How to Get Nursing Jobs in USA for Foreigners: H-1B Visa & NCLEX Requirements

Your path to nursing jobs in USA for foreigners

If you're an internationally educated nurse looking to work in the United States, the process is more structured than it might initially appear. There are specific visa categories, licensing requirements, and credential verifications that apply, and understanding them in the right order is essential.

The demand is real: the U.S. is facing a significant and growing nursing shortage, with projections of 4.6 million unfilled direct care positions by 2032. For qualified international nurses, this translates into genuine opportunity, provided you meet the requirements and pursue the right visa pathway.

Here's the process at a high level:

1. Confirm your eligibility - Do you hold a Bachelor of Science in Nursing (BSN)? This is the minimum education requirement for H-1B sponsorship.
2. Pass the NCLEX-RN - The U.S. nursing licensure exam. Employers require this before they'll consider filing a visa petition.
3. Obtain your VisaScreen certificate - A federally mandated credential verification for all international healthcare workers seeking U.S. work visas.
4. Secure a job offer from a sponsoring employer - Not all hospitals sponsor visas. Knowing which ones do, and how to reach them, is critical.
5. Your employer files the visa petition - The employer handles the petition and associated costs. You should never pay an employer for sponsorship.

H-1B visa for nurses: how it works

The H-1B visa is the most common pathway for international nurses seeking employment in the United States. It's a "specialty occupation" visa, meaning the role must require at least a bachelor's degree, and the worker must hold that degree.

For nurses, this means:

• You must hold a BSN (Bachelor of Science in Nursing). Associate degrees (ADN) and nursing diplomas do not qualify. If you currently hold an ADN, you'll need to complete an RN-to-BSN bridge program before you're eligible.
• The position must be classified as a specialty occupation. Registered Nurse roles at hospitals and healthcare systems typically meet this threshold. Home health aide, personal care aide, and CNA positions do not qualify for H-1B because they don't require a bachelor's degree.

What changed for the H-1B visa in 2026

Two significant policy changes affect the H-1B visa for nurses this year:

Wage-weighted lottery (effective Feb 27, 2026): USCIS has replaced the previous random selection process with a wage-weighted system. Each registration now receives weighted entries based on the offered salary's DOL wage level, Level 4 receives four entries, Level 3 receives three, and so on. For nurses, this means targeting roles at Wage Level 2 or above significantly improves your selection odds. Experienced nurses with specialized skills (ICU, OR, ER, oncology) are well-positioned for higher wage levels.

$100,000 supplemental fee: A presidential proclamation issued in September 2025 requires an additional $100,000 payment for certain new H-1B petitions, primarily for beneficiaries outside the United States who do not hold a valid H-1B visa. This fee does not apply to change-of-status petitions for individuals already in the U.S., which is why the F-1 student pathway (covered below) has become an increasingly attractive alternative.

H-1B visa for nurses: complete requirements

• Bachelor of Science in Nursing (BSN) from an accredited institution
• NCLEX-RN pass (U.S. nursing licensure exam)
• VisaScreen certificate from CGFNS (verifies foreign nursing credentials)
• English proficiency: IELTS Academic (6.5 overall, 7.0 speaking) or OET Nursing (Grade B in all sections), score requirements may vary by state board of nursing
• State RN license or eligibility in your target employment state

Alternative visa pathways for international nurses

The H-1B isn't the only option. Depending on your citizenship, education level, and career stage, one of these pathways may be a better fit.

TN visa (Canadian and Mexican nurses)

If you're a Canadian or Mexican citizen, the TN visa is often the fastest and most straightforward path to nursing jobs in the USA for foreigners from USMCA countries.

• No annual cap or lottery - unlimited TN visas available
• No $100,000 supplemental fee
• Fast processing - Canadian nurses can be approved at the U.S. border; Mexican nurses can file through USCIS with processing in as little as 15 days
• Requirements: Canadian or Mexican citizenship, valid nursing license, NCLEX-RN pass, and a job offer from a U.S. healthcare employer

For eligible nurses, the TN visa eliminates the uncertainty of the H-1B lottery entirely.

