Green Cards For MDs
Practice Medicine in the USA, with a Green Card
Medical Doctors: The following pages set forth information on how medical doctors can earn a
nursing diploma for purposes of obtaining a high paying job in the US, as a registered/licensed
nurse, and while there and earning a good salary with their green cards, pursue their ECFMG
requirements for medical licensing. It additionally addresses the USA immigration rules as they
apply to doctors immigrating to the US as nurses.
Dental Doctors: The information presented herein about how a “Medical Doctor” obtains his or
her nurse diploma in order to qualify for the CGFNS/NCLEX-RN examinations to immigrate to the
US with a Green Card applies equally to Dental Doctors.
Have you considered living in the USA and practicing medicine?
If you are not a US citizen, that goal requires either a non-immigrant working visa J-1, H1-B, or a Lawful Permanent Resident
(LPR)) Green Card. But that first assumes that you have passed all required medical examinations, e.g. ECFMG, English
tests and USMLE.
This information concerns how you, a graduate from a foreign medical school (non-US medical school) or a medical student,
can go to the USA with a green card to initially work as a NURSE, earning more than $4,000 per month.
While legally in the US, working and earning money as a nurse, you can take your required medical doctor exams, Steps 1 &
2 of the USLME, plus Step 3 which is only given in the US. If you pass all your required exams, you can apply for a residency
in a US hospital, which is a condition for all medical doctors licensing in any US state. You can accept any residency you can
be admitted to, because you will have legal work authorization (a green card), which is the main obstacle for any foreign
medical graduate to do residency in the US.
The following are the steps for a Foreign Medical Graduate (FMG) to become licensed in the US as a MD.
Pathway to Medical Licensure in the United States
http://www.bibl.u-szeged.hu/reac-europe/med_licensure.html
There are two organizations a Foreign Medical Graduate (FMG) must deal with. The Educational Commission for Foreign
Medical Graduates (ECFMG) and the United States Medical Licensing Exam (USMLE).
The FMG must meet all requirements to earn an ECFMG certificate, through its certification program. See ECFMG Certification
Fact Sheet http://www.ecfmg.org/cert/certfact.html
In order to qualify for the ECFMG certification program, the FMG must have graduated from a medical school recognized by it.
This first requirement was until recently medical schools listed with the World Health Organization (WHO), but now your
medical school must be listed with the International Medical Education Directory (IMED).
Once you are accepted into the ECFMG certification program, you will be required to complete three steps, plus pass English
language proficiency requirements (TOEFL).
Steps 1 & 2 are USMLE examinations, which can be taken in or outside the US, including Moscow if you’re studying in Russia.
Step 3 is the Clinical Skills Assessment (CSA) examination, which is a test of your skills using Standardized Patients (real
people).
The CSA is given only in the US. The cost to take this test is alone $1,200 US Dollars. The FMG is responsible for making
their own arrangements for travel to the US to take this exam, including any necessary visas for entry into the US.
For a medical doctor living in Asia or Africa for example, paying to take this exam, and going to the US to take it is a formidable
challenge in itself. In fact, many doctors can't even get visitor visas to go to the US to take this exam. Even though the FMG
has already taken the time, and incurred the expenses of passing Steps 1& 2, and usually paid and registered for the CSA in
order to get an exam date, of which the Consulate is aware of this, it does not make any difference to them. The "refusal" rate
for MDs trying to get into the US for testing purposes is very high, and may be higher than the refusal rate for the average
visitor visa applicant. And when denied the visa, there be is nothing, nothing, the FMG can do.
But this is not the major obstacle the FMG must overcome to eventually become licensed in the US.
If you are successful in passing all 3 Steps and the English requirement, you are issued a Standard ECFMG Certificate. At
this point, the FMG is considered educationally equal to a MD who has graduated from an American medical school.
Like American MD graduates, the FMG must undergo additional post-graduate hospital training in a particular area/specialty
of medicine, in order to become a licensed physician in some US state. This training is known as residency.
See: Entry into Graduate Medical Education in US:
http://www.nrmp.org/
Residencies are performed in hospitals. Finding a residency in the US is a major obstacle, even if the doctor is not too
selective as to the type of residency, e.g. pediatrics, orthopedics, psychiatry, etc., and where he or she wants to perform the
residency. It is a lot harder to find a residency program in Beverly Hills California, than it is in Alaska. (With a green card, you
can work in any US state you can get a job, as opposed to a J-1 sponsored visa where the doctor is strictly limited to the
hospital that has sponsored he or she).
Annually in the US there are more residence positions available, than there are available doctors to fill them. However,
obtaining a residency is not easy for any doctor. In 2010 there continues to exits a "Medical Emergancy" that has resulterd in a
shortage of "Primary Care Phyisians", and that shortage is expected to grow with the passage of the "Health Care Bill".
