The CGFNS Certification Program is designed specifically for first-level, general nurses educated and licensed outside the United States who wish to assess their chances of passing the U.S. registered nurse licensing exam, the NCLEX-RNŽ examination, and attaining licensure to practice as registered nurses within the United States. 

The program is comprised of three parts: a credentials review of the nurse's education, registration and licensure; the CGFNS Qualifying Exam, a one-day qualifying exam testing nursing knowledge; and an English language proficiency exam. Upon successful completion of all three elements of the program, the applicant is awarded a CGFNS Certificate. 

During the late 1960s, the United States experienced a marked increase in the number of foreign-educated nurses immigrating to the U.S. to practice nursing. U.S. immigration officials had a difficult time identifying which nurses educated abroad, who were applying for occupational visas, met the requirements for licensure as registered nurses in the United States. The reality was that, on average, only 15-20% of foreign-educated nurses were passing the U.S. registered nurse licensure exam, now the NCLEX-RNŽ examination.*The CGFNS Certification Program was created to serve as a predictor exam and evaluation process for foreign-educated nurses to more accurately forecast which nurses were likely to meet the requirements for licensure as registered nurses in the United States.

Why CGFNS?

Many graduate degree programs in nursing require applicants to be licensed as registered nurses. A few programs may waive this requirement for foreign nursing school graduates licensed in their home country, but generally these nurses will be required to obtain certification from the Commission on Graduates of Foreign Nursing Schools (CGFNS). They will also often be asked to achieve US licensure before they can take part in the clinical practicum that is generally included in their curriculum. 

CGFNS certification is also essential for foreign nurse graduates who want to work in the United States. Foreign nurse graduates who hold the CGFNS certificates are eligible to apply for a nonimmigrant or H-1 visa and a labor certificate (or work permit). This work permit is a requirement to obtain immigrant occupational preference visa status. 

The CGFNS certificate is also required by the majority of state boards of nursing before the foreign nurse graduate can take the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and gain US licensure. The first part of the CGFNS certification process involves a review of the applicant's educational credentials and home country licensure status. If the foreign nurse graduate is judged to have an educational background comparable to that of a US nursing school graduate and possesses current and valid licensure nursing licensure in his or her native country, the applicant becomes eligible to take the CGFNS Qualification Examination. 

The CGFNS test is a one-day examination that assesses an applicant's basic level of knowledge in nursing and English. The purpose of this screening exam is to identify and predict which foreign nurse graduates have reasonable assurance of passing the NCLEX-RN in the United States. The English portion of the CGFNS exam is one hour long and tests an applicant's level of listening comprehension and correct usage of English vocabulary and sentence structure. Eight to ten weeks after the exam, CGFNS notifies all applicants whether they have passed or failed. If they have passed, they receive CGFNS certificates. If they have failed, they can reapply to take the exam as many times as necessary. 

CGFNS certificate holders who decide to pursue a nursing career in the United States need to apply to take the NCLEX-RN exam by writing directly to the nursing board in the state where they intend to practice. Eighty percent of the states require applicants to have the CGFNS certificate before they can sit for the licensure exam. Fifty percent of state boards will waive their own review of credentials for foreign nurse graduates who hold CGFNS certificates. 

CGFNS sends everyone who passes a list of state nursing boards. Applicants may, however, wish to spare themselves delays in the licensure process by doing their own research and writing state boards while they wait for their results on the CGFNS exam. The NCLEX-RN licensure examination is used by every US state. It is a six-hour examination administered over a two-day period that tests nursing knowledge through multiple-choice questions depicting clinical situations that an entry-level nurse might face. 
Other requirements for licensure may differ from state to state. Each state board can provide information on its own requirements.

Eligibility

The CGFNS Certification Program is designed ONLY for first-level, general nurses educated and/or licensed outside the United States who wish to assess their chances of passing the NCLEX-RNŽ examination and attaining licensure to practice as registered nurses within the United States.
In order to be eligible for the program, a nurse must be educated and hold both initial and current registration/licensure as a first-level, general nurse as defined historically by the International Council of Nurses (ICN).

A first-level nurse is called a registered or professional nurse in most countries. A second-level nurse, often called an enrolled, vocational, practical nurse or nurse assistant, is not eligible to be licensed as a registered nurse in the U.S., and therefore, is not eligible for the Certification Program.

A general nurse must have obtained theoretical instruction and clinical practice in a variety of nursing areas. A nurse who specialized in one area without being educated and registered/licensed as a general nurse is not eligible for the Certification Program.

Elements of the Program
The Certification Program is 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, the applicant is awarded a CGFNS Certificate. 

Credentials Review
CGFNS evaluates an applicant's education and registration credentials to certify that the applicant is a first-level, general nurse and meets all of the registration requirements to be licensed as a professional in that field.
Applicants must have completed a senior secondary school education separate from their nursing education; graduated from a government-approved nursing program of at least two years in length; and received theoretical instruction and clinical practice in nursing care of the adult (including medical and surgical nursing), maternal/infant nursing care, nursing care of children and psychiatric/mental health nursing. Note: All transcripts must come directly from source agencies.
Applicants must have a full and unrestricted license/registration to practice as a first-level, general nurse in the country where they completed their general nursing education; and hold a current license/registration as a first-level, general nurse. Note: All validations must come directly from the source agencies.

