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The CGFNS Exam and the NCLEX

CGFNS is a not-for-profit organization dedicated to guaranteeing that foreign-educated healthcare professionals, including nurses, are both qualified and eligible to meet U.S. licensure and practice requirements. CGFNS offers three services, one of which is required by United States INS (the Immigration and Naturalization Service) to obtain an occupational visa. One or both of the other two services are frequently required by the majority of U.S. state boards of nursing for practice as a nurse within those individual states. The first program is the CGFNS Certification Program (CP), the second is the CGFNS Credentials Evaluation Service (CES), and the third is the VisaScreen.

CGFNS Certification Program (CP)

The CGFNS Certification Program is a three-step program intended for foreign nurses that would like to work in the United States. It is designed for what the United States refers to as first-level nurses, also known as a registered or professional nurse in several countries. In order to be considered as a first level nurse you must have acquired academic knowledge at a post-secondary level and have clinical practice in several nursing areas.

Certification Program Process

The certification program has three parts. The first stage is a review of your nursing education, registration, and licensure. You must be a licensed and practicing nurse in order to qualify. The second stage is the CGFNS qualifying exam that is offered three times per year at over 469 testing sites available in several countries. The third stage of the program is an English language proficiency exam such as the TOEFL or the academic version of the IELTS (International English Language Testing System). The English proficiency exam can be taken at another qualified testing facility or at the CGFNS testing facility.

Test Areas Covered in the CGFNS Qualifying Exam

Before taking the exam, you must prove that you have both classroom and clinical experience in areas including adult medical and surgical nursing, obstetrics, pediatrics, and mental health nursing. You can expect that there will be test questions relating to each of those areas, as well as general nursing and calculations, on the exam.

Test Taking

There is a paper-based exam, but the internet-based exam is being used more frequently at testing centers. It takes approximately three hours to complete, and is comprised of multiple-choice, and alternate-item type questions. If you fail the exam the first time, you are eligible to take it again after paying another testing fee.

CGFNS Credentials Evaluation Service (CES)

The CGFNS Credentials Evaluation Service (CES) is a report prepared by CGFNS that may be required by a state board of nursing, university, immigration office, or employer. The report includes an analysis of an individual's non-US licensure and education, and compares it with current US standards and requirements for nurses.

The Process (Credentials Evaluation Service)

The CES program does not include an exam. It is a review of your current documentation. It requires submission of official documents such as your credentials, school records, and licenses along with the CGFNS fee for their services. Once CGFNS has reviewed your documentation they will submit a report to your state board of nursing who will determine if you are eligible to take the state board exams (also known as the NCLEX).


A VisaScreen certificate is necessary for nursing professionals wishing to live and work in the United States, and meets part of the requirement for a green card. The International Commission on Healthcare Professions (ICHP), a division of CGFNS, offers this service. The certificate they present upon successful completion must be received by the INS (the Immigration and Naturalization Service) if you are applying for an occupational visa.

Process and requirements

The VisaScreen is similar to the CES mentioned above, but with additional requirements to meet the needs of the INS. It includes a full review of your nursing education and any nursing licenses or credentials that you hold or have held. It also requires a passing score on the CGFNS certification program (mentioned above) or on the NCLEX. In addition, it requires proof of English proficiency that can be obtained through a passing score on an exam such as the TOEFL (Test of English as a Foreign Language).

Preparing for the NCLEX

The NCLEX examination, also known as the state boards, is an examination that is required to obtain your nursing license in the United States. In order to take the NCLEX, which is available at testing facilities within the United States, most state licensing boards will require foreign nurses to have gone through the credential evaluation process or the certification program provided by CGFNS. It is important to consider your individual needs and to contact the licensing board for the state you intend to work in to determine which CGFNS services you will require.

The CGFNS Qualifying Exam is intended to emulate the NCLEX and thus help you prepare to pass that exam. It is important to note any weak areas that may show up in the results of your CGFNS Qualifying Exam so that you can study those areas in order to be better prepared to pass the NCLEX the first time you take it.