CGFNS Credentials Evaluation: Your First Step to Nursing in the USA

What Is CGFNS International and Why It Matters

CGFNS International (originally the Commission on Graduates of Foreign Nursing Schools) is a US non-profit organisation that verifies the education, registration and licensure of internationally trained nurses. Most US state boards of nursing rely on CGFNS to independently confirm that a foreign nursing qualification is comparable to a US programme, because state boards themselves have no practical way to contact nursing schools and regulators overseas.

For most internationally trained nurses, CGFNS involvement is unavoidable — it is usually the very first formal step in the entire US nursing pathway, before you can even sit the NCLEX-RN. Getting this stage right early, with accurate documentation and the correct product for your target state, sets the pace for everything that follows.

The Credentials Evaluation Service (CES)

The Credentials Evaluation Service (CES) is CGFNS's core course-by-course evaluation of your nursing education. CGFNS contacts your nursing school directly to verify your transcripts, clinical hours, theory hours and graduation status, then compares your programme against US nursing education standards.

• Output: a detailed CES report showing your US education equivalency (e.g. equivalent to an Associate Degree in Nursing or Bachelor of Science in Nursing)
• Used by: most US state boards of nursing as part of your licensure application
• Timeline: typically 8–16 weeks once your nursing school responds to CGFNS's verification request
• Cost: indicative 2026 range of USD 350–500

The most common delay at this stage is a slow or unresponsive nursing school — start this step as early as possible, even before you've decided on a specific US state.

The CGFNS Certification Program

Some state boards require the full CGFNS Certification Program rather than CES alone, particularly for nurses trained in certain countries or programmes. This is a more comprehensive review that combines a credentials evaluation with additional verification steps, and in some cases has historically included a predictor examination of nursing knowledge, depending on current CGFNS offerings.

Because requirements differ significantly by state — and CGFNS periodically updates its programme structure — always check directly with your target state board of nursing which specific CGFNS product they require before you pay for an evaluation.

English Language Requirements

Alongside your education evaluation, CGFNS and state boards require proof of English proficiency. Commonly accepted tests include:

• IELTS Academic — typically an overall band of 6.5, with minimum component scores
• OET (Occupational English Test) — typically grade B across all four sub-tests, popular with nurses as it uses healthcare-specific scenarios
• TOEFL iBT — typically a total score around 83, with minimum section scores

Exemptions sometimes apply if you trained and were taught entirely in English in an approved country — confirm this with CGFNS and your target state board, as exemption rules vary and change periodically. It's worth sitting your English test as early as possible in your planning, since results typically remain valid for about two years and you don't want an expired score to hold up licensure once every other document is ready.

VisaScreen: The Immigration-Specific Certificate

Once you've passed the NCLEX-RN and hold an active state RN licence, you'll need a separate VisaScreen: Visa Credentials Assessment certificate before USCIS will approve any occupational visa petition, including the EB-3 immigrant visa. VisaScreen verifies:

• Your nursing education (drawing on your CES evaluation)
• Your licensure status, confirming no restrictions or disciplinary history
• Your NCLEX-RN result
• Your English language test scores

VisaScreen is legally required under the Immigration and Nursing Relief Act 1999 and is entirely separate from CES — completing CES does not automatically give you a VisaScreen certificate. Indicative 2026 timeline is 8–12 weeks, with fees typically around USD 500–600.

How State Boards Use CGFNS Reports

Each of the 50 US state boards of nursing sets its own rules for internationally trained applicants, and CGFNS reports are used differently depending on the state:

• Some boards accept a CES report as sufficient proof of education equivalency
• Others require the full Certification Program
• Some boards additionally require primary-source verification of your licence directly from your home regulator, alongside CGFNS documentation
• Nearly all now use the Nursys system to verify and track licensure across boards, useful if you plan to later work in multiple states via a multistate compact licence

Choosing a foreign-graduate-friendly state with clear, well-documented requirements — such as Texas, New York, California or Florida — can meaningfully shorten your overall timeline.

Timelines, Costs and Practical Tips

Adding CES, English testing and VisaScreen together, budget for roughly 4–8 months and USD 1,000–1,500 in CGFNS-related fees alone (indicative 2026, excluding NCLEX and state licensure fees). Practical tips to keep this on track:

• Request your official transcripts and clinical hour records from your nursing school well in advance — some schools take months to respond
• Create your CGFNS online account and start the CES application before you've finalised your target state, since verification can run in parallel
• Book your English test early — slots can be limited in some regions
• Keep certified copies of every document CGFNS requests, as re-submission delays are common

Common Pitfalls with CGFNS Applications

Avoidable errors at this stage can cost months. The most frequent include:

• Submitting an incomplete application, forcing CGFNS to place your file on hold pending missing documents
• Assuming a CES report alone satisfies a state that actually requires the full Certification Program
• Letting English test results expire — most are valid for around two years, so timing matters if your overall process runs long
• Not creating certified true copies where CGFNS specifically requires them, rather than plain photocopies
• Paying unlicensed agents or "facilitators" for CGFNS processing — always deal directly with CGFNS or a WHO-code-compliant agency such as Ava Medical

Ava Medical guides candidates through the CGFNS process step by step, helping you choose the right evaluation product, avoid documentation delays, and connect with vetted US employers — entirely free of charge, as required under the WHO ethical recruitment code.

Frequently asked questions