pharmacists and managers of health care facilities;

to trainees in H-3, F or J status; to the spouse and

dependent children of any non-immigrant (tempo-

rary); and to any health care worker seeking

admission as the spouse or child of a principal

alien, or as a family based immigrant, or in an

uncovered profession.

There will be a transition period for these health

care workers not covered by the interim rule but

now covered by the final rule. DHS may admit a

temporary, including TN, foreign-educated health

care worker, or extend or change their status if

they are already within the U.S., even if the health

care worker does not at the time of application

possess the required certification. The length of

transition time includes: (1) a 10-month period

ending on July 25, 2004 during which a temporary

foreign health care worker may be admitted or

may change or extend his or her status without

having to present the Section 343 certification at

the time of admission or of extension or change of

status, and (2) a 12 month period, beginning on the

date of the foreign health care worker’s admission,

extension or change of status during which the for-

eign worker must obtain the required Section 343

certification.

Grants of admission, extension, or changes of

status to temporary immigrants during the transition

period will be valid for only one year.. There is no

change and no transition period in the requirement

for those applying to enter the U.S. under an

employment-based permanent visa.

and certified before they will be allowed to work

in their profession in the United States. The final

rule became effective on September 23, 2003.

The regulations cover workers in seven major

health care occupations. They include: nurses,

registered nurses and licensed practical (vocation-

al) nurses; physical therapists; occupational thera-

pists; medical laboratory technicians; medical

technologist (scientists); speech language patholo-

gists and audiologists; and physician assistants.

The final rule applies to temporary and perma-

nent employment based visas as well as Trade

NAFTA (TN) health care workers from Canada

and Mexico. Prior to the promulgation of the

final rule, the interim rule covered only those

health care workers entering under a permanent

visa.

This rule

does not apply

to foreign-edu-

cated physicians,

health care

workers seeking

admission to

work in a non-

clinical health

care occupation,

including med-

ical teachers,

medical

researchers,

a quarterly report on global healthcare education and licensure Fall 2003

C o m m i s s i o n o n G r a d u a t e s o f F o r e i g n N u r s i n g S c h o o l s

Bureau of Citizenship and ImmigrationServices Issues Final Rule on HealthcareProfessionals Seeking Occupational Visas

On July 25, 2003, the Department of Homeland Security (DHS) publishedits final rule related to Section 343 of the Illegal Immigration Reformand Immigrant Responsibility Act of 1996 (IIRIRA). Section 343

requires that certain foreign health care workers have their credentials evaluated1

2

3

4

BCIS Issues FinalRules on Visas

CGFNS beginsaccepting TOEICand IELTS examina-tions as proof ofEnglish languageproficiency

CGFNS launchesnew Integrated Voice ResponseSystem

continued: CGFNSbegins acceptingTOEIC and IELTSscores

CGFNS opensadditionalQualifying Examcenters in Indiaand Mexico

1FINAL RULE / See page 3

HealthScope InternationalVolume 4, Number 4

HealthScope International is publishedquarterly by the Commission onGraduates of Foreign Nursing Schools(CGFNS). Copyright © 2003 by theCommission on Graduates of ForeignNursing Schools. Comments or ques-tions should be directed to: CGFNS, Attn:HealthScope International, 3600 MarketStreet, Suite 400, Philadelphia, PA19104-2651, USA.

Barbara Nichols, DHL, MS, RN, FAANChief Executive Officer & Executive Editor

Judy PendergastDirector of Planning, Marketing &Communications

Silvia PomponiMarketing Specialist

Phyllis Kritek, PhD, RN, FAANPresident, Board of Trustees

HealthScope International2

CGFNS begins accepting TOEIC and IELTS examinations as proof of English language proficiency

In March 2003, CGFNS began accepting both the Test ofEnglish for International Communication (TOEIC) andthe International English Language Testing System

(IELTS) in addition to the already-approved Test of English as aForeign Language (TOEFL) examination for foreign healthcareworkers applying for the CGFNS Certification Program and/orthe ICHP VisaScreen™: Visa Credentials Assessment program.

