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How Foreign Healthcare Workers Can Relocate to the U.S.

How Foreign Healthcare Workers Can Relocate to the U.S.

AllHealthcare.com, UnitedStatesVisas.gov, USCIS.gov

Take the Correct Exams

Healthcare workers wishing to enter the United States must attain certain English language requirements in order to seek employment in the healthcare sector. The following testing services have been approved:

• Educational Testing Services

• Test of English in International Communication

• International English Language Testing System

Minimum scores differ by occupation. The minimum score is determined by the Secretary of Health and Human Services.

• Occupational and physical therapists. An alien seeking to perform labor in the United States as an occupational or physical therapist must obtain the following scores on the English tests:

ETS: Test Of English as a Foreign Language (TOEFL): Paper-Based 560, Computer-Based 220; Test of Written English (TWE): 4.5; Test of Spoken English (TSE): 50.

Important: The certifying organizations shall not accept the results of the TOEIC, or the IELTS for the occupations of occupational therapy or physical therapy.

• Registered nurses and other health care workers requiring the attainment of a baccalaureate degree. An alien coming to the United States to perform labor as a registered nurse (other than a nurse presenting a certified statement under section 212® of the Act) or to perform labor in another health care occupation requiring a baccalaureate degree (other than occupational or physical therapy) must obtain one of the following combinations of scores to obtain a certificate:

ETS: TOEFL: Paper-Based 540, Computer-Based 207; TWE: 4.0; TSE: 50;

TOEIC Service International: TOEIC: 725; plus TWE: 4.0 and TSE: 50; or

IELTS: 6.5 overall with a spoken band score of 7.0. This would require the Academic module.

• Occupations requiring less than a baccalaureate degree. An alien coming to the United States to perform labor in a health care occupation that does not require a baccalaureate degree must obtain one of the following combinations of scores to obtain a certificate:

ETS: TOEFL: Paper-Based 530, Computer-Based 197; TWE: 4.0; TSE: 50;

TOEIC Service International: TOEIC: 700; plus TWE 4.0 and TSE: 50; or

IELTS: 6.0 overall with a spoken band score of 7.0. This would allow either the Academic or the General module.

Questions and Answers about Exemptions for Certain Health Care Workers

Q: Are foreign health care workers – trained in the United States or in possession of a valid state license – subject to the health care certification requirement?

A: Yes. While Congress provided certain nurses with a less rigorous, alternative certification process, it did not provide a less rigorous alternative certification option to state-licensed foreign health care workers. Possession of a state license does not exempt a foreign health care worker from compliance with the certification requirement. Similarly, health care workers who have been trained in the United States are not exempt from the certification requirement.

Q: Are there any accommodations for foreign health care workers who have been trained in the United States?

A: Yes. Foreign health care workers may be automatically deemed to have met the English language and/or educational comparability requirements if they have graduated from certain programs or from programs in certain countries. The following groups may be deemed to have met the English language requirements:

• Graduates of health professional programs in Australia, Canada (except Quebec), Ireland, New Zealand, the United Kingdom, and the United States.

• Alien nurses who are presenting the alternate certified statement under section 212® of the Act.

• For nurses, graduation from an entry-level program accredited by the National League for Nursing Accreditation Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE);

• For occupational therapists, graduation from a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) of the American Occupational Therapy Association (AOTA);

• For physical therapists, graduation from a program accredited by the Commission on Accreditation in Physical Terapy Education (CAPTE) of the American Physical Therapy Association (APTA); and

• For speech language pathologists and audiologists, graduation from a program accredited by the Council on Academic Accreditation in Audiology and Speech Language Pathology (CAA) of the American Speech-Language-Hearing Association (ASHA).

The following groups may be deemed to have met the educational comparability requirements:

• For nurses, graduation from an entry-level program accredited by the National League for Nursing Accreditation Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE);

• For occupational therapists, graduation from a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) of the American Occupational Therapy Association (AOTA);

• For physical therapists, graduation from a program accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE) of the American Physical Therapy Association (APTA); and

• For speech language pathologists and audiologists, graduation from a program accredited by the Council on Academic Accreditation in Audiology and Speech Language Pathology (CAA) of the American Speech-Language-Hearing Association (ASHA).

Q: Are dependents subject to the health care worker certification requirement?

A: No. For example, if you are here as an L-2 nonimmigrant, your primary purpose for entering the United States is to join your spouse. Since an L-2 nonimmigrant spouse is authorized employment, you may engage in employment as a health care worker without obtaining the certification. This will also apply to other dependents who are accompanying a principal alien and who are employment authorized within their dependent status.


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