Residencies are paid employment, where the resident MD is paid to train in the specialty. This is the most salient point facing
the FMG. Because residency is "employment" the FMG (alien) must have a Green Card (which permits the holder to work
anywhere he or she can get a job) or a non-immigrant H1-B or J-1 visa (which permits the FMG to work ONLY in the residency
position).
J-1 visas are obtained by the FMG by sponsorship through ECFMG. This is a non-immigrant visa, and it is very difficult to
obtain, because the FMG is competing with other FMGs from all over the world to get sponsored, for a very limited number of
positions. Moreover, the J-1 is a non-immigrant, temporary visa, which requires the FMG to return to his or her own country
and work in their specialty (in which they did their residency in the US) for two years at the end of their training. (Waivers of
this 2-year return rule are available, but difficult to obtain). And then, after the two years in their native country, the FMG would
still need to get a green card or a non-immigrant visa to return to the US to work as a doctor.
Effective October 2009 President Obama signed into law an Appropriation Bill which included a provision that extended for 3
years the Conrad 30 Waiver Program for IMG. FMGs that have been granted J-1 visas to do their residencies are permitted to
apply for a waiver of the 2 year home country physical presence requirement if they are willing to work as primary care
physcians in medically underserved areas. Each state is permitted 30 waivers a year. The IMG must still find a means to
obtaining a green card.
See: Exchange Visitor Sponsorship Program:
http://www.ecfmg.org/evsp/index.html
H1-B visa is a non-immigrant professional work visa. Non-immigrant means that at the end of the visa period, you have to
leave the US, or have found a way to adjust (change) your visa to permanent residence/green card.
Earning a Standard ECFMG Certificate and finding a hospital residency are not the major obstacles for a FMG. Obtaining
permission to work in the US to do the mandatory residency is the major obstacle.
THE EXAM
In order for a foreign trained nurse (or FMG with a nursing diploma) to work in the US as a nurse, they must first pass an
international nursing test, offered in many countries around the world. Passing this international nursing test will make one
eligible for their green card to go to the US to work as a nurse.
The required international nursing test is administered around the world by the Commission for Graduates of Foreign
Nursing Schools (CGFNS), passage of which leads to employment in the US as a nurse, and a green card to GO TO THE US
to work as a nurse.
While in the US working as a nurse, the MD-RN can study and take the USMLE tests, take the CSA (only given in US), as well
as the English tests and find a residency.
There are many professional "Review Courses" given in most major cities in the US, e.g. the Kaplan USMLE Review
Courses, which prepare MDs (both US and FMGs) for the USMLE exams and the CSA.
If successful in passing the tests, which earns the MD-RN his or her Standard ECFMG Certificate, the MD-RN can apply for
hospital residency. Because the MD-RN has a green card, he or she can accept any available residency, and eventually
become licensed in the US as a MD.
The MD, who has earned his or her nurse's diploma, and passed the CGFNS and English tests, will need a US employer to
offer them a job. The employer, a hospital or other health care provider, will sponsor the nurse for their green card, with a
condition that the nurse work for it for at least two years as an RN. (Note: "as an RN").
Time wise, once the MD-RN is in the US with their green card and working for the hospital/employer, it could take two years or
more for the MD-RN to earn their ECFMG certificate, and find a residency program. This assumes the MD has not earlier
started taking their USMLE tests.
So, during the time the MD-RN is taking these necessary steps, he or she will be working as a nurse, earning a good living.
They will also be assured that in the worst case scenario, even if he or she is not able to pass all the MD tests, they will
always keep their green cards. There is no legal requirement that the immigrant who received a green card to work as a
nurse remain working as a nurse in order to keep the green card. So long as the alien arrived in the US and worked for the
sponsoring employer for a reasonable amount of time (reasonable being 6 months), they can seek any other type of work
they want or can obtain.
This last sentence assumes the MD-RN has fulfilled his or her contract requirement to the sponsoring employer, of two years
employment.
Demand for nurses in the US!
In order to commit to studying to receive a nursing diploma, the MD/student must believe independently, that if he or she
obtained a nursing diploma, and passed the required nursing exam (CGFNS) and English tests, that there would be a job in
the USA available to them, as a nurse. They must also believe that they would receive a Green Card to go to the US to work
as a nurse.
US Nurses Shortage: There has been, is, and will continue to be a shortage of nurses in the US. For many years foreign
nurses have found it easy to go to the US to work as nurses. There are many reasons for the shortages of nurses in the US.
Suffice it to say that a simple Google search will substantiate this shortage of qualified nurses in the US. (Google: “Shortage
of Nurses in USA”). Government surveys estimate that the US nurse's shortage will last for at least the next 20 years. This is
not an exaggeration. The reader interested in taking the time to visit the below web sites, will find this is a fact.
