The USA offers the highest nursing salaries in the world and a clear pathway to permanent residency for Indian nurses. In 2026, demand for internationally educated nurses in the USA remains at record levels. This guide breaks down every step — from your Indian nursing degree to working as a US Registered Nurse.
Avg. RN Salary USA
$60K–$100K+
Per yearNCLEX Fee
USD 200
(~₹16,600)EB-3 Leads To
Green Card
Permanent residencyTotal Timeline
18–36 months
India to USA workingStep 1: Verify Your Nursing Qualification
Before anything else, confirm your eligibility:
- You need a BSc Nursing degree from an institution recognised by the Indian Nursing Council (INC)
- GNM (General Nursing & Midwifery) holders: eligibility varies by US state. Some states accept GNM after assessment; most require BSc Nursing or a bridging programme. We check your specific situation.
- Your nursing programme must have included both theory and clinical hours meeting the state board's requirements
At Swas CareNest, our free eligibility assessment at Suchitra Circle checks your specific institution and qualifications against the requirements of your target US state.
Step 2: CGFNS Credential Evaluation
The Commission on Graduates of Foreign Nursing Schools (CGFNS) evaluates whether your Indian nursing education meets US standards. This is the critical first step and takes 3–6 months.
Two pathways:
- CGFNS CES (Credentials Evaluation Service): Required by most US states. CGFNS reviews your transcripts, verifies your nursing programme and issues an evaluation report to the state board.
- Direct State Board Application: Some states (Texas, Georgia, Florida) allow direct application with your INC certificate and transcripts without CGFNS evaluation. Faster but state-specific.
We recommend starting CGFNS and NCLEX preparation simultaneously — waiting for CGFNS to complete before starting NCLEX costs you 3–6 months of valuable preparation time.
Step 3: Pass NCLEX-RN
The NCLEX-RN (National Council Licensure Examination – Registered Nurse) is the licensing exam that every nurse must pass to practice in the USA. Without it, no US hospital will hire you regardless of your Indian experience.
Key facts about NCLEX for Indian nurses:
- You can sit the exam in India at a Pearson VUE centre — no need to travel to the USA first
- The exam uses the Next-Generation NCLEX (NGN) format since April 2023 — focused on clinical judgement, not memorisation
- 75–145 questions, up to 5 hours, computer-adaptive
- NCLEX registration fee: USD 200 + state board application fee (USD 100–200)
- Results within 48 hours via Pearson VUE Quick Results
Our 20-week NCLEX coaching programme at Suchitra Circle, Hyderabad is fully aligned to the 2026 NGN format. See programme details.
Step 4: State Nursing Licence
After passing NCLEX, you apply to your target US state's Board of Nursing for your RN licence. Popular states for Indian nurses:
| State | Why Popular | Avg. RN Salary | Notes |
|---|---|---|---|
| Texas | High demand, lower cost of living, direct licensure | $70,000–$85,000 | Endorses NLC (travel nurse friendly) |
| California | Highest salaries, large Indian community | $85,000–$120,000 | Longer processing, not NLC member |
| New York | Major hospitals, strong nursing demand | $78,000–$100,000 | Requires English proficiency documentation |
| Florida | Direct CGFNS application accepted | $68,000–$82,000 | Fast processing |
| New Jersey | High pay, close to NYC hospitals | $80,000–$105,000 | Strong Indian nursing community |
Step 5: CGFNS Visa Screen Certificate
Before a US employer can sponsor your visa, you need a CGFNS Visa Screen Certificate. This is different from the CES credential evaluation — it is a separate document specifically required for the immigration process.
The Visa Screen verifies that:
- Your nursing licence is valid in your home country
- Your nursing education meets US standards
- You have passed NCLEX-RN
- You have an acceptable English language score: IELTS 6.5 overall with no band below 6.0 (or TOEFL equivalent)
Before working in the USA, you need a Visa Screen Certificate from CGFNS — which requires IELTS Academic 6.5+ with no band below 6.0. Our IELTS coaching is integrated with our NCLEX programme so both are completed simultaneously. Read the full IELTS for USA nursing guide.
Step 6: Job Placement and Employer Sponsorship
US hospitals actively recruit internationally educated nurses. Many offer two types of employer sponsorship:
EB-3 Visa (Immigrant – leads to Green Card)
The EB-3 is an employment-based immigrant visa — meaning it leads directly to a US Green Card (permanent residency). For nurses, the EB-3 Skilled Worker category is the most common pathway.
- Employer files PERM Labour Certification with the US Department of Labor
- Employer then files I-140 Immigrant Petition
- When a visa number becomes available (Priority Date), you apply for the immigrant visa (DS-260)
- Total processing time: 2–5 years (Indian nationals face longer wait due to demand)
- Result: Green Card — permanent right to live and work in the USA
H-1B Visa (Temporary – 3 years, extendable)
H-1B is a temporary work visa. Faster than EB-3 in some cases, but subject to annual lottery. Many hospitals sponsor nurses on H-1B initially while the EB-3 petition processes.
Swas CareNest connects you directly with US hospital employers who sponsor Indian nurses. We do not work with agencies who charge placement fees to nurses — our employer relationships are direct.
Step 7: Pre-Departure and Settling In
Once your visa is approved, we conduct a pre-departure orientation covering:
- Airport arrival, Social Security Number (SSN) application
- Bank account setup (you will need an SSN first)
- Driving licence conversion process
- Workplace culture differences — US hospitals operate differently from Indian hospitals
- What to expect in your first 90 days as a new RN in the USA
Total Timeline: India to USA Working as an RN
| Step | Timeline | Running Total |
|---|---|---|
| CGFNS CES application & processing | 3–6 months | Month 3–6 |
| NCLEX coaching (simultaneous) | 5 months | Month 5 |
| NCLEX exam + state licence | 1–3 months | Month 6–9 |
| IELTS for Visa Screen | 1–2 months (alongside NCLEX prep) | Month 5–7 |
| CGFNS Visa Screen Certificate | 2–3 months after NCLEX pass | Month 8–12 |
| Employer match & EB-3/H-1B filing | 3–6 months | Month 12–18 |
| Visa approval & travel | 3–12 months (varies) | Month 18–30 |
USA Nursing Career FAQs
Can I work in the USA as a nurse with a GNM certificate?
It depends on the US state. Some states (like Texas) review GNM applications case by case. Most states require a BSc Nursing or completion of a bridging programme. We assess your specific qualifications during the free eligibility check at our Hyderabad office.
Can I take NCLEX in India?
Yes. Pearson VUE test centres in Hyderabad, Chennai, Mumbai, Pune and other Indian cities administer the NCLEX. You apply to a US state board, pay the exam fee and schedule your test at your nearest centre.
What is the EB-3 visa and how long does it take?
EB-3 is an employment-based immigrant visa leading directly to a US Green Card. For Indian nationals, wait times are currently 3–5 years due to annual visa cap limits. However, you can work in the USA on H-1B while the EB-3 processes.
How much can I earn as an Indian nurse in the USA?
RNs earn $60,000–$100,000+/year depending on state, specialty and experience. California pays highest ($85,000–$120,000). New York and New Jersey also pay well ($78,000–$105,000). With overtime, differential pay and benefits, total compensation is often $80,000–$100,000+.
