Career Pathways
There are several pathways to sponsorship in the USA, however, the costs and complexity of these rules are constantly changing.
The EB-3 is one direct pathway for foreign-educated nurses. Nurses qualify under the “Skilled Worker” category, as the profession requires at least two years of training and licensure. Hospitals and other healthcare employers may sponsor nurses directly, and family members can be included on the application. Once approved, this pathway leads to permanent residency.
A major consideration for the EB-3 is visa retrogression—when demand for green cards from a certain country exceeds the annual quota set by the U.S. government. In practice, this creates backlogs on the Department of State’s Visa Bulletin, meaning nurses from countries with high demand (such as India or the Philippines) may wait years before receiving a green card, even if their petition is approved. During retrogression, many nurses begin work in the U.S. on temporary visas (H-1B, TN, etc.) while waiting for their EB-3 priority date to become current.
While historically less common for nurses, the H-1B visa can be used in certain circumstances, such as for advanced practice nurses (nurse practitioners, clinical nurse specialists, nurse anesthetists) or roles requiring a bachelor’s degree minimum. Standard H-1Bs are capped annually, though “cap-exempt” opportunities exist when the sponsoring employer is a nonprofit hospital affiliated with a university or a government research institution. The H-1B can also serve as a bridge to permanent residency.
Under the U.S.-Mexico-Canada Agreement (USMCA, formerly NAFTA), Canadian and Mexican nurses can apply for TN status. This visa is relatively fast to obtain, often processed at the border or a U.S. consulate, and allows renewable three-year work authorization. However, TN visas do not directly lead to permanent residency, so many nurses eventually transition to EB-3 sponsorship.
H-1B1 and E-3 visas are available specifically for nationals of Chile, Singapore, and Australia (E-3).
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