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English Test for Healthcare Professionals

Thinking about a career in U.S. healthcare? The TOEFL iBT® test is accepted for visa, certification and licensure for the nursing, pharmacology, dentistry, and physical therapy pathways to U.S. practice.

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Group of nurses

Find Your Profession's Pathway

Every profession has its own route to U.S. practice. Choose yours to see the full TOEFL requirements, exemptions, and score-sending steps.

TOEFL FOR NURSES

Visa process, certification for NCLEX and your pathway to licensure

Why TOEFL for Healthcare Professionals?

Your training has prepared you to care for patients. Now one step stands between you and practicing in the United States: proving your English. For internationally educated nurses, pharmacists, dentists, physical therapists, and more, an English proficiency test for healthcare workers is a requirement for the visa, certification, licensure, or admissions process. TOEFL iBT is accepted across 13 healthcare professions, so one score can move your application forward wherever U.S. healthcare needs you.

WHERE TOEFL COULD TAKE YOU

  • Nursing: The TOEFL iBT is accepted for the visa process, certification for NCLEX, and all State Boards of Nursing in the U.S. that require English proficiency.
  • Pharmacy: The TOEFL iBT is only one of two English tests accepted for FPGEC Certification, required of every foreign pharmacy graduate before the NAPLEX.
  • Dentistry: The TOEFL iBT is required by CODA approved dental programs for internationally trained dentists, and some programs accept only TOEFL.
  • Physical Therapy: TOEFL iBT is accepted for visa certificates, and it is the only test accepted for licensure review.
  • And More: Occupational therapists, veterinarians, physician assistants, lab scientists and other professionals also use TOEFL scores on U.S. pathways.

WHY HEALTHCARE PROFESSIONALS CHOOSE TOEFL

  • One Test, Many Pathways: The same TOEFL iBT score is recognized by credentialing bodies including TruMerit, NABP, FCCPT and NBCOT. No additional Speaking test is required.
  • Measures Real Communication: The TOEFL iBT tests reading, listening, speaking and writing in English—the skills behind clear patient communication and safe handoffs.
  • Clear Section Scores: Section scores on the 1–6 scale show exactly where you meet each board's minimums.
  • Federally Approved: HRSA recognizes TOEFL iBT for foreign healthcare workers.
Nurses

Healthcare Professionals

PROFESSIONS
13 accept TOEFL
VISA STEP
Visa Process
SCORE SCALE
1–6 (since Jan 2026)
TEST FORMAT
Test center for most boards

Your Path to U.S. Practice: What to Expect

Most internationally educated healthcare professionals meet the English requirement at one of the following touchpoints: the visa process, credential review and certification, licensure by a state board, or admission to a U.S. retraining program. The pathway varies by profession, and some, like nursing and physical therapy, can involve more than one touchpoint.

The requirement exists for a reason. U.S. healthcare depends on precise communication to ensure patient safety: explaining a medication, documenting a change in condition, or handing off a patient at shift change. Boards set English language requirements to make sure every professional can do this safely and effectively.

Plan your timing carefully. Most pathways require the TOEFL iBT test to be taken at a test center, some require subsection scores, and scores expire after two years. Check requirements for your pathway before you book the test.

Male Nurse working

TOEFL Score Requirements by Profession

Know your target score before test day. Here's what the leading U.S. pathways ask of TOEFL iBT test takers.

  • Registered Nurses: Federal regulations require 4.5 overall, with minimum subsection scores: Speaking 4.5 and Reading, Listening and Writing 3.5 each. Each state board sets its own individual requirements, and tests must be taken at a test center.
  • Pharmacists: NABP does not have an overall score requirement, but requires Reading 4, Listening 5, Writing 4.5 and Speaking 5. Tests must be taken at a U.S. test center. As of November 1, 2026, NABP accepts TOEFL MyBest scores.
  • Physical Therapists: Federal regulations require 4.5 overall, with Speaking 4.5 and Reading, Listening and Writing 3.5 each. Each state board sets its own individual requirements, and tests must be taken at a test center.
  • Dentists: CODA approved dental programs set their own minimums. Check each program’s requirements on ADEA CAAPID.
Women nurse
Score Table
 
Profession Who reviews your scores Overall Speaking Reading Listening Writing
Registered Nurse International credential evaluation organization & State Boards of Nursing 4.5 4.5 3.5 3.5 3.5
Licensed Practical / Vocational Nurse International credential evaluation organization & State Boards of Nursing 4 4.5 3 3 3
Pharmacist NABP (FPGEC) Not used 5 4 5 4.5
Dentist Individual dental schools via ADEA CAAPID or ADEA PASS Varies (e.g. 4.5–5) Varies Varies Varies Varies
Physical Therapist International credential evaluation organization & State Boards of Physical Therapy 4.5 4.5 3.5 3.5 3.5

English Language Requirements in U.S. Healthcare

English language proficiency is a core requirement for internationally educated healthcare workers seeking a U.S. occupational visa and employment. TOEFL iBT is a trusted standard across U.S. healthcare, accepted by credential evaluation organizations and state boards for U.S. licensure. 

How TOEFL® Supports You

The TOEFL iBT test is your next step toward practicing in the United States. It proves to licensing boards, credentialing bodies and employers that you can communicate clearly and safely with patients and care teams.

START YOUR PREP REGISTER FOR THE TOEFL iBT TEST
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Frequently Asked Questions

 

FAQ

Many do. Most internationally educated nurses, physical therapists, occupational therapists and other allied health professionals need an English test for visa processing, credentialing, or state board licensure. You may be exempt if your professional education was in English in a country such as Australia, Canada (outside Quebec), Ireland, New Zealand or the UK. Check the individual requirements for your profession for details.

They depend on your profession and the organization reviewing your application. Check the individual requirements for your profession for details.

Usually not. Most healthcare professions require TOEFL iBT to be taken at a test center. Some organizations and programs accept the Home Edition, so confirm with the body reviewing your scores before you register.

No. The NCLEX itself has no English section. Internationally educated nurses usually prove English proficiency separately through TOEFL iBT.

TOEFL iBT scores are valid for two years. Some professions have stricter requirements on validity (e.g. one year).