How to practice nursing overseas

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Practice makes pitch-perfect and a nurse from the Philippines must learn the different tunes, accents and accompaniments to be part of the operating room band in the country where she or he intends to work or migrate. US bound nurses, however, seem to be singing out of tune.

Among the favorite countries with permanent migration programs, the United States calls the process of meeting the occupational requirements “licensure.” Australia, Canada, New Zealand and the UK call the eligibility to practice nursing “registration.”

Also, it is only the United States that allows the taking of the licensure exam outside the country. There are NCLEX test sites in the Philippines. The accessibility of test sites, however, has not improved the passing rates of Filipino nurses.

Of the 20,755 first batch takers of the first NCLEX exam by Pearson-VUE exam on August 23, 2007, less than half passed, 10,217 or a 49.2% passing rate. The results continued downhill. In 2012, out of 3,313 takers, only 1,183 passed (35.7%). The next year, of 3,402 takers, only 999 passed for a woeful 29.4% passing rate.


If it’s any consolation, first time US educated NCLEX takers also performed badly. In 2012, of the 150,266 takers, 135,743 passed for a high 90.3%. The next year, the passing rate went down to 83%. Of the 155,095 takers, 128,791 passed.

The long waiting period for priority date of immigrant visa petitions in the EB3 category (where RNs are included) and the consequent drying up of US sponsors resulted in the drastic reduction of NCLEX takers from the Philippines. In 2007, there were 20,755 applicants. Six years later, only 3,402 took the US state board examination.

The nurse migration shifted from the US to the Middle East. In addition to the Kingdom of Saudi Arabia (6,266 in 2007 and 8,513 in 2013), even the war-torn countries like Libya got increased RN deployment. Filipino RNs bound for Canada increased from 17 to 58 in 2007 and 2010 respectively. While the UK experienced increased migration of Filipino nurses, the US saw a decline in numbers from 186 to 83 in the same period.

Registration, licensure info for work visas:
Kingdom of Saudi Arabia – http://www.scfhs.org.sa/en/registration/exams/Pages/ComputerBased.aspx.

In the Philippines, the accredited testing center for Prometric exam is the Thomson Prometric located at Ateneo Professional Schools, 130 H. Dela Costa St., Salcedo Village, Makati. The exam fee in the Philippines is US$90, $80 in Saudi Arabia. Online registration would only accept payment via major credit card companies such as MasterCard, Visa and America Express.

United Arab Emirates – Dubai Health Authority’s official licensure information – http://www.dha.gov.ae/EN/SectorsDirectorates/Directorates/HealthRegulation/HealthProfessionals/Nurse/Pages/LicensingRequirements.aspx

Australia – http://www.ahpra.gov.au/Registration/Registration-Process/Overseas-Practitioners.aspx. Apply for registration with the Australian Health Practitioner Regulation Agency. IELTS 7.0 in each English component. Overseas RNs usually take a bridging course given only in Australia. A new model was set in place on February 10, 2014 listing the eight criteria that international or overseas RNs must meet to be able to practice in Australia.

Canada – Unlike Australia, Canada has independent and separate registration bodies (called Colleges or Associations) in each province. Each provincial and territorial nursing regulatory body in Canada is responsible for ensuring that the individuals registering as nurses meet an acceptable level of competence before beginning to practice. However, there is a uniform national exam called the Canada Registered Nurse Examination (CRNE) http://cna-aiic.ca/en/becoming-an-rn/regulation-of-rns/regulatory-bodies.

New Zealand. The regulatory agency for RNs is the Nursing Council of New Zealand. International nurses must complete the Competency Assessment Programme (CAP). Securing a place to take the CAP is difficult as places are limited. Because of reciprocity arrangement, your registration with NZ as an RN will allow you to practice your profession in Australia. The qualification prescribed by the Nursing Council for Registered Nurses from overseas was updated March 1, 2013. The web link is – http://www.nursingcouncil.org.nz/Nurses/International-registration

United Kingdom – Starting October 2014, overseas nurses intending to work in the UK must take a two-part competency test (computer based and clinical assessment) administered by the Nursing & Midwifery Council (NMC). The first part will be given in specified countries around the world, but the practical exam will only be given in the UK initially at a test center at the University of Northampton and expanded to more centers thereafter. The current administrative fee is £140. The NMC website is http://www.nmc-uk.org/

United States of America –While there is a uniform national examination for foreign nurses, each state in the US is responsible for the licensure of nurses within that state. Some states have signed the Nurse Licensure Compact agreement to honor the license obtained from a member state. To check the specific requirement in the state where you want to practice, visit the board of nursing websites – https://www.ncsbn.org/contactbon.htm. For updated information on the NCLEX test info in the Philippines, log on to – http://www.pearsonvue.com/about/release/archive/07_08_22_ncsbn.asp. Passing the NCLEX is just the first step. Filipino RNs intending to apply for a work or immigrant visa must obtain the VisaScreen Certificate issued by the Commission on Graduates of Foreign Nurses – http://www.cgfns.org/services/visascreen/

While the nursing degree lost some of its luster and a number of nursing schools were ordered closed, there were still 176,646 nursing enrollees and nursing remained the most popular in medical and allied discipline during the academic year 2011-2012.

This despite the advise of Labor Secretary Rosalinda Baldoz for unemployed nurses “to seek jobs in the booming business process outsourcing industry, which has an array of non-clinical but medical-related information outsourcing opportunities such as medical transcriptionists, billers and health care secretaries.”

Those who waited in line for their EB3 immigrant visas seem to be seeing light at the end of the tunnel. The number of approved or available job orders for nurses by POEA licensed recruitment agencies is on the upswing for both the US and the UK. Those who have been waiting for their immigrant visas in 2007 are now being scheduled for interviews at the US Embassy.

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1 Comment

  1. Atty. Roslee M. Formoso on

    Philippine Nursing Education is not that far from the U.S. Nursing Education, however, U.S. requires for a Filipino licensed nursed to gain 10 years experience in Surgery or Operating Room to come closed to the U.S. BSN graduates and licensed. From here, Filipino nurses may now apply for U.S. jobs and statistics shows that those with experience passed the NCLEX Examinations. I am very familiar with staffing agencies and I would say that if everyone complies with the requirements, all will be able to have the opportunity to work in the U.S.