Applicants applying to either the Certification or VisaScreenprograms must pass an English language proficiency examina-tion as part of their requirements to receive their certificate(s).At the present time, only the TOEFL examination administeredby the Educational Testing Service (ETS) is approved to meetthis requirement. ETS also administers the Test of WrittenEnglish (TWE) and the Test of Spoken English (TSE).

CGFNS believes that expanding the English testing optionswould increase access and availability to English proficiencytests for foreign healthcare professionals, and in turn, expeditethe certification and screening processes for applicants. CGFNSbegan searching for other "nationally recognized, commerciallyavailable, standardized assessments" of the English languageskills of foreign healthcare professionals in order to facilitatethe Certification and VisaScreen processes. As a result of thatsearch, CGFNS has concluded that both the TOEIC and IELTSexaminations meet statutory, as well as CGFNS' high standards,for English language proficiency assessments set forth in sec-tion 343 of the Illegal Immigration Reform and Immigrant

Responsibility Act of 1996 (IIRIRA). Since March 3, 2003, foreign registered nurses applying to

the Certification Program have the option to take either theTOEFL (administered by ETS), the TOEIC (also administeredby ETS) or the academic module of the IELTS (administered byCambridge ESOL Examinations, the British Council and IDPEducation Australia). Certain foreign healthcare professionalsapplying to the VisaScreen program will have the option to takeone of the following three groups of English exams: theTOEFL, TWE and TSE; the TOEIC, TWE and TSE; or theIELTS and IELTS Spoken Band. VisaScreen applicants areadvised to contact CGFNS in order to confirm which groupsand what module of English examinations will be accepted fortheir profession.

For those applicants who have taken TOEIC or IELTS with-in the past two years, those passing scores will be accepted forthe VisaScreen and Certification Programs, as long as theypassed the TOEIC or IELTS within two years from the date thatthey passed the CGFNS Qualifying Exam. Applicants are alsoreminded that all English language proficiency scores must beforwarded to CGFNS/ICHP by the administering body.

Additional information on the TOEFL Examination can beobtained from ETS at www.toefl.org; information on theTOEIC Examination can also be obtained from ETS but atwww.toeic.com; information on the IELTS Examinations can beobtained at www.ielts.org.

CGFNS launches new Integrated VoiceResponse System

In April 2003 CGFNS instituted animproved version of its IntegratedVoice Response System. The new

telephone system can be reached at 001+(215) 599-6200 and is available 24 hours aday, seven days a week, from any locationaround the world (long distance telephonecharges may apply). The IVR system isintegrated with the CGFNS On-LineApplication System in order to bring appli-cants increased access to the status of theirapplication with the most current informa-tion possible.

The new Integrated Voice ResponseSystem allows applicants access to thesame, in-depth information about their fileas the CGFNS website application system,which enables them to apply directly on-line for any CGFNS service, check the sta-tus of any application, confirm whether theyhave been rostered for a CGFNS QualifyingExam, verify receipt of documents, makechanges to their application, order study

materials and check their account balance.Applicants can check the status of their appli-cation(s) for any of CGFNS' services, such asthe Certification Program, CredentialsEvaluation Service, VisaScreen Program, andCredentials Verification Service for NewYork State.

CGFNS continuously strives to pro-vide applicants with the most efficient andup-to-date resources and information possi-ble, and remains committed to providing thesame high standard in its screening, evaluat-ing and testing services that foreign-educatedhealthcare professionals worldwide havecome to expect and depend upon.

HealthScope International 3

CGFNS is authorized to certify all thenamed health care workers. CGFNS pro-vides the certification mandated under thelaw through its division named theInternational Commission on HealthcareProfessions (ICHP).

In addition, the Foreign CredentialingCommission on Physical Therapy is author-ized to certify physical therapists only andthe National Board for Certification inOccupational Therapy is authorized to certi-fy occupational therapists only.

To obtain the required certification,called the CGFNS VisaScreen™ Certificate,CGFNS must verify that:

• The foreign health care worker’s educa-tion, training, license, and experience iscomparable with that required for a U.S.worker of the same type;

• The foreign health care worker’s educa-tion, training, license, and experience isauthentic and, in the case of the health careworker’s license, unencumbered. The rulerequires that the verification of the educationand license come directly from the issuingsource.

