Becoming a Nurse in the USA as a Ghanaian-Trained Nurse: Ultimate 2025 Guide

Are you a registered nurse trained in Ghana and dreaming of practicing in the United States? You’re not alone. According to U.S. Bureau of Labor Statistics projections, nursing jobs in the U.S. continue to grow faster than average, with strong demand for internationally educated nurses to fill critical shortages across hospitals, long-term care, and community health settings. Yet, the path from Ghana to a U.S. RN license can feel complex: credential evaluations, English proficiency exams, the NCLEX-RN, visa options, and state-by-state requirements.

This comprehensive, step-by-step guide explains exactly how to become a nurse in the USA as a Ghanaian-trained nurse. You’ll learn the eligibility criteria, which documents to prepare, how to choose a state and licensing pathway, how to pass the NCLEX on the first try, the difference between employment-based visas and student routes, and what to expect in terms of timelines, costs, and salaries. You’ll also find practical checklists, credible resources, and expert tips to avoid common pitfalls. By the end, you’ll have a clear roadmap from Ghanaian RN to U.S.-licensed Registered Nurse.

Source: www.facebook.com

Overview: The Pathway for Ghanaian-Trained Nurses

To practice as a Registered Nurse (RN) in the U.S., internationally educated nurses (IENs) must obtain a state RN license. This generally involves:

• • • 1. Credential evaluation of your Ghanaian nursing education
      2. Proof of English language proficiency (unless exempt)
      3. State Board of Nursing (BON) application
      4. Authorization to Test (ATT) and passing the NCLEX-RN
      5. Immigration/visa processing for U.S. work authorization
      6. Obtaining a Social Security Number (SSN) and completing employer onboarding

While requirements vary by state, the steps below will guide you through a typical and efficient route.

Source: globalnurseforce.com

Step 1: Confirm Your Eligibility as a Ghanaian-Trained Nurse

Source: advising.nd.edu

Core prerequisites

• Completed nursing education recognized by the Nursing and Midwifery Council (NMC) of Ghana (e.g., Diploma or Bachelor of Science in Nursing)
• Active Ghana nursing license (RN) in good standing with NMC Ghana
• Clinical training hours comparable to U.S. standards (adult, pediatric, maternal/newborn, mental health)

Tip: If your program emphasized midwifery or public health without sufficient adult/med-surg content, consider documenting additional clinical rotations or bridging modules. U.S. evaluators look for broad-based general nursing competencies.

Step 2: Choose Your State Strategically

Each U.S. state has its own Board of Nursing (BON) and licensing rules. Some are more streamlined for international nurses. Consider:

• Acceptance of CGFNS CES (Credentials Evaluation Service) vs. other evaluators
• English test exemptions for instruction in English
• SSN requirements before or after licensure
• Processing timelines and fees
• Compact state status (Nurse Licensure Compact, NLC) for multi-state practice

Popular choices for IENs: Texas, Florida, New York, and Illinois often have clear IEN processes. New York, for example, uses CGFNS CVS for NYS specifically and does not require a separate English exam in many cases. Texas may require English testing unless exempt and typically asks for a CES report.

Action: Shortlist 2–3 states and study their BON requirements. If you plan to work with a U.S. recruitment agency, ask which states they commonly place Ghanaian nurses in and why.

Source: www.cgfns.org

Step 3: Get Your Credentials Evaluated (CGFNS, CES, or State-Mandated Services)

Understanding credential evaluation

Most BONs require a third-party evaluation of your education to confirm it is comparable to a U.S. nursing program. The most recognized service is CGFNS International.

Common evaluation products

• CGFNS CES Professional Report (widely accepted by BONs)
• CGFNS CVS for New York State (mandatory for NY)
• Alternative evaluators (e.g., ERES, Josef Silny & Associates, IERF) where allowed

Documents you’ll typically submit

• Proof of identity (passport)
• Official transcripts from your nursing school in Ghana (sent directly to evaluator)
• License verification from the Nursing and Midwifery Council of Ghana (sent directly)
• Secondary school certificate (WASSCE/SSSCE) if requested

Processing time: 6–16 weeks after all documents are received. Start early and follow up to ensure your school and NMC Ghana dispatch documents promptly.

Step 4: Meet English Language Proficiency Requirements

Many states require proof of English proficiency if your primary language or program language is not English. Since nursing education in Ghana is typically delivered in English, some states grant exemptions. Others still require test scores.

