International Nursing License in the US

Tanya Freedman, CEO Connetics USA: Hi everybody and welcome. Welcome today to our monthly Lefora talk show. This is season three, episode six. Who would ever believe that the Lefora talk show has been been going for three years? I cannot believe it. We are excited today to have our expert legal panel join us. I am your host, Tanya Friedman. I'm the chief executive of Connetics USA, and I am joined today by Holly. Hi Holly. Welcome. And we also have Michelle with a beautiful background. Michelle, welcome.

Good morning. Morning, Michelle. Our topic today, everybody, is US. Licensure. How does US. Licensure work? So if you are an international nurse who is thinking about coming to the United States and you want to learn about the US. Licensure, this is the show for you today. We're going to be talking about a lot of different topics. We're going to be speaking about the NCLEX, we're going to be speaking about application by exam, application by endorsement. What does that mean? We're going to be talking about in click score, transfers in place, past verifications, credentialing, temp permits, emergency permits, contact license, lots of information available today. And we have our expert legal team that are going to be sharing your pointers and tips and taking your questions.

Before we get started, I want to just give a shout out to the Lafora admin team, to Ms. Jean, to Louise, to Anna, to James, Nurse Juan. Everybody on Paul from the Lefora admin team who do such a fabulous job of nurses helping nurses. And that's what today's all about. So today I welcome Holly and Michelle. Let's start off with introductions. Holly, do you want to introduce yourself?

Sure. Hello everybody. I'm Holly Muscle White. I'm a registered nurse for 22 years and I've worked with internationals throughout my entire career, have had some wonderful experiences that have certainly enriched my life as a nurse and currently with Connetics, I am a clinical educator. I work with nurses who are working on their NCLEX and I work with nurses who are preparing to come to the US and occasionally also with nurses who are here in the US who are getting adjusted to their first job working here. So I appreciate every opportunity I can to help a nurse navigate through all of these processes and I look forward to sharing more about life insurance today with you. Thank you, Holly.

And join today as well is Michelle. Welcome, Michelle. Thank you. And introduce yourself. Sure. Good morning. Hello to everybody in the different time zones. My name is Michelle Kilkenny. I'm the Senior Director of Immigration, Licensing Credentialing. I've been working with international nurses for over three decades and I'm an immigrant myself. I actually was fortunate enough to get a lottery green card over 30 years ago. And I have been working with bringing nurses since then to America. Initially on H one A, if you won't remember those, but in the old days, they probably weren't born then. And now since 95, we've been bringing nurses on green cards. So I know immigration and licensure NCLEX and endorsements, which we'll talk about. And I will tell you, I've been passionate about it since I first started 33 years ago, and I still feel the same passion. There's nothing like welcoming a nurse here and seeing them start their new life in America with their family, and that just still brings me joy. So thank you.

Well, Catherine is saying it's a pleasure meeting you, so thank you for joining us, Harley and Michelle today. And as I said, if you are a nurse who's starting this journey, coming to the United States, don't know where to start. If you are nurses already started this journey and say, oh, my goodness, I don't know how to do a licensed endorsement, I don't know about the Visa screen, I don't know about the CES. This show is for you because this is free information to help you to navigate the tricky roadmap of licensure upcoming to the United States. If you have questions, please put them into the chat. I have a lot of questions that's been sent to us already, and we're going to get started now and pick the brains of this expert licensure team. The only one that I just wanted to say is Ms. Jean. We wanted Ms. Jean from iPad to be with us today. Unfortunately, she couldn't make it for today's show. She's really busy. But she will be joining us on Future Joe. So shout out to Ms. Jean, who I think these three minds are probably the top experts in the United States on licensure. So I'm very excited for this opportunity. All right, so let's get started.

Holly, let's start with you. Many nurses, when they look at the success path, and if you don't know the success path, please go to the Connetics USA website and look at the success path, because this is kind of the roadmap that you need to take if you want to come to the United States. So first is to pass the NCLEX, then prepare for the interview. Then you will have your Visa framework if you're coming on a TN green card. And number four is Licensure and Credentialing. So if you don't know where to start, sometimes the biggest barrier of entry is that you don't understand the terms, like what things mean.

So we have a graphic of the different terms to understand in terms of US licensure. Can you walk us through these terms so that everybody is on the same page and knows what we mean when we talk about NCLEX score transfer or licensure or emergency permit. Yes. So I'll just run through each of these terms for you. When we talk about applications for licensure, we're referring to the paperwork that gets submitted to the state board that you're applying to. So currently, when you want to take the NCLEX, you would apply to a state by examination or an application by examination. And that means in most cases that you have yet to take your NCLEX exam, and so you're seeking permission to do that. An application by endorsement means that you have already passed the exam and you've established a US license. And therefore, from the original state that you passed NCLEX through or obtained, that what we call an exam license or a home license. You're now looking to endorse that to another state, to obtain a license in that second state. And most of the time, for international nurses, the license that they may get initially is not necessarily the license that they're going to go to work on, because many times the states that you may work with as an international nurse have enough difference in criteria that it's easier to go ahead and get your exam done in one state. And then once you've got an assignment or a place of employment and it's in a different state, you work through the endorsement process.

Board, or Board of Nursing is a term that is used even though not every state calls it the Board of Nursing. If you were to use this in Google, like if you said the Washington Board of Nursing, you could search that and it would come up with a link to that state Board of Nursing or to the regulatory body that is managing licensure for that state. Licensure itself means that you have fully qualified to work in the US as a registered nurse in a specific state. We'll talk about compact licenses in just a second. Credentialing refers to, on the licensure side, not talking immigration at the moment. Credentialing refers to a review of your nursing education, and the intent is for every state to validate that your education is substantially equivalent to what a nurse who trains in the US. Would receive in order to qualify to sit the NCLEX exam.

So what this Credentialing process looks at, regardless of who does the Credentialing review for you, is how do your transcripts and your nursing education compared to that particular state's requirements for their nurses to be able to become eligible to sit the exam or to be licensed on endorsement? Even the Inquest is a national licensure exam that RNS and LPNs can take to obtain their first nursing license in the United States. The NCLEX is, like I said, a national exam.

What that means is that every single state has agreed to accept this particular exam as the one that the nurse can achieve in order to meet the requirements for initial US licensure. It is not saying that the nurse is an expert in everything that they should be, but it says they've got a baseline level of nursing competency that allows them to practice safely and entry level nursing in the United States and Hollywood .I'm sorry to interrupt you at this point, but just a quick question. If the nurse passes the NCLEX, do they ever have to take the NCLEX again, like if they move from one state to the other. So moving from one state to another should not require you to repeat the NCLEX. The only time where I've ever seen a nurse potentially be asked to take and clicks again is if they were to let their qualifications lapse. So if they don't maintain those and we'll talk a little further about that in a future part of this segment, but if they don't follow those requirements, they could actually that NCLEX path maybe come invalid in a particular state. And that's, again, why you want to pay very close attention to what each state requires to maintain it. But overall, NCLEX doesn't expire. So it's nice that you get it in one state. And just because you're going from Florida to New York doesn't mean you have to take it again.

Thank goodness. Okay, good. Thank you, Harley. Okay, so let's finish off the terms and then we can move on to the NCLEX application process. Yes. So an inflex score transfer earlier on this slide, I was talking about an application by examination and your exam license. A score transfer can be done in circumstances where the international nurse was to pass their NCLEX exam, but the state that they passed it through might not have issued them a license at the time that they passed. And every state has different rules about this. So if they don't pass sorry, if they pass but they don't get a license issued when they pass NCLEX, then there is an option with some boards to take that NCLEX pass without having been fully licensed afterwards and transfer the pass itself electronically from that state. They got permission to pass through to a state that will issue them a license. And the most common one that we see that with is like California.

For people who years ago applied through California, they passed and they never got a license. And they know that the California board is not the one they're going to go work through or the one that they want to initially work through. So we can transfer that score from California to Illinois, who will issue what we call an exam license because they accept that that score transfer, and then they issue the nurse's very first license, what we call the exam license. So that's in a nutshell, score transfer, a path verification is a little bit different. So states are often looking at the time of Licensure, whether that's an initial Licensure or by endorsement to verify where the nurse took in class.

So sometimes that may be for me, as a US trained and initially licensed nurse, they may want to know, where did you take your NCELX through and can we validate that? There's an electronic system called nurses that often allows us to, when they go to validate that initial Licensure or that exam license, the state that issued it will actually have recorded my information around my NCLEX exam. So it's happening behind the scenes. But occasionally the state board will ask for a form to be filled out from the board that you were given permission to take in clicks through to the board that you wish to endorse to. So that is pass verification attempt permit or license is something that is going to be unique to every state. Some states will allow a nurse to receive a license that has a finite period of time on it in which they can provide some initial qualifications as part of the application.

Receive a temp permit, which is not going to be something you can transfer from one state to another. You can only practice in the state that issued that temporary permit. And most of the time that temporary permit is only good for somewhere between 60 to 90 days. And occasionally we'll see a board that will stay for 120 days. There are many boards that will not issue a temporary permit to an international nurse. The reason for that is they're looking at those education credentials again and they want to validate that the nurse who trained overseas, even on endorsement, has achieved that equivalent level. So again, not every board says I'll give you a temp permit so that you can work on the rest of the requirements. Some will. And so for that it's nice. But keep in mind, if you don't already know that some employers also are not very friendly towards temporary permits because if the permit runs out before the nurse has met all of the requirements, now they have a nurse that they've onboarded and they're hoping that the nurse gets that license. But if something happens and it expires before they do, that can create risk for the facility. So not every facility will also be happy to work with someone while they're still pending a permanent license. The next one is an emergency permit. So the most common emergency permits that we saw in the last couple of years were due to COVID.

