NCLEX for Foreign Nurses: A Step-by-Step Guide for Internationally Educated Nurses

Internationally educated nurses take the NCLEX-RN or NCLEX-PN, the exams every U.S. board of nursing uses. You apply first to the board in the state where you want your license; it decides whether you need a credentials evaluation or an English test. Then you register with Pearson. Testing at an international center adds a $150 USD scheduling fee.

Who Counts as an Internationally Educated Nurse

NCSBN, which develops the NCLEX, defines an internationally educated nurse, "also referred to as foreign-educated nurse," as someone "who has completed a nursing education program that is not located within the U.S." The definition is about where you studied, not your citizenship.

You take the exam for the license you apply for, and NCSBN's Uniform Licensure Requirements call for a program comparable to a board-approved RN or LPN/VN program; the NCLEX-PN is used for U.S. licensure only. See our NCLEX-RN and NCLEX-PN pages, and NCLEX-RN or NCLEX-PN for how the choice is made.

Step 1: Apply to a U.S. Board of Nursing

Your first stop is the board, not Pearson. NCSBN tells candidates to first "submit an application for licensure/registration to the NRB where seeking to be licensed/registered," a step required to become eligible for the NCLEX. NRB stands for nursing regulatory body; in the U.S., that is the board of nursing.

Apply in the state where you plan to work. Applications come from that state's board "as requirements vary," and NCSBN "does not maintain a list of requirements for each NRB." Its Nurse Licensure Guidance points you to a state's requirements for internationally educated nurses, such as English proficiency examinations, credentials evaluation and Social Security Number requirements, and its board directory links to every board.

Expect more than a diploma check: NCSBN's Uniform Licensure Requirements for internationally educated applicants also cover your licensure status in your country of origin, English proficiency, disclosure of misdemeanors, felonies and plea agreements, and state and federal fingerprint checks. Boards add their own rules: Florida needs a Social Security number before it issues a license, but not to apply or to take the NCLEX. The board's licensure fee is separate and is paid to the board with your application.

Step 2: Credentials Evaluation, If Your Board Requires It

A credentials evaluation compares your nursing education with nursing education in the U.S. NCSBN's resource manual notes that most boards use an evaluation agency, some do the review themselves, and the report is advisory: the board decides.

TruMerit is the new name of CGFNS International (CGFNS stands for Commission on Graduates of Foreign Nursing Schools); New York's page uses the new name, Florida's and California's the old one.

• Florida's instructions for applicants educated outside the U.S. require "a full education credentials review by a Florida board-approved credentialing agency." The board lists six approved agencies, among them the Commission on Graduates of Foreign Nursing Schools (CGFNS, now TruMerit) and Josef Silny & Associates, and warns that a report "may take several months to complete."
• New York, where the State Education Department (NYSED) licenses nurses, accepts two routes: TruMerit's Credential Verification Service for New York State, or a certification your nursing school sends on Form 2F with your transcript. TruMerit is optional, but NYSED notes that applying without it "is often more difficult and time consuming."
• California's Board of Registered Nursing reviews international transcripts itself; they must be sent to the board by mail. Passing the CGFNS examination "is not required to be licensed in California," though the board accepts transcripts sent through CGFNS.

Start early: among the best practices NCSBN's manual lists for evaluation agencies is requiring documents "sent directly from the issuing institution, not from the applicant."

Step 3: English Proficiency, Where It Applies

NCSBN's Uniform Licensure Requirements include an English proficiency exam covering reading, speaking, writing and listening, "except for applicants from countries where English is the native language and the nursing program where the applicant attended was taught in English and used English textbooks." Boards apply that differently:

• Florida asks for proof of English competency "if textbooks and instruction were not completed in English" and lists approved exams with minimum scores, such as 6.5 overall with 7.0 on the spoken portion of the academic IELTS, or 300 on the Occupational English Test (OET).
• California requires an English examination when the board "has reasonable doubt" that an applicant understands English well enough to practice safely.

Check your board's current list before you book a test, because scores change: Florida's TOEFL minimum is different for exams taken on or after January 21, 2026. If you plan to work in the U.S., the federal health care worker certification described below has its own English requirement.

Step 4: Register With Pearson and Wait for Your ATT

Pearson is the testing vendor: "Payment and scheduling for the NCLEX is done through Pearson." You register online or by phone with your program code (NCSBN's list has codes by country for programs outside the U.S. and Canada), an email address and a Visa, Mastercard or American Express credit, debit or prepaid card; schools, agencies and employers can also pay. Register under your first and last names exactly as they appear on the ID you will present; at an international center, that must be your passport.

