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You cannot take the CGFNS exam if you were never licensed in the Philippines. Being licensed in the country of your education is one of the requirements. With this in mind, you can still apply for the CES report which does not necessary require a license. However, some state boards still require that you hold a license from your country, so you should call the Massachusetts board and find out if they do.

Just to add to the comments about internationally educated nurses. Here are a few more recent resources: Here is a Department of Health report from April 2013- http://bhpr.hrsa.gov/healthworkforce/reports/nursingworkforce/nursingworkforcefullreport.pdf The section on IENs shows that NCLEX takers with foreign education spiked in 2007 at more than 22,000. Since then the figure dropped to around 6,000, probably due to the recession. It should be noted that passing NCLEX does not necessarily mean that the nurse has moved to the U.S. Many who pass still have to wait several years for their immigration documentation to get worked out. It is difficult to find an exact number of actively working IENs. But here is a report on a study published last year, which attempts to assess the risks of employing substantial numbers of IENs- INQRI Blog: Employing Substantial Numbers of Foreign Educated Nurses in U.S. Hospitals Raises Risks of Poor Patient Outcomes The report does not discuss the reasons why and I have not read the actual study, but its findings are that there is an increase in safety concerns in employing a substantial number of IENs with staffing ratios of four patients per nurse or less. My guess would be it's a language issue that is causing the safety concerns. The study makes the recommendation for hospitals to employ no more 25% IENs among their staff in such instances. So this indicates that there are some places where foreign nurses are being recruited at higher rates. (Probably North Dakota is one such place.) Here is another report on a study released earlier this year by AJN- Foreign-Educated Nurses Report Unequal Treatment in U.S. Workplace | publichealth.gwu.edu In this study 40% of IENs report having lower wages and worse benefits, so it would seem that there is some credence to the author's claim that they are being paid less. Another report from 2012 mentions that Filipino nurses are generally paid lower, at least when they first start out. (http://www.economics.neu.edu/activities/seminars/documents/cortespaper.pdf) Related to this is the existence of the Alliance for Ethical International Recruiting Practices (The Alliance for Ethical International Recruitment Practices) which was originally founded because of the significant level of unethical recruiting practices of nurses. In 2008, the Alliance published the "Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Nurses to the United States" which nurse recruiters can choose to follow. However, there are still many recruiters that do not follow the code, and nurses from other countries often are not aware of which recruiters they should be using. Regardless of whether nurses are being ethically recruited it is a basic economic principle that when the labor supply increases, employment opportunities and wages decrease. Importing nurses was originally done because health care needs outpace the ability to produce new nurses. It's good for health care costs to import nurses, but not necessarily good for individual nurses, who, as a result, have more trouble finding jobs and lower wages when they do find them. This factor could have the effect of dissuading U.S. citizens from going into nursing and further exacerbate the country's ability to produce homegrown nurses, causing a greater need to import nurses. A secondary question is, what is the effect on the sending countries from which the U.S. imports nurses? It's too complex to get into here.

The VisaScreen Renewal requires updated license validation according to the web site: "Updated validations of every license you have held, including both expired licenses and licenses validated for a previous order if the validation on file is more than three years" [Found here: https://cgfns.zendesk.com/entries/25621426-VisaScreen-Renewal] To me this indicates that the document is time-sensitive. So regardless of whether you ordered eSaved, what matters for the license verification is the date on the document sent to CGFNS. If it is less than three years ago it can still be used for VisaScreen. If it is more than three years ago you need a new one.

Actually, Superman was born on Krypton, but his escape pod spaceship crash-landed in Kansas. ;-)

I appreciate your explaining the specific requirements of H1B visa process. This is very clear and well-expressed. For nurses who do not have a bachelor's degree, what are the options? I am aware of the Green Card (which has a long waiting list) or Trade-NAFTA status for Canadians and Mexicans. Citizenship can be gotten through other means (marriage for instance), or refugees and asylees may also be granted the right to work. But are there other visa categories available to foreign educated nurses with a diploma or associates degree equivalent? More generally, are there other visa categories available any kind of nurse at any educational level beside H1B?