There were specific laws that were enacted to allow the state boards to actually issue emergency permits or allow nurses to work. If they were fully US licensed in one state, they could work in that emergency situation in another state. Sometimes you had to file paperwork, sometimes the employer just had to be able to see that you did have a valid US license in a US state somewhere and that was all that there was to it. So every single state also has different rules around emergency licensing. And when that's appropriate, when there are disasters that happen, we often see there is legislation that is introduced to allow nurses to be able to come in and help in those types of situations.

So for instance, those of you who've dealt with typhoons or what we call hurricanes here in my part of the world, if that happens and there's major devastation and there's a need for augmented medical professionals. Sometimes the state will go through a quick process to be able to allow nurses to do that work as a nurse in the state without having to go through the full endorsement process. And Holly, that's where we watch that very closely because those emergency licenses are going to kind of shift in flow with the pandemic right before we talk about the compact license, I see we have a lot of questions from the chat. I wanted to take some of those questions, and if you have licensing questions for our expert panel, please go ahead and share them into the chat. And I'm going to try and get through as many questions as possible. So I see we have a lot of people joining us from Cyril Leone, ale Dee from Nigeria. Irish saying hi. Catherine saying hi.

We have a question from a Facebook user who's asking? Good day. Any tips on how to contact the Board of Illinois? I've been following up for my license for two months already. No replies to my email. I don't know if they already possessed my license. Docs accept the password to verify because everybody knows now what the pass letter is. Explanation to verify while waiting for official license from Illinois.

Michelle, how would you answer that question about the Board of Illinois? Yes, they can verify NCLEX. They don't have to have the license issued to qualify for a Visa screen as long as they have a current license overseas. They just need one current license for the Visa screen. But Illinois, if you've passed NCAA to Illinois and you've submitted the application for the $50 for the actual license, it should be issued within two months, so there shouldn't be a delay there. Okay, and what should the Facebook user do if there is a delay? They should let CGFNS know through the wizard and that they have passed anchor through Illinois. But CGFNS can't pull it themselves because they need a license number to pull it digitally.

So they're just going to have to follow up with Illinois and ask them to verify. And how can they verify NCLEX? Okay. There is a phone number, too, that they can call. So we see that with some of the nurses we already work with. I will tell you during this what we call the summertime, where everybody kids are out of school and whatever, but nurses have just graduated in large volumes all over the United States. And the state boards during the summer months experienced a very large influx of applications from the US because they're also trying to take NCLEX. Sometimes that does slow their response times a little more. But what we've been advised is that it's ideal if you're waiting for a response, even if you've emailed, to actually call. Unfortunately, state boards for these types of applications for international nurses, often they're paper based, and so there's no way to electronically look to see what part of the process they're in until it's issued. Yeah.

So you can try call as well. And we know it's frustrating, but we have a term at Connetics USA and at AMN Obsessive follow up. That's what it is. You just got to keep following up. Unfortunately, it can be very frustrating. Janetel is asking as a bank today, she knows, can I apply? What's the process? So in a few minutes, Michelle is actually going to take us through the NCLEX application process and what that involves. We have another question about Illinois. Illinois, obviously a very popular board, another question is licensed from Illinois, was already transferred to Texas. If temporary license is nearly expiring, can I just renew it so as not to repeat the license endorsement process?

Michelle, no, they won't extend your temporary license in Texas, but you need to find out what's the reason. I mean, some of our nurses, it would be they haven't taken the law test or they haven't had their foreign license verified and sent to the board. But Texas, they give you the four months. I believe in a temporary, it should be enough time to get the permanent license through. So you need to check what exactly is missing and get it submitted. But they won't accept your template. Okay. Thank you, Michelle.

I see a lot of people are tagging their friends, so thank you for doing that. Please share this video with your friends. Tag your friends. The Lefora talk show is about nurses helping nurses. This is free information. This process is very confusing. You're not only dealing with immigration. If you have immigration questions, watch our Onwards and Upwards show once a month where we have been bringing our immigration experts, but the licensing side is equally as confusing. So please share and tag your friends on this show because our experts are here to help you.

Okay, well, we've got a lot of questions coming in now, so I'm going to try and get through as many questions as I can. And Michelle and Holly are also going to be taking us through both the application and the endorsement process. Mahut is asking, I have passed the NCLEX exam last month from Texas board, but my license is not yet updated. What should I do? Honey? So when you're in the Texas application process yes, when you pass the inquest, you should be issued a license. We have seen with the nurses we're working with a little bit of a lengthier time for that to happen. But again, as Michelle said with the previous question, is there something missing? Is there something that they needed to be able to complete your file and issue the license? So I would also use phone calls, email, messaging through their system to request clarity on whether you may be missing part of the criteria that they needed in order to issue. But we are seeing an increased amount of time between NCLEX path and that license being issued as well.

Okay, thank you. So there you go. My head, Cherry Lin is asking I recently passed my NCLEX exam into Texas. Till now, I haven't had any letter from the Board of Nursing. Now that everybody knows what the Bon means for going through those terms tiny and that I've officially passed through quick results sorry, I haven't received in there on the end, that I have officially passed those through Quicken results, I've already seen it. What should I do, Michelle? Well, again, if they've seen it on the quick results, I don't know how quickly Texas will send the actual NCSBN. I don't even know if they send that out anymore. But you will get yeah, I don't think so either. So you should be waiting for your license to be issued.

You need to check with the Texas Board on the status of your actual application and to make sure you're not missing maybe the law test or something simple that you just need to complete so that they can issue a license. Okay. Thank you, Michelle.

And I'm going to take a few more questions before we move to talk a little bit more about the NCLEX application process and the NFLEX endorsement process. Janet hall is asking, is Bangladesh nurses eligible for NCLEX exam? Honey? So I haven't personally worked with a lot of nurses from Bangladesh. What I would say is it may depend on whether your nursing education was similar to the nursing education in the US. And so that process can be done a couple of different ways. One way is to look at the State Board laws, and I'll talk about how many hours for each course or training you may need, how many clinical hours you may need in each of those segments. Typically for international nurses, if you're not going to qualify to sit the NCLEX, it's because your education was in some way not substantially equivalent most of the time.

That's because it was short in hours in psychology, either on the classroom side or the classroom and the clinical experience side, meaning you were going in and having rotation or maternity without looking at your individual transcripts against what the State Board requires, it's hard to say for sure. I've worked with nurses from Bangladesh before, but I haven't worked them through the process myself to know how they got there. Thank you. Honey, do you have something to add on this question about nurses from Bangladesh? No, I agree with what you're saying. I feel like I've worked with Bangladesh nurses before, but I don't understand yet in 30 years. But I will say the only way to find out is to get that Credential report or to check with your school. But you need hours in the five areas of nursing. So if you've done theory and clinical in the five areas of nursing, you should qualify.

Okay, fabulous. There you go. Janetel, Denise is asking, do you know CGFNS will accept OET from Visa screen? The short answer? Denise our answer is yes. Please watch our shows. We had two shows Onwards and upwards in the last two weeks. Onwards and Upwards is Connetics USA weekly show that we host for international health care workers all over the United States. And we had two very comprehensive shows last Friday and the Friday before. Talking about this new announcement for CGFNS If you have not seen those shows, please go and watch them. You can go to the Connetics USA website or the Connetics USA social channels and watch those shows and find out about the OET and the PST and PTE change that is happening through the CGFNS on the 1 August.

Okay, Kylie is asking, I passed my entry through California Board Nursing years ago. Is it still valid? I don't get to have my Social Security. Michelle yes, it's still valid. And you can't activate your California license because you don't have a Social Security number, but you can apply to another board. I would suggest that you apply to the Illinois board by exam and you have your scores sent from California and then you will get an Illinois license. But that does require and we'll talk about that in a minute. You will need to get a Credential report done for Illinois and then get your scores over there. So there is a process involved, but yes, your NCLEX is safe. Okay, great. Colin so I'm sure that's a big sigh of relief for you.

And thank you for asking that question because this is a very common question that we get from many nurses who are shaking in their boots because they're thinking, oh, my goodness, I took my NCLEX years ago through California and maybe it's no longer valid. So the short answer is it's still valid. Suleimay is asking, is there anything for medical lab technologists? Yes. Connetics USA and AMN. Connetics, you say, is part of the AMN family today, we are so proud to say. And both of us have positions for medical technologies. And we have a show coming up slowly for medical technologies, so keep watching out for that. Okay, Michelle, we're going to start talking now a little bit about the NCLEX application process. Highly explained the difference between NCLEX application and NCLEX endorsement.

So let's talk a little bit more about the NCLEX application. And we have a slide which really talks a little bit about the process and the requirements. So we're going to put that graphic up about the requirements. Can you talk us through these exam application requirements? Of course. So the first thing you want to do is for your journey to the States, you do need to pass NCLEX and step is to sort of find out what board you want to apply to. You obviously are coming from, you are with different agencies or you're with Connetics USA nurse agency they will guide you and give you advice on what boards to apply to.

One thing I would suggest is do your homework because you don't want to apply to a board who won't issue a license at the end of when you pass NCLEX. And we have a lot of nurses who took the Florida boards. It's a great board and you can pass NCLEX, but you won't get a license because they require a Social Security number to issue the license. And again, Social Security number, that's something you get after you come here on a visa.

So we would suggest you do your homework. There's a lot of boards you can apply to. Some of the top ones I would think of would be Illinois, Michigan, Texas, but there are plenty of others, but you don't want to apply to somewhere where they won't issue license, like the Florida, Nevada, California. Well, you can't apply to California anymore without a Social, but there are several states like that. So do your homework on the board that you apply to. They all have a fee and they differ greatly and they're non refundable.

So you also need to think in terms of how long it's going to take. When are you going to be ready to take NCLEX? You should be doing a study program or getting prepared for NCLEX, but at the same time, concurrently, you can do your NCLEX application to a board and you can do your Credential report. So you decide on a board, then you have to most of them require a Credential report, which there are plenty of Credentialing agencies out there. Of course, the main ones would be CGFNS, and then thereafter, like Joseph Silny and there's several others that boards approve of, but there are hundreds out there.