November 2009 "post" recession article regarding job market for registered nurses
The following web sites support this claim:
• American Association of Colleges of Nurses: http://www.aacn.nche.edu/Media/Backgrounders/shortagefacts.htm
• July 2003 article, "Jobs await new nurses"
http://www.enquirer.com/editions/2003/07/12/loc_christnursing12.html
• rediff.com "Employment growth due acute shortage nurses USA" (India)
http://mboard.rediff.com/board/board.php?boardid=money2004jun02job
• Discover Nursing, Job Opportunities:
http://mboard.rediff.com/board/board.php?boardid=money2004jun02job
• U. S. Department of Labor, Bureau of Labor Statistics:
http://www.bls.gov/oes/2001/oes291111.htm
The Bureau of Labor Statistics is general information, but will give a good idea of what a nurse will be earn per hour. The
bottoms 10% of the country's nurses earn $15.92 per hour, yearly $33,110. The 25 percentile make $18.85 per hour, and the
median 50% make $22.44 per hour/yearly $46,670. This is for a regular 40 hour week, which is usually 5 days (night shift
usually more) at 8 hours per day. Some nurses work 4 day weeks for 10 hours per day. When you exceed the day’s minimum
hours (8/10) and work extra hours, the nurse is usually paid time and a half, or the hourly wage, plus 50%. As indicated, night
shifts are extra hourly, plus unscheduled holidays, which can pay double the hourly wage.
• California Job Market: http://www.calmis.cahwnet.gov/file/occguide/NURSEREG.HTM
• National Council of State Boards of Nursing (NCSBN), March 31, 2006 article, “Americans for Nursing Shortage Relief”
http://www.ncsbn.org/news/index.asp
I reference the California Job Market specifically, because this is the primary state we place nurses in. California is the most
populace state in the US, and is the 5th largest economy in the world. (USA, Japan, Germany, United Kingdom, and
California).
The US nurse's shortage is such, that CGFNS offers the international nursing examination in many cities around the world.
Before November 2005, in Eastern Europe, the closest, and only cities this exam was available in was Frankfurt Germany,
and Goteborg Sweden. It is being offered now in Moscow, Russia. The test is given in Pakistan, India, Indonesia and many
other countries. In India, there are 4 test sites in New Delhi, Bangalore, Mumbai and Cochin.
Students in St. Petersburg, Russia can take and earn their CGFNS certificates while still in medical school by taking the test
in Moscow.
www.cgfns.org at bottom of page, click "Programs", next page click "Certification Program"
The CGFNS and the NCLEX-RN are given outside of the US, and only for nurses, which will allow an Examinee who passes
the exam to go work in the US, with a green card. The nurse must also have good minimum scores on the TOEFL or IELTS
exams, including the Test of Spoken English, (TSE), in order to qualify for their CGFNS Certificate, which allows the US
Employer to file for their green cards.
There are other requirements and procedural steps the nurse must take, but these CGFNS and English tests are the exams
the nurse must pass in order to receive a job offer from a US employer, and start the process (petition) for a green card.
MDs don't qualify for CGFNS nursing exam!
The requirements and rules for a nurse to qualify to take the CGFNS exam are clear. A nurse must have graduated from a
nursing school which issues him/her a diploma, and the degree must allow him/her to work as a registered nurse in that
country. CGFNS will not accept a MD diploma for purposes of qualifying to take the nurse's exam. That is their rule and
applies to all FMGs.
Common Misunderstanding by Medical Doctors re the CGFNS Rules?
Many medical doctors have received this information, and a common misunderstanding they have from reading the CGFNS
web pages is their belief that the "Nursing Diploma" must authorize them to "Work" in "Their Home Country" as a "Licensed
Nurse". This is a misreading of the CGFNS rules. The CGFNS rule requires that the nurse diploma be earned at a
"Government" approved school, authorized in that country to issue a nurse diploma. The Nurse Diploma MUST permit the
nurse to work as a licensed (legally authorized) nurse in the country where the nurse diploma was earned. If the nurse
diploma authorizes the nurse to work as a licensed nurse in the country where earned, (e.g. Russia), the nurse diploma will
be recognized for CGFNS eligibility purposes, so long as it also meets curriculum specific nurse education content, e.g.
practice and theory.
As a practical matter, if it was possible for a MD (FMG) to qualify to take the CGFNS based on their medical doctor education,
and get a green card to the US, there would be no shortages of nurses in the US.
So, CGFNS requires a government approved nursing diploma, from a nursing school.
In cooperation with the St. Petersburg State University Medical University , we have developed a one-year nursing program for
medical doctors, dentists and medical students, which will earn them a nursing diploma.
It is not a short cut diploma, which CGFNS would not accept anyway. It is a nursing curriculum that takes into consideration
your general medical studies. Courses that where studied by the doctors in their respective professional schools, which are
common to courses covered in a nursing school, are credited towards the nursing curriculum. Those courses not covered by
the doctors in their professional schools, but which are studied by a nurse, are the courses you will study in the program.
