U.S. immigration law now requires that healthcare professionals, other than physicians, complete a screening program in order to qualify for certain occupational visas. VisaScreen: Visa Credentials Assessment, a program offered by CGFNS' division the International Commission on Healthcare Professions (ICHP), enables healthcare professionals to meet this requirement by verifying and evaluating their credentials to ensure compliance with the government's minimum eligibility standards.
Applicants who successfully complete VisaScreen receive a VisaScreen Certificate, which can be presented to a consular office, or in the case of adjustment of status, the attorney general as part of a visa application.

Meeting Federal Requirements
Section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA) of 1996 requires that certain non-U.S. healthcare professionals successfully complete a screening program prior to receiving an occupational visa. Screening includes an assessment of an applicant's education to ensure that it is comparable to a U.S. graduate in that same profession; verification that licenses are valid and unencumbered; English language proficiency; and, in the case of nurses, verification that the nurse has either earned a CGFNS Certificate or passed the National Council Licensure Examination for Registered Nurses (NCLEX-RNŽ examination).

The Commission on Graduates of Foreign Nursing Schools (CGFNS) was named in the legislation as an organization qualified to offer this federal screening program. In response to this legislation, CGFNS created a new division, the International Commission on Healthcare Professions (ICHP), which administers VisaScreen.

Program Elements

The VisaScreen program is comprised of an educational analysis, licensure validation, English language proficiency assessment, and, in the case of nurses, an exam of nursing knowledge. Once the applicant has successfully completed all elements of the VisaScreen program, the applicant is awarded a VisaScreen Certificate, which can be presented to a consular office, or in the case of adjustment of status, the attorney general as part of a visa application.

Educational Review
The educational review ensures that the applicant's education meets all applicable, statutory and regulatory requirements for the profession the applicant intends to practice, and is comparable to that of a U.S. graduate seeking licensure.

In order to meet the educational requirements for the VisaScreen program, applicants must have:

Successfully completed a senior secondary school education that
       is separate from their professional education;
Graduated from a government-approved, professional healthcare
       program of at least two years in length; and
Successfully completed a minimum number of clock and/or credit
       hours in specific theoretical and clinical areas during their
       professional program.

* Physical therapists must include a self-reported, typewritten summary of their supervised clinical experience.

Licensure Review
The licensure review evaluates initial and all current and past licenses. Validations provided directly to ICHP by the issuing/validating institution, affirm that the applicant has completed all practice requirements and that the registration/licensure has no encumbrances.

English Language Proficiency Assessment
The English language proficiency assessment confirms that the applicant has demonstrated the required competency in oral and written English by submitting passing scores on tests approved by the U.S. Departments of Education and Health and Human Services. Currently, to fulfill this requirement, applicants must take either the Test of English as a Foreign Language (TOEFL), Test of Written English (TWE) and Test of Spoken English (TSE), or the Michigan English Language Assessment Battery (MELAB) parts 1-4, which include the Oral Interview and the Speaking Test.

The English language proficiency assessment requirement is different for each healthcare profession. Contact CGFNS to find out which exams your profession is eligible to take and what the passing scores are for those exams.

Certain applicants may be exempt from the English language proficiency requirement if they meet all of the following criteria:

Country of professional education was Australia, Canada (except
       Quebec), Ireland, New Zealand, the United Kingdom or the United
       States;
Language of instruction was English; and
Language of textbooks was English.

Predictive Examination for Nurses
Applicants who wish to obtain an occupational visa to practice as nurses in the United States must present a CGFNS Certificate or a passing score on the NCLEX-RNŽ examination to provide proof of their nursing knowledge.
In order to obtain a CGFNS Certificate, applicants must successfully complete CGFNS' Certification Program, a three-part program, comprised of a credentials review, a one-day Qualifying Exam of nursing knowledge and an English language proficiency exam. Upon successful completion of all three elements of the program, applicants are awarded a CGFNS Certificate. Most states require the CGFNS Certificate from nurses educated abroad before they can take the NCLEX-RNŽ examination.

Program Benefits

Applicants who successfully complete the VisaScreen program will receive a VisaScreen Certificate. The VisaScreen Certificate, which satisfies all federal screening requirements as set forth in section 343 of IIRIRA, can then be presented to a consular office or, in the case of adjustment of status, the attorney general as part of a visa application. ICHP, through its parent company CGFNS, was named in section 343 as a qualified provider of such a screening program.