So be very sure that the board you're applying to for the NCLEX accepts the agency that you use. So let's just say you're applying to CGFNS. You apply for a CF report. I think it's just increased to 420 for that. And you have to indicate when you apply what board you're taking and clicks through. So that's why it's very important you pick the board first so you can start your CES even before you start your eclectic application to the actual board. You just need to be sure what board you're applying to. CJ they will require your high school diploma. Every nurse has to graduate from high school, just so you know, as an American nurse for the American exam, you have to have graduated high school. So they will require your high school certificate or diploma. And that's very important because a lot of people don't have that. So you need to look for it. And then they will require your nursing transcripts or academic request form, and they will also require your foreign license verification. And I would include all licenses. So if you're in the Middle East but you're from the. Philippines, you need to apply for your PRC, but then whichever country you're in, you need to apply for verification from there as well, which could be important later on. Some boards want to know everywhere you're licensed. Others only care about where you're educated.

So again, you have to do your homework there  or work with whatever agency you're working with. And then fingerprints, they do ask for background checks. So many boards will have fingerprint cards. You will need to complete and submit with your application. Social Security. You don't have one. So many boards have a Social Security affidavit you basically are notarizing that I don't have a Social, but when I do have one, I will provide it. English proficiency. While it may not be required for the board, many boards will accept that. If your CEO, your Credential report says you're educated in English with English textbooks, that will make you eligible to take NCLEX in that state. However, you need to remember that you're going to need English to get the Visa screen thereafter, once you've passed NCLEX, because you need that Visa screen certificate or Healthcare Worker certificate in order to get a Visa to work in the United States. So while English proficiency may not be needed at this stage, you are going to need it to get the Visa screen. And then continuing education topics. Some boards will want continued or CEUs, as we call them over here. And again, those can be obtained. Whoever you're working with can advise you on how to obtain them, but not everybody requires it.

There are a couple of things with exam applications. I suppose we'll be going through the map in a second, but you can apply to the board. You apply for a CES report. It's submitted to the board by whichever agency you have, and then the board makes you eligible to test. Once they make you eligible to test, that's when you pay. Thank you. Pearson View, who administer the exam, you pay $200 to register with them. Once you've registered with them, they will then issue an ATT. Currently, since COVID, the ATPs are valid for six months prior to Covid. And maybe they'll change it again. We don't know until we're told. But they may go back to just being a 90 day window. Actually, some boards have a one year window. It's crazy that they're different, but they are. So you have to know your board.

But right now, the minimum is six months. So you get a window of six months, and during that six months, you need to schedule your test wherever you are. If you're taking in America, there's no extra fee involved. But if you schedule it, let's say in Manila, it's $150 that you pay when you're scheduling the actual test. If you're in the UK. London, I think, is $180. Most of them are $150, but there are a few who are a little different. I think India is like 177. So you need to schedule your test. And then once you take the test, you obviously get the quick results within 48 hours and you've passed. And then it's exciting. You move on to your immigration.

Now, depending on the board, like, if you took the Illinois NCLEX well, as soon as you pass, then you have to wait for they send you an application for an actual license, which you then need to submit with $50 to get your license issued. But if you're in Texas, they'll issue your license. I talk quicker, but obviously, from the chat, maybe not as good. I know Michigan issues it straight away. It just depends on the board. New York issues it, so there might be a waiting period. But you certainly want that license because we'll talk about that soon. But the license is very important. Now, if, unfortunately, you don't pass, different boards have different rules. Some boards only let you have the one take, and then you have to apply again. Others, like Illinois, for example, their application is good for three years. You can take it as many times as you like in those three years. Hopefully, it won't take that many times, but you can retake the test. You have to pay every time, but you have a three year window. Michigan, I think it's a two year window where you can take the test. It used to be they limited it to three times, but now they just changed the rules.

And I think it's unlimited in Michigan as well. But it's still within that two year window and that the application is still valid. Thank you, Michelle. That's a really comprehensive explanation of the NCLEX application process. It's very confusing to so many nurses, so it's really important to be able to get this guidance. So having these two licensing brains with us today is just so valuable and so helpful, I know, for so many nurses who are watching all over the world today because it really can feel very overwhelming and very scary, and it's expensive. So you want to make sure that you're taking the right steps when you're doing your NCLEX application process.

We have a question here, and we're getting this question actually a lot this question has been sent to me before as well, which is, hi, I'm about to take my NCLEX RN in the state of New York. If I pass, can I seek endorsement outside of New York? Holly so you can seek endorsement. New York, as Michelle mentioned, is one of those boards that will issue a license when you pass. So that's great.

They're also a board that requires two topics of continuing education when you apply for the exam. So one of the things you need to be aware of is that when you endorse to another state from an original state of New York, if the new state requires a Credentialing evaluation, you may have to go through CGFNS to get that done where originally you had New York evaluate your credentials. So just be prepared. You might, depending on where you're going to end up working.

As you look at the endorsement requirements, look to see whether they require a CES. If you've done Visa screen with CGF and S at that time, then remember they're going to have your transcripts on record already, so you wouldn't have to go get your transcripts again unless it's been more than four years. CGFNS discards your electronic files if it's been more than four years, unless you pay to e save them to Step Yi. So, yes, you can. Okay, good.

So there you go. You can transfer. And that's another thing, another question of confusion, because many nurses think, if I take my NCLEX in New York, I have to work in New York. So the answer is, no, you don't have to. And there are ways of doing an endorsement. Lexi Bus has a question. I am currently in Qatar, past the NCLEX through Vermont, but no active license because of Social Security. If I will endorse my license to Illinois to be able to get an active license, there's a portion that Social Security is asked, can I use a dummy number? If yes, what is the dummy Social Security number? Michelle I think there's a Social Security affidavit for Illinois, so we can answer that again. But I would have one question on Vermont. The question would be, was a license issued and it was never active, so that it was issued versus wasn't a pass letter. I think in Vermont they issue, but they just won't give you it's not active, if you know what I mean. And there is a different there's other states you can apply to with an inactive license where they can issue a current one so that you don't have to go through Illinois. Yeah, the other thing with that it's important is if it's just that you wanted to get an active license so that you can endorse to somewhere else. Vermont, when they do receive your social, usually within 24, 48 hours, they turn it around and issue. That's unique. Some states take a little longer once you do provide the social, and that's why you may try to endorse somewhere else first instead of waiting. But Vermont's pretty quick. Yes, we've definitely seen Vermont being very efficient overall.

So that's helpful because years ago, when highly michelle and I started doing this international recruitment, most international nurses actually rode through California and Vermont in those days. So these are very common questions. If you pass the NCLEX many years ago, Lexi is asking, can a nurse transfer her Canada or Australia NCLEX Pass to a US. Board of Nursing? Michelle yes, they can. Again, I'd probably apply to Illinois. I suppose it depends, really, on where you're going, but if you weren't sure where you're going, I would apply to Illinois and get your scores transferred. From Canada or from Australia? And there's a follow up question that was sent directly to me from Etsy who's saying, should I take the NCLEX to Canada or Australia instead of applying to a US state? I wouldn't recommend that. If your objective is to get to the United States, then I would apply for the US version and to get a license like apply to a board that will issue a US license versus going the long way around, which I would call that if you're in Canada working, that's different. Yeah.

So I think that's good advice and that's where we love the Lefora talk show. And thank you again to the Lefora Admin team for giving us this opportunity to be able to share important information about licensure in the United States with all nurses around the world. Okay, so we have more questions about the PTE and OET. I know this is a hot topic. Please, if you did not watch the Connetics USA Onwards and Upwards show on Friday, last week and the week before, please go and do so. They are on the Connetics USA website and on our social media channels. I know that this is a big topic for many international healthcare workers, not just nurses, and because it's a big change in the requirements. So please make sure to watch those shows so you can educate yourself and we will keep updating you about any changes from a state perspective on the PTE and OET requirements.

Okay, so Neka is asking, what license do I need for support worker in the USA? And I'm not sure what Nika means by support worker. I think maybe she's referring to a nurse aide. Honey, every state is different for nurse aid. So some require that you take a state approved course, usually about 75 hours for most states. If that's the case, it requires a clinical component so you can't just do it online for some of those. And then there are some that if you had training overseas, like as a nurse and you wanted to take a nurse aide exam, there is a way you can bypass that. With some states, the training course, because you've basically already received medical training, you can request permission to take that state approved nurse aid exam without having to go through a nurse aide course.

So, again, it's very state specific and those are licenses that don't always endorse from state to state. So, for instance, if you became a nurse aide in Florida, you couldn't necessarily go and be a nursing in North Carolina or Tennessee without first going through whatever their requirements were or their training was or taking their exam. So you have to be a little more precise in where you plan to work as a nurse aide and then look at that state's requirements. Okay, thank you, Nica. And we have a whole show on nurse aide that is going to be shown in the coming weeks and months as well.

Led I have a question. I'm from India, but born in the UAE. If I pass my integration, can I apply? Michelle yes, definitely. If you're born in the UAE, that's awesome because that means you're nativity. Immigration is all based on where you were born. And so even though you're an Indian national or citizen, your place of birth was UAE, so you would fall under all of the other chargeable areas and not on India, and visas are currently there right now. Okay, perfect. Lucy saying Holly and Michelle know so much, love the Lefora Talk Show.

So, yes, you're right. Lucy, Holly and Michelle are the dream team on the side. So this is your chance. Everybody ask questions, and we'll try and get through as many as we can in the chat. Okay. Shalaya, I hope I pronounced that correctly, is asking about the North Dakota board requiring a yearly evaluation for CGFNS to issue the CES for license? Holly, do you want to take that question? It broke up a little bit. So, for North Dakota, for international nurses, many of the countries that may apply to the board, they will ask that you do a CES evaluation for endorsement. That is because they want to make sure that when they issue you a license, you are determined to be equivalent to the degree that you're needing in North Dakota to get your original license.