• The foreign health care worker’s educa-tion, training, license, and experience meetsall applicable statutory and regulatoryrequirements for admission to the U.S.;

• If the health care worker is a registerednurse he or she must have passed either theCGFNS Qualifying Exam or the NCLEX-RN; and

• The health care worker must havepassed an approved English language profi-ciency examination.

The certification is valid for five years andmust be renewed before the end of that time.

The health care worker must demonstratea certain level of proficiency in written andspoken English. Three options exist to ful-fill this requirement. The health care workermay take the (1) Test of English as a ForeignLanguage (TOEFL) plus the Test of WrittenEnglish (TWE) and the Test of SpokenEnglish (TWE); or (2) the Test of English inInternational Communications (TOEIC) plusTSE and TWE; or (3) the InternationalEnglish Language Testing System (IELTS).

Health care workers must apply directlywith the following organizations to schedulethe English examinations:

TOEFL, TWE and TSEEducational Testing Service (ETS)PO Box 6151Princeton, NJ 08541-6151 Tel: (609) 771-7100 Website: www.ets.org

TOEICEducational Testing Service Rosedale Road, MS 10-PPrinceton, NJ 08541 Tel: (609) 734-1540 Fax: (609) 734-1560

Email: toeic@ets.orgWebsite: www.toeic.com

IELTSCambridge Examinations and ELTSInternational100 East Corson StreetSuite 200Pasadena, CA 91103Tel: (626) 564-2954Email: ielts@ceii.org Website: www.ielts.org

Although the English Language Instituteof the University of Michigan no longer pro-vides the MELAB to fulfill the English lan-guage proficiency requirement under Section343, CGFNS does accept those valid testresults obtained prior to MELAB’s cessationof this service. A test result is valid if it iswithin two years of the date of test adminis-tration.

A health care worker may be exemptfrom the English language proficiencyrequirement if:

• The country of professional educationwas Australia, Canada (except Quebec),Ireland, New Zealand, the United Kingdomor the United States, and

• The language of spoken instruction wasEnglish, and

• The language of the textbooks wasEnglish.

Certain foreign educated registered nurs-es who qualify under Section 212 (r) of theImmigration and Nationality Act are exemptfrom the English language proficiencyexamination requirement also.

Section 212 (r) authorizes CGFNS toissue "Certified Statements" to foreign edu-cated nurses who meet all the following cri-teria:

• The nurse has a valid and unrestrictedlicense as a nurse in a state where the alienintends to be employed and such state veri-fies that the foreign license of the nurse isauthentic and unencumbered. At presentonly the states of New York, Florida,Georgia and Illinois qualify.

• The nurse has passed the NCLEX-RNexam for registered nurses;

• The nurse was a graduate of a nursingprogram in which the language of instruc-tion was English

• The nursing program was located inAustralia, Canada (except Quebec), Ireland,New Zealand, South Africa, the UnitedKingdom or the United States; and

• The nursing program was in operationon or before November 12, 1999, or hasbeen approved by CGFNS.

The "Certified Statement" satisfies all therequirements of Section 343 for the purposeof visa issuance and admission to the UnitedStates, or for the extension, change oradjustment of visa status.

Some health care professionals who wereeducated in the U.S. and seeking permanentor temporary employment visas or TN statusneed not meet all of the requirements for theVisaScreen™ Certificate.The final ruleallows for a streamlined certificationprocess. A health care worker is exemptfrom the educational comparability reviewand English language proficiency examina-tion in the follow circumstances:

• Nurses: A nurse who has graduatedfrom an entry level program accredited bythe National League for NursingAccreditation Commission or theCommission on Collegiate NursingEducation.

• Occupational Therapists: AnOccupational Therapist who has graduatedfrom a program accredited by theAccreditation Council for OccupationalTherapy Education of the AmericanOccupational Therapy.

• Physical Therapists: A physicalTherapist who has graduated from a pro-gram accredited by the Commission onAccreditation in Physical Therapy Educationof the American Physical TherapyAssociation.