Also, anyone with an interest in selecting highly-qualified, foreign-educated healthcare professionals for employment or education in the United States will find the program highly beneficial. Federal agencies, healthcare employers, academic institutions, health and education ministries, professional regulatory boards and international management companies all make use of VisaScreen or other ICHP evaluation services.
ICHP can provide a full examination of a healthcare professional's credentials by not only reviewing educational history, but also the professional licensing standards and practical experience that complete the professional's credentials.


Frequently Asked Questions:

What is VisaScreen and why do I need it?
U.S. Immigration law now requires that healthcare professionals, other than physicians, complete a screening program in order to qualify for certain occupational visas. VisaScreen, a program offered by The International Commission on Healthcare Professions (ICHP), a division of CGFNS, enables healthcare professionals to meet this requirement by verifying and evaluating their credentials to ensure that they meet the government's minimum eligibility standards. CGFNS is named in the new law as a qualified provider of such a screening program.

What does VisaScreen look at?
VisaScreen does an educational review, licensure review, English language skills assessment and predictive examination for nurses. Applicants who successfully complete VisaScreen will receive a VisaScreen Certificate, which can be presented to a consular office or, in the case of adjustment of status, the Attorney General as part of a visa application.

Do I need to complete the CGFNS Qualifying Exam and the NCLEX-RN examination in order to complete my VisaScreen application?
No. You only need to successfully complete either one of the exams.

What are the VisaScreen requirements?
Complete the VisaScreen application.
Complete the enclosed forms to send to your nursing school(s). Academic transcripts must come directly from the nursing school(s).
Complete the enclosed forms to send to your licensing authority(ies). Validations of all licenses, past and present, must come directly from the licensing authorities.
You must successfully complete an English language proficiency test and have the scores directly forwarded to ICHP from the testing agency.
You must successfully pass either the CGFNS Qualifying Exam or the NCLEX-RNâ examination if you are a nurse.
Enclose a copy of your high school diploma or equivalent.
Enclose the application fee.

Who is exempt from fulfilling the English language proficiency requirement?
Applicants may be exempt from the English language proficiency requirement if they meet all of the following criteria:
Country of professional education was Australia, Canada (except
       Quebec), Ireland, New Zealand, United Kingdom or the United
       States;
Language of instruction was English; and
Language of textbooks was English.

Who pays for the program?
The applicant typically pays for the VisaScreen program. The application fee can be paid by an international money order or certified bank check in U.S. dollars, drawn on a U.S. bank and made payable to "ICHP," or by one of the following credit cards: Visa, Mastercard or Discover/Novus.

Must I submit my original documents for review?
Yes and no. ICHP accepts clear and legible photocopies of secondary school documents for evaluation. However, ICHP will only accept original verification from issuing agencies. All validation of registration/licenses and the applicant's professional school's transcripts must come directly from the issuing authority to ICHP. In addition, since ICHP verifies credential authenticity, ICHP maintains the right to validate any documentation with the source agency.

What do I do if my educational institution has closed?
ICHP only accepts certain documentation from source agencies (such as transcripts and validations of registration/ licensure). If your school has closed or no longer operates, you will need to contact the organization or agency authorized to hold documentation for that institution (such as a ministry of health or the national, provincial or state licensing authority in your country of education).

Do I need to have validations for all licenses I have ever held to complete my VisaScreen application?
Yes. CGFNS requires all VisaScreen applicants to provide validations of ALL licenses they have held, past and present. The validations must be sent directly to CGFNS from the issuing authority(ies).

Can I provide a photocopy of my license instead of a validation?
No. CGFNS requires that official validations of licenses must be completed and sent directly from the issuing authorities.

What do I do if the agency that issued my license is no longer in existence?
CGFNS only accepts validations of licensure from the source agency. If that agency has closed or no longer operates, you will need to contact the organization or agency authorized to hold documentation for that institution (such as a Ministry of Health or the national, provincial or state licensing authority in your country).

What if my documents are not in English?
A certified word-for-word English translation, signed with a certification of authenticity by the translator, must accompany any credentials not in English. If you cannot furnish a translation of your documents, ICHP can provide an official translation of each document for an additional fee. ICHP will accept translations of documents submitted by source agencies (such as transcripts and validations) only from the issuing authorities. Otherwise, ICHP will translate documents for the appropriate fee.

How does ICHP ensure its evaluations?
To ensure quality evaluations, ICHP consistently uses standards developed by the specific profession as the foundation for the assessment of an applicant's qualification.