So they may at first, for some countries, accept just a transcript, but there is a high likelihood that they could still come back and say, we've got your transcripts, but we still want you to go ahead and submit a CES for us. It seems to be less common with some of the schools in the Philippines, but there's no guarantee that even Filipino nurses might not have to produce that CES at some point for them to be able to get the license. If North Dakota receives your transcripts from your school and a couple of other items, they can actually issue you a temp license to give you a little bit of time.

It's a 90 day temp license to do a credentials evaluation if they happen to ask for that and follow up. Okay. I don't know North Dakota that well, but the question was asking about an annual that said yearly evaluation. Once they get your evaluation, they don't need another one. Like, once they've validated that you meet the requirements, they should not ask for a second CES report.

Okay, so we have a question from Camillo who's saying NCLEX was checked. My license is from New York. I'm pending asylum. You can help with it to work with the Visa screen in process. Michelle so my license, I'm pending your help with it. You can apply. Excuse sorry about that. It depends where you educated overseas or were you educated in the US. You will need a Visa screen process. And so depending on who you're working with, they will help you apply. CGFNS and Joseph. Sylvie now issue Visa screens.

It doesn't matter where you're educated, whether it's us or overseas, you will need a Visa screen if you're applying for a visa to work in the United States. Whether it's a permanent visa or a non immigrant visa. You can apply, I suppose, through thank you, Michelle. And we have a question here about Texas, and please help us, our end, who will be doing license endorsements to Texas to fix issues in a comment that Ireland should be fixed in all four sub tests. This applies only on applicants who plan to take NCLEX through Texas, but not for those who will do endorsement, right? Please clarify.

Holly and Michelle, I'm not sure if you have any comment on that question. I think the question is, is the IELTS in each subtest required for both application and for endorsement? Michelle honey, English is not required for endorsement.

So on the NCLEX, I'll have to double check. There are several states that require six in all areas, and Texas might be one of them. I haven't got done and click through Texas. Okay. It's not fresh enough for me either, what the specific scores are. However, I'm assuming then that the nurse was not educated in English or with English textbooks, and that's why they're requiring it or asking for it at the time of influx application. But yeah, I'm checking it out now. While we're talking, if there are any questions that we haven't got to or that we didn't have a specific answer because they're very specific questions, our expert Licensure team will go into the chat after the show and answer those specific questions for you.

Vidjaya Krishnan is asking, what about the Kentucky board regarding license issue and NCLEX pass? I think Kentucky board we have lots of nurses in Kentucky. I think Kentucky board is actually a little easier to work with. Honey? Yeah, we don't typically work with them for applications for the NCLEX exam. We do work with them more for endorsement, and they are fairly timely and easier to work with in that way. I would have to look at their NCLEX requirements a little more in depth about English, whether they issue a license by exam when they pass or not. So? I didn't think so. Better. I wonder, too, because to get your perm, they're great at issuing temps, but to get your perm, you have to have the social. So I wonder, could that have an effect on getting a license from Apex? Absolutely.

Okay. We've got so many questions that I'm just trying to pick out ones that we haven't asked as yet. So we have a question, let me see here from Joy, who's asking, does it matter how much time passes between when the NCLEX is passed and the date of us arrival? Michelle, so we talked about this one before. It depends on what they're actually asking in the sense of if you've got a license issued, then after you pass NCLEX, there is no issue if you pass NCLEX through California, like that Indian nurse who passed in California years and years ago, they can endorse or they can apply by exam to Illinois.

However, we have come up recently with a case in Florida where is that right where it was like four years since they had never received a US. License. And in that instance, there is a concern. So I think they were saying they had to do a refresher course or something before they would issue. Five years. Five years. Thank you. So our advice, and that's what we've been saying is if you take an try and apply somewhere that has a license, and if you haven't, it is worth applying to Illinois just to get a license in your hand. If it's going to take you several years to get here based on immigration or whatever other reasons, I would say just take the best bet and get yourself a license in hand. And for us right now, Illinois would be a good place to do. Okay. Thank you, Michelle.

So I see the questions are coming fast and furious, and we want to try and get through as many as we can, but I want you to just speak a little bit about the license endorsement process and what is required, what are the common requirements. So we have a graphic holly, do you want to maybe just take us very briefly through this licensed endorsement common Requirements graphic? So, as we've been saying, it's best if when you pass NCLEX, you do it through a state that issues you a license. When that happens, then it's your responsibility to maintain that license.

Some nurses choose to let it expire when they still have the option to keep it active. And my advice is, as much as you're allowed to keep it active, you may also benefit from, if it's going to expire, maybe endorsing it to a state that will allow you to keep it active throughout the time that you're waiting. It's best to try and keep an active license because it makes it much easier to go through the endorsement process. With most of the states, if you have an active license at the time you apply, the next thing you need to think about is if you have that license and you're applying for endorsements, you will be going through a verification process. There's a website called Nurses that's run by NCSBN, and the majority of the US. States do use nurses for electronic verification of your US. Licensure from one state to another. Some states will require that you validate for endorsements the exam license, meaning the state that you got your first license through because you took and collected through them and your current US.

License if those states are different. So if you pass through Illinois, but then you endorsed to Tennessee, then now you're looking to go to another state, you may end up having to validate both of those. Right now, the fee is $30 to do that process for each board that you're verifying. Endorsements may require another Credentialing review. I mentioned that earlier.

So, like through New York, if you end up wanting to go to Texas to work, Texas requires a CES, so you would have to complete a Credentialing review. Typically that's through CGFNS or Joseph Silney. One of those are the most popular ones accepted by state board. Be very careful because the term CES is a Credentialing evaluation term, and we do Credentialing evaluations both for Licensure and for Visa Screen. Visa Screen may have a lot more agencies that they will accept that CES from than your state board will. So don't assume I got virtuoso. CES. So now that works for all these different boards most of the time.

I've not actually heard of a board that accepts that for licensure. Okay. Many states you can get a license activated before you come, but it may not be the one that you're going to work on. So if possible, try and have an active license before you come. Do the requirements to maintain the active license, and then when you arrive, there may be some final requirements needed, which could be providing the board with your Social Security number so that they will issue that license to you. Or it may be that they want some Visa documents provided that show you're in the US. And have permission to work here.

Finally, Licensure, based on your primary state of residence, we have both single state and multi state licenses. Most of the time, international nurses don't have an address here before they come. That's a residence. So when they arrive, they're receiving a single state license for the state that they are endorsing to so that they can start work. That license gives them full permission to work in that state. And if they want a multi state license after that, they can work with the board on providing the appropriate identifications that show their primary state of residence, like a state ID and go on to achieve a multi state license. But what they really need to go to work is the single state license in that state that they're wanting to work in.

Okay, thank you, Holly. So I cannot believe it at the end of the hour. How you have flown. Oh my goodness, I'm getting so excited. I'm knocking over my microphone. You can see this is live, everybody. So we have so many questions. The bad news is we're coming to the end of the hour, everybody. The good news is that Michelle and Harley will be back and we'll be able to answer more of your licensing questions because this is a very confusing part of coming to the United States.

We're going to take one last question, and that is from Mohit, who's asking, how much time does it take to complete all the process after passing the NCLEX. Michelle so I'm assuming they're asking about the immigration process after passing and clicks. So if we're filing for an I-140, I mean, it depends on their job, on where they are and what agency they're with, but the actual filing, when somebody actually files for you, I would say anywhere from twelve to 18 months, give or take, whether you're expedited and all of that. So we would hope so. 2024.

If you're starting the process now, you'll be here in 2024. can I just give a quick answer to the Texas person? Because one of my team already messaged me with the answer. Okay, thank you, Nina. Just waiting out. Nina it's 6.5 for Ireland and six in each area, but they do take Pearson PTE and then TOEFL IBT as well in Texas. And that's just for the exam. And it's NCAA's exam. And it's also, if you weren't educated in English, with English textbooks.

Okay, thank you so much, Michelle. Thank you so much, Holly. That was so informative, so valuable. I know that there are many nurses all over the world right now that are breathing aside relief that they're starting to understand more about the licensure requirements for coming to the United States. As I said earlier, it can feel so scary, so overwhelming and expensive, so really important to educate yourself about this process so that you can get to the United States as quickly and as seamlessly as possible. Before you leave us, I just wanted to give a quick shout out again to the Lefora admin team for your support for all nurses around the United States and around the world, I should say. And also wanted to just let everybody know about some upcoming shows. So we have a graphic with some upcoming shows with the Connetics College. For those of you who don't know, the Connetics College is a live show. Every Monday, check out on our social media.

This is live classes, both on the IELTS. On Friday the 25th, we have nine of doing an IELTS class on the spot writing task. We have NCLEX partners who will be speaking about various topics coming up on the Connetics College. And then every Friday, we have Onwards and Upwards, which is on the Connetics USA Facebook page at 07:00, a.m. Pacific time. Check what time it is in your local time. And on the 22nd, we have the Immigration Expert Legal Panel who will be taking your immigration questions.

So if you have immigration questions, please check out that show. On the 29th. We have a very interesting show on transportation in the US. And we've got lots of experts coming in to speak about transportation, what's available in the different parts of the US, how to buy a car, how to get a car loan, all different topics about transportation. And our next Lefora talk show we do this once a month, will be in August on the 16 August. And this is we're going to be speaking specifically about the clinical aspect of the ICU. And this is your chance to ask nurses about working in the United States about the ICU. We did a poll in the forum and asked which specialty you want us to start with and the ICU got the most votes. So the ICU it is. So thank you, everybody, for joining us on the Lefora talk show. Thank you to Holly, thank you to Ms. Michelle and we will see you next month. Thank you, everybody. Thank you. Bye.

