The Global Tapestry: Charting the Role of Internationally Educated Nurses in the U.S. Healthcare Workforce

Executive Summary

To address ongoing staffing shortages, the United States healthcare system increasingly relies on a diverse, globally sourced nursing workforce. This comprehensive statistical review examines the composition, scale, and geographic origins of immigrant nurses in the US. Using recent data from federal agencies, professional organizations, and migration research institutions, this report demonstrates the critical role of immigrant nurses in sustaining U.S. healthcare delivery.

The Scale of International Nurse Migration

The presence of internationally educated nurses in the US has grown into a structural pillar of the healthcare system:

• Approximately 500,000 immigrant nurses work in the United States as of 2022.
• They represent approximately 15–16% of all practicing registered nurses (1 in 6 RNs nationwide).
• Between 2010 and 2022, the proportion of U.S. hospitals hiring foreign-educated RNs nearly doubled, increasing from 16% to 32%.
• The Commission on Graduates of Foreign Nursing Schools (CGFNS) International reported 24,733 VisaScreen certification applications in fiscal year 2024, an increase of approximately 200% from pre-pandemic levels.

Countries of Origin for Immigrant Nurses in the US

The Philippines: Primary Source Country

The Philippines represents the predominant country of origin for foreign-trained nurses practicing in the United States.

• In 2024, 28,258 Filipino nursing graduates sat for the U.S. licensure examination (NCLEX) for the first time, with a 54% pass rate.
• Filipino nurses comprise 33% of all foreign-born RNs and approximately 4% of all practicing nurses in the U.S.
• Currently, approximately 141,000 Filipino RNs work in the U.S.

India: Second Major Source Country

India ranks as the second-largest source country for immigrant nurses in the United States.

• In 2024, India produced the second-highest number of NCLEX candidates, with 5,869 Indian nursing graduates taking the exam.
• Approximately 32,000 Indian-born registered nurses work in the U.S.

Kenya: Emerging African Leader

Kenya has emerged as the third-largest source country for nurse migration to the United States.

• Kenya ranked third among nations in NCLEX test-takers, with 3,740 graduates taking the examination in 2024.
• In 2024, Kenya accounted for 6.5% of CGFNS VisaScreen certificates.

Canada: Unique Bilateral Exchange

In 2024, Canada represented the second-largest source of CGFNS VisaScreen certificates after the Philippines. According to historical CGFNS surveys, 23% of licensed foreign nurse graduates practicing in the U.S. were Canadian-born, though recent trends show a slight reversal with U.S. workers seeking rapid licensure in British Columbia.

Nigeria & The Caribbean

Nigeria: Approximately 24,000 Nigerian registered nurses work in the United States, representing 5% of the immigrant registered nurse workforce.

Jamaica: Despite severe domestic shortages, Caribbean nations contribute heavily to U.S. diversity. Between 1997 and 2000, 185 Jamaican nurses applied for U.S. positions, a trend that continues today.

Other Significant Source Regions (2024 NCLEX Data)

• Nepal: 2,662 nursing graduates (4th highest globally).
• South Korea: 2,636 nursing graduates (5th highest globally).

Geographic Distribution Across the United States

Immigrant nurses in the US exhibit geographic concentration patterns corresponding with immigrant communities and healthcare demand.

• States with the highest proportions include California (37%), Nevada (35%), New Jersey (32%), Florida (29%), and the District of Columbia (29%).
• Notably, 94.5% of immigrant healthcare professionals live in urban areas, compared with 77% of U.S.-born healthcare professionals.

Workforce Characteristics and Educational Credentials

Immigrant nurses bring substantial educational credentials to the U.S. healthcare workforce. During the 2010–2018 survey period, 37% of foreign-born healthcare professionals held graduate degrees, compared with 27.2% of U.S.-born healthcare professionals. Notably, 93% of Filipino nurses practicing in the U.S. hold bachelor’s degrees or higher.

Additionally, 73% of foreign-born healthcare workers speak a foreign language at home, facilitating culturally competent care for increasingly diverse patient populations.

Workforce Stability and Retention Patterns

Research consistently demonstrates that internationally trained nurses remain employed longer than domestically trained nurses. Hospital units employing larger proportions of IENs maintain more stable, educated nursing staff. The percentage of international nurses transitioning from temporary to permanent employment ranges from 80% to 100%, substantially exceeding domestic nurse retention.

For Healthcare Employers: Securing Your Global Pipeline

The data is clear: the U.S. healthcare system requires 203,200 new nursing positions annually, but domestic schools only graduate 170,000. Relying solely on local talent is a mathematical impossibility.

However, navigating immigration from the Philippines, Kenya, or India requires immense logistical expertise. That is where SPARRTH serves as your strategic partner. We are not a temporary agency; we are a permanent Direct Hire solution. We manage the global sourcing, credentialing, and relocation pipelines so your HR team can focus on what matters most: staffing your units with loyal, highly educated professionals.

Summary and Insights

Immigrant nurses in the US constitute a vital component of America’s healthcare workforce, totaling approximately 500,000 individuals. The Philippines predominates as the primary source country, followed by India, Nigeria, and Kenya. With CGFNS VisaScreen applications remaining elevated, international recruitment is no longer an alternative staffing method—it is an essential, long-term strategy for maintaining safe, high-quality patient care across American healthcare facilities.