MedicsHire

Immigration Services

Permanent Residence for Nurses (RN)
Physical Therapist

Permanent Residence for Nurses (RN)

With certain limited exceptions detailed below, petitioning for a foreign-born registered nurse ("RN") to work in the United States involves sponsoring for permanent residence.

Permanent Residence For Nurses

If the RN resides abroad, the following steps must be completed before the nurse may be employed in the US:

The RN must be in possession of:
- A diploma from a nursing school in her country;
- An RN license in her country; and
- A full and unrestricted license to practice professional nursing in the state of intended employment, or a certification that she has passed the examination given by the Commission on Graduates of Foreign Nursing Schools (CGFNS)
The following states require that foreign nurses pass the CGFNS examination before taking the state RN licensing (NCLEX) examination: Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, District of Columbia, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hamsphire, New Jersey, North Carolina, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Vermont, Washington, West Virginia and Wyoming.
RNs together with physical therapists are listed as shortage, or "Schedule A", occupations in regulations (20 C.F.R. 656.22) issued by the Department of Labor. An employer who wishes to immigrate an RN is exempt from having to submit an application for alien labor certification to the Department of Labor or to the State Employment Security Agency.

The immigration process begins when the employer submits an immigrant visa petition (Form I-140) to the office of the Immigration and Naturalization Service (INS) having jurisdiction over the nurse's place of intended employment. The petition must be accompanied by Labor Department forms ETA-750A and B and by various documents including those listed above. The petition should be accompanied by a check for filing fees. Typically, the INS will approve the visa petition in two to three months.
If the RN is a native of one of the ten selected countries (including Canada, China and the Philippines), the IND first sends the approved visa petition to the National Visa Center (NVC) in Portsmouth, New Hamsphire. If there is no backlog for immigrant visas from the RN's native country (her "priority date" is "current"), the NVC forwards a packet to the nurse or her attorney containing biographical information forms to be completed by her and her family members, and a list of documents which must be presented at her interview for permanent residence.
The RN, or her attorney, sends the signed and completed forms to the US consulate where the nurse will have her interview for permanent residence. At this interview, the nurse must present various documents including the following:
- Application for Immigrant Visa
- Police Clearance
- Birth Certificate
- Marriage Certificate, if any
- Divorce or Death Certificate of Spouse, if any
- Valid Passport
- Medical Examination
- Photographs
- Recent job offer letter (or employment contract)
- Financial information regarding employer
- Government filing fee
- VisaScreen Certificate
The VisaScreen Certificate requirement was imposed by S343, a last-minute amendment to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA). It added "uncertified health-care workers" to the list of persons who are inadmissible to the US. See S212(a)(5)(C), INA.

A VisaScreen Certificate is issued only after the RN has demonstrated that (1) her education, license and training in her country are equivalent to education, licensure and training in the US and that (2) her level of competence in oral and written English are appropriate to practice professional nursing in the US.

For more than two years after the effective date of IIRIRA, te INS failed to issue regulations governing the VisaScreen requirement for RNs. As a result, between September 30, 1996 and December 14, 1998, the effective date of regulations, it was impossible for an RN to immigrate through her employment. However, both the INS and the State Department continue to waive the application of S343 for RNs who are employed in the US on temporary visas.

The INS regulations provide that the only organization authorized to issue VisaScreen certificates to RNs is the Commission on Graduates of Foreign Nursing Schools (CGFNS), the organization which is listed in S343. The CGFNS is located at 3600 Market Street, Philadelphia, PA, 19104-2651; telephone: (215) 349-8767; fax: (215) 349-0026; email: support@cgnfs.org

Caveat: It may be very difficult to contact the CGFNS. The CGFNS website ( www.cgfns.org) warns that
- Due to an unsually large volume of phone calls (up to 4000 calls per week), CGFNS phone lines are extremely busy. Your call is important to us. If you have been unsuccessful in contacting a CGFNS representative by phone, please call after 6:00 pm Eastern Time and leave a message, and we will respond as soon as we can.
- You may also fax or email CGFNS, however please be advised that it may take some time before we can respond as we are receiving a marked increase in faxes and emails as well.
- CGFNS is doing everything it can to try and alleviate the large number of calls, faxes and emails it is currently receiving. You can now download application packets for most CGFNS programs from the CGFNS website. Also, please check the website for the latest news on CGFNS exam dates and sites and other information.
- CGFNS thanks everyone for their patience. We know your questions and inquiries are important and are making every effort to respond as soon as possible.
The INS interim VisaScreen regulations (8 C.F.R . S212.15) provide that even if a foreign-born RN is educated, licensed and trained in the US, she still must obtain a VisaScreen certificate. Obtaining such a certificate requires a significant expenditure of time, effort and money (over $300) on the part of the nurse.

In addition, unless the nurse was educated in an English-speaking country (US, Australia, New Zealand, Ireland, United Kingdom or Canada - all provinces except Quebec), she must achieve a certain score on tests in written and spoken English administered by TOEFL (Test of English As A Foreign Language) or MELAB (Michigan English Language Assessment Battery) in order to qualify for a VisaScreen certificate.

Passing scores for RNs are as follows: TOEFL Paper-based 540; TOEFL Computer-Based 207; Test of Written English (TWE) 4.0; Test of Spoken English (TSE) 50.