This should not be an academic challenge to doctors who have studied medicine or dentistry Frankly, most of these doctors
could probably pass the CGFNS exam, simply by studying the study guides, or review courses, without attending any nursing
courses.
However, in order to qualify for the CGFNS exam, the nurse must have graduated from a nursing school, with a diploma, and
the only way to do that is to attend a nursing school, albeit, for a shorter time for the doctor.
CGFNS CERTIFICATE AND TOEFL
When you have earned the CGFNS Certificate (which requires the proper TOEFL/ESL scores to earn), we'll get you a job in
the US. We'll have the US employer make you the job offer, and process your green card petition through the US immigration
department.
After you have received your green card from the US Consulate, we'll give you an airplane ticket, fly you to the US, and take you
to your employer.
Either your US employer will arrange for your initial housing, or our California based organization will be responsible. In order
to minimize your housing costs, we will try to house nurses in common housing, where several doctors share a “residential
home” with our other placed nurses.
There is another documentary requirement, called VisaScreen, which essentially is a document verification service, required
by the US immigration authority. All health care workers must obtain this certification before they go to the US Consulate for
their immigration interview, but this document is only applied for after you have passed CGFNS and the English tests.
VisaScreen is not an exam. It is a service that essentially reviews the same educational documents you submitted to CGFNS
in order to sit for their exam. If your documents qualified you to sit for the CGFNS exam, they are acceptable for issuance of
the VisaScreen certificate.
CGFNS, the English tests, VisaScreen, and the green card do not give you the right to work as a registered nurse (RN) in the
US.
While this may seem strange, this is the rule, and only for nurses immigrating to the US.
When you receive your green card to go to the US, you will not be a licensed Registered Nurse (RN) in California, and will not
be able to work as a RN until you have taken and passed the state's RN exam. You will be able to work in a lesser (non-
licensed position) at the hospital that sponsored you, while you wait to pass the state's nursing exam.
However, once you apply to the State Nurse's Licensing Board to take the exam, you are also given a temporary or "Interim"
nursing license which allows you to work as a “supervised” registered nurse at the hospital while you are waiting to take your
scheduled exam. If you pass the exam, your temporary license becomes permanent. If you fail, you can reschedule to take the
next exam, but no further temporary licenses are issued to you. You could still work for the hospital in the lesser capacity
while waiting for the next exam.
CAVEAT: I mention this point here because it is important to both you and the hospital. Your 2 year contract to work as nurse
for the petitioning employer starts when you become a licensed nurse and can work in that capacity. If you fail the test the first
time, the two-year period will not start until you later pass the test. This point should be carefully considered and understood
by you.
STATE NURSING BOARD: Each US State has a Registered Nurses Board, which licenses nurses. In order to work as a RN,
the nurse must pass the state's exam, administered by the National Council of State Boards of Nursing, known as NCLEX-RN
http://www.ncsbn.org
Unlike CGFNS which is scheduled four times a year (excepting special sessions) the NCLEX-RN exam can be scheduled
year round.
The NCLEX-RN examination is now offered outside the US and is known as International NCLEX. This is a definite benefit to
foreign nurses and US employers, and further demonstrates the “need” for registered nurses in the US.
While this is a benefit to prospective nurses and employers, by permitting the nurse to “license” outside the US before
immigrating, it does not change the basic rule that the CGFNS certificate in itself qualifies the Employer to file the immigration
petition to bring the nurse to the US with a green card. These newly established NCLEX-RN “testing” centers will afford
nurses the opportunity to take this exam after they have earned their CGFNS certificates and are waiting outside the US for
their immigrant visas.
However, it should be noted that the immigration laws for nurses permit the nurse to have passed either CGFNS or NCLEX-
RN to have the employer file the petition with the immigration department (which starts the visa waiting period). The obvious
question is “why should I take CGFNS if taking and passing NCLEX-RN permits the employer to file the immigration petition
and permits me to work in a US State”?
The answer is that while all states require the nurse to have passed NCLEX-RN to work as a registered nurse, 40 of the US
states also require the nurse to also have earned a CGFNS certificate as a condition to being eligible for their state license.
California is one of the states that does not require the nurse pass CGFNS as a condition to being licensed. So, in effect,
doctors who have the ability to take the NCLEX-RN exams in one of the exam sites outside the US, could elect to take this
exam in lieu of CGFNS.
Additionally, these NCLEX-RN testing centers outside the US will increase the employment desirability of nurses with
employers. While some nurses who have passed CGFNS are able to travel to the US to take the NCLEX-RN before
accepting offers of employment, the vast majority of foreign nurses cannot due to financial considerations or visa
requirements. Prior to 2005 these nurses’ only option was to earn the CGFNS certificate, secure a job offer from a US
employer, and take the NCLEX-RN only after they arrived in the US with their green cards.