F-1 student visa → OPT → H-1B pathway

This pathway is designed for individuals who want to become U.S.-educated nurses, or who hold a nursing diploma or ADN and need a BSN to qualify for H-1B sponsorship.

1. Enroll in a BSN program at a U.S. university on an F-1 student visa
2. After graduation, use Optional Practical Training (OPT) for 12 months of work authorization (up to 36 months if your program qualifies as STEM-designated)
3. Pass the NCLEX-RN and obtain your state license during the OPT period
4. Your employer files for H-1B sponsorship while you're already working in the U.S.

Why this pathway is increasingly popular: Because you're already in the U.S. when the H-1B petition is filed as a change of status, the $100,000 supplemental fee does not apply. And with STEM OPT, you get up to three H-1B lottery attempts, significantly improving your chances of selection.

Best for: Early-career candidates willing to invest in a U.S. nursing education, or current nurses with ADN/diploma credentials who need a BSN.

EB-3 green card (employer-sponsored)

Some healthcare employers sponsor international nurses directly for permanent residence through the EB-3 visa category. This bypasses the H-1B lottery entirely, but processing times vary significantly by country of birth and can take several years. It requires the employer to complete a PERM labor certification process, and sponsorship opportunities are limited.

J-1 Au Pair (childcare only, not applicable to nursing)

A common misconception: the J-1 Au Pair program does not apply to nursing or elder care. It is restricted to childcare in host family homes for participants ages 18–26, with a maximum duration of two years. It is not a pathway to nursing employment in the U.S.

NCLEX requirements for international nurses

The NCLEX-RN (National Council Licensure Examination for Registered Nurses) is the standardized exam that all nurses, domestic and international, must pass to practice as a registered nurse in the United States. No employer will file an H-1B petition or begin the visa sponsorship process until you've passed this exam. It is the single most important prerequisite for nursing jobs for foreigners in USA.

What the NCLEX-RN covers

The exam tests your competency across four major areas of nursing practice: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity. It uses a Computerized Adaptive Test (CAT) format, meaning the difficulty adjusts based on your responses.

• Number of questions: 75–145 (varies based on performance)
• Time limit: 5 hours maximum
• Format: Multiple choice, select-all-that-apply, ordered response, and other question types
• Scoring: Pass/fail, determined by the NCSBN logit standard

NCLEX pass rates for international nurses

Understanding the pass rates helps you plan your preparation realistically:

• First-time internationally educated test takers: approximately 45–55%
• Repeat international test takers: approximately 38–42%
• First-time U.S.-educated test takers: approximately 80–85% (for comparison)

These numbers underscore why structured preparation is essential. International nurses who invest in dedicated NCLEX prep see meaningfully higher pass rates.

How to prepare for the NCLEX-RN

The most effective preparation strategy combines three resources:

• UWorld NCLEX-RN QBank - 2,500+ practice questions widely regarded as the closest to actual exam content
• Saunders Comprehensive Review - a foundational textbook for content review
• NCSBN Learning Extension - official practice exams from the organization that develops the NCLEX

International nurses who use all three resources and dedicate 8–12 weeks of focused preparation typically achieve pass rates 15–20% higher than average.

Beyond NCLEX: additional requirements

VisaScreen certificate: Administered by CGFNS (Commission on Graduates of Foreign Nursing Schools), VisaScreen is a federally mandated credential verification required for all international healthcare workers seeking U.S. work visas. It verifies your nursing education, license, and English proficiency. Processing takes 6–10 weeks after all documents are submitted. Apply here →

English proficiency: You'll need to demonstrate English proficiency through one of two exams:

• IELTS Academic: Minimum 6.5 overall, 7.0 speaking (requirements vary by state board)
• OET Nursing: Grade B (350+) in all four sections, often recommended for nurses because the test uses nursing-specific scenarios, and pass rates tend to be higher

State RN license: After passing the NCLEX-RN, you'll apply for an RN license in the specific state where you plan to work. Requirements vary by state, check your target state's board of nursing for details.

