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Professionals trained outside the United States face a specific process before practicing their careers in the country. Contrary to what many imagine, there is no automatic diploma validation mechanism: what exists is a credential evaluation system followed by professional licensing, each with its own rules that vary according to the field and the state. Understanding each step, from equivalency evaluation to licensing exams, is the first step to resuming your career in the American market.
The process involves distinct stages and timelines that can extend for months or even years, depending on the regulated profession. Understanding each phase from the beginning is essential to avoid unnecessary costs and frustrations with rework. This guide covers the entire path, from evaluation organizations to licensing exams, with updated data for 2026.
What Is Credential Evaluation
Credential evaluation is a comparative analysis of your foreign academic record in relation to the United States educational system. An evaluation organization examines your diplomas, transcripts, and course loads to determine equivalency in the American context. The result is an official report that universities, employers, and licensing boards accept as a reference.
There are two main types of evaluation. The Document-by-Document evaluation is simpler and confirms the degree level, being useful for general employment or immigration purposes. The Course-by-Course evaluation details each subject taken with course hours and grades converted to the American GPA system, and is required for professional licensing and admission to graduate programs.
Accredited Organizations
The evaluation must be conducted by an organization that is a member of NACES (National Association of Credential Evaluation Services) or AICE (Association of International Credential Evaluators). These are the entities whose reports are widely accepted by universities, professional boards, and USCIS. The most commonly used include:
- WES (World Education Services): the largest and best known. In 2026, it charges approximately US$ 121 for Document-by-Document evaluation and US$ 192 for Course-by-Course, with a processing time of about 7 business days after receiving the documents.
- ECE (Educational Credential Evaluators): a nonprofit organization with over 40 years of experience, with prices in the same range as WES.
- Josef Silny & Associates: widely used by candidates from Latin America, with specific familiarity with the Brazilian educational system.
- SpanTran: a NACES member since 1996, with expertise in diplomas from various regions of the world.
It is important to check which organization your state licensing board accepts before requesting the evaluation, as some boards require reports from specific evaluators. Requesting the evaluation from the wrong organization can mean delays and duplicated costs.
Licensing by Field
Credential evaluation is only the first step. Most regulated professions in the US require state licensing, with requirements that vary significantly between states and fields.
Healthcare
Foreign physicians must obtain certification from the ECFMG (Educational Commission for Foreign Medical Graduates), which includes passing the USMLE Step 1 and Step 2 CK exams, as well as completing an approved pathway for clinical and communication skills. In 2026, the ECFMG closed new applications for the certification Pathways in April, signaling changes in the process. After certification, the physician still needs to complete a medical residency in the US before obtaining a full license to practice.
Nurses must pass the NCLEX-RN or NCLEX-PN exam and, to obtain a work visa, need the VisaScreen certificate issued by CGFNS. Some states, such as New York, consider that passing the NCLEX already demonstrates English proficiency; others require TOEFL or IELTS separately.
Dentists, pharmacists, and physical therapists follow similar processes with their own national exams (INBDE for dentistry, NAPLEX for pharmacy, NPTE for physical therapy) and possible requirements for supervised internships or additional courses.
Engineering and Architecture
Engineers need to obtain the PE (Professional Engineer) license in the state where they intend to work. The process generally includes passing the FE (Fundamentals of Engineering) exam, followed by four years of supervised experience and, finally, the PE exam in the specialty. Each state has its own engineering board with specific rules regarding the acceptance of foreign degrees.
Architects must complete the process with the NCARB (National Council of Architectural Registration Boards), which includes credential evaluation, documented practical experience hours (AXP), and passing the ARE (Architect Registration Examination).
Law
Foreign lawyers face one of the most restrictive paths. Only a few states, such as New York and California, allow foreign law graduates to take the Bar Exam. In many cases, it is necessary to complete an LL.M. (Master of Laws) at an ABA-accredited American law school before becoming eligible for the bar exam.
Education
Teachers need to obtain state certification, which usually involves diploma evaluation, additional courses in American pedagogy, and passing exams such as the Praxis. Each state sets its own requirements; some offer provisional licenses while the professional completes the additional requirements.
English Proficiency
Proof of English proficiency is required in virtually all licensing processes. The most accepted exams are the TOEFL iBT and the IELTS Academic, with minimum scores that vary by state and profession. For healthcare professionals, the required scores tend to be higher, reflecting the need for precise communication in a clinical context.
In addition to general English exams, many professional evaluations are conducted entirely in technical English, which requires specific preparation in the field’s vocabulary. Investing in preparatory courses focused on professional terminology can be as important as studying for the licensing exams themselves.
Estimated Costs and Timelines
The total financial investment to validate credentials and obtain licensing varies widely depending on the profession. A general estimate for 2026 includes:
| Stage | Estimated Cost (2026) |
|---|---|
| Credential Evaluation (Course-by-Course) | US$ 150 to US$ 250 |
| Certified translation of documents | US$ 100 to US$ 500 |
| Proficiency exams (TOEFL/IELTS) | US$ 200 to US$ 310 |
| Licensing exams (varies by field) | US$ 500 to US$ 4,000+ |
| Additional courses (if required) | US$ 2,000 to US$ 50,000+ |
Timelines are also variable. A credential evaluation can take from 1 to 8 weeks. The complete licensing process, including exams and any courses or medical residency, can extend from 6 months to several years, especially in the medical field, where residency lasts from 3 to 7 years.
Alternative Paths
When the licensing process is long or restrictive, there are legitimate alternatives to work professionally in the US. Professionals can work in related roles that do not require state licensing, such as consulting, project management, or corporate education in their area of expertise. Another option is to start a business in adjacent areas: a physical therapist can open a wellness studio, a lawyer can work as an international compliance consultant.
Regardless of the chosen path, early planning is the most decisive factor for success. Researching the specific requirements of the state and profession even before starting the immigration process allows you to align expectations, calculate real costs, and set a realistic timeline for resuming your career in the United States.
Victoria Harper
Editor-in-Chief
Leading journalism and editorial content at Visto n’ Visa, Victoria helps make immigration topics clear, trustworthy, and easy to understand. Her focus is on delivering useful, human, and relevant content for people exploring new paths abroad.
