it can only be performed by a person with a degree.
- The employer usually requires a degree or equivalent for the position.

The nature of the specific duties is so specialized and complex that the knowledge required to perform the duties is usually associated with obtaining a bachelor's degree or higher.

Typically, USCIS focuses on the first level, examining whether a bachelor's degree is required for the nursing profession. This can make it difficult to obtain an H-1B visa as a registered nurse, as many states do NOT require a bachelor's degree for a typical registered nurse position. Instead, most states require a shorter certification process for this position. Be sure to check with your employer about the requirements for the registered nurse position in the state where you want to work.

Although it can be difficult to get an H-1B as a registered nurse, almost every state requires at least a bachelor's degree for these positions if you hold the position of clinical registered nurse or registered nurse. Therefore, you would have better chances of getting an H-1B visa.

Again, be sure to find out the state requirements for any nursing position a US employer will offer you. As part of the question of whether it is a skilled occupation, it is less a question of your qualifications than of the qualifications required for the position. Suppose you have a master's degree in nursing and a US employer offers you a position as a registered nurse in California. California does not require a bachelor's degree to become a registered nurse. Therefore, even though you hold a master's degree, it is highly unlikely that USCIS would qualify this position as a specialty.

Can I Obtain a U.S. Green Card as a Foreign Nurse?

Your US employer may also be willing to sponsor you for a green card. The employer must first offer you a permanent, full-time position. Second, your employer must complete a process known as "employment certification" (more commonly referred to as PERM) on your behalf. Well, you may have heard a lot about the PERM/work certification process with all of its promotional requirements, but this process is completely different (and simpler) for nursing positions.

A Nursing position is classified as a "Schedule A" position. Plan A positions are positions that the US government has recognized that the US needs more workers to fill. Therefore, employers are not required to post advertisements for Schedule A positions (a common PERM requirement) because the US government already knows there are labor shortages in these positions.

To file the PERM for a foreign nurse, the U.S. employer fills out the standard ETA Form 9089, but submits the form along with an I-140 petition to USCIS — not the Department of Labor, which is the agency issuing the ETA -Form checks 9089 for all non-Schedule-A positions.

Once USCIS approves the I-140 and the foreign nurse's priority date is current (meaning that a visa number has become available if a waiting period has been imposed as a result of the annual allocation of such visas), the nurse may apply for the U.S. Green Card by filing the I-485 Application for Adjustment of Status with USCIS (see How to Determine Your Priority Date for Immigration Purposes for explanation).

Importantly, while the typical PERM advertising requirements do not apply to Plan A positions, the Posting Notice requirement does apply. Your U.S. employer must post a notice at the place of business informing other workers that the certificate of employment has been submitted.

As a Foreign Nurse, What Certification Must I Show to Apply for a U.S. Visa or Green Card?

All foreign nurses, whether coming to the United States on an H-1B visa or with a green card, must demonstrate to USCIS that they are "certified" to work in the medical field in the United States. (This information is intended specifically for caregivers. Doctors and other medical personnel have different requirements.)

To do this, the foreign nurse must be certified by the Commission on Graduates of Foreign Nursing Schools (CGFNS). The nurse must submit all of their qualifications and educational credentials to CGFNS. Upon verification of this, the CGFNS issues a certified statement confirming the following:

The nurse has a valid and unrestricted license in the US state where she or he will be working and the state has certified that the nurse's foreign license is genuine.

2. The nurse has passed the NCLEX, which is the US Nursing Licensing Examination.
3. The nurse is a graduate of an English language nursing program.
4. The nursing program was located in a country recognized by the United States as acceptable for medical education, and
5. The maintenance program was in operation on or before November 12, 1999.

The CGFNS certificate must accompany any visa or green card application submitted on behalf of the nurse by the US employer. If the employer forgets to include it, USCIS will almost certainly ask for it before approving the petition.

As you can see, there are many nuanced issues to navigate through these procedures, so most applicants or their employers hire an immigration attorney to ease the process.


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    Huyen Trang Dang works as a Creative Manager in an international shoe company. Her core competencies are social media marketing and brand building. Even though Dang is a graduate in Business Economics; she has been working as a Social Media ... [ Read more ]