The Cost of Becoming a Nurse in the U.S. as an International Applicant

International nurses often perceive employment in the U.S. as a dream come true. Suddenly, you have a chance to earn ten times more than you could’ve in your home country, while also having numerous prospects for specialization. Even better, after a few years in the U.S. healthcare system, you’ll have a chance to apply for various positions across the globe.

While all of this sounds great, that doesn’t mean you won’t encounter any challenges. Adapting to a completely different way of working is tough, even for younger nurses. You’ll likely have to learn how to use new machines and software, and do so in a foreign language.

But perhaps the biggest issue is the initial payments. While hiring an international nursing agency is the cheapest way to go about things, it will still cost you money. Your expenses are even higher if you’re an international student.

To clear things up, we’ve decided to list all the costs of living and working in the U.S., mostly focusing on upfront payments you’ll have to make.

Credentialing Process

There are major differences in how countries educate their nurses. Some of the systems are completely opposite to what the local U.S. nurses are taught, which is why a lot of medical professionals never manage to adapt. To have a starting point, international talent must undergo a credentialing process.

The procedure usually goes through CGFNS (Commission on Graduates of Foreign Nursing Schools), but you might also do credentialing through a different governmental agency. If you undergo CGFNS credentialing, you’ll need to pay between $350 and $500. You’ll also have to verify your transcripts and licenses ($100-$300) and pay for translation services ($50-$200).

Keep in mind, there might be some variation between these prices. For example, translation services can be lower or higher than what we’ve mentioned, depending on where you live. Nevertheless, the credentialing step is vital as it establishes whether or not you’re eligible for the U.S. licensure and NCLEX-RN exam.

NCLEX-RN Exam and Preparation

Speaking of the NCLEX-RN (National Council Licensure Examination for Registered Nurses), this is one of the crucial prerequisites for international nurses. Without this document, you’re not even considered a nurse and won’t be able to work in the healthcare system.

However, once you’re done with it, you can seek employment in any state, hospital, or clinic. Here are the main expenses related to the NCLEX-RN:

• Basic Fee: To get tested, you’ll have to spend $200, a cost that applies to all candidates, whether they hail from the U.S. or some other country.
• Test Material: Even if you’re confident in your knowledge and have worked in the profession for many years, you have to take this exam seriously. Most international nurses spend a lot of money on books, practice exams, and courses to ensure they’ll pass the test. Depending on who’s helping you, nurses might have to spend from $300 to $1,000.
• International Scheduling: Things are even more expensive if you’re an international nurse. You’ll have to schedule testing at a Pearson VUE testing center, which will cost you an additional $150.
• Travel and Accommodation: Many countries don’t have Pearson VUE testing centers, so you’ll likely have to travel to another country. In other words, you’ll have to pay for a plane ticket, a hotel room, and food. These expenses quickly pile up and can cost you up to $2,000 or even $3,000.

This part of the process is usually the hardest for international nurses. The worst thing is that there’s no telling how you’ll perform during the test, so you might lose several thousand dollars with nothing to show for it. This is why preparation is so important.

State Licensure

One of the bigger issues when applying for work in the U.S. is that each state has its own laws. You have to apply to the local Board of Nursing for another licensure. So, to avoid additional costs, you have to make sure that this is a suitable destination and that you won’t change states in the next few years.

Here are a few expenses that await you:

• Application Fee: By paying an application fee, you’ll cover the application process. This will cost you from $100 to $350, depending on the state you wish to work in.
• Background Check: The local law enforcement officers will check your fingerprints and background to ensure there’s no criminal record, which costs an additional $50 to $100.
• English Tests: If previously mentioned tests weren’t done in English, you’ll need proof that your language mastery is good enough to work in the U.S. So, you’ll have to spend another $200 for IELTS or TOEFL.

Keep in mind that this might not be the only document required, as some states might ask you for additional paperwork.

Visa Processing

Given that you’re coming from abroad, you’ll also need a permanent immigration visa. There are a few main types of documents international nurses apply for, including TN, H-1B, and EB-3 visas. It’s worth mentioning that H-1B and EB-3 are for specialized workers (including nurses), while the TN visa only applies to Canadian and Mexican citizens.

The visa application fee will cost you anywhere from $160 to $350, depending on the document you’re applying for. You’ll also have to pay vaccination and medical exams ($200-$500), USCIS filing fees ($700-$1225), and potentially attorney fees ($2,000-$5,000).

What Is the Total Cost?

When everything is said and done, you’ll have to invest between $9,000 and $23,000 for the entire process. Besides the mentioned fees and tests, you’ll also have to consider airplane tickets and temporary housing. The initial few months are the hardest, before getting your first paychecks.

The best way to reduce these costs is by choosing a state with lower licensure fees. You should also consider employer sponsorship and free/cheap NCLEX preparation resources. The good news is that you’ll be able to recover these costs rather quickly, as RNs in the U.S. can earn around $98,000 a year.

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