CEO Connetics USA: Hi everybody and welcome. Welcome today to our monthly Lefora talk show. This is season three, episode six. Who would ever believe that the Lefora talk show has been been going for three years? I cannot believe it. We are excited today to have our expert legal panel join us. I am your host, Tanya Friedman. I'm the chief executive of Connetics USA, and I am joined today by Holly. Hi Holly. Welcome. And we also have Michelle with a beautiful background. Michelle, welcome.

Good morning. Morning, Michelle. Our topic today, everybody, is US. Licensure. How does US. Licensure work? So if you are an international nurse who is thinking about coming to the United States and you want to learn about the US. Licensure, this is the show for you today. We're going to be talking about a lot of different topics. We're going to be speaking about the NCLEX, we're going to be speaking about application by exam, application by endorsement. What does that mean? We're going to be talking about in click score, transfers in place, past verifications, credentialing, temp permits, emergency permits, contact license, lots of information available today. And we have our expert legal team that are going to be sharing your pointers and tips and taking your questions.

Before we get started, I want to just give a shout out to the Lafora admin team, to Ms. Jean, to Louise, to Anna, to James, Nurse Juan. Everybody on Paul from the Lefora admin team who do such a fabulous job of nurses helping nurses. And that's what today's all about. So today I welcome Holly and Michelle. Let's start off with introductions. Holly, do you want to introduce yourself?

Sure. Hello everybody. I'm Holly Muscle White. I'm a registered nurse for 22 years and I've worked with internationals throughout my entire career, have had some wonderful experiences that have certainly enriched my life as a nurse and currently with Connetics, I am a clinical educator. I work with nurses who are working on their NCLEX and I work with nurses who are preparing to come to the US and occasionally also with nurses who are here in the US who are getting adjusted to their first job working here. So I appreciate every opportunity I can to help a nurse navigate through all of these processes and I look forward to sharing more about life insurance today with you. Thank you, Holly.

And join today as well is Michelle. Welcome, Michelle. Thank you. And introduce yourself. Sure. Good morning. Hello to everybody in the different time zones. My name is Michelle Kilkenny. I'm the Senior Director of Immigration, Licensing Credentialing. I've been working with international nurses for over three decades and I'm an immigrant myself. I actually was fortunate enough to get a lottery green card over 30 years ago. And I have been working with bringing nurses since then to America. Initially on H one A, if you won't remember those, but in the old days, they probably weren't born then. And now since 95, we've been bringing nurses on green cards. So I know immigration and licensure NCLEX and endorsements, which we'll talk about. And I will tell you, I've been passionate about it since I first started 33 years ago, and I still feel the same passion. There's nothing like welcoming a nurse here and seeing them start their new life in America with their family, and that just still brings me joy. So thank you.

Well, Catherine is saying it's a pleasure meeting you, so thank you for joining us, Harley and Michelle today. And as I said, if you are a nurse who's starting this journey, coming to the United States, don't know where to start. If you are nurses already started this journey and say, oh, my goodness, I don't know how to do a licensed endorsement, I don't know about the Visa screen, I don't know about the CES. This show is for you because this is free information to help you to navigate the tricky roadmap of licensure upcoming to the United States. If you have questions, please put them into the chat. I have a lot of questions that's been sent to us already, and we're going to get started now and pick the brains of this expert licensure team. The only one that I just wanted to say is Ms. Jean. We wanted Ms. Jean from iPad to be with us today. Unfortunately, she couldn't make it for today's show. She's really busy. But she will be joining us on Future Joe. So shout out to Ms. Jean, who I think these three minds are probably the top experts in the United States on licensure. So I'm very excited for this opportunity. All right, so let's get started.

Holly, let's start with you. Many nurses, when they look at the success path, and if you don't know the success path, please go to the Connetics USA website and look at the success path, because this is kind of the roadmap that you need to take if you want to come to the United States. So first is to pass the NCLEX, then prepare for the interview. Then you will have your Visa framework if you're coming on a TN green card. And number four is Licensure and Credentialing. So if you don't know where to start, sometimes the biggest barrier of entry is that you don't understand the terms, like what things mean.

So we have a graphic of the different terms to understand in terms of US licensure. Can you walk us through these terms so that everybody is on the same page and knows what we mean when we talk about NCLEX score transfer or licensure or emergency permit. Yes. So I'll just run through each of these terms for you. When we talk about applications for licensure, we're referring to the paperwork that gets submitted to the state board that you're applying to. So currently, when you want to take the NCLEX, you would apply to a state by examination or an application by examination. And that means in most cases that you have yet to take your NCLEX exam, and so you're seeking permission to do that. An application by endorsement means that you have already passed the exam and you've established a US license. And therefore, from the original state that you passed NCLEX through or obtained, that what we call an exam license or a home license. You're now looking to endorse that to another state, to obtain a license in that second state. And most of the time, for international nurses, the license that they may get initially is not necessarily the license that they're going to go to work on, because many times the states that you may work with as an international nurse have enough difference in criteria that it's easier to go ahead and get your exam done in one state. And then once you've got an assignment or a place of employment and it's in a different state, you work through the endorsement process.

Board, or Board of Nursing is a term that is used even though not every state calls it the Board of Nursing. If you were to use this in Google, like if you said the Washington Board of Nursing, you could search that and it would come up with a link to that state Board of Nursing or to the regulatory body that is managing licensure for that state. Licensure itself means that you have fully qualified to work in the US as a registered nurse in a specific state. We'll talk about compact licenses in just a second. Credentialing refers to, on the licensure side, not talking immigration at the moment. Credentialing refers to a review of your nursing education, and the intent is for every state to validate that your education is substantially equivalent to what a nurse who trains in the US. Would receive in order to qualify to sit the NCLEX exam.

So what this Credentialing process looks at, regardless of who does the Credentialing review for you, is how do your transcripts and your nursing education compared to that particular state's requirements for their nurses to be able to become eligible to sit the exam or to be licensed on endorsement? Even the Inquest is a national licensure exam that RNS and LPNs can take to obtain their first nursing license in the United States. The NCLEX is, like I said, a national exam.

What that means is that every single state has agreed to accept this particular exam as the one that the nurse can achieve in order to meet the requirements for initial US licensure. It is not saying that the nurse is an expert in everything that they should be, but it says they've got a baseline level of nursing competency that allows them to practice safely and entry level nursing in the United States and Hollywood .I'm sorry to interrupt you at this point, but just a quick question. If the nurse passes the NCLEX, do they ever have to take the NCLEX again, like if they move from one state to the other. So moving from one state to another should not require you to repeat the NCLEX. The only time where I've ever seen a nurse potentially be asked to take and clicks again is if they were to let their qualifications lapse. So if they don't maintain those and we'll talk a little further about that in a future part of this segment, but if they don't follow those requirements, they could actually that NCLEX path maybe come invalid in a particular state. And that's, again, why you want to pay very close attention to what each state requires to maintain it. But overall, NCLEX doesn't expire. So it's nice that you get it in one state. And just because you're going from Florida to New York doesn't mean you have to take it again.

Thank goodness. Okay, good. Thank you, Harley. Okay, so let's finish off the terms and then we can move on to the NCLEX application process. Yes. So an inflex score transfer earlier on this slide, I was talking about an application by examination and your exam license. A score transfer can be done in circumstances where the international nurse was to pass their NCLEX exam, but the state that they passed it through might not have issued them a license at the time that they passed. And every state has different rules about this. So if they don't pass sorry, if they pass but they don't get a license issued when they pass NCLEX, then there is an option with some boards to take that NCLEX pass without having been fully licensed afterwards and transfer the pass itself electronically from that state. They got permission to pass through to a state that will issue them a license. And the most common one that we see that with is like California.

For people who years ago applied through California, they passed and they never got a license. And they know that the California board is not the one they're going to go work through or the one that they want to initially work through. So we can transfer that score from California to Illinois, who will issue what we call an exam license because they accept that that score transfer, and then they issue the nurse's very first license, what we call the exam license. So that's in a nutshell, score transfer, a path verification is a little bit different. So states are often looking at the time of Licensure, whether that's an initial Licensure or by endorsement to verify where the nurse took in class.

So sometimes that may be for me, as a US trained and initially licensed nurse, they may want to know, where did you take your NCELX through and can we validate that? There's an electronic system called nurses that often allows us to, when they go to validate that initial Licensure or that exam license, the state that issued it will actually have recorded my information around my NCLEX exam. So it's happening behind the scenes. But occasionally the state board will ask for a form to be filled out from the board that you were given permission to take in clicks through to the board that you wish to endorse to. So that is pass verification attempt permit or license is something that is going to be unique to every state. Some states will allow a nurse to receive a license that has a finite period of time on it in which they can provide some initial qualifications as part of the application.

Receive a temp permit, which is not going to be something you can transfer from one state to another. You can only practice in the state that issued that temporary permit. And most of the time that temporary permit is only good for somewhere between 60 to 90 days. And occasionally we'll see a board that will stay for 120 days. There are many boards that will not issue a temporary permit to an international nurse. The reason for that is they're looking at those education credentials again and they want to validate that the nurse who trained overseas, even on endorsement, has achieved that equivalent level. So again, not every board says I'll give you a temp permit so that you can work on the rest of the requirements. Some will. And so for that it's nice. But keep in mind, if you don't already know that some employers also are not very friendly towards temporary permits because if the permit runs out before the nurse has met all of the requirements, now they have a nurse that they've onboarded and they're hoping that the nurse gets that license. But if something happens and it expires before they do, that can create risk for the facility. So not every facility will also be happy to work with someone while they're still pending a permanent license. The next one is an emergency permit. So the most common emergency permits that we saw in the last couple of years were due to COVID.

