Nursing Prerequisites for International Students: Your US Nursing Path

English Proficiency Requirements

TOEFL, IELTS, or Duolingo English Test

International students must typically submit English proficiency exam scores unless they completed their entire degree at an English-speaking institution.

TOEFL (Internet-Based Test) Requirements

Most nursing programs require TOEFL scores:

• Minimum overall score: 79-100 depending on program
• Penn Nursing: 100 overall (Reading 26, Listening 26, Speaking 25, Writing 25)
• Duke University: 100 overall (Reading 22, Listening 22, Speaking 26, Writing 24)
• Score validity: Must be current (typically no more than 2 years old)

IELTS Requirements

IELTS is an alternative to TOEFL:

• Minimum overall band: 6.0-7.0 depending on program
• Duke and University of Pittsburgh: 7.0 overall with 7.0 in speaking and 6.0+ in other sections
• Score validity: Must be current (typically no more than 2 years old)

Duolingo English Test (DET)

Some programs accept Duolingo as an alternative:

• Minimum score: 120-130 depending on program
• Advantage: Faster results and lower cost than TOEFL/IELTS

English Proficiency Exemptions

You may be exempt from English proficiency exams if:

• You completed your entire degree at an institution where English was the principal language of instruction
• Your country is on the institution's recognized English-speaking countries list
• You obtain institutional attestation of English proficiency

Foreign Credential Evaluation

Why Credential Evaluation is Required

International applicants must have foreign transcripts evaluated by accredited third-party evaluation services. This verifies that your education meets US standards and converts your GPA to the 4.0 scale.

Credential Evaluation Services

Use recognized evaluation services:

• World Education Service (WES) - Most widely recognized
• NACES members - Accredited evaluation services
• Institutional evaluation - Some programs offer their own evaluation

Evaluation Requirements

Credential evaluations must include:

• Course-by-course evaluation - Detailed breakdown of all courses
• GPA conversion - Conversion to 4.0 scale
• English translation - Certified English translation if documents are in another language
• Official documentation - Direct submission from your institution

Timeline and Cost

Plan for credential evaluation:

• Processing time: 2-4 weeks for standard service
• Cost: $100-$300 per evaluation
• Recommendation: Start evaluation process 6+ months before application deadline

Nursing Licensure and CGFNS Certification

What is CGFNS?

The Commission on Graduates of Foreign Nursing Schools (CGFNS) provides certification and credential evaluation for internationally educated nurses. CGFNS certification is required before taking NCLEX-RN in most states.

CGFNS Certification Process

The CGFNS process includes:

• CGFNS International Qualifying Exam (IQE) - Comprehensive nursing exam
• Credential evaluation - Review of your nursing education
• English proficiency verification - TOEFL/IELTS scores
• Certificate issuance - Upon successful completion

Timeline for CGFNS

Plan for CGFNS certification:

• Application processing: 4-6 weeks
• Exam preparation: 8-12 weeks of study
• Exam scheduling: 2-4 weeks
• Results: 4-6 weeks after exam
• Total timeline: 4-6 months from application to certification

Cost of CGFNS

Budget for CGFNS expenses:

• Application fee: $200-$300
• Exam fee: $400-$500
• Credential evaluation: $100-$300
• Total cost: $700-$1,100

Visa Requirements for International Nursing Students

F-1 Student Visa

Most international nursing students use the F-1 student visa:

• Form I-20: Required documentation from your nursing program
• Financial documentation: Proof of ability to pay tuition and living expenses
• Visa interview: At US embassy or consulate in your country
• Processing time: 4-8 weeks for visa approval

J-1 Exchange Visitor Visa

Some programs use J-1 visas for exchange students:

• Form DS-2019: Required documentation
• Sponsoring organization: Program-specific exchange sponsor
• Similar requirements: Financial documentation and visa interview

Financial Documentation

You must demonstrate ability to pay:

• Tuition costs: Full program tuition
• Living expenses: Typically $15,000-$25,000 per year
• Bank statements: Proof of funds
• Sponsor documentation: If someone else is funding your education

Prerequisite Requirements for International Students

US Prerequisite Coursework Required

International students must complete all prerequisite courses at accredited US institutions; foreign prerequisite credits are not accepted.

Core Prerequisite Courses

Required prerequisites include:

• Anatomy & Physiology I & II - With lab components
• Microbiology - With lab
• Chemistry - General or introductory level
• English Composition - Demonstrates English proficiency
• Psychology - General or developmental
• Statistics - College-level mathematics

GPA Requirements

International students must meet same GPA requirements as domestic students:

• Minimum cumulative GPA: 3.0
• Minimum prerequisite GPA: 3.0-3.5
• Competitive GPA: 3.5+ for selective programs

Universities Accepting International Nursing Students

Major universities actively admit international nursing students, including:

• Rutgers School of Nursing
• University of Pittsburgh School of Nursing
• Texas A&M College of Nursing
• Duke University School of Nursing
• University of Maryland School of Nursing
• CU Anschutz School of Nursing
• George Washington University School of Nursing
• University of Pennsylvania School of Nursing

Timeline for International Students

Strategies for International Students

1. Start Credential Evaluation Early

Begin credential evaluation 6+ months before application deadlines to allow processing time.

2. Prepare for English Proficiency Exams

Budget time and money for TOEFL/IELTS preparation:

• Allow 8-12 weeks for exam preparation
• Take practice exams to identify weak areas
• Aim for scores above minimum requirements

3. Complete US Prerequisites

If your foreign degree didn't include recent science courses, complete prerequisites at accredited US institutions:

• Online options allow flexible completion
• Community colleges offer affordable options
• Plan 6-9 months for prerequisite completion

4. Prepare for Visa Application

Gather required documentation early:

• Official transcripts and credential evaluation
• Financial documentation and bank statements
• Passport and travel documents
• Medical examination (required for visa)

5. Plan for CGFNS Certification

Budget time and money for CGFNS:

• Plan 4-6 months for certification process
• Budget $700-$1,100 for all fees
• Begin CGFNS application during final year of nursing program

Challenges International Students Face

Prerequisite Completion

Foreign prerequisite credits don't transfer, requiring US coursework completion before or during nursing program.

Credential Evaluation Delays

Credential evaluation takes time and money, requiring early planning.

Visa Processing Complexity

Visa application requires coordination with your nursing program and US embassy.

CGFNS Certification

CGFNS certification adds 4-6 months and $700-$1,100 in costs after graduation.

Licensing Variations

State nursing board requirements vary, requiring research of your target state's specific requirements.

Moving Forward as an International Student

Pursuing nursing in the US as an international student requires careful planning and preparation. By starting credential evaluation early, preparing for English proficiency exams, completing US prerequisites, and budgeting for visa and CGFNS costs, you can successfully navigate the pathway to US nursing licensure.

Major universities actively welcome international nursing students. Your international background brings valuable perspective to nursing practice and education.

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