USA immigration options for registered nurses
As the COVID-19 pandemic rages on, the U.S. has experienced a shortage of registered nurses, physicians and other medical staff. The situation with nurses is especially dire now but has been problematic since before the pandemic, and the U.S. has made several attempts to ease the immigration of medical professionals.
The U.S. recognizes that because of its aging population, increased demand for healthcare and a great number of registered nurses reaching retirement age, the healthcare system will face increased strain without the immigration of qualified nurses from abroad, in addition to increasing the number of domestic graduates from nursing schools.
The high demand for registered nurses together with higher salaries and better working conditions has motivated many registered nurses around the world to consider working in the U.S.
There are several types of visas available for registered nurses but before looking at those U.S. visas and green card options, we need to first take a brief look at the other requirements that have to be met before any visa application is possible.
Foreign Nurse Certification
People who wish to come to the U.S. and work as registered nurses either on a temporary basis (nonimmigrant visas) or permanent basis (green card) must meet certain criteria and show proof to U.S. immigration authorities that they are certified to work in the state of their desired employment.
The most basic requirements are that nurses wishing to work in the U.S. graduate from an accredited nursing education program in their home country, obtain a registered nursing license for outside the U.S. and practice for at least a couple of years.
Nurses who graduated outside the U.S. and that have had their degrees from non-English speaking countries, must also take an exam that demonstrates their proficiency in English. These exams include the Test of English as a Foreign Language (TOEFL), the Test of English for International Communication (TOEIC) or the International English Language Testing System (IELTS).
The next step will be to submit the academic and professional credentials to a screening program such as the Commission on Graduates of Foreign Nursing Schools (CGFNS) International, Inc. to have their academic and professional credentials evaluated to ensure that their documents are authentic and that their education is comparable to U.S. nursing standards. You can find out more about the evaluation requirements by clicking here.
After submitting their credentials for evaluation with screening program the nurse who wishes to work in the U.S. can choose to apply for the NCLEX-RN for the state of their intended employment. Note that some states also might require applicants to complete the CGFNS Qualifying Exam before they can sit for NCLEX-RN. Only after the nurse has completed a screening program and sat for either NCLEX-RN or CGFNS Qualifying Exam, they can move on to the next step and apply for a U.S. visa.
Nonimmigrant (Temporary) Work Visa Options
1. H-1B Visa – this visa gives the nurse the right to work in the United States for the sponsoring employer for an initial period of 3 years that can be extended for another 3 years.
This type of visa is only for positions that require a minimum of bachelor’s degree and will exclude candidates that have completed a lesser degree or if the position in the U.S. does not require a bachelor’s degree.
To qualify for an H-1B the job position must be a specialty occupation, which presents some difficulties for registered nurses because many U.S. states do NOT require a bachelor’s degree for a typical registered nurse position.
A safer bet would be to have a U.S. employer sponsor for an H-1B nursing position that requires more qualifications and that is more complex such as clinical nurse or a nurse practitioner because almost every state requires at least a bachelor’s degree for these positions.
The H-1B visa is subject to an annual quota of 65,000 for those applicants with only a bachelor’s degree and an additional 20,000 for those with a master’s degree or higher.
The application process starts in March of each year and the “lucky” applicants that make the quota are selected by a computerized lottery system, usually held each summer. A nurse would be competing with candidates from all other professions for the quota and that has been a big hurdle for employers since there are many H-1B petitions in recent years, especially in the tech space.
2. E-3 Visa. For Australian citizens, E-3 visa is similar to H-1B and registered nurses from Australia can qualify for this visa if the job position offered by the U.S. employer is a specialty occupation – one that requires at least a bachelor’s degree as discussed above for H-1B visa. However, the E-3 visa classification is not subject to the computerized lottery and quota as is the case with the H-1B visa.
3. TN Visa – is available only to citizens of Canada and Mexico and it requires the candidate to have a job offer from a U.S. employer in NAFTA approved professions. Registered nurse is an approved profession under the NAFTA list and requires a state/provincial license or Licenciatura Degree. Canadians can apply directly at a U.S. port of entry or a pre-clearance US Customs and Border Protection (CBP) facility while Mexican citizens must first apply at their respective consulate and obtain a visa stamp before entering the U.S. on a TN nonimmigrant status. The TN visa for registered nurses can be granted for maximum 3 years and can be renewed indefinitely.
4. Other Visas
In addition to the H-1B and TN visa, other temporary visas might be available for nurses to come work in the United States. These options include J-1 student exchange visa, O-1 extraordinary ability in the sciences, L-1 visa for international organizations, E-3 visa for nationals of Australia if the position is a specialty occupation and H-1B1 for citizens of Chile and Singapore. These other visas are much less often used for nurses to come to the U.S. and are very case specific.
Immigrant Visa (Permanent Resident or Green Card) Options
The best options for nurses that seek to immigrate to the U.S. permanently are EB2 and EB3. EB2 is open only for candidates with master’s degrees or equivalent (bachelor’s degree plus at least 5 years of relevant experience) while EB3 is open to candidates that have a bachelor’s degree. Both EB2 and EB3 require the candidate to be sponsored by a U.S. employer who is offering the candidate a permanent full-time position.
Typically, the sponsoring employer must apply first with the U.S. Department of Labor to certify that there are no U.S. candidates willing and able to take the position. However, this requirement is waived for nurses since they are considered Schedule A position. Schedule A positions have the requirement to post advertisements for open EB2 and EB3 positions waived because the U.S. government already knows there is a shortage of workers in these positions. That saves candidates, employers, and their attorneys a lot of effort, time and expense that is usually spent to get a prevailing wage, advertise and recruit for position.
To file the PERM for a foreign nurse, the U.S. employer completes the usual labor certification form directly with the petition for immigrant worker.
Once USCIS approves the petition for immigrant worker and the foreign nurse’s priority date is current (meaning that a visa number has become available, if a wait had been imposed due to the annual allotment of such visas having run out), the nurse can apply for the U.S. permanent residency while in the United States by filing an adjustment of status application with USCIS or for an immigrant visa at the U.S. Embassy or Consulate abroad if he or she is outside of the United States.
Other Green Card Options for Nurses
In addition to the EB-2 and EB-3 Schedule A streamlined green card, there are other immigrant visas that might be available for nurses to come work and live in the US on a permanent basis – obtain a green card. These other green card options are much less often used for nurses to come to the U.S. and are very case specific and place significant emphasis on the person’s individual achievement. These options include:
- EB-1 Green Card. EB-1 immigrant visa is for individuals with extraordinary achievement who are coming to the United States to work in their field of expertise. These other visas are much less often used for nurses to come to the U.S. and are very case specific.
- EB-2 National Interest Waiver (NIW). This category of Green Card waives the job certification if it can be proven that the employee’s skills are in the national interest of the U.S. To qualify for an EB-2 NIW Green Card, the individual must possess a graduate degree or be able to show that he or she possesses extraordinary ability by meeting certain criteria.
How can Malescu Law assist?
If you work as licensed nurse outside the U.S. and wish to explore your visa options to come the United States contact us, your U.S. licensed immigration lawyer in Miami, Florida USA.
Malescu Law P.A. – Immigration Lawyers