There were specific laws that were enacted to allow the state boards to actually issue emergency permits or allow nurses to work. If they were fully US licensed in one state, they could work in that emergency situation in another state. Sometimes you had to file paperwork, sometimes the employer just had to be able to see that you did have a valid US license in a US state somewhere and that was all that there was to it. So every single state also has different rules around emergency licensing. And when that's appropriate, when there are disasters that happen, we often see there is legislation that is introduced to allow nurses to be able to come in and help in those types of situations.

So for instance, those of you who've dealt with typhoons or what we call hurricanes here in my part of the world, if that happens and there's major devastation and there's a need for augmented medical professionals. Sometimes the state will go through a quick process to be able to allow nurses to do that work as a nurse in the state without having to go through the full endorsement process. And Holly, that's where we watch that very closely because those emergency licenses are going to kind of shift in flow with the pandemic right before we talk about the compact license, I see we have a lot of questions from the chat. I wanted to take some of those questions, and if you have licensing questions for our expert panel, please go ahead and share them into the chat. And I'm going to try and get through as many questions as possible. So I see we have a lot of people joining us from Cyril Leone, ale Dee from Nigeria. Irish saying hi. Catherine saying hi.

We have a question from a Facebook user who's asking? Good day. Any tips on how to contact the Board of Illinois? I've been following up for my license for two months already. No replies to my email. I don't know if they already possessed my license. Docs accept the password to verify because everybody knows now what the pass letter is. Explanation to verify while waiting for official license from Illinois.

Michelle, how would you answer that question about the Board of Illinois? Yes, they can verify NCLEX. They don't have to have the license issued to qualify for a Visa screen as long as they have a current license overseas. They just need one current license for the Visa screen. But Illinois, if you've passed NCAA to Illinois and you've submitted the application for the $50 for the actual license, it should be issued within two months, so there shouldn't be a delay there. Okay, and what should the Facebook user do if there is a delay? They should let CGFNS know through the wizard and that they have passed anchor through Illinois. But CGFNS can't pull it themselves because they need a license number to pull it digitally.

So they're just going to have to follow up with Illinois and ask them to verify. And how can they verify NCLEX? Okay. There is a phone number, too, that they can call. So we see that with some of the nurses we already work with. I will tell you during this what we call the summertime, where everybody kids are out of school and whatever, but nurses have just graduated in large volumes all over the United States. And the state boards during the summer months experienced a very large influx of applications from the US because they're also trying to take NCLEX. Sometimes that does slow their response times a little more. But what we've been advised is that it's ideal if you're waiting for a response, even if you've emailed, to actually call. Unfortunately, state boards for these types of applications for international nurses, often they're paper based, and so there's no way to electronically look to see what part of the process they're in until it's issued. Yeah.

So you can try call as well. And we know it's frustrating, but we have a term at Connetics USA and at AMN Obsessive follow up. That's what it is. You just got to keep following up. Unfortunately, it can be very frustrating. Janetel is asking as a bank today, she knows, can I apply? What's the process? So in a few minutes, Michelle is actually going to take us through the NCLEX application process and what that involves. We have another question about Illinois. Illinois, obviously a very popular board, another question is licensed from Illinois, was already transferred to Texas. If temporary license is nearly expiring, can I just renew it so as not to repeat the license endorsement process?

Michelle, no, they won't extend your temporary license in Texas, but you need to find out what's the reason. I mean, some of our nurses, it would be they haven't taken the law test or they haven't had their foreign license verified and sent to the board. But Texas, they give you the four months. I believe in a temporary, it should be enough time to get the permanent license through. So you need to check what exactly is missing and get it submitted. But they won't accept your template. Okay. Thank you, Michelle.

I see a lot of people are tagging their friends, so thank you for doing that. Please share this video with your friends. Tag your friends. The Lefora talk show is about nurses helping nurses. This is free information. This process is very confusing. You're not only dealing with immigration. If you have immigration questions, watch our Onwards and Upwards show once a month where we have been bringing our immigration experts, but the licensing side is equally as confusing. So please share and tag your friends on this show because our experts are here to help you.

Okay, well, we've got a lot of questions coming in now, so I'm going to try and get through as many questions as I can. And Michelle and Holly are also going to be taking us through both the application and the endorsement process. Mahut is asking, I have passed the NCLEX exam last month from Texas board, but my license is not yet updated. What should I do? Honey? So when you're in the Texas application process yes, when you pass the inquest, you should be issued a license. We have seen with the nurses we're working with a little bit of a lengthier time for that to happen. But again, as Michelle said with the previous question, is there something missing? Is there something that they needed to be able to complete your file and issue the license? So I would also use phone calls, email, messaging through their system to request clarity on whether you may be missing part of the criteria that they needed in order to issue. But we are seeing an increased amount of time between NCLEX path and that license being issued as well.

Okay, thank you. So there you go. My head, Cherry Lin is asking I recently passed my NCLEX exam into Texas. Till now, I haven't had any letter from the Board of Nursing. Now that everybody knows what the Bon means for going through those terms tiny and that I've officially passed through quick results sorry, I haven't received in there on the end, that I have officially passed those through Quicken results, I've already seen it. What should I do, Michelle? Well, again, if they've seen it on the quick results, I don't know how quickly Texas will send the actual NCSBN. I don't even know if they send that out anymore. But you will get yeah, I don't think so either. So you should be waiting for your license to be issued.

You need to check with the Texas Board on the status of your actual application and to make sure you're not missing maybe the law test or something simple that you just need to complete so that they can issue a license. Okay. Thank you, Michelle.

And I'm going to take a few more questions before we move to talk a little bit more about the NCLEX application process and the NFLEX endorsement process. Janet hall is asking, is Bangladesh nurses eligible for NCLEX exam? Honey? So I haven't personally worked with a lot of nurses from Bangladesh. What I would say is it may depend on whether your nursing education was similar to the nursing education in the US. And so that process can be done a couple of different ways. One way is to look at the State Board laws, and I'll talk about how many hours for each course or training you may need, how many clinical hours you may need in each of those segments. Typically for international nurses, if you're not going to qualify to sit the NCLEX, it's because your education was in some way not substantially equivalent most of the time.

That's because it was short in hours in psychology, either on the classroom side or the classroom and the clinical experience side, meaning you were going in and having rotation or maternity without looking at your individual transcripts against what the State Board requires, it's hard to say for sure. I've worked with nurses from Bangladesh before, but I haven't worked them through the process myself to know how they got there. Thank you. Honey, do you have something to add on this question about nurses from Bangladesh? No, I agree with what you're saying. I feel like I've worked with Bangladesh nurses before, but I don't understand yet in 30 years. But I will say the only way to find out is to get that Credential report or to check with your school. But you need hours in the five areas of nursing. So if you've done theory and clinical in the five areas of nursing, you should qualify.

Okay, fabulous. There you go. Janetel, Denise is asking, do you know CGFNS will accept OET from Visa screen? The short answer? Denise our answer is yes. Please watch our shows. We had two shows Onwards and upwards in the last two weeks. Onwards and Upwards is Connetics USA weekly show that we host for international health care workers all over the United States. And we had two very comprehensive shows last Friday and the Friday before. Talking about this new announcement for CGFNS If you have not seen those shows, please go and watch them. You can go to the Connetics USA website or the Connetics USA social channels and watch those shows and find out about the OET and the PST and PTE change that is happening through the CGFNS on the 1 August.

Okay, Kylie is asking, I passed my entry through California Board Nursing years ago. Is it still valid? I don't get to have my Social Security. Michelle yes, it's still valid. And you can't activate your California license because you don't have a Social Security number, but you can apply to another board. I would suggest that you apply to the Illinois board by exam and you have your scores sent from California and then you will get an Illinois license. But that does require and we'll talk about that in a minute. You will need to get a Credential report done for Illinois and then get your scores over there. So there is a process involved, but yes, your NCLEX is safe. Okay, great. Colin so I'm sure that's a big sigh of relief for you.

And thank you for asking that question because this is a very common question that we get from many nurses who are shaking in their boots because they're thinking, oh, my goodness, I took my NCLEX years ago through California and maybe it's no longer valid. So the short answer is it's still valid. Suleimay is asking, is there anything for medical lab technologists? Yes. Connetics USA and AMN. Connetics, you say, is part of the AMN family today, we are so proud to say. And both of us have positions for medical technologies. And we have a show coming up slowly for medical technologies, so keep watching out for that. Okay, Michelle, we're going to start talking now a little bit about the NCLEX application process. Highly explained the difference between NCLEX application and NCLEX endorsement.

So let's talk a little bit more about the NCLEX application. And we have a slide which really talks a little bit about the process and the requirements. So we're going to put that graphic up about the requirements. Can you talk us through these exam application requirements? Of course. So the first thing you want to do is for your journey to the States, you do need to pass NCLEX and step is to sort of find out what board you want to apply to. You obviously are coming from, you are with different agencies or you're with Connetics they will guide you and give you advice on what boards to apply to.

One thing I would suggest is do your homework because you don't want to apply to a board who won't issue a license at the end of when you pass NCLEX. And we have a lot of nurses who took the Florida boards. It's a great board and you can pass NCLEX, but you won't get a license because they require a Social Security number to issue the license. And again, Social Security number, that's something you get after you come here on a visa.

So we would suggest you do your homework. There's a lot of boards you can apply to. Some of the top ones I would think of would be Illinois, Michigan, Texas, but there are plenty of others, but you don't want to apply to somewhere where they won't issue license, like the Florida, Nevada, California. Well, you can't apply to California anymore without a Social, but there are several states like that. So do your homework on the board that you apply to. They all have a fee and they differ greatly and they're non refundable.

So you also need to think in terms of how long it's going to take. When are you going to be ready to take NCLEX? You should be doing a study program or getting prepared for NCLEX, but at the same time, concurrently, you can do your NCLEX application to a board and you can do your Credential report. So you decide on a board, then you have to most of them require a Credential report, which there are plenty of Credentialing agencies out there. Of course, the main ones would be CGFNS, and then thereafter, like Joseph Silny and there's several others that boards approve of, but there are hundreds out there.

