Specialist Language Courses

How to WORK in the USA as a nurse

USA Nurse

Are you a nurse who’d love to live and work in the United States of America?

Whether you want California sunshine or the busy streets of New York, here’s your guide to getting a job in the USA.

Requirements for nursing in the USA

Firstly, you must apply for a Registered Nurse Immigrant Visa, otherwise known as a ‘Green Card’, or H-1B visa. Find out how to apply here.

You also need a US-based employer that will vouch for you.

You can have your credentials validated by a non-profit organisation called CGFNS.

CGFNS (Commission on Graduates of Foreign Nursing Schools) helps foreign healthcare professionals live and work in countries like the USA.

It provides the Credentials Evaluation Service (CES), a requirement in some states for foreign nurses.

You may then need to pass a licensure exam, known as the NCLEX, depending on the state in which you plan to work.

American Green Card

English language exams needed

Eighteen states in the USA require an English Language Proficiency Report (you can see the list here).

You can add the report on to your CES if you want to work in those states.

The report requires you to either have the TOEFL iBT, or IELTS Academic.

You must have passed the test less than two years before you apply.

IELTS score requirement

The CGFNS website states that it requires a ‘passing score’ in TOEFL or IELTS to confirm your English language proficiency.

This is generally assumed to be Band 7.

In addition, your test agency or centre must send the report directly to CGFNS.

You won’t be able to send it yourself. 

IELTS Score
US English Language Proficiency - State by state

 

IELTS 

TOEFL IBT 

OET 

TOEIC 

TOEFL Computer 

MET 

Pearson  

Cambridge 

Alabama 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

Alaska 

Overall 6.5 with 6.0 on all papers 

Overall 84 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

Arizona 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 84 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

Arkansas 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

x 

Overall 725 

Overall 220 

x 

x 

x 

California 

x 

Minimum 22 on all modules. Minimum 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

Colorado 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 81 Minimum 24 on Speaking Module 

Overall 300 

Listening and Reading: 725, Speaking/Writing: 160/150 

x 

Overall 55 

Overall 55, with no sub-scores lower than 50 

Overall 185 Minimum Speaking 185 

Connecticut 

x 

x 

x 

x 

Overall 213 

x 

x 

x 

DC (District Columbia) 

Overall 6.5 with 7.0 on Speaking Paper 

81 with minimum of 57 on Reading, Listening, and Writing and 24 on Speaking 

x 

Overall 725 

x 

Overall 55; Speaking 55 

x 

176 overall and 185 Speaking 

Delaware 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

Reading, Writing, and Listening: 300; Speaking: 350 

Listening and Reading: 725; Speaking/Writing: 160/150 

x 

Overall: 55; Speaking: 55 

Overall: 55; Reading, Listening, and Writing: 50; Speaking: 63 

Overall: 175; Speaking: 185 

Florida 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 76 

Overall 300 

x 

Overall 207 

Overall: 55; Speaking: 55 

x 

x 

Georgia 

x 

Overall 83 with 26 on Speaking Module 

x 

Overall 725 

Overall 220 

x 

x 

x 

Hawaii 

Accepted 

Accepted 

Accepted 

Accepted 

Accepted 

Accepted 

Accepted 

Accepted 

Idaho 

Accepted 

Accepted 

Accepted 

Accepted 

Accepted 

Accepted 

Accepted 

Accepted 

Illinois 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

x 

x 

x 

Overall: 55; Speaking: 55 

x 

x 

Indiana 

Contact Nursing Board 

Contact Nursing Board 

x 

x 

x 

x 

x 

x 

Iowa 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

Kansas 

Overall 6.5, Speaking 6.5 

Reading 19, Writing 20, Listening 20, Speaking 20 

x 

x 

x 

x 

x 

x 

Kentucky 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

x 

x 

x 

Overall: 55; Speaking: 55 

x 

Overall 185 Minimum Speaking 185 

Louisiana 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

x 

x 

x 

 

x 

x 

Overall 185 Minimum Speaking 185 

Maine 

x 

Overall 83 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

Maryland 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

Massachusetts 

Overall 6.5 with 6.0 on all papers 

Overall 83 

x 

x 

Overall 220 

Overall 55 

Overall 55 

x 

Michigan 

Overall 6.5  

Overall 80 

Overall 300 

x 

x 

Overall 55 

x 

x 

Minnesota 

x 

Overall 84 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

Mississippi 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

Missouri 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

x 

Overall 725 

x 

x 

x 

x 

Montana 

Overall 6.5 

Overall 80 

x 

x 

x 

x 

x 

x 

Nebraska 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 84 with 26 on Speaking Module 