The National Council of State Boards of Nursing released in January 2005 the 2004 fact sheet of NCLEX examination
statistics. The release shows that the largest number of foreign educated examinees includes Filipinos, Canadians, Indians,
South Koreans and Chinese, respectively. The NCLEX pass rate for internationally educated RN’s in 2004 was 44%.
Employers are aware of this passing rate, which translates into the fact that less than 50% of the foreign nurses for whom the
employer petitions who only have their CGFNS certificates, will pass the NCLEX-RN. http://www.ncsbn.org (see fact sheet)
Or considered otherwise: The first time passing rate for the CGFNS exam is less than 50%. The first time passing rate for
foreign trained nurses for NCLEX-RN is less than 50%. In effect, this means that out of 100 nurses sponsored outside the
US for US employment in the US, less than 25% will be successful.
The foreign nurse who earns her CGFNS certificate, who thereafter is petitioned by a US employer, becomes a more valuable
future employee to that employer if while they are waiting for the green card interview they are able to sit for an pass the
NCLEX-RN exam.
Keeping Your Green Card:
Assume you earned your CGFNS certificate and did not take the NCLEX-RN exam outside the US, immigrated, but were not
able to pass the state nursing licensure exam. You could not work as a RN for the hospital/employer as described above.
However, once you physically arrived in the US, your green card process was perfected, and you became a Lawful Permanent
Resident. There is no legal (as opposed to contractual) requirement that you pass the nursing exam, or even continue to
work for the employer after you have worked for it for a reasonable amount of time.
Two Classes of students:
The program enrolls two classes of students. Students presently studying medicine in St. Petersburg, in their 4th, 5th or 6th
years, and MD Graduates, both Russian MDs and FMGs.
English Language Prerequisites:
Unless you were educated in the English language, meaning the language of instruction in your country was the English
language, you must take a TOEFL test, and score 500 or higher, to be enrolled in the program. While the required score is
540, (below), if you score 500 or higher before commencing the course, you will be able to bring this score up with the one
year of the program.
TOEFL: Paper-Based 540; TOEFL Computer -Based 207; Test of Written English (TWE) 4.0; Test of Spoken English (TSE) 50
IELTS: 5.5 average score
Other Doctors Training to be Nurses:
Presently, more than 2000 medical doctors in the Philippines are studying to receive their nursing diplomas:
Doctors in Nurses caps
http://www.inq7.net/nwsbrk/2002/dec/09/nbk_6-1.htm
In Philippines, as of 2004, curriculum changed from one year to two years to stem the exodus of doctors emigrating as
nurses. "The initial special curriculum for doctors, required one year classroom/practical training before receiving nurse
diploma. ,,,,,,,,,".
http://www.manilatimes.net/others/special/2004/feb/09/20040209spe1.html
Philippine doctors work overseas as nurses
http://www.sikhspectrum.com/022004/nurses.htm
Foreign Educated Doctors Train as Nurses in Fl. (500 apply and growing)
http://www.findarticles.com/cf_dls/m0CYD/17_37/91485405/p1/article.jhtml
In the Florida program, the doctors study for two years, but earn a bachelor degree upon graduation. A Registered Nurse
(RN) in the US studies two years and earns a two-year Associate of Arts degree to qualify for a State's RN licensing
examination (NCLEX-RN). Doctors in our one-year program earn a nurse's diploma.
Accelerated Bachelor of Science Nursing (BSN) degrees offered in the US (BSN)
In the US, there are many colleges and universities that offer what is commonly referred to as Accelerated BSN degrees.
These programs offer second career or degrees in nursing in as little as 11 months to persons who have already earned a
bachelor, masters or doctor degree in another major, who also possess certain prerequisites in the basic sciences, e.g.
biology, physiology, chemistry, anatomy, etc. The degree earned specifically qualifies the graduate for both the CGFNS and
NCLEX-RN.
USA Today “Professionals sick of old routine find healthy rewards in Nursing”
http://www.usatoday.com/printedition/money/20040816/nurses.art.htm?POE=click-refer#
Here are several sites that offer the programs in the US.
Research College of Nursing:
http://www.researchcollege.edu or http://www.researchcollege.edu/CustomPage.asp?guidCustomContentID={011BACCC-
DAE9-47ED-90F5-D99C3D539CD7}
State University of New York
http://sonce1.nursing.sunysb.edu/nursingweb.nsf/OnSite12MonthAcceleratedProgram?OpenForm
College of Nursing and Health Science
http://cnhs.gmu.edu/bsn/bsn2ndpath.html
Drexel College of Nursing (11 month program)
http://www.drexel.edu/cnhp/nursing/undergrad_bsn_ace.asp
There are numerous other colleges and universities offering these types of programs.
http://www.aacn.nche.edu/Publications/issues/Aug02.htm
Many nurses going to US with their green cards:
The majority of foreign nurses who are going to the US to work are from the Philippines and India. In those country, and
others, people enter the nursing profession with the specific intention of earning the diploma and passing the tests to go to
work and live in the US. These people commence their education with the intention of using it to get to the US.