So be very sure that the board you're applying to for the NCLEX accepts the agency that you use. So let's just say you're applying to CGFNS. You apply for a CF report. I think it's just increased to 420 for that. And you have to indicate when you apply what board you're taking and clicks through. So that's why it's very important you pick the board first so you can start your CES even before you start your eclectic application to the actual board. You just need to be sure what board you're applying to. CJ they will require your high school diploma. Every nurse has to graduate from high school, just so you know, as an American nurse for the American exam, you have to have graduated high school. So they will require your high school certificate or diploma. And that's very important because a lot of people don't have that. So you need to look for it. And then they will require your nursing transcripts or academic request form, and they will also require your foreign license verification. And I would include all licenses. So if you're in the Middle East but you're from the. Philippines, you need to apply for your PRC, but then whichever country you're in, you need to apply for verification from there as well, which could be important later on. Some boards want to know everywhere you're licensed. Others only care about where you're educated.

So again, you have to do your homework there  or work with whatever agency you're working with. And then fingerprints, they do ask for background checks. So many boards will have fingerprint cards. You will need to complete and submit with your application. Social Security. You don't have one. So many boards have a Social Security affidavit you basically are notarizing that I don't have a Social, but when I do have one, I will provide it. English proficiency. While it may not be required for the board, many boards will accept that. If your CEO, your Credential report says you're educated in English with English textbooks, that will make you eligible to take NCLEX in that state. However, you need to remember that you're going to need English to get the Visa screen thereafter, once you've passed NCLEX, because you need that Visa screen certificate or Healthcare Worker certificate in order to get a Visa to work in the United States. So while English proficiency may not be needed at this stage, you are going to need it to get the Visa screen. And then continuing education topics. Some boards will want continued or CEUs, as we call them over here. And again, those can be obtained. Whoever you're working with can advise you on how to obtain them, but not everybody requires it.

There are a couple of things with exam applications. I suppose we'll be going through the map in a second, but you can apply to the board. You apply for a CES report. It's submitted to the board by whichever agency you have, and then the board makes you eligible to test. Once they make you eligible to test, that's when you pay. Thank you. Pearson View, who administer the exam, you pay $200 to register with them. Once you've registered with them, they will then issue an ATT. Currently, since COVID, the ATPs are valid for six months prior to Covid. And maybe they'll change it again. We don't know until we're told. But they may go back to just being a 90 day window. Actually, some boards have a one year window. It's crazy that they're different, but they are. So you have to know your board.

But right now, the minimum is six months. So you get a window of six months, and during that six months, you need to schedule your test wherever you are. If you're taking in America, there's no extra fee involved. But if you schedule it, let's say in Manila, it's $150 that you pay when you're scheduling the actual test. If you're in the UK. London, I think, is $180. Most of them are $150, but there are a few who are a little different. I think India is like 177. So you need to schedule your test. And then once you take the test, you obviously get the quick results within 48 hours and you've passed. And then it's exciting. You move on to your immigration.

Now, depending on the board, like, if you took the Illinois NCLEX well, as soon as you pass, then you have to wait for they send you an application for an actual license, which you then need to submit with $50 to get your license issued. But if you're in Texas, they'll issue your license. I talk quicker, but obviously, from the chat, maybe not as good. I know Michigan issues it straight away. It just depends on the board. New York issues it, so there might be a waiting period. But you certainly want that license because we'll talk about that soon. But the license is very important. Now, if, unfortunately, you don't pass, different boards have different rules. Some boards only let you have the one take, and then you have to apply again. Others, like Illinois, for example, their application is good for three years. You can take it as many times as you like in those three years. Hopefully, it won't take that many times, but you can retake the test. You have to pay every time, but you have a three year window. Michigan, I think it's a two year window where you can take the test. It used to be they limited it to three times, but now they just changed the rules.

And I think it's unlimited in Michigan as well. But it's still within that two year window and that the application is still valid. Thank you, Michelle. That's a really comprehensive explanation of the NCLEX application process. It's very confusing to so many nurses, so it's really important to be able to get this guidance. So having these two licensing brains with us today is just so valuable and so helpful, I know, for so many nurses who are watching all over the world today because it really can feel very overwhelming and very scary, and it's expensive. So you want to make sure that you're taking the right steps when you're doing your NCLEX application process.

We have a question here, and we're getting this question actually a lot this question has been sent to me before as well, which is, hi, I'm about to take my NCLEX RN in the state of New York. If I pass, can I seek endorsement outside of New York? Holly so you can seek endorsement. New York, as Michelle mentioned, is one of those boards that will issue a license when you pass. So that's great.

They're also a board that requires two topics of continuing education when you apply for the exam. So one of the things you need to be aware of is that when you endorse to another state from an original state of New York, if the new state requires a Credentialing evaluation, you may have to go through CGFNS to get that done where originally you had New York evaluate your credentials. So just be prepared. You might, depending on where you're going to end up working.

As you look at the endorsement requirements, look to see whether they require a CES. If you've done Visa screen with CGF and S at that time, then remember they're going to have your transcripts on record already, so you wouldn't have to go get your transcripts again unless it's been more than four years. CGFNS discards your electronic files if it's been more than four years, unless you pay to e save them to Step Yi. So, yes, you can. Okay, good.

So there you go. You can transfer. And that's another thing, another question of confusion, because many nurses think, if I take my NCLEX in New York, I have to work in New York. So the answer is, no, you don't have to. And there are ways of doing an endorsement. Lexi Bus has a question. I am currently in Qatar, past the NCLEX through Vermont, but no active license because of Social Security. If I will endorse my license to Illinois to be able to get an active license, there's a portion that Social Security is asked, can I use a dummy number? If yes, what is the dummy Social Security number? Michelle I think there's a Social Security affidavit for Illinois, so we can answer that again. But I would have one question on Vermont. The question would be, was a license issued and it was never active, so that it was issued versus wasn't a pass letter. I think in Vermont they issue, but they just won't give you it's not active, if you know what I mean. And there is a different there's other states you can apply to with an inactive license where they can issue a current one so that you don't have to go through Illinois. Yeah, the other thing with that it's important is if it's just that you wanted to get an active license so that you can endorse to somewhere else. Vermont, when they do receive your social, usually within 24, 48 hours, they turn it around and issue. That's unique. Some states take a little longer once you do provide the social, and that's why you may try to endorse somewhere else first instead of waiting. But Vermont's pretty quick. Yes, we've definitely seen Vermont being very efficient overall.

So that's helpful because years ago, when highly michelle and I started doing this international recruitment, most international nurses actually rode through California and Vermont in those days. So these are very common questions. If you pass the NCLEX many years ago, Lexi is asking, can a nurse transfer her Canada or Australia NCLEX Pass to a US. Board of Nursing? Michelle yes, they can. Again, I'd probably apply to Illinois. I suppose it depends, really, on where you're going, but if you weren't sure where you're going, I would apply to Illinois and get your scores transferred. From Canada or from Australia? And there's a follow up question that was sent directly to me from Etsy who's saying, should I take the NCLEX to Canada or Australia instead of applying to a US state? I wouldn't recommend that. If your objective is to get to the United States, then I would apply for the US version and to get a license like apply to a board that will issue a US license versus going the long way around, which I would call that if you're in Canada working, that's different. Yeah.

So I think that's good advice and that's where we love the Lefora talk show. And thank you again to the Lefora Admin team for giving us this opportunity to be able to share important information about licensure in the United States with all nurses around the world. Okay, so we have more questions about the PTE and OET. I know this is a hot topic. Please, if you did not watch the Connetics USA Onwards and Upwards show on Friday, last week and the week before, please go and do so. They are on the Connetics USA website and on our social media channels. I know that this is a big topic for many international healthcare workers, not just nurses, and because it's a big change in the requirements. So please make sure to watch those shows so you can educate yourself and we will keep updating you about any changes from a state perspective on the PTE and OET requirements.

Okay, so Neka is asking, what license do I need for support worker in the USA? And I'm not sure what Nika means by support worker. I think maybe she's referring to a nurse aide. Honey, every state is different for nurse aid. So some require that you take a state approved course, usually about 75 hours for most states. If that's the case, it requires a clinical component so you can't just do it online for some of those. And then there are some that if you had training overseas, like as a nurse and you wanted to take a nurse aide exam, there is a way you can bypass that. With some states, the training course, because you've basically already received medical training, you can request permission to take that state approved nurse aid exam without having to go through a nurse aide course.

So, again, it's very state specific and those are licenses that don't always endorse from state to state. So, for instance, if you became a nurse aide in Florida, you couldn't necessarily go and be a nursing in North Carolina or Tennessee without first going through whatever their requirements were or their training was or taking their exam. So you have to be a little more precise in where you plan to work as a nurse aide and then look at that state's requirements. Okay, thank you, Nica. And we have a whole show on nurse aide that is going to be shown in the coming weeks and months as well.

Led I have a question. I'm from India, but born in the UAE. If I pass my integration, can I apply? Michelle yes, definitely. If you're born in the UAE, that's awesome because that means you're nativity. Immigration is all based on where you were born. And so even though you're an Indian national or citizen, your place of birth was UAE, so you would fall under all of the other chargeable areas and not on India, and visas are currently there right now. Okay, perfect. Lucy saying Holly and Michelle know so much, love the Lefora Talk Show.

So, yes, you're right. Lucy, Holly and Michelle are the dream team on the side. So this is your chance. Everybody ask questions, and we'll try and get through as many as we can in the chat. Okay. Shalaya, I hope I pronounced that correctly, is asking about the North Dakota board requiring a yearly evaluation for CGFNS to issue the CES for license? Holly, do you want to take that question? It broke up a little bit. So, for North Dakota, for international nurses, many of the countries that may apply to the board, they will ask that you do a CES evaluation for endorsement. That is because they want to make sure that when they issue you a license, you are determined to be equivalent to the degree that you're needing in North Dakota to get your original license.