CGFNS Qualifying Exam
The CGFNS Qualifying Exam of nursing knowledge is offered three times a year at more than 40 locations spanning the globe. To date, more than 300,000 exams have been administered to over 175,00 applicants. The exam is divided into two parts with a total of 260 questions. Applicants are given two hours and 30 minutes for Part 1, which includes 150 questions. After breaking for lunch, applicants are given one hour and 50 minutes to complete Part 2, consisting of 110 questions.
The Qualifying Exam measures an applicant's nursing knowledge and is based on what nurses must know and do when they practice nursing in the United States. The foundations of the Qualifying Exam are based on client (patient) needs. The traditional clinical areas of nursing practice -- nursing care of the adult, nursing care of children, maternal/infant nursing, psychiatric/mental health nursing and community health nursing -- are covered. The exam ensures that an applicant has the same level of understanding of nursing with various client groups, in various settings, as recent graduates of U.S. schools of nursing.
Both the CGFNS Qualifying Exam and the NCLEX-RNŽ examination are based on the same framework of client needs because it provides a universal structure for defining nursing actions and competencies across all settings for all clients.


English Language Proficiency Exam
The Test of English as a Foreign Language (TOEFL) is currently used to meet the English language proficiency requirement of the Certification Program. TOEFL is administered worldwide by the Educational Testing Service (ETS). The exam measures listening, comprehension, structure and written expression and reading comprehension.
Applicants must successfully complete TOEFL and the Qualifying Exam within a two-year period in order for test scores to be considered valid. TOEFL may be taken prior to or following the CGFNS Qualifying Exam.
Applicants must apply directly to ETS in order to take the TOEFL exam. 

Certain applicants may be exempt from the English language proficiency requirement if they meet all of the following criteria:
1) Native language is English;
2) Country of nursing education was Australia, Canada (except Quebec), Ireland, New Zealand or the United Kingdom;
3) Language of instruction was English; and
4) Language of textbooks was English.

Program Outcomes
First, the Certification Program identifies nurses with a high potential for achieving licensure in the United States. Since the introduction of the Certification Program, first time RN licensure pass scores of foreign-educated nurses holding a CGFNS Certificate have shown a marked improvement (up from 15-20% prior to the Certification Program in the 1970s to 88-92% today).** 

Second, the opportunity to take the CGFNS Qualifying Exam and TOEFL at a number of locations throughout the world enables applicants to save both time and money by providing them with the opportunity to earn a CGFNS Certificate in their home country before traveling to the United States to take the NCLEX-RNŽ examination. 

Program Benefits
Anyone with an interest in selecting candidates who have a high probability of success on the NCLEX-RNŽ examination will find the program highly beneficial. Nurse applicants, U.S. Boards of Registered Nurses, the U.S. Department of Labor, the U.S. Immigration and Naturalization Service, universities and employers all make use of the CGFNS Certification Program.
Attaining a CGFNS Certificate helps applicants in three ways. 

First, the certificate will help applicants meet state requirements for the registered nurse licensure exam. Most states require a CGFNS Certificate from nurse educated abroad before they can take the NCLEX-RNŽ examination.

Second, CGFNS Certificate holders consistently have a higher rate of success on the NCLEX-RNŽ examination than internationally-educated nurses who do not hold a CGFNS Certificate. Passing the CGFNS Qualifying Exam can help applicants to feel reasonably assured of success on the NCLEX-RNŽ examination.

Finally, the CGFNS Certificate helps applicants to qualify for an occupational visa. CGFNS was named in section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA) of 1996 as an organization qualified to administer a screening program for healthcare professionals who are seeking an occupational visa. The International Commission on Healthcare Professions (ICHP), a division of CGFNS, developed VisaScreenTM: Visa Credentials Assessment to meet the requirements of section 343. For foreign-educated nurses who do not hold a U.S. license by examination, passing a predictor exam, such as the CGFNS Qualifying Exam, is a requirement of section 343.

History of CGFNS: 

The story behind the Commission on Graduates of Foreign Nursing Schools (CGFNS) begins in the late 1960s when the United States experienced an increase in nurse migration from other countries. Immigration officials had a difficult time identifying which of the nurses educated abroad, and applying for nursing occupational visas, would be eligible for licensure as a registered nurse in the United States. On average, only 15 to 20% of nurses educated outside the United States were passing the U.S. registered nurse licensure exam on their first attempt. 
This led the Division of Nursing of the then Department of Health, Education and Welfare (DHEW) to contract for two studies regarding RN-licensure of foreign educated nurses in the United States. The findings of these landmark studies on foreign nurse immigration conducted by the American Nurses Association and Pace University were discussed at a 1975 HEW conference attended by representatives of the American Nurses Association (ANA), the National League for Nursing (NLN), U.S. boards of nursing, the American Hospital Association (AHA), the American Medical Association (AMA), the U.S. Department of Labor, the U.S. Immigration and Naturalization Service, and the New York State Education Department, among other organizations. The outgrowth of the conference was the establishment of a private, independent, non-profit organization. The organization created was CGFNS. 

Mission of CGFNS:

CGFNS was established to protect the public health by insuring that nurses educated in other countries who wish to practice nursing in the U.S. are eligible and qualified to meet licensure and others practice requirements. The CGFNS mission is to provide leadership in [healthcare education], registration and licensure to the global nursing and professional healthcare communities. CGFNS protects the public in relation to evolving healthcare policies and standards of professional practice for migrating healthcare professionals. CGFNS provides products and services that validate credentials and enhance international regulatory and educational standards for healthcare professionals.

Why do I need to be CGFNS Certified?
How to get application for CGFNS
Eligibility
Elements of the Program
Credentials Review
CGFNS Qualifying
  Exam
English Language
  Proficiency Exam
Program Outcomes
Program Benefits
History of CGFNS
Mission of CGFNS

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