Because this "bridge" is available only to nurses, and because of the high wages a nurse can earn in the US, many medical
doctors are presently studying to earn the nursing diploma.
These Nurse Diploma programs for medical doctors should serve to convince you that this type of additional training is a
viable means of earning the green card, and hopefully some day becoming a licensed medical doctor in the US.
Sequentially the steps are as follows:
1. After having earned the nursing diploma, one registers for the CGFNS exam, and is scheduled for the next available
exam date. The exam is given four times a year around the world;
2. If the CGFNS exam is passed, and the necessary scores have been earned on the English tests, the nurse is awarded
the CGFNS Certificate (with a date of issuance);
3. Employers, US hospitals or other Health Care Providers will have been contacted prior to your taking the CGFNS exam,
and your information presented for their consideration;
4. If required a phone interview or video conferencing call are conducted between you and the employer. In some
instances personnel from the hospital will come to St. Petersburg while you are studying to interview you;
5. If the employer offers you a job, we (us and the employer) will file an immigration work "I-140 Petition" to the US
Citizenship and Immigration Services (CIS) having jurisdiction over the place the nurse will work.
6. The CIS then sends the approved petition to the National Visa Center, (NVC) in Portsmouth, NH;
7. The nurse (or her agent/attorney) then receives a “fee bill” from the NVC for requesting all government processing fees
be paid in advance of processing the nurse’s application (and those of her immediate family members if applicable);
8. After fees are paid, the NVC forwards a packet to the nurse or her agent/attorney containing biographical information to
be completed by nurse and family members immigrating, and a list of documents to compile for submission to the
Consulate;
9. Next, the RN or her agent/attorney send the signed and completed forms and documents to the NVC;
10. Upon receipt, the NVC schedules an appointment for an immigrant visa for the nurse (and family members
immigrating) at the US Consulate or Embassy where they will have their green card interviews.
11. Before the interview the nurse must present various documents including the VisaScreen Certificate. When the
employer makes the job offer to the nurse, the VisaScreen procedures are started;
12. A successful interview results in an approval and an immigrant visa is issued to the nurse to go to the US to start
working with the employer who offered the job;
13. You are responsible for booking and paying for your travel costs to the USA;
14. Upon arrival in California, we meet the nurse and take him/her to the employer. Either the employer or our
organization assumes responsibility for living and orientation.
15. Welcome to America
Diploma Guarantee for CGFNS Purposes:
Naturally, you want to be sure that your nursing diploma will qualify you to sit for the CGFNS nursing test.
I again refer you to the MAPS web site: http://www.maps.spb.ru/eng/studies/courses/nurse.htm
The following information is taken from the official MAPS web site:
"The MD/Nursing Diploma English language program was designed for medical doctors interested in ultimately entering
hospital residency in the United States of America. By earning the nursing diploma through MAPS, the MD will become
eligible to take the qualifying examination offered by the Commission for Graduates of Foreign Nursing Schools (CGFNS)
http://www.cgfns.org
The MAPS MD/Nurse Diploma Program has been officially evaluated by CGFNS and accepted for its Certification
Program. See below letter from CGFNS".
"The designated responsible person at MAPS for this program is Olga Y. Kuznetsova, MD., Ph.D., D.Sc., Professor, Vice
Rector for Residency and International Activity, Head of the Family Medicine Department. Interested doctors may submit
their questions directly to Professor Kuznetsova's Department regarding the program. ’’
The first group of doctors have completed the MD/Nurse Program, been accepted for the CGFNS Certification Program
examination, sat for the examination and have received CGFNS Certificates.
June 2005: In June 05 the first class group of doctors completed the MAPS program, and applied for the CGFNS Exam.
November 25, 2005 the Russian Ministry of Health in Moscow issued the official response to the CGFNS letter and sent
directly to CGFNS. The response letter from the Ministry effectively notifies CGFNS that MAPS St Petersburg is authorized to
retrain medical doctors as level one nurses, and officially acknowledges that the diploma holder is authorized to work as a
licensed nurse in Russia.
February 2006, first doctor to complete MAPS MD/Nurse Program received his CGFNS Certificate.
March 2006, all other doctors that completed MAPS MD/Nurse Program and applied for CGFNS Certification examination
were rostered and sat for test.
April 2006, MAPS MD/Nurse graduates who sat for test notified of their results. Most passed.
April 26, 2006 CGFNS officially evaluates and accepts MD/Nurse Diploma for Certification Program. See Appendix A.
Qualifications for enrollment:
• Graduation from a Russian or Foreign medical school, e.g. MD/MBBS degree;
• Graduation from a medical school whose language of instruction was English; or
• Graduates from non-English language medical schools must have taken and received a score of 500 or higher on a
computer based TOEFL examination. IELTS 5.5
English Language Instruction:
• The nursing course is instructed entirely in the English language, and English language text is used.