Registration is not eligibility. Your board decides when you are eligible, and only then does Pearson email your Authorization to Test (ATT). New York, for example, warns that Pearson "will not allow you to take the NCLEX-RN until NYSED completes a review" of your application. Three rules can cost you the fee:

• 365 days to become eligible. If your board does not make you eligible within 365 days of registration, you forfeit the registration and the exam fee.
• One registration at a time. A second open registration for the same exam is denied, and its fee is not refunded.
• A fixed testing window. You must test within your ATT's validity dates, which average 90 days and cannot be extended.

Step 5: Book an International Test Center

You do not have to travel to the U.S. NCSBN says you can take the NCLEX "year-round at any Pearson Professional Testing location, regardless of where you are applying for licensure/registration."

For U.S. licensure, domestic test centers are those in the U.S. and in American Samoa, Guam, the Northern Mariana Islands and the U.S. Virgin Islands; all others are international, including centers in Canada and Puerto Rico. NCSBN's Testing Locations page says international locations include Australia, Brazil, France, Hong Kong, India, Israel, Japan, Jordan, Kenya, Malaysia, Mexico, Pakistan, the Philippines, Puerto Rico, South Africa, Spain, Taiwan, Türkiye and the United Kingdom, and its July 2026 list of international center addresses also has Guangzhou, China. The Candidate Bulletin warns that the list of international test centers "is subject to change without prior notice," so look up your city in Pearson's test center search before you book.

At an international center:

• An extra scheduling fee of $150 USD applies for U.S. licensure, plus value-added tax (VAT) where applicable. It is nonrefundable, unless your international center becomes unavailable and you move to a domestic one, in which case the Candidate Bulletin says the fee is refunded.
• Passport only. A passport book or card is the only ID accepted, including in Puerto Rico; without it you lose the exam fee and the scheduling fee. If it has no signature, bring a secondary ID with one.
• Changes by phone. Call Pearson Candidate Services to change an international appointment. Moving to another international center keeps the scheduling fee; moving to a domestic one forfeits it.
• Sanctioned countries. Under U.S. trade restrictions, people living in a sanctioned country cannot take the NCLEX, and a passport from one must come with government-issued proof of residency in a non-sanctioned country.

Book soon after your ATT arrives: NCSBN warns that waiting "may significantly limit the selection of dates," and if no center can seat you before the ATT expires, you register and pay again. What happens on test day covers check-in, and your official result comes from your board within six weeks.

Fees When You Test at an International Center

You pay NCLEX fees to Pearson. The registration fee follows the country where you seek a license, not where you live, and the date you complete your registration, not your exam date. An international test center adds a scheduling fee, plus VAT where applicable, that does not change on February 1, 2027:

• U.S. or Australian licensure: $200 USD plus $150 USD, or $350 USD in total, if you register before February 1, 2027; $350 USD plus $150 USD, or $500 USD, if you register on or after that date.
• Canadian licensure: $360 CAD (excludes local taxes), or $570 CAD from February 1, 2027, plus $150 CAD at a center outside Canada and the mainland U.S.

NCLEX fees are not refunded for any reason; board and evaluation-agency fees are separate, and a retake is a new registration at the fee in effect when you register. The 2027 fee change explains the date rule, and what the NCLEX costs covers the other NCLEX fees.

What to Expect on the Exam If You Trained Abroad

A few of NCSBN's answers about the exam matter especially if you trained abroad:

• Drug names. On most occasions, items use generic medication names only; NCLEX pharmacology essentials is organized by drug class.
• Units and lab values. On average, items include a combination of international system (SI) and imperial units, and an item with a numeric lab value includes the normal reference range; see the lab values guide.
• Wording and format. The exam "uses consistent language for every examinee" and bolds key words such as best, first and priority; the test-taking strategies guide shows how to work with them, and how the NCLEX works explains the adaptive format.

In 2025, 47.3% of the 52,827 first-time, internationally educated candidates who took the NCLEX-RN for U.S. licensure passed. The average spans nurses educated in many countries; NCLEX pass rates puts it in context, and the 2026 NCLEX study roadmap turns the Test Plan into a weekly routine.

Working in the U.S.: Health Care Worker Certification (VisaScreen)

Boards of nursing do not handle immigration; NCSBN sends visa questions to USCIS: "Obtaining a Visa is not within the authority of the board of nursing." Below is only what USCIS and TruMerit publish; for your own case, use their pages or ask an immigration attorney.

