CGFNS International reports nurse migration rates to the U.S. remained high in 2024

CGFNS International released a report last month concluding that nurse migration to the US remains high as healthcare systems continue to look to foreign-educated nurses to address persistent staffing shortages.

In 2024, CGFNS received 24,733 VisaScreen applications, down 4.6% from 2023, but still nearly 200% above pre-pandemic fiscal year 2018.

Allocation by country and visa type

Candidates with credentials from the Philippines accounted for more than 51% of issued VisaScreen certificates in 2024, followed by Canada with 8%, and Kenya with 6.5%.

76% of visa screen certificates issued by CGFNS were issued to candidates seeking permanent green cards, followed by candidates seeking TN visas (12%) and H-1Bs (11%).

According to the President and CEO of CGFNS, the report’s findings confirm that U.S. healthcare systems, “continue to depend on nurse immigrants to address persistent staffing shortages.”

Looking ahead

The report states that between 6% and 16% of registered nurses (RNs) in the U.S. are foreign-born, representing between 258,000 and 688,000 migrant nurses as of 2023. 

High immigration rates in the face of barriers such as visa retrogression highlight the continued appeal of nurse migration as a pathway for career advancement and economic opportunity.

However, visa retrogression persists, alongside new, likely stricter, immigration policies from the Trump Administration.

The report notes that while an increase in visa wait times may strain direct-hire models, staffing agencies can more effectively absorb wait periods, making staffing and recruitment even more essential for nursing immigration to the US in the coming years.

CGFNS International to Change Its Name to TruMerit™

The Commission on Graduates of Foreign Nursing Schools (CGFNS) announced it will change its name to TruMerit™.

Immigration regulations require that when filing an immigration petition for certain healthcare occupations, including Registered Nurses, the Petitioner must include a healthcare worker’s certificate (sometimes called a Visa Screen) from an authorized credentialing organization, such as CGFNS.

CGFNS indicated the name change will be the centerpiece of a comprehensive rebranding of the organization, which will also involve changes to its website, customer portals, credentials and certificates, and social media channels. The rebranding effort will begin rolling out in mid-March and will be completed by the summer.

English Exam Score Set at 50 for International Nurses: Could Increase in Future, says HRSA

The Commission on Graduates of Foreign Nursing Schools (CGFNS) announced that it will reset its standard passing English exam score to 50, after raising the standard to 63 in the Fall of 2024.

Immigration regulations require that when filing an immigration petition for certain healthcare occupations, including Registered Nurses, the Petitioner must include a healthcare worker’s certificate (sometimes called a Visa Screen) from an authorized credentialing organization. A passing English exam score is required for Visa Screen issuance.

One such English exam, the PTE, will now have a standardized passing score of 50 across all Visa Screen providers.

However, the Health Resources and Services Administration (HRSA) could soon increase the standardized English exam score across all providers.

To determine the appropriate English exam score requirement to protect patient safety and to safeguard healthcare professionals coming into the U.S. to work, HRSA has asked for comments through the Federal Register and will be reviewing a comprehensive report on English proficiency standards within the coming month.

International Education Evaluations, LLC Now Authorized to Issue Visa Screens

As of October 25, 2024, USCIS has added International Education Evaluations, LLC to the list of organizations authorized to issue certificates and certified statements for Registered Nurses. Notice of the organization’s addition was provided in the Federal Register.

Immigration regulations require that when filing a nonimmigrant or immigrant petition for certain healthcare occupations, including Registered Nurses, the Petitioner must include a healthcare worker’s certificate (sometimes called a Visa Screen) from an authorized credentialing organization.

The immigration regulations expressly authorize the Commission on Graduates of Foreign Nursing Schools (CGFNS), the National Board for Certification in Occupational Therapy (NBCOT), and the Foreign Credentialing Commission on Physical Therapy (FCCPT), to issue valid healthcare workers’ certificates.

USCIS may also approve additional organizations for issuance of certificates by providing notice in the Federal Register. MU previously published an August 2021 blog post on the addition, via Federal Register notice, of Josef Silny Associates, Inc. to the list of authorized organizations.

HOW DOES CGFNS FIT INTO US NURSE IMMIGRATION

We often receive questions about the role of CGFNS in nurse immigration.  CGFNS has a number of different product lines which overlap and add to the confusion.

Here are three of the most common uses of CGFNS within the US visa processing system.  It is best to think of these three product lines as independent: 

CGFNS credentials evaluation (CES) – Many US state licensing bodies call on CGFNS to review and evaluate foreign nurse’s credentials in advance of qualifying the nurses to sit for the NCLEX exam.  CES is the process by which applicants can have their nursing education evaluated by CGFNS for clearance to sit for the state’s nursing exam (NCLEX).

CGFNS Predictor (Qualifying) Exam – This is an older, legacy exam that is now rarely used to assess a foreign nurse’s competence in nursing.  It was more widespread before the expansion of international NCLEX testing centers. 

CGFNS Visa Screen – This is the Healthcare Worker Certificate (HWC) that is needed by RNs at the very end of their immigration process, at their consular interview.  CGFNS’ HWC is branded the Visa Screen.  All nurses and allied healthcare workers must have:

·        Passed the US licensing exam;

·        Graduated from a university that is equivalent to a US school in the same profession;

·        Passed an English fluency examination; and

·        Hold a spotless overseas professional license. 

In recent years USCIS approved a second issuer of HWCs, Josef Silney.  

CGFNS WILL ACCEPT ADDITIONAL ENGLISH EXAMS FOR VISASCREEN STARTING AUGUST 1, 2022

On May 24, 2022, the Health Resources & Services Administration (HRSA) of the US Department of Health and Human Services updated their list of tests and scores acceptable for foreign healthcare workers. This full list can be found here.

Upon this HRSA update, CGFNS International, Inc. stated that starting August 1, 2022, CGFNS will accept additional English exams for the VisaScreen process. Currently, CGFNS only accepts the Test of English as a Foreign Language (TOEFLS) and International English Language Testing Systems (IELTS) for the English exam requirement of the VisaScreen.

CGFNS will be issuing an announcement of the full details of the additional tests and score requirements on August 1, 2022. CGFNS has confirmed that they will accept the Occupational English Test (OET) and Pearson PTE Academic (PTE) for VisaSceen purposes starting August 1, 2022. CGNFS has also stated that they will accept PTE and OET exams taken before August 1, 2022, as long as they are still valid on August 1, 2022.

Acceptance of these additional English exams only applies to the CGFNS VisaScreen process, each state still has their own requirements for state licensure.