Duration:
• 12-months, full time
Diploma Earned:
• Nursing Diploma, fully authorized as a first level nurse's diploma by the Russian Federation.
Tuition and Living Accommodations:
• One-Year Course: $4,000 US Dollars;
• MAPS Dormitories: $100 per month, per person. Two room apartments, two persons per room, with toilet/bath/kitchen;
• Doctors are registered as postgraduate students of MAPS, and receive visa support;
• Health Insurance: Approximately $100 for the year;
• Russian Language Course and orientation. Prior to commencing the nursing program, doctors will receive a two week
(+) full time course in the Russian language, as well as an orientation program on "living in Russia";
• Application, Processing, Visa and Administrative Fees $2,000.
Financial Obligations and Tuition
Medical doctors enrolling in the program must pay their own tuition and related living expenses while they study for their
nursing diploma. However, there is no charge to the FMG for our obtaining them a job with an employer, a green card and a
ticket to the US. Subject to Conditions.
Tuition for the 12-month program is $4,000 paid directly to the Academy in St. Petersburg, in addition to the indicated
application, processing and administrative fees.
- PLUS -
The cost for finding you a job in the US as a nurse, getting you a green card and getting your employer to pay for your plane
ticket to California is $20,000 US Dollars.
Yes, that is correct, Twenty-Thousand US Green Back, Uncle Sam Dollars.
But, if we are both successful, you in passing the CGFNS exam and English requirements to earn the certificate, and we in
finding you an employer in the US to hire you as a nurse, you will not pay this amount, or anything else to us for our services.
Obviously, we are not in this for our health, and neither are we receiving any financial benefits from your tuition payments for
your nursing diploma.
We benefit financially from this program by placing you in the US with an Employer. The Employer pays us for bringing
qualified nurses, as well as for the cost to immigrate you (filing of petition in the US with immigration). Such is the shortage of
nurses in the US, that this is the industry practice. But the employer only pays us when you arrive in the US with your green
card.
If you don't arrive in the US with your green card to go to work for the employer, we don't get paid, Period.
So, we have a real interest in seeing you earn your diploma, qualify for and pass CGFNS and get to the US with your green
card.
We also have an interest, and concern in seeing that AFTER you do earn your CGFNS certificate, you do not find another
agent to find a job for you in the US. And believe me, once a nurse has this certificate, and especially a doctor-nurse, there is
no difficulty finding a nursing job, whether through an agent or individually by the doctor/nurse finding his or her own job over
the Internet.
You WILL NOT pay this $20,000:
1. If you do not complete the nursing program and earn your diploma;
2. If you earn your diploma but do not pass the CGFNS exam (Fail to pass). But you must register and take the CGFNS
exam within at least one year after receiving your diploma;
3. If after receiving your CGFNS certificate (by fulfilling English requirements and passing test), within one year we do not
find you a job with an Employer in the US to work as a nurse. Your CGFNS certificate will have a "validity date" on it. We will
have one year from that date to find you a job. Within this one year, not only must I find you an employer in the US, but the
employer must have offered you a contract of employment, or we (the employer and us) must have filed the immigration
papers (I-140 Petition) with the immigration office for your green card;
4. If the petition is approved, but you fail to receive your green card to go to the US as a nurse;
5. If you receive your green card and arrive in the US to work with the employer;
6. To reiterate, if you arrive in the US with your green card, you will not owe this $20,000 or anything else to us for having
gotten you there, with the green card, IF YOU FULL FILL YOUR 24 MONTHS WORKING FOR THE PETITIONING EMPLOYER,
according to at a written agreement.
The above are all reasons why you will not pay this $20,000.
Once the employer files the green card petition in the US, it will take approximately one year for you to arrive in the US with
your green card. The employers are aware of this time frame.
By contract, you must agree that while the employer's petition (I-140) is pending and you are waiting for your green card
interview, you will be prohibited from contracting with another US employer for the same purpose of working for it as a nurse.
You WILL pay this $20,000:
1. If you earn your diploma, fail to take the CGFNS exam within one year, and at a later time in the future, obtain
employment with a US employer as a nurse, through the services of another agent, or by finding the job yourself;
2. You earn your CGFNS certificate, but within the one year above stated, you accept employment as a nurse in the US
through the services of another agent, or on your own.
3. You arrive in the US with your green card but: (a) do not start your employment with the Petitioning Employer, or (b) start
your employment with the US Employer, but do not complete your 24 month contract obligation.
As a legal matter, the jobs are for "registered nurses". This means that you will only be able to get your license, in any state, in
the name that is on your documents, and your nurse diploma. As a "registered nurse" the license is a public record and we or
practically anyone can find a registered nurse by simply doing a name check through the state nurse's boards.
