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IML U.S. Requirements
Basic Requirements Contract Terms
Language Examination Options Once You Are Here
Licensure & NCLEX Information Benefits & Salaries
Visas Your Commitment to Us
Working in the U.S. Online Application Form

Basic Requirements
To work as a nurse in the United States, there are a few basic requirements. These include:


Graduation from a 4-year general nursing program at an accredited school of nursing. This program must be equivalent to a U.S. Bachelor of Nursing Degree.

A current nursing license in your home country


Two years of acute-care experience in specialties such as intensive care (either adult, pediatric or neo-natal), coronary care, medicine, surgery, emergency room, general theatres, recovery and obstetric nursing.


A passing grade on the qualifying exam of the Commission on Graduates of Foreign Nursing Schools (CGFNS),

Must qualify for U.S. Visa, e.g. no criminal record.


In addition, immigrant healthcare workers must demonstrate competence in oral and written English as shown by an appropriate score on one or more nationally recognized tests. These tests are commercially available, standardized   assessments of English language proficiency. Foreign-educated nurses applying to the VisaScreen™ program must satisfy these requirements by choosing one of the following options:

Language Examination Options

Take each of the three following tests administered by the Educational Testing Service (ETS):

Test of English as a Foreign Language (TOEFL) with a score of 540 or higher AND

Test of Spoken English (TSE) with a score of 50 or higher AND

Test of Written English (TWE) with a score of 4.0 or higher.
International English Language Testing Service (IELTS)

You must pass the exam with a score of 6.5 overall without the Spoken Band and a score of at least 7.0 on the Spoken Band.
Test of English in English Communication (TOEIC)
You must pass this exam with a score of 725 or higher and
You must pass the Test of Spoken English (TSE) with a score of 5.0 or higher.
When these requirements are met, we will help you move on to the visa process.

Licensure & NCLEX Information
To work as a Registered Nurse in the United States, you must be licensed in the state in which you plan to practice. Initial licensure in a state is awarded by receiving a passing grade on the National Council License Examination for Registered Nurses (NCLEX-RN�). Once you pass the NCLEX-RN and are licensed in a state, you may apply to other states through a process known as endorsement.

The NCLEX-RN is designed to make sure that each nurse has the knowledge to practice safely at a minimum of an entry-level registered nurse. Many nursing schools in other countries have examinations that are knowledge-based, testing you on the facts you have learned. The NCLEX-RN, however, is an application-based examination.

The NCLEX-RN examination, administered via Computerized Adaptive Testing (CAT), uses standard NCLEX-RN-examination, multiple-choice questions. With CAT, each candidate's test is unique: It is assembled interactively as the individual is tested. As the candidate answers each question, the computer calculates a competence estimate based on all earlier answers. CAT provides greater measurement efficiency, because it administers only those questions which will offer the best measurement of the candidate's competence. For more information on the NCLEX-RN visit the National Council of State Boards Web site at

IML will assist in your preparation for the NCLEX-RN. The review program will be administered through our review partners in your country. You should not take this review program lightly but complete all materials provided to ensure adequate practice.

When you are ready to take the NCLEX-RN, IML will fly you to Saipan, Hong Kong or the country closest to the nurse, where you will take the exam. IML will also pay for your accommodations. You should bring enough money to pay for food and other incidentals.

To work in the U.S., all citizens of foreign countries must obtain a visa issued by the United States Citizenship and Immigration Service (USCIS). While this can be a lengthy and complex process, IML will work hard to make it as simple as possible for you. Our immigration attorney will guide you through every stage of the process.

The Green Card
All nurses who come to America to work for an IML employer enter the U.S. with what is commonly called the "Green Card." Also known as an Immigrant Visa or EB-3 this allows you to work in the U.S. for as long as you like as a permanent resident of the United States. Because of the large number of people who apply for a "Green Card," the process can take about twelve to eighteen months to complete.

The "Green Card" is especially valuable for married applicants. IML employers sponsor the nurse for a "Green Card," but the nurse's spouse and any unmarried children under the age of 21 will also be automatically be entitled to apply for a "Green Card." All "Green Card" holders are legally entitled to work in the USA.