For more information about taking the TOEFL, TWE and TSE exams contact:

TOEFL/TSE Publications
Test of English as a Foreign Language
PO Box 6151 Princeton, NJ 08541-6151
Telephone: 609/771-7100
http://www.toefl.org

Passing scores for the MELAB are as follows; Final Score 79+; Oral Interview 3+.

For more information on taking MELAB examination contact:

English Language Institute (ELI)
MELAB Testing
3020 North University Building University of Michigan
Ann Arbor, MI 48109-1057
Telephone: 734/763-3452 or 734/764-2416
Fax: 734/763-0369
E-mail: melabelium@umich.edu
http://www.lsa.umich.edu/eli/melab.htm

Unlike the TOEFL, TWE and TSE which are offered worldwide, the MELAB is only offered in the US and Canada.

Generally, the process of obtaining permanent residence may take between 12 to 24 months assuming that the immigrant visa quota from the RN's country of birth is not backlogged. Currently, none of the employment-based quotas are backlogged. However, it is probable that backlogs will develop in the near future for RNs born in India, mainland China, and possibly from the Philippines.

If the RN is in the United States, the nurse may be able to start working for the employer more expeditiously that if she reside abroad:
1. The RN is required to have the same documents as stated at the beginning of this article. However, since she is in the US, she may take the state licensing examination (officially known as the National Council Licensure Examination for Registered Nurses or "NCLEX-RN"). Generally, the NCLEX-RN may only be taken in the US, although it is also offered in Guam, Saipan, the Virgin Islands, Puerto Rico and American Samoa. NCLEX officials have indicated that starting in 2003, the NCLEX-RN will be offered abroad. The NCLEX-RN is administered by the National Council of State Boards of Nursing, Inc. For more information about taking the NCLEX-RN, see National Council's website at http://www.ncsbn.org. This website contains contact information for nurse licensing boards in each state.
2. The employer must submit an immigrant visa petition to the appropriate INS Service Center on behalf of the nurse.
3. The INS does not forward the approved visa petition to the NVC when an RN submits an application to adjust her status to permanent resident in the US.
4. Upon approval of her visa petition, assuming her priority date is current, the RN and her family members (spouse and unmarried children under 21 years of age) may apply for adjustment of status to permanent residence in the US. Simultaneously, they may apply for employment authorization cards, and possibly, travel authorization documents ("advance parole"). The number of documents which must be included with an application for adjustment of status is less than is required when one immigrates to the US from abroad. However, a nurse cannot qualify for permanent residence until she presents a VisaScreen certificate.

Physical Therapists

American Therapy Jobs in the USA
For Foreign Professionals

MedicsHire Group LLC welcomes applications from foreign professionals in Physical Therapy searching for American therapy jobs. There are three stages to complete in order to secure American therapy jobs as a physical therapist. Each includes working with agencies or groups-from FCCPT to FSBPT-to be eligible for our American therapy jobs.

Credentialing
Licensing
Immigration Approval

Credentialing is performed by a board approved agency to ensure that your education is equivalent to a U.S. awarded Physical Therapy degree. Every state has specific requirements for the number of hours in each subject and the breakdown of clinical requirements. Each state also has specific credentialing agencies they work with-such as the FCCPT or the International Credentialing Associates-including one or more of the following agencies.
- FCCT - Foreign Credentialing Commission on PT
  P. O. Box 25827
  Alexandria, VA 22314
  Phone: (703) 684-8562
- International Consultants of Delaware, Inc.
  109 Barksdale Professional Center
  Newark, DE 19711
  Phone: (302) 737-8715
- International Credentialing Associates, Inc.
  7245 Bryan Dairy Rd., Park #2
  Largo, FL 33777
  Phone: (727) 549-8555
- International Educational Research Foundation, Inc.
  P. O. Box 3665
  Culver City, CA 90231
  Phone: (310) 258-9451 Fax: (310) 342-7086
For licensing each state has specific requirements which can include English competency tests as well as specific hours from credentialing. You are also required to register with the FSBPT (http://www.fsbpt.org) to take the NPTE (National Physical Therapy Examination). Once the candidate's file is complete with the state including application, fees, English Tests (if required) and other state requirements, the state will contact the FSBPT to give the okay to take the test. The FSBPT then sends an "Authorization to Test" letter to the candidate. The candidate will then contact testing firm Prometric to schedule an exam date. Currently the FSBPT exam is only given in the U.S. and Guam.
Once the candidate has successfully passed the NPTE and has a license in hand the company can file for an H1B visa for the candidate. Physical Therapists are now required to present a visa screen with applications for H1B approval. Currently there are two sources for the Visa Screen for Physical Therapists: FCCPT (http://www.fccpt.org) and CGFNS (http://www.cgfns.org). The visa screen also compares your education to U.S. education and you are required to pass:
- TOEFL (Test of English as a Foreign Language)
- TSE (Test of Spoken English)
- TWE(Test of Written English)
- FSBPT (The Federation of State Boards of Physical Therapy)
  You are required to register with the FSBPT to take the NPTE (National Physical Therapy Examination)
  http://www.fsbpt.org
- VISA Screening Sources
  Physical Therapists are now required to present a visa screen with applications for H1B approval. Currently there are two sources for the Visa Screen for Physical Therapists:
  FCCPT http://www.fccpt.org and CGFNS http://www.cgfns.org
- English Language Testing Service
  For TOEFL, TSE and TWE testing
  http://www.ets.org
- USCIS
  U.S. Citizenship and Immigration Services
  http://uscis.gov

H-1B requirements for Foreign Physical Therapists to work in USA