• Who needs it. Health care workers other than physicians who seek admission to the U.S. to work in their field, including registered, licensed practical and licensed vocational nurses, must present a certification from a USCIS-approved credentialing organization.
• Who issues it for nurses. USCIS lists CGFNS (now TruMerit), Josef Silny & Associates, International Education Evaluations and The Evaluation Company.
• TruMerit's VisaScreen compares your education with a U.S. graduate's, verifies every professional license you have held, requires an English proficiency exam (not an at-home version) and, for registered nurses, a pass on TruMerit's Nurse Qualifying Exam or the NCLEX-RN. If your entry-level professional education was in the United Kingdom, Australia, Canada (except Quebec), New Zealand, Ireland or the United States and was taught in English, with English textbooks, you may be exempt from the English exam. The approved tests and scores changed on May 12, 2026.
• An alternative for some nurses. USCIS also accepts a certified statement for nurses who, among other conditions, passed the NCLEX and hold a valid, unrestricted license in the state of intended employment.
• Validity. You present the certification each time you seek admission or change, extend or adjust status. It is valid for five years and does not replace licensure requirements.

NCLEX for Internationally Educated Nurses in Canada and Australia

Canada. The Canadian Council of Registered Nurse Regulators states that anyone applying to practice as a registered nurse in Canada, "with the exception of Quebec," must pass the NCLEX-RN and meet a provincial or territorial regulator's other requirements. Start with the regulator where you want to work; you may first need the National Nursing Assessment Service (NNAS), whose reports are accepted by all Canadian nursing regulators except those in Quebec and the territories. The regulators, not NNAS, grant licenses and set the English or French language requirements. NCSBN offers the NCLEX-RN in French for French-speaking Canadian candidates. The NCLEX-PN is used for U.S. licensure only; for practical nurses in British Columbia and Ontario, see the REx-PN in NCLEX-RN or NCLEX-PN.

Australia. For internationally qualified nurses seeking registration as a registered nurse, NCSBN describes the NCLEX-RN as "the first stage of the NMBA's outcomes-based assessment" (NMBA: the Nursing and Midwifery Board of Australia). The Australian Health Practitioner Regulation Agency (Ahpra), acting for the NMBA, advises you how to proceed; you register and pay with Pearson, Ahpra must make you eligible within 365 days, and Ahpra sends your official results within six weeks. For Australian licensure, only centers in the U.S. and its listed territories count as domestic, so testing in Australia adds the international scheduling fee. Since the NCLEX-RN is only the first stage, ask Ahpra what follows.

Frequently Asked Questions

Can foreign nurses take the NCLEX?

Yes. Internationally educated nurses take the NCLEX-RN or NCLEX-PN after applying to a U.S. board of nursing, which decides what they must submit and when they are eligible. The NCLEX-RN is also used in Canada outside Quebec and, for internationally qualified nurses, in Australia.

Do I need TruMerit (CGFNS) before I can take the NCLEX?

Only if your board requires it. Florida accepts a review from any of its six approved agencies, TruMerit among them; New York lets you choose TruMerit or a certification from your school; California's board reviews your transcripts itself.

Can I take the NCLEX outside the United States?

Yes. You can test at any Pearson Professional Testing location, regardless of where you apply for licensure. An international test center adds a scheduling fee of $150 USD for U.S. or Australian licensure, plus VAT where applicable. For Canadian licensure, centers in Canada and the mainland U.S. count as domestic, and a center anywhere else adds $150 CAD. The fee is nonrefundable and does not change on February 1, 2027.

Does passing the NCLEX mean I can work in the United States?

Not by itself. Passing is one of your board's licensure requirements, and the license comes from the board. Visa questions go to USCIS, not to the board, and nurses seeking admission to work must present a health care worker certification such as VisaScreen or, if they qualify, a certified statement.

What happens if I do not pass?

The same NCSBN retake policy applies, with at least 45 test-free days between attempts, and some boards are stricter. Each retake is a new registration and fee, plus the scheduling fee again at an international center. See the NCLEX retake rules.

Before You Apply

The paperwork takes time, and the exam at the end is the part you can prepare for now. Explore ExamReady NCLEX preparation when you want a structured place to practice while your application moves through the board.

Official resources

• NCSBN: U.S. Nursing Licensure for Internationally Educated Nurses
• NCSBN: Nurse Licensure Guidance
• NCSBN: Contact a U.S. board of nursing
• NCLEX: How to register
• NCLEX: Testing locations
• NCLEX: Fees and payment
• 2026 NCLEX Candidate Bulletin
• USCIS: Health Care Worker Certification
• Canadian Council of Registered Nurse Regulators: Registered nurses
• NCSBN: NCLEX pathway for internationally qualified nurses in Australia