on Graduates of Foreign Nursing Schools (CGFNS) began in the late 1960s when the United
States experienced an increase in nurse migration from other countries. Immigration
officials had a difficult time identifying which of the nurses educated abroad, and
applying for nursing occupational visas, would be eligible for licensure as a registered
nurse in the United States. On an average, only 15 to 20% of nurses educated outside the
United States were passing the US registered nurse licensure exam on their first attempt.
led the Division of Nursing of the then Department of Health, Education and Welfare (DHEW)
to contract for two studies regarding RN-licensure of foreign educated nurses in the
United States. The findings of these landmark studies on foreign nurse immigration
conducted by the American Nurses Association and Pace University were discussed at a 1975
HEW conference attended by representatives of the American Nurses Association (ANA), the
National League for Nursing (NLN), US boards of nursing, the American Hospital Association
(AHA), the American Medical Association (AMA), the US Department of Labor, the US
Immigration and Naturalization Service, and the New York State Education Department, among
other organizations. The outgrowth of the conference was the establishment of a private,
independent, non-profit organization. The organization created was CGFNS.
The 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 US registered nurse licensing exam, the NCLEX-RNŽ examination, and attaining
licensure to practice as registered nurses within the United States.
program comprises three parts:-
credentials review of the nurse's education, registration and licensure;
CGFNS Qualifying Exam - a one-day qualifying exam testing nursing knowledge;
English language proficiency exam.
successful completion of all three elements of the program, the applicant is awarded a
The 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-RNŽ examination and attaining licensure to practice as registered nurses within the
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).
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 US, and therefore,
is not eligible for the Certification Program.
general nurse must have obtained theoretical instruction and clinical practice in a
variety of nursing areas. A nurse who has 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.
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.
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.
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
TThe 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.
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 US schools of nursing.
the CGFNS Qualifying Exam and the NCLEX-RNŽ
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. The main difference between the CGFNS and the NCLEX examinations is that the
former is a written exam while the later is a computerized examination. It is because of
this that we say that if you pass the CGFNS you will find it extremely difficult to fail
the NCLEX as long as you have a basic knowledge of computers.
a CGFNS Certificate
All applicants are reminded that in order to obtain a CGFNS Certificate, they must pass
both the CGFNS Qualifying Exam and the Test of English as a Foreign Language (TOEFL),
administered by the Educational Testing Service (ETS) or IELTS. For information and/or
registration for the TOEFL exam, contact ETS at: Test of English as a Foreign Language,
Educational Testing Service, P.O. Box 6151, Princeton, NJ 08541-6151, USA; Telephone (609)
Contact CGFNS at:
Commission on Graduates of Foreign Nursing Schools
3600 Market Street, Suite 400
Philadelphia, PA 19104-2651 USA
Business Office: (215) 222-8454
Applicant Enquiries: (215) 349-8767
Facsimile: (215) 662-0425
Telex: 402409 CGFNS PHA
Cable: CGFNS, Philadelphia, USA
hours of operation are:
Monday through Thursday, 8:30 am to 5:00 pm, and Friday, 8:30 am to 4:30 pm, Eastern Time.