What is the difference between a CGFNS Certificate and the ICHP VisaScreen Certificate?
The VisaScreen Certificate is a result of successful completion of the ICHP VisaScreen program, which meets all federal requirements of a screening program for healthcare professionals seeking certain occupational visas in the United States.

The CGFNS Certificate is a result of successful completion of the CGFNS Certification Program, which is a program consisting of an educational and registration/licensure review, a qualifying examination of nursing knowledge, as well as an English language proficiency assessment, designed specifically for first-level, general (registered) nurses seeking licensure in the United States.

Once a VisaScreen Certificate is issued, who receives the original document?
The VisaScreen Certificate is issued directly to the applicant who successfully completed all of the requirements of the program. The applicant then presents it to a consular office or attorney general (when applicable) as part of a visa application.

I am from a foreign country, but graduated from a college in the United States. Do I still need to apply for the VisaScreen program?
Yes. Although your professional education was completed in the United States, the purpose of the VisaScreen program is to provide a screening program which meets all federal requirements for international healthcare professionals seeking an occupational visa in the United States, irrespective of where the professional education was completed.

What are the passing scores for the TOEFL, TWE and TSE, as well as the MELAB exams?
For registered nurses (RNs): 540 paper-based TOEFL or 207 computer-based TOEFL; 4.0 TWE; 50 TSE; 79 overall MELAB; 3+ oral MELAB. For licensed practical nurses (LPNs) and Licensed Vocational Nurses (LVNs): 530 paper-based TOEFL or 197 computer-based TOEFL; 4.0 TWE; 50 TSE; 77 overall MELAB; 3+ oral MELAB. For physical and occupational therapists: 560 paper-based TOEFL or 220 computer-based TOEFL; 4.5 TWE; 50 TSE.

What healthcare professions does ICHP certify?
Under the current Immigration and Naturalization Service (INS) interim regulations, ICHP can certify registered nurses, licensed practical nurses, occupational therapists, physical therapists, speech language pathologists and audiologists, medical technologists, medical technicians and physicians' assistants.

I am a foreign-educated healthcare worker (not in one of the professions mentioned) who is subject to the provisions of Section 343. I have all the necessary paperwork to immigrate to the United States. Why can't CGFNS issue me the necessary certification?
INS has chosen to limit the number of occupations for which certificates can be issued. INS anticipates that additional occupations, and perhaps additional organizations, would be added when a final rule is promulgated. CGFNS has consistently expressed its disagreement with this approach to INS, noting that it has statutory authority to certify all healthcare professions other than physicians. INS continues to disagree.

Do I need a VisaScreen Certificate if I am a Canadian entering the United States on a "TN" visa?
No. Certifications are not required for healthcare workers entering the United States on a temporary or "non-immigrant" visa, including the TN (Trade NAFTA) category. However, if you decide to adjust your visa status and seek permanent residency, you will be required to go through a federally-approved visa screening program, such as the VisaScreen.

I am a foreign-educated healthcare professional who is seeking to obtain my permanent residence status based on my relationship (e.g., spouse or minor) to a U.S. citizen. Do I need to obtain a VisaScreen Certificate?
No. Foreign-educated healthcare professionals who seek permanent residence status based on their relationship to an American citizen are not subject to Section 343 and do not need to obtain a VisaScreen Certificate.

I am a foreign-educated healthcare professional in a non-clinical occupation (such as medical teachers or researchers, administrators of healthcare facilities, medical consultants, etc.). Do I need to obtain certification under Section 343?
No. Healthcare professionals coming to the United States to perform services in non-clinical healthcare occupations that do not provide patient care are not required to obtain certification under Section 343. However, healthcare professionals who are indirectly involved in the performance of patient care (such as supervisory nurses, etc.) must obtain certification under Section 343, such as the VisaScreen Certificate.

I am a nurse who holds a CGFNS Certificate. Do I still need to apply for the VisaScreen Certificate?
Yes. The VisaScreen Certificate is required for all healthcare professionals (except physicians) who are seeking an immigrant visa or a change in status to permanent residency. One of the requirements of the VisaScreen program is that nurses must have passed either the CGFNS Qualifying Exam or the NCLEX-RNŽ examination. Since you already have the CGFNS Certificate, you will not have to take another nursing exam to obtain your visa, and your transcripts on file may be used for the educational evaluation element of the VisaScreen program.

See the Nursing Kit