Basic study for the nursing profession in the United States takes place at the undergraduate level. The professional- level “registered nurse” (R.N.) has a bachelor’s degree in nursing and must fulfill state licensure requirements to practice. Each U.S. state has its own criteria and regulations for licensure; however, every state uses the same licensing examination, known as the NCLEX-RN, which must be passed before a license is awarded. Most states also require nurses educated outside the United States to be certified by the Commission on Graduates of Foreign Nursing Schools (CGFNS) before taking the NCLEX-RN. Certain graduate programs in nursing require state licensure or CGFNS certification, depending on level of patient contact and the laws of the state where the program is offered. Another option in many states is a special limited license for educational purposes. Check licensing requirements carefully with individual programs to see if you qualify for this option. CGFNS certification will also be required if you apply for either a temporary nonimmigrant visa (H-1A) or a permanent visa. To obtain a CGFNS certificate involves a credential review and an examination. You can be registered for the CGFNS Exam if CGFNS determines that you:

  • are currently registered as a first-level general nurse in the country where you were educated;
  • have completed an upper secondary school education, separate from nursing education;
  • have graduated from a government-recognized general nursing program lasting at least two years;
  • have received theory and clinical practice instruction in medical, surgical, obstetric, pediatric, and psychiatric nursing.

The CGFNS Exam tests nursing knowledge and is given approximately three times a year at sites around the world. Candidates for certification must also demonstrate English language proficiency as measured by the Test of English as a Foreign Language (TOEFL) (Web site: For information on the CGFNS certification program, contact your nearest U.S. educational information or advising center or CGFNS, 3600 Market Street, Suite 400, Philadelphia, PA 19104- 2651, USA; Telephone: 215-349-8767; Web site: A variety of options for advanced, specialized nursing education exist in the United States, including university master’s and doctoral programs as well as non-degree certificates and continuing education programs, which are usually very brief, offered by universities, hospitals, associations, and other sources. Specializations include nursing administration, nursing education, nurse midwifery, psychiatric nursing, gerontological nursing, public health nursing, and many others.

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