Common exams and score targets

• IELTS Academic: overall 6.5–7.0 with speaking 7.0 (varies by state/employer)
• OET Nursing: typically Grade B in all subtests
• TOEFL iBT: around 83–100+ depending on requirements

Tip: Check the exact requirement for your chosen state’s BON and for immigration (see VisaScreen below). Even if the BON exempts you, the VisaScreen certificate often requires an English exam unless you meet strict education-in-English country criteria. Ghana is usually not on the automatic exemption list for VisaScreen English, so plan to test.

Step 5: Apply to the State Board of Nursing

What the BON application involves

• Online application form and fees
• Requesting your CES/CVS report be sent to the BON
• Criminal background check and fingerprints (may require U.S. presence or approved overseas channels)
• Submission of identity documents

Once the BON confirms that your credentials are comparable and other prerequisites are satisfied, you’ll be declared eligible to take the NCLEX-RN.

Step 6: Register for and Pass the NCLEX-RN

About the NCLEX-RN

The NCLEX-RN is a computerized adaptive exam testing minimum competence in entry-level nursing. Registration is via Pearson VUE after your BON approves eligibility. You’ll receive an Authorization to Test (ATT) with an exam window.

NCLEX test centers

You can sit the NCLEX outside the U.S. at international Pearson VUE centers (e.g., in South Africa, the UAE, the UK, or India). Check the current international test center list on Pearson VUE’s website and plan accordingly.

NCLEX preparation strategy

• Study timeline: 8–16 weeks of focused prep
• Resources: UWorld, Archer Review, NCLEX-RN Review by Saunders, NCSBN Review
• Method: 75–150 questions/day with thorough rationales; weekly content refreshers on weak areas
• Simulations: Take full-length CAT exams and track pass predictors

High-impact tip: Focus on delegation, prioritization, safety, infection control, and pharmacology. Practice SATA (select all that apply) and clinical judgment scenarios. Consistency beats intensity—daily practice is key.

Step 7: Secure Your RN License and Next Steps

Once you pass the NCLEX, your BON will issue your RN license (some states require SSN to issue or activate the license). If your state requires SSN and you don’t yet have one, consider endorsing your license to a state that issues without SSN or plan your immigration route to obtain SSN after arrival.

License by endorsement

If you later move states, you can apply for license by endorsement. If you choose an NLC compact state and meet residency requirements, you can gain multi-state privileges once you establish domicile there.

Step 8: Immigration Pathways for Ghanaian Nurses

Licensure and immigration are separate processes. To work in the U.S., you need lawful work authorization.

Common visa routes

• EB-3 Immigrant Visa (Skilled Workers/Professionals): A popular route for nurses. Requires a U.S. employer sponsor and a VisaScreen certificate. Leads to permanent residency (Green Card).
• H-1B (less common for bedside RNs): Typically used for advanced practice or specialized roles. Most staff RN roles don’t qualify.
• TN (not applicable to Ghanaian nationals): Reserved for Canadians/Mexicans under USMCA.
• F-1 Student Visa (for U.S. nursing education): If you intend to study in the U.S. (e.g., BSN/MSN), this is a training route, not an employment route.

VisaScreen certificate (CGFNS)

U.S. federal regulations require foreign-educated nurses to obtain a VisaScreen certificate to receive certain visas or change status for nursing employment. It verifies education, license, English proficiency, and NCLEX pass/CGFNS exam status.

• Components: CES-type evaluation, license verification, English scores, and exam verification
• Plan early: Apply once you’re close to completing NCLEX/English requirements

Expert tip: Work with reputable U.S. staffing agencies or immigration attorneys experienced with nurse visas. They can sponsor EB-3 and manage PERM, I-140, and consular processing.

Step 9: Find Employment and Navigate Offers

Where Ghanaian nurses are in demand

• Acute care hospitals (med-surg, telemetry, ICU step-down)
• Long-term care and skilled nursing facilities
• Home health and hospice
• Behavioral health and psychiatric nursing

Evaluating an offer

• Wage and differentials (night/weekend/holiday)
• Relocation assistance and housing support
• NCLEX/credentialing reimbursement
• Contract length and buyout clauses
• Immigration sponsorship terms and attorney fees
• Orientation length, preceptorship, and residency program options

Negotiation tip: Consider cost of living in the location, shift schedules, and overtime policies. Ask about continuing education benefits and tuition support for BSN/MSN if you plan to advance.