So they may at first, for some countries, accept just a transcript, but there is a high likelihood that they could still come back and say, we've got your transcripts, but we still want you to go ahead and submit a CES for us. It seems to be less common with some of the schools in the Philippines, but there's no guarantee that even Filipino nurses might not have to produce that CES at some point for them to be able to get the license. If North Dakota receives your transcripts from your school and a couple of other items, they can actually issue you a temp license to give you a little bit of time.

It's a 90 day temp license to do a credentials evaluation if they happen to ask for that and follow up. Okay. I don't know North Dakota that well, but the question was asking about an annual that said yearly evaluation. Once they get your evaluation, they don't need another one. Like, once they've validated that you meet the requirements, they should not ask for a second CES report.

Okay, so we have a question from Camillo who's saying NCLEX was checked. My license is from New York. I'm pending asylum. You can help with it to work with the Visa screen in process. Michelle so my license, I'm pending your help with it. You can apply. Excuse sorry about that. It depends where you educated overseas or were you educated in the US. You will need a Visa screen process. And so depending on who you're working with, they will help you apply. CGFNS and Joseph. Sylvie now issue Visa screens.

It doesn't matter where you're educated, whether it's us or overseas, you will need a Visa screen if you're applying for a visa to work in the United States. Whether it's a permanent visa or a non immigrant visa. You can apply, I suppose, through thank you, Michelle. And we have a question here about Texas, and please help us, our end, who will be doing license endorsements to Texas to fix issues in a comment that Ireland should be fixed in all four sub tests. This applies only on applicants who plan to take NCLEX through Texas, but not for those who will do endorsement, right? Please clarify.

Holly and Michelle, I'm not sure if you have any comment on that question. I think the question is, is the IELTS in each subtest required for both application and for endorsement? Michelle honey, English is not required for endorsement.

So on the NCLEX, I'll have to double check. There are several states that require six in all areas, and Texas might be one of them. I haven't got done and click through Texas. Okay. It's not fresh enough for me either, what the specific scores are. However, I'm assuming then that the nurse was not educated in English or with English textbooks, and that's why they're requiring it or asking for it at the time of influx application. But yeah, I'm checking it out now. While we're talking, if there are any questions that we haven't got to or that we didn't have a specific answer because they're very specific questions, our expert Licensure team will go into the chat after the show and answer those specific questions for you.

Vidjaya Krishnan is asking, what about the Kentucky board regarding license issue and NCLEX pass? I think Kentucky board we have lots of nurses in Kentucky. I think Kentucky board is actually a little easier to work with. Honey? Yeah, we don't typically work with them for applications for the NCLEX exam. We do work with them more for endorsement, and they are fairly timely and easier to work with in that way. I would have to look at their NCLEX requirements a little more in depth about English, whether they issue a license by exam when they pass or not. So? I didn't think so. Better. I wonder, too, because to get your perm, they're great at issuing temps, but to get your perm, you have to have the social. So I wonder, could that have an effect on getting a license from Apex? Absolutely.

Okay. We've got so many questions that I'm just trying to pick out ones that we haven't asked as yet. So we have a question, let me see here from Joy, who's asking, does it matter how much time passes between when the NCLEX is passed and the date of us arrival? Michelle, so we talked about this one before. It depends on what they're actually asking in the sense of if you've got a license issued, then after you pass NCLEX, there is no issue if you pass NCLEX through California, like that Indian nurse who passed in California years and years ago, they can endorse or they can apply by exam to Illinois.

However, we have come up recently with a case in Florida where is that right where it was like four years since they had never received a US. License. And in that instance, there is a concern. So I think they were saying they had to do a refresher course or something before they would issue. Five years. Five years. Thank you. So our advice, and that's what we've been saying is if you take an try and apply somewhere that has a license, and if you haven't, it is worth applying to Illinois just to get a license in your hand. If it's going to take you several years to get here based on immigration or whatever other reasons, I would say just take the best bet and get yourself a license in hand. And for us right now, Illinois would be a good place to do. Okay. Thank you, Michelle.

So I see the questions are coming fast and furious, and we want to try and get through as many as we can, but I want you to just speak a little bit about the license endorsement process and what is required, what are the common requirements. So we have a graphic holly, do you want to maybe just take us very briefly through this licensed endorsement common Requirements graphic? So, as we've been saying, it's best if when you pass NCLEX, you do it through a state that issues you a license. When that happens, then it's your responsibility to maintain that license.

Some nurses choose to let it expire when they still have the option to keep it active. And my advice is, as much as you're allowed to keep it active, you may also benefit from, if it's going to expire, maybe endorsing it to a state that will allow you to keep it active throughout the time that you're waiting. It's best to try and keep an active license because it makes it much easier to go through the endorsement process. With most of the states, if you have an active license at the time you apply, the next thing you need to think about is if you have that license and you're applying for endorsements, you will be going through a verification process. There's a website called Nurses that's run by NCSBN, and the majority of the US. States do use nurses for electronic verification of your US. Licensure from one state to another. Some states will require that you validate for endorsements the exam license, meaning the state that you got your first license through because you took and collected through them and your current US.

License if those states are different. So if you pass through Illinois, but then you endorsed to Tennessee, then now you're looking to go to another state, you may end up having to validate both of those. Right now, the fee is $30 to do that process for each board that you're verifying. Endorsements may require another Credentialing review. I mentioned that earlier.

So, like through New York, if you end up wanting to go to Texas to work, Texas requires a CES, so you would have to complete a Credentialing review. Typically that's through CGFNS or Joseph Silney. One of those are the most popular ones accepted by state board. Be very careful because the term CES is a Credentialing evaluation term, and we do Credentialing evaluations both for Licensure and for Visa Screen. Visa Screen may have a lot more agencies that they will accept that CES from than your state board will. So don't assume I got virtuoso. CES. So now that works for all these different boards most of the time.

I've not actually heard of a board that accepts that for licensure. Okay. Many states you can get a license activated before you come, but it may not be the one that you're going to work on. So if possible, try and have an active license before you come. Do the requirements to maintain the active license, and then when you arrive, there may be some final requirements needed, which could be providing the board with your Social Security number so that they will issue that license to you. Or it may be that they want some Visa documents provided that show you're in the US. And have permission to work here.

Finally, Licensure, based on your primary state of residence, we have both single state and multi state licenses. Most of the time, international nurses don't have an address here before they come. That's a residence. So when they arrive, they're receiving a single state license for the state that they are endorsing to so that they can start work. That license gives them full permission to work in that state. And if they want a multi state license after that, they can work with the board on providing the appropriate identifications that show their primary state of residence, like a state ID and go on to achieve a multi state license. But what they really need to go to work is the single state license in that state that they're wanting to work in.

Okay, thank you, Holly. So I cannot believe it at the end of the hour. How you have flown. Oh my goodness, I'm getting so excited. I'm knocking over my microphone. You can see this is live, everybody. So we have so many questions. The bad news is we're coming to the end of the hour, everybody. The good news is that Michelle and Harley will be back and we'll be able to answer more of your licensing questions because this is a very confusing part of coming to the United States.

We're going to take one last question, and that is from Mohit, who's asking, how much time does it take to complete all the process after passing the NCLEX. Michelle so I'm assuming they're asking about the immigration process after passing and clicks. So if we're filing for an I-140, I mean, it depends on their job, on where they are and what agency they're with, but the actual filing, when somebody actually files for you, I would say anywhere from twelve to 18 months, give or take, whether you're expedited and all of that. So we would hope so. 2024.

If you're starting the process now, you'll be here in 2024. can I just give a quick answer to the Texas person? Because one of my team already messaged me with the answer. Okay, thank you, Nina. Just waiting out. Nina it's 6.5 for Ireland and six in each area, but they do take Pearson PTE and then TOEFL IBT as well in Texas. And that's just for the exam. And it's NCAA's exam. And it's also, if you weren't educated in English, with English textbooks.

Okay, thank you so much, Michelle. Thank you so much, Holly. That was so informative, so valuable. I know that there are many nurses all over the world right now that are breathing aside relief that they're starting to understand more about the licensure requirements for coming to the United States. As I said earlier, it can feel so scary, so overwhelming and expensive, so really important to educate yourself about this process so that you can get to the United States as quickly and as seamlessly as possible. Before you leave us, I just wanted to give a quick shout out again to the Lefora admin team for your support for all nurses around the United States and around the world, I should say. And also wanted to just let everybody know about some upcoming shows. So we have a graphic with some upcoming shows with the Connetics College. For those of you who don't know, the Connetics College is a live show. Every Monday, check out on our social media.

This is live classes, both on the IELTS. On Friday the 25th, we have nine of doing an IELTS class on the spot writing task. We have NCLEX partners who will be speaking about various topics coming up on the Connetics College. And then every Friday, we have Onwards and Upwards, which is on the Connetics USA Facebook page at 07:00, a.m. Pacific time. Check what time it is in your local time. And on the 22nd, we have the Immigration Expert Legal Panel who will be taking your immigration questions.

So if you have immigration questions, please check out that show. On the 29th. We have a very interesting show on transportation in the US. And we've got lots of experts coming in to speak about transportation, what's available in the different parts of the US, how to buy a car, how to get a car loan, all different topics about transportation. And our next Lefora talk show we do this once a month, will be in August on the 16 August. And this is we're going to be speaking specifically about the clinical aspect of the ICU. And this is your chance to ask nurses about working in the United States about the ICU. We did a poll in the forum and asked which specialty you want us to start with and the ICU got the most votes. So the ICU it is. So thank you, everybody, for joining us on the Lefora talk show. Thank you to Holly, thank you to Ms. Michelle and we will see you next month. Thank you, everybody. Thank you. Bye.