• Speech Language Pathologists andAudiologists: A Speech LanguagePathologist and/or Audiologist who hasgraduated from a program accredited by theCouncil on Academic Accreditation inAudiology and Speech Language Pathologyof the American Speech-Language-HearingAssociation.

It is advisable to apply for the CGFNSVisaScreen Program as soon as possiblebefore you need to present yourVisaScreen™ Certificate or the "CertifiedStatement". Because CGFNS/ICHP, in com-pliance with the final rule, requires all docu-mentation to come to CGFNS directly fromthe issuing source, timeliness of CGFNS’ability to process your application will bedetermined in large part by the responsive-ness and comprehensiveness of the docu-ments sent to CGFNS/ICHP by the licensingagencies and/or educational institutions inthe health care worker’s home country.Applicants are urged to make every effort toensure that the responsible foreign institu-tions provide these documents to CGFNS, inthe requested format, at the earliest possibledate. It will be important to complete theCGFNS application for the VisaScreen™service as early as possible.

You can obtain an application from theCGFNS/ICHP website at www.cgfns.org.You can apply on-line or you can downloadthe application and mail it to CGFNS. Or,you can contact CGFNS and request that anapplication be sent to you via the regularmail.

FINAL RULE / from page 1

Beginning with the November 12,2003 Exam, CGFNS is pleasedto announce that it will be

administering its Qualifying Exam for reg-istered nurses in additional exam centers inboth India and Mexico.

The new exam center in India will belocated in New Delhi, and will be in additionto the existing test sites in Bangalore (center# 850) and Cochin (center # 851). The examcenter number for the New Delhi, India sitewill be 852. In Mexico, a new exam centerwill be located in Monterrey (center # 928),

CGFNS opens additional Qualifying Exam centers in India and Mexico

Commission on Graduatesof Foreign Nursing Schools3600 Market Street, Suite 400Philadelphia, PA 19104-2651 USAwww.cgfns.org

CGFNS will be exhibiting at the fol-lowing conferences. If you will beattending any of these conferences,please stop by the CGFNS booth. Wewould love to see you there.

Nov. 1-4Sigma Theta Tau International37th Biennial ConventionToronto, ONTARIO

as well as a re-opening of the exam center inMexico City (center # 927). Eligible appli-cants who are approved to sit for a CGFNSQualifying Exam will receive further detailson their exam site location when they receivetheir Examination Permit several weeks priorto their scheduled Examination.

CGFNS administers its Qualifying Examthree times each year for nurseseducated/licensed outside the United Stateswho wish to practice nursing in the U.S.The new exam centers will be open for theNovember 12, 2003 exam and all examsthereafter. Applicants wishing to sit for theNovember 12, 2003 Qualifying Exam, orany exam thereafter, in New Delhi, MexicoCity or Monterrey, should designate theappropriate exam center numbers listedabove on their Certification Program application.

The CGFNS Qualifying Exam is onecomponent of the CGFNS CertificationProgram (CP), and is designed for first-

outside the United States who wish tobecome licensed in the U.S. More thanforty U.S. states require that foreign-edu-cated registered nurses pass the CGFNSQualifying Exam and upon successfulcompletion of all parts of the CertificationProgram, obtain the CGFNS Certificatebefore they will be authorized to sit for theNCLEX-RN® examination, the U.S.national licensure exam for registerednurses. In addition, United States law pro-vides that nurses seeking to obtain perma-nent work visas to the United States towork in their profession must obtain a"VisaScreen Certificate" from CGFNS.This certificate attests to: 1) the compara-bility of the nurse's education and trainingto that offered in the U.S., (2) ability tospeak and write English at an appropriatelevel, and (3) possession of a currentlyvalid and unencumbered nursing license inthe home country.

2003-2004 Qualifying Exam Dates

November 12, 2003(New App. Deadline: Aug 13, 2003)

March 10, 2004(New App. Deadline: Dec 10, 2003)(Re-App. Deadline: Jan 07, 2004)

July 14, 2004(New App. Deadline: April 14, 2004)(Re-App. Deadline: May 14, 2004)

November 10, 2004(New App. Deadline: Aug 11, 2004)(Re-App. Deadline: Sept 08, 2004)