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Updated List of Tests and Scores for Foreign Health Care Workers (as of May 24, 2022)

English Competency TestsScores: Occupational Therapists/Physical TherapistsScores: Registered Nurses and other B.S. level Health Care WorkersScores: <B.S. level Health Care Workers
Cambridge Assessment English: B2 First, C1 Advanced, or C2 qualifications examsCambridge English Scale 185 overall and 185 SpeakingCambridge English Scale 176 overall and 185 SpeakingCambridge English Scale 169 overall and 185 Speaking
Educational Testing Service: Test of English as a Foreign Language (TOEFL) Paper-delivered Test560540530
Educational Testing Service: TOEFL Internet-Based Test89 with minimum of 63 on Reading, Listening, and Writing and 26 on Speaking81 with minimum of 57 on Reading, Listening, and Writing and 24 on Speaking77 with minimum of 53 on Reading, Listening, and Writing and 24 on Speaking
Educational Testing Service: TOEIC (Listening and Reading)No725700
Educational Testing Service: TOEIC (Speaking/Writing)Not applicable160 Speaking/150 Writing160 Speaking/150 Writing
International English Language Testing System (IELTS)Not applicable6.5 academic with
minimum of 7 on Speaking		6 academic or general
with minimum of 7 on Speaking
Michigan English Test (MET)Not applicableOverall 55; minimum Speaking section score of 55Overall 55; minimum Speaking section score of 55
Occupational English Test (OET)Not applicableOET Grade C+ for Reading, Writing, and Listening
OET Grade B for Speaking		OET Grade C for Reading, Writing, and Listening
OET Grade B for Speaking
Pearson PTE AcademicNot applicable55, no section below 5055, no section below 50

In making the determinations, HRSA relied on information obtained following a request for comments published in the Federal Register (PDF - 200 KB) in May 2019.

Holding a certificate indicating that an individual meets these updated English proficiency standards does not establish an individual’s eligibility to enter the United States for the purpose of performing health care or constitute professional authorization to practice in that health care occupation. 

This updated list only describes one aspect of the required processes administered by the Department of Homeland Security (DHS), U.S. Citizenship and Immigration Services (USCIS), for authorizing entry of foreign health care workers to the United States to perform as health care workers.

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