Hospitals that sponsor H-1B visa for nurses

Not all healthcare employers sponsor visas, and identifying the ones that do is one of the most time-consuming parts of the process. The types of institutions most likely to sponsor H-1B visas for nurses include:

Academic medical centers - Many are affiliated with universities and qualify as cap-exempt H-1B employers, meaning your petition is not subject to the annual lottery. These institutions typically have established immigration departments and experience sponsoring international nurses.

Large hospital systems (500+ beds) - Systems like Mayo Clinic, Cleveland Clinic, and Kaiser Permanente have the financial capacity and administrative infrastructure to manage visa sponsorship at scale.

Magnet-designated hospitals - These represent the top 8–10% of U.S. healthcare facilities as recognized by the American Nurses Credentialing Center. Magnet hospitals tend to have more robust international recruitment programs.

Specialty units with high demand - Nurses with experience in ICU, emergency, operating room, oncology, and labor and delivery are in particularly high demand and more likely to receive sponsorship offers at competitive wage levels.

How to find nursing jobs for foreigners in USA

Migrate Mate provides access to nursing positions with verified visa sponsorship history, so you can focus your applications on employers who actually sponsor rather than applying broadly and hoping for the best.

• Filter by occupation (Registered Nurse, Physical Therapist, Occupational Therapist), location, and visa type
• Check each employer's sponsorship track record from the past year
• Access direct hiring contacts to reach recruiters and hiring managers directly

Search nursing jobs with visa sponsorship →

How to avoid caregiver visa sponsorship scams

The demand for international nurses has created an environment where scams targeting healthcare workers are common. Before you engage with any recruiter or agency, know these red flags:

Upfront fees for "guaranteed" jobs

The claim: "Pay us $5,000–$15,000 and we guarantee you an RN job in America with H-1B sponsorship."

The reality: It is illegal for U.S. employers to charge you for H-1B petition costs. No recruiter or agency can guarantee visa sponsorship - employers make that decision case by case. Legitimate recruitment agencies do not charge candidates upfront fees for job placement.

What you should expect to pay for: VisaScreen ($525–$675), English proficiency exams ($200–$575), NCLEX-RN exam ($200), and credential evaluation fees. These are standard costs paid directly to testing and credentialing organizations - never to an employer or recruiter.

"Start working now, we'll fix your status later"

The claim: "Begin working as a caregiver on a tourist visa or without work authorization. We'll sponsor your H-1B later."

The reality: It is illegal to work on a B-1/B-2 tourist visa or without valid work authorization. Doing so creates a permanent immigration record that can disqualify you from future visa applications. If an employer suggests this arrangement, they are unlikely to follow through on sponsorship - and you would be putting your entire immigration future at risk.

The legitimate process: Your employer files the visa petition before you start working. You receive work authorization before employment begins. Everything is documented with legal immigration status throughout.

Start your search for nursing jobs in USA for foreigners

The path from internationally educated nurse to practicing RN in the United States is demanding - but it's well-defined. If you hold a BSN, are prepared to pass the NCLEX-RN, and know which employers actively sponsor international nurses, the opportunity is real.

Here's how to move forward:

1. If you haven't taken the NCLEX-RN yet - begin your preparation now. This is the prerequisite that unlocks everything else.
2. If you've passed the NCLEX-RN - start your VisaScreen application and English proficiency testing in parallel while you search for sponsoring employers.
3. If you're ready to apply - use Migrate Mate to identify hospitals that sponsor H-1B visa for nurses, verify their sponsorship history, and connect directly with hiring teams.

Find nursing jobs with visa sponsorship →

Frequently Asked Questions