x 

Overall 725 

Overall 220 

x 

x 

x 

Nevada 

x 

Overall 84 with 26 on Speaking Module 

x 

x 

x 

x 

Overall 55 

x 

New Hampshire 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

Reading, Writing, and Listening: 300; Speaking: 350 

x 

x 

x 

x 

x 

New Jersey 

Overall 6.5 with 6.0 on all papers 

Overall 83 with 26 on Speaking Module 

Reading, Writing, and Listening: 300; Speaking: 350 

x 

x 

x 

x 

x 

New Mexico 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 84 with 26 on Speaking Module 

x 

Overall 725 

x 

x 

Overall 59 

x 

New York 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 76 

x 

x 

x 

x 

x 

x 

North Carolina 

Overall 6.5 with 6.0 on all papers 

x 

x 

x 

x 

x 

x 

x 

North Dakota 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

Ohio 

x 

Overall 83 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

Oklahoma 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 84 with 26 on Speaking Module 

x 

Overall 725 

Overall 220 

x 

x 

x 

Oregon 

Overall 6.5 with 7.0 on Speaking Paper 

x 

Reading, Writing, and Listening: 300; Speaking: 350 

x 

x 

x 

x 

x 

Pennsylvania 

Overall 6.5 with 6.0 on all modules 

Overall 84 with 26 on Speaking Module 

x 

x 

x 

Overall: 55; Speaking: 55 

Overall: 55; Speaking: 55 

x 

Rhode Island 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

South Carolina 

Overall 6.5 

Overall 84 with 26 on Speaking Module 

x 

x 

x 

Overall 55;Minimum 55 in all modules 

x 

x 

South Dakota 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

Reading, Writing, and Listening: 300; Speaking: 350 

Listening and Reading: 725; Speaking/Writing: 160/150 

x 

Overall: 55; Speaking: 55 

Overall: 55; Reading, Listening, and Writing: 50; Speaking: 63 

Overall: 175; Speaking Score: 185 

Tennessee 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

Reading, Writing, and Listening: 300; Speaking: 350 

x 

x 

Overall: 55; Speaking: 55 

x 

xx 

Texas 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 84 with 26 on Speaking Module 

x 

Listening and Reading: Minimum score of 725 

Speaking/Writing: Minimum scores of 160/150 

Overall 220 

x 

x 

x 

Utah 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 84 with 26 on Speaking Module 

Reading, Writing, and Listening: 300; Speaking: 350 

Listening and Reading 725; Speaking/Writing 160/150 

x 

Overall 55; Speaking 55 

Overall 55; Reading, Listening, and Writing 50; Speaking 63 

Overall 175; Speaking 185 

Vermont 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 83 with 26 on Speaking Module 

Reading, Writing, and Listening: 300; Speaking: 350 

x 

x 

x 

x 

x 

Virginia 

x 

Overall 84 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

West Virginia 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 84 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

Wisconsin 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 84 with 26 on Speaking Module 

x 

x 

x 

x 

x 

x 

Wyoming 

Overall 6.5 with 7.0 on Speaking Paper 

Overall 84 with 26 on Speaking Module 

x 

x 

x 

Overall 55; Speaking 55 

55 overall with no sub scores lower than 50  

x 

  1. Information correct as of July 2024 
  2. Information taken from https://www.cgfns.org/ and individual State Nursing Board Websites 
  3. Test generally valid with 2 year period 
  4. OET Test is accepted on other routes in 39 states https://oet.com/test/who-recognises-oet 

     

Download this table here:

How to prepare for the IELTS exam

Want to pass the IELTS exam at your first attempt? We can help!

We are IELTS preparation specialists. Our uniquely effective course design and delivery offers an unparalleled range of Medical- and exam-focused courses and tests.

Our courses will help you to achieve a high score in the IELTS Academic English test.

IELTS Preparation Courses
OET now accepted in the USA

The US Health Service has recently added the OET to its list of recognised English tests for immigration.

You’ll need to pass the Occupational English Test with a Grade C+ or higher in Reading, Writing, and Listening.

For Speaking, you’ll need to get a Grade B or higher.

If you can do that, you’ll be eligible to apply for a visa to the US.

oet scores

Want to pass the OET exam? We want to help!

SLC is the OET-accredited Premium Preparation Provider in Europe and is the leading provider of OET preparation services to the UK National Health Service.

SLC offers a wide range of OET Nursing preparation services, including self-study, tutoring, practice tests, and writing correction.

OET Preparation Courses
Want to contact us?

We are happy to help you with your IELTS or OET preparation to achieve your American dream and move to the United States.

If you have any questions or don’t know which course is best for you, we are here for you.

You can contact us by filling this form or giving us a call on +44 1273 900213

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