If you are working as a registered nurse, or as a doctor, we will enforce our contract with you in the courts, and we will collect.
Plus costs, plus interest, plus attorney's fees, plus,
Current Green Card Issues for Doctors immigrating as Nurses:
Readers Note November 2005: Starting in January 05, there developed a shortage of immigrant visas for certain immigrants
from India, China and the Philippines, which applied to nurses from India. In May 05, President Bush signed into law a
special Bill which made 50,000 immigrant visas available to NURSES and physical therapists. The doctors enrolled in the
class group that graduated with their nurse diplomas in June of 05, where kept informed of the backlog and the events
leading up to the “recapturing” of the 50,000 immigrant visa. That information is posted at our web site at www.mdnurse.
com. so that doctors can learn; of the backlogging/visa shortage which developed in January 05; the reaction by the US
Health Care Industry; the swift action by the US Congress to address the shortage; the passage of legislation within 5
months; and the signing into law by President Bush five months later which made immigrant visas available to nurses.
Further, for the readers information, the backlog that developed in the immigrant preference category to which nurses are
subject, remains backlogged for all other immigrants in the Employment Based 3 Category, and as of December 05, was
backlogged three years. Other than the normal processing time from when an Employer files the I-140 petition to when the
nurse goes to the US Consulate for the green card interview, there are no other waiting periods or backlogging of visas for
nurses.
Business Experience Nurses Employment US:
Professionally, I am an American immigration attorney, having practiced in this area of the law for over ten years and as an
adjunct professor of law in California for 6 of those years in the subject of federal immigration laws. I have remained current
on the US immigration laws.
In the early 90s I developed nursing programs in Nigeria and Ghana, and in mid 90s programs for nurses in Russia, for
employment in the US, under "old" immigration laws. The “old” special visa (H1-A, non-immigrant) category “only” for nurses
expired in 1995, which made it more difficult for nurses to go to the US to work. The present immigration rules allow foreign
trained nurses to come to the US with their green cards, and created the opportunity for medical doctors to immigrate as
nurses.
Continuing Enrollment, Twice Yearly:
The MAPS MD/Nurse Diploma Program is offered twice yearly. Annually MAPS will accept and educate 100 medical doctors.
Class groups are limited to 50 doctors per group. Class groups start twice yearly, in September and February.
With the issuance of the official response letter to CGFNS from the Russian Ministry of Health (above page 10) that officially
validates the MAPS Nurse Diploma for international licensing purposes, it is anticipated that the hundreds of doctors that
have inquired about the program will now apply, and that the applicants for enrollment will far exceed the available seats.
We foresaw the shortage of seats for interested doctors, once the Russian Ministry validated the nurse diploma to CGFNS.
As a result, we have made preliminary arrangements to offer the MD/Nurse Diploma program in “other” similar institutions,
both in Russia and other Eastern European countries.
Those “other” MD/Nurse Programs are planned. Interested doctors are encouraged to apply early to secure a seat in the
MAPS classes in order not to be placed on the MAPS waiting list, or have to wait for a seat in the to be established “other”
programs.
Doctors that Completed MD/Nurse Program in June 05:
Several doctors that completed the MAPS program in June 05, have volunteered to respond to inquiries from medical doctors
interested in the program about their personal experiences and opinions. Those interested in communicating with these
doctors can send me your request for their individual contact information at rudy@mdnurse.com or click onto “Doctor’s
Opinions”
The first class of doctors that completed the course in June 05 includes a medical doctor who resides in the US with a green
card. Knowledgeable by personal experience of the demand for nurses in the US, and aware of the “waiting lists” to get into a
nurse college in the US, or the higher costs to enroll into one of the “accelerated BSN” programs, he opted to enroll in the one
year program in St. Petersburg at MAPS. His contact information is available at our web site www.mdnurse.com , Left Index
“Dr Raza, Pakistan”.
The “other” programs presently being established for medical doctors, will be broadened to include homeopathic doctors,
Unani doctors, as well as programs for Dentists and Pharmacists, whose professional educations are similar to medical
doctors.
As of January 2006 a similar program for Dentists, Pharmacists, Homeopathic and Unani Doctors has been approved by
the "Kiev Medical Institute", Kiev Ukraine, and the first classes for this group of health care professionals will be offered
in September 2006. Please see "Kiev Medical Institute" button at our Home Page, Left Index, for information on those
programs.
As is indicated at the MAPS web site, I personally worked with the Postgraduate Academy to develop the MD/Nurse program,.
I am the exclusive representative for MAPS for the enrollment of medical doctors into the program. All doctors must be
personally represented by myself, directly or through one of my authorized agents to be enrolled into the program.
Thank you for your consideration of this information.
Rudolph Mosqueda, Esq.
Copyright by R. M. Mosqueda 2006
 | |  | |  | |  |