When you are ready to take the NCLEX-RN, IML will fly you to Saipan, Hong Kong or the country closest to the nurse, where you will take the exam. IML will also pay for your accommodations. You should bring enough money to pay for food and other incidentals.

1. The First Step
USCIS must approve an immigrant visa petition (Form I-140, Petition for Alien Worker) for the person wishing to immigrate to the United States. Pacific Rim Nurses' client healthcare facility acts as the sponsor (or petitioner) for the nurse (or beneficiary) who wants to live and work on a permanent basis in the United States.

Note: 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, in association with CGFNS), enables healthcare professionals to meet this requirement by verifying and evaluating their credentials. This assures compliance with the government's minimum eligibility standards

The time period to receive the VisaScreen™ certificate varies. Pacific Rim Nurses recommends that you complete an application at the same time as your I-140, Petition for Alien Worker, has been filed with USCIS. You'll need to present the certificate when you go for the final visa interview at the consulate, so having it in plenty of time before your interview will help relieve some of the stress you'll naturally be feeling at that point!
2. The Second Step
Once the I-140 has been submitted to USCIS, approval can take three to six months or longer. Pacific Rim Nurses will notify you when we receive both the receipt and approval notice from the USCIS.
3. The Third Step
Several weeks after the I-140 has been approved, you'll receive forms and instructions from the National Visa Center in New Hampshire. It is important that you respond immediately to this mailing. Pacific Rim Nurses will assist you with the completion of these final forms. Once the forms have been submitted to the consulate, you'll receive instructions for obtaining the medical exams and fingerprinting that are required for working in the U.S.

Please keep in mind that the waiting periods for all these steps can vary greatly from consulate to consulate.
4. The Fourth Step
The fourth and final step is the interview at the consulate. The American consulate in your country will contact you and ask you to come in for the interview. We will give you information on how this interview is usually conducted and will tell you what questions you can expect as well as what documents to take with you.
When you receive your visa, you will be ready to come to the United States and begin your new nursing career.

Working in the U.S.
Many internationally trained nurses will tell you there is no better way for Registered Nurses to improve their skills and professional experience than by working in a U.S. hospital. You will have the opportunity to work in a fast-paced, acute-care environment that will challenge you to expand your nursing practice.

Most U.S. hospitals schedule their nurses for either five eight-hour shifts per week (usually 7:00 a.m. to 3:00 p.m., 3:00 p.m. to 11:00 p.m., or 11:00 p.m. to 7:00 a.m.), or three twelve-hour shifts per week (usually 7:00 a.m. to 7:00 p.m., or 7:00 p.m. to 7:00 a.m.). U.S. hospitals also have their own policies with regard to day, evening and night shifts, as well as weekend and holiday assignments. Weekend and holiday assignments are generally shared by all nurses, but hospitals do hire for specific shifts: day, evening or night.

You can expect your first year of nursing in a U.S. hospital to be an extraordinary learning experience. The environment is fast paced, there are new skills to learn and the patient load can be substantial. The experience you gain during this year will help you grow in your nursing profession.

Contract Terms
Prior to your arrival in the US, you will have already signed your employment agreement with our client healthcare facility. The average contract term with IML client healthcare facilities is twenty-four months.

The twenty-four month contract is perfect for nurses who want the opportunity to settle into a community. It allows them to settle down and establish lasting friendships in their work and social environments and get a feel for how they would like to progress in their careers.

Once You Are Here
When you arrive in the United States, a IML representative will be there to meet you. We will have already made arrangements for your transition to your new hospital and community. Your IML representative can also assist you in setting up a bank account and making housing arrangements, if not already confirmed. We know that it can take some time for you to feel comfortable in your new surroundings. That's why you will be assigned a member of the Pacific Rim Nurses team to be your contact and resource for questions you might have.

Benefits & Salaries
Salaries are based on the prevailing wage for registered nurses, as set by the United States Department of Labor (DOL). Your benefit package includes medical benefits, life insurance paid time off and other incentives that will be discussed when you sign your Pacific Rim Nurses contract.

Your Commitment to Us
In return for the expenses we pay and the assistance we offer you in coming to the United States, we ask that you contract with us as an employee of IML for two years.
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