Certification Program

The Commission on Graduates of Foreign Nursing Schools (CGFNS) Certification Program is designed specifically for first-level, general nurses educated and licensed outside the United States who wish to assess their chances of passing the U.S. registered nurse licensing exam, the NCLEX-RN® examination, and attaining licensure to practice as registered nurses within the United States.

The program is comprised of three parts: a credentials review of the nurse's education, registration and licensure; the CGFNS Qualifying Exam, a one-day qualifying exam testing nursing knowledge; and an English language proficiency exam. Upon successful completion of all three elements of the program, the applicant is awarded a CGFNS Certificate.

Why the Certification Program was Created
During the late 1960s, the United States experienced a marked increase in the number of foreign-educated nurses immigrating to the U.S. to practice nursing. U.S. immigration officials had a difficult time identifying which nurses educated abroad, who were applying for occupational visas, met the requirements for licensure as registered nurses in the United States. The reality was that, on average, only 15-20% of foreign-educated nurses were passing the U.S. registered nurse licensure exam, now the NCLEX-RN® examination.*

The CGFNS Certification Program was created to serve as a predictor exam and evaluation process for foreign-educated nurses to more accurately forecast which nurses were likely to meet the requirements for licensure as registered nurses in the United States.

EligibilityThe CGFNS Certification Program is designed ONLY for first-level, general nurses educated and/or licensed outside the United States who wish to assess their chances of passing the NCLEX-RN® examination and attaining licensure to practice as registered nurses within the United States.

In order to be eligible for the program, a nurse must be educated and hold both initial and current registration/licensure as a first-level, general nurse as defined historically by the International Council of Nurses (ICN).

A first-level nurse is called a registered or professional nurse in most countries. A second-level nurse, often called an enrolled, vocational, practical nurse or nurse assistant, is not eligible to be licensed as a registered nurse in the U.S., and therefore, is not eligible for the Certification Program.

A general nurse must have obtained theoretical instruction and clinical practice in a variety of nursing areas. A nurse who specialized in one area without being educated and registered/licensed as a general nurse is not eligible for the Certification Program.

Elements of the Program

The Certification Program is a three-part program, comprised of a credentials review, a one-day qualifying exam of nursing knowledge, and an English language proficiency exam. Upon successful completion of all three elements of the program, the applicant is awarded a CGFNS Certificate.

Credentials Review
CGFNS evaluates an applicant's education and registration credentials to certify that the applicant is a first-level, general nurse and meets all of the registration requirements to be licensed as a professional in that field.

Applicants must have completed a senior secondary school education separate from their nursing education; graduated from a government-approved nursing program of at least two years in length; and received theoretical instruction and clinical practice in nursing care of the adult (including medical and surgical nursing), maternal/infant nursing care, nursing care of children and psychiatric/mental health nursing.
Note: All transcripts must come directly from source agencies.

Applicants must have a full and unrestricted license/registration to practice as a first-level, general nurse in the country where they completed their general nursing education; and hold a current license/registration as a first-level, general nurse.
Note: All validations must come directly from the source agencies.

CGFNS Qualifying Exam
The CGFNS Qualifying Exam of nursing knowledge is offered three times a year at more than 40 locations spanning the globe. To date, more than 300,000 exams have been administered to over 175,00 applicants. The exam is divided into two parts with a total of 260 questions. Applicants are given two hours and 30 minutes for Part 1, which includes 150 questions. After breaking for lunch, applicants are given one hour and 50 minutes to complete Part 2, consisting of 110 questions.

The Qualifying Exam measures an applicant's nursing knowledge and is based on what nurses must know and do when they practice nursing in the United States. The foundations of the Qualifying Exam are based on client (patient) needs. The traditional clinical areas of nursing practice -- nursing care of the adult, nursing care of children, maternal/infant nursing, psychiatric/mental health nursing and community health nursing -- are covered. The exam ensures that an applicant has the same level of understanding of nursing with various client groups, in various settings, as recent graduates of U.S. schools of nursing.

Both the CGFNS Qualifying Exam and the NCLEX-RN® examination are based on the same framework of client needs because it provides a universal structure for defining nursing actions and competencies across all settings for all clients.

English Language Proficiency Exam
The Test of English as a Foreign Language (TOEFL) is currently used to meet the English language proficiency requirement of the Certification Program. TOEFL is administered worldwide by the Educational Testing Service (ETS). The exam measures listening, comprehension, structure and written expression and reading comprehension.

Applicants must successfully complete TOEFL and the Qualifying Exam within a two-year period in order for test scores to be considered valid. TOEFL may be taken prior to or following the CGFNS Qualifying Exam.

Applicants must apply directly to ETS in order to take the TOEFL exam. For information or an application, contact: Test of English as a Foreign Language, Educational Testing Service, P.O. Box 6151, Princeton, NJ 08541-6151 USA; telephone: (609) 771-7100; or e-mail: toefl@ets.org.

Certain applicants may be exempt from the English language proficiency requirement if they meet all of the following criteria:

1. Native language is English;
2. Country of nursing education was Australia, Canada (except Quebec), Ireland, New Zealand or the United Kingdom;
3. Language of instruction was English; and
4. Language of textbooks was English.

Program Outcomes
First, the Certification Program identifies nurses with a high potential for achieving licensure in the United States. Since the introduction of the Certification Program, first time RN licensure pass scores of foreign-educated nurses holding a CGFNS Certificate have shown a marked improvement (up from 15-20% prior to the Certification Program in the 1970s to 88-92% today).**

Second, the opportunity to take the CGFNS Qualifying Exam and TOEFL at a number of locations throughout the world enables applicants to save both time and money by providing them with the opportunity to earn a CGFNS Certificate in their home country before traveling to the United States to take the NCLEX-RN® examination.

Program BenefitsAnyone with an interest in selecting candidates who have a high probability of success on the NCLEX-RN® examination will find the program highly beneficial. Nurse applicants, U.S. Boards of Registered Nurses, the U.S. Department of Labor, the U.S. Immigration and Naturalization Service, universities and employers all make use of the CGFNS Certification Program.

Attaining a CGFNS Certificate helps applicants in three ways. First, the certificate will help applicants meet state requirements for the registered nurse licensure exam. Most states require a CGFNS Certificate from nurse educated abroad before they can take the NCLEX-RN® examination.

Second, CGFNS Certificate holders consistently have a higher rate of success on the NCLEX-RN® examination than internationally-educated nurses who do not hold a CGFNS Certificate. Passing the CGFNS Qualifying Exam can help applicants to feel reasonably assured of success on the NCLEX-RN® examination.

Finally, the CGFNS Certificate helps applicants to qualify for an occupational visa. CGFNS was named in section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA) of 1996 as an organization qualified to administer a screening program for healthcare professionals who are seeking an occupational visa. The International Commission on Healthcare Professions (ICHP), a division of CGFNS, developed VisaScreen?: Visa Credentials Assessment to meet the requirements of section 343. For foreign-educated nurses who do not hold a U.S. license by examination, passing a predictor exam, such as the CGFNS Qualifying Exam, is a requirement of section 343.

*Survey of Foreign Nurse Graduates. U.S. Department of Health, Education and Welfare, DHEW Publication No. (HRA) 76-13, 1976.

**1997 Report on the CGFNS Validity Study. The Commission on Graduates of Foreign Nursing Schools, 1997. For more information about the CGFNS Certification Program, check out Frequently Asked Questions about the program.