Step 10: Prepare for U.S. Practice and Transition

Clinical and cultural readiness

• Review U.S. documentation standards, EHR charting, and medication safety protocols
• Know “scope of practice” for RNs in your state
• Practice SBAR communication and interprofessional collaboration
• Understand patient autonomy, informed consent, and HIPAA privacy rules

Soft skills matter: Clear communication, time management, and patient education are highly valued. Shadowing, simulation, or transition-to-practice programs can accelerate your effectiveness.

Costs, Timelines, and Budgeting

Typical cost breakdown (estimates; can vary by provider/state)

• Credential evaluation (CGFNS CES/CVS): $365–$500+
• VisaScreen: ~$665 plus courier and English exam costs
• English exam (IELTS/OET/TOEFL): $210–$500 per attempt
• State BON application: $100–$400
• Fingerprint/background check: $50–$100
• NCLEX registration: $200, plus international scheduling fees
• NCLEX prep materials: $150–$400
• Exam travel (if outside Ghana): variable

Timeline overview

• Credentials and BON eligibility: 3–6+ months (depending on document speed)
• NCLEX preparation and testing: 2–4 months
• VisaScreen and EB-3 processing: 6–18+ months (varies by USCIS backlogs and country quotas)

Planning insight: Start credential evaluation, English prep, and gathering documents concurrently to compress timelines.

Salary Expectations and Career Growth

RN salaries vary by state, specialty, and setting. As of 2024–2025, median RN salaries generally range from $70,000 to $110,000 annually, with higher pay in states like California and New York. Differential pay for nights/weekends, overtime, and specialty certifications (e.g., CCRN, PCCN, CMSRN) can increase earnings.

Long-term opportunities

• BSN completion or MSN/NP pathways
• Specialties: ICU, ER, OR, oncology, dialysis, perioperative
• Leadership and education roles
• Travel nursing (once experienced and licensed appropriately)

Common Pitfalls and How to Avoid Them

• Delays in document dispatch from school/NMC Ghana: Follow up weekly and use tracked courier services.
• Choosing a state with hidden SSN barriers: Verify whether SSN is required to issue vs. renew license.
• Underestimating English or NCLEX difficulty: Build a study plan with measurable weekly goals.
• Accepting restrictive contracts: Read the fine print on buyouts and location commitments; seek legal advice.
• Missing VisaScreen timing: Start early to align with employer immigration filing.

Sample Pathway: A Ghanaian Nurse’s 12–18 Month Plan

1. Month 1: Select target state; register for CGFNS CES/CVS; request transcripts and license verifications; begin IELTS/OET prep.
2. Month 2–3: Sit English exam; retake if needed; submit BON application and fingerprints; start NCLEX prep.
3. Month 4–6: Receive BON eligibility; register with Pearson VUE; sit NCLEX at the closest international center.
4. Month 6–8: Apply for VisaScreen; approach reputable U.S. employers or agencies; interview and secure job offer.
5. Month 9–18: Employer files EB-3; complete consular processing; relocate; complete orientation; begin practice.

Frequently Asked Questions (FAQ)

1) Do I need to redo nursing school in the U.S.?

No. Most Ghanaian-trained RNs do not need to repeat school if their education is deemed comparable. You’ll need credential evaluation and NCLEX-RN.

2) Can I take the NCLEX in Ghana?

As of 2025, there isn’t a Pearson VUE NCLEX center in Ghana. You must travel to an approved international test center.

3) Is English testing always required?

It depends on the state and VisaScreen. Even if a BON waives it due to English-medium education in Ghana, VisaScreen often requires IELTS/OET/TOEFL scores.

4) Do I need U.S. experience to get hired?

No, but employers value recent acute-care experience in Ghana. Strong orientation programs help bridge gaps.

5) What if my state requires an SSN to issue my license?

Consider choosing a state that issues without SSN, or plan to endorse after you obtain SSN through immigration.

6) Can an agency sponsor my EB-3 visa?

Yes. Many healthcare staffing agencies and hospitals sponsor EB-3 for qualified international nurses.

Document Checklist for Ghanaian Nurses

• Valid passport
• NMC Ghana license verification
• Official nursing school transcripts and course descriptions
• Secondary school certificate (if required)

 

• Proof of English