OET and IELTS requirements for nurses in the US 

The process of moving to the United States to live and work as a nurse can be an overwhelming experience as there are many steps you need to take before you can relocate. Understanding the OET and IELTS exam requirements for nurses moving to the US will be crucial to helping you decide which exam is best for you. In this guide, we’ll outline the difference between the two language exams, reasons you may want to choose them and the scores you’ll need to move to the US. 

Nursing in USA – requirements for international students  

When it comes to applying for visas in the USA, there are a few crucial steps that international nurses must take as part of their transfer. For popular US visas, standards are similar:  

1. Secure a job offer: Get offered a role by a US healthcare employer or staffing agency that offers visa sponsorship. 
2. Pass the NCLEX-RN exam: This is the US licensing exam for registered nurses and is mandatory. 
3. Credential evaluation: Have your nursing education and license evaluated by an agency like CGFNS to ensure they meet US standards. 
4. Obtain VisaScreen certification: This verifies your credentials, English proficiency and licensure, and it may vary by state. 
5. Apply for a work visa: Most nurses apply for the EB-3 visa (Employment-Based Third Preference). Some may qualify for H-1B or TN visas (for Canadians and Mexicans) depending on their situation.  
6. Complete immigration requirements: This includes a medical exam and an interview at a US embassy or consulate. 
7. Relocate and start work: Once approved, you can begin to find accommodation and move. 

For more information, read our article on how to get a US work visa as a nurse. 

What is the IELTS exam? 

The International English Language Testing System (ILETS) is an internationally recognised exam that tests people’s ability to speak, read, write and listen in English. It’s recognised by the US government and US Visa and Immigration department as a reliable method to validate that non-native English speakers have the required language skills and ability to live and work in the USA. 

Why should I take the IELTS test? 

The IELTS exam is beneficial for many international nurses looking to move to the USA for a variety of reason, including: 

• Widely recognised: The exam is recognised by over 12,000 organisations worldwide across 150 countries, making it accessible for those working in different sectors.  
• Easily accessible: Most test centres around the world operate year-round, with some even open 365 days a year. Additionally, the test can be taken manually on paper or by using a computer, which can be chosen for preference and access to materials and resources. 
• Valid for visas and licensure: It fulfils English language criteria for US work visas and state nursing licensure, including for the Commission on Graduates of Foreign Nursing Schools (CCFNS) alongside other verification services. 

IELTS scores needed to work in the USA 

For international applicants, most jobs accept a minimum overall IELTS score of 6.5. This includes a score of 7 in the speaking section of the exam as this is crucial for you to work effectively in a US healthcare position. This is so internationals can prove they have the required skills to work in their specific role. 

The USA doesn’t have a set minimum score needed to get a working visa, instead, employers set minimum scores for the roles they offer. However, when applying for state licensure, it’s important to note what the required scores are as these may be set to align competency standards.  

What is the OET exam? 

The occupational English test (OET exam) is an international English language proficiency exam that’s specifically designed to be taken by healthcare professionals. Similar to the IELTS exam, you can take the OET via paper, computer or there is an option to take it at home. However, the way you take your test will affect how long it will take you to receive your results.  

Why should I take the OET test? 

Nurses looking to relocate to the US should consider the OET exam because it’s: 

• Specifically designed for healthcare professionals  
• Recognised globally by healthcare bodies 
• Accessible, offering different formats or the option to complete it at home 
• Relevant, using real healthcare scenarios 
• Easy to prepare for with many resources to help you prepare 

OET grade needed to work in the USA 

To work in the USA, particularly in roles such as nursing, medicine or allied health, most regulatory boards and employers require the following minimum OET scores: 

• Listening: Grade B (350 points) 
• Reading: Grade B (350 points) 
• Speaking: Grade B (350 points) 
• Writing: Grade C+ (300 points) 

These scores demonstrate that you have the English communication skills necessary to provide safe and effective care in an English-speaking environment. However, each state board of nursing will also set their own score thresholds, so it’s best to check whilst you prepare for the exam.