Moving to Canada as a Nurse: A Guide for Internationally Trained Nurses

In recent years, changes to immigration and licensing processes have made it easier for internationally qualified nurses to move to Canada and work here. This is especially true for nurses trained in the United States. 

This guide covers everything from getting licensed in a Canadian province to finding the right immigration program. Although we focus on US-trained nurses, this guide is relevant for all internationally educated nurses. 

Key Takeaways 

• If you passed the NCLEX-RN in the US, it counts toward Canadian licensure in most provinces. You generally don’t need to take another exam. 

• British Columbia and Ontario have fast-tracked licensing for US-educated nurses. 

• US-trained registered nurses can apply for a work permit under CUSMA without their employer needing an LMIA. 

• The Express Entry healthcare category allows nurses with foreign work experience to qualify for PR.  

The Two Tracks: Licensing and Immigration 

Working as a nurse in Canada requires two things: a valid provincial nursing licence, and legal immigration status. 

You can’t practise without a licence, no matter what your immigration status is. And you can’t legally work without proper immigration authorization (a Canadian work permit, permanent residency, or citizenship). These processes run in parallel, and ideally you should start both at the same time. 

Getting Licensed to Practise in Canada 

Nursing is a regulated profession in Canada. Each province has its own nursing regulator. You need to be licensed by that body before you can work there as a nurse.  

There are three main levels of nursing in Canada. Licensed Practical Nurses (LPNs, also called Registered Practical Nurses) typically have a two-year diploma and a limited scope of practice. Registered Nurses (RNs) have a broader scope of practice and require a four-year bachelor’s degree. Nurse Practitioners (NPs) have authority to prescribe medicationand require a master’s degree. 

Registered Psychiatric Nurse is a separate regulated profession. It exists only in British Columbia, Alberta, Saskatchewan, and Manitoba. 

Generally, as an internationally educated nurse, your path will involve credential assessment, a licensing exam, and registration with the relevant college. 

Step 1: Credential Assessment Through NNAS 

For all provinces and territories, except Quebec, the first step is applying to the National Nursing Assessment Service (NNAS). NNAS reviews your nursing education and employment history and produces an Advisory Report. You submit this report to the provincial regulator when you apply for licensure. 

Note: Some provinces, such as British Columbia, have created direct pathways for US-trained nurses that bypass NNAS.  

Step 2: The Licensing Exam 

The entry-to-practice exam varies depending on your nursing category. 

Registered Nurses in Canada must take the NCLEX-RN, the same exam used in the United States. This gives US-trained nurses a meaningful advantage. If you’ve already passed the NCLEX-RN, Canadian provinces generally accept those results and you don’t need to sit the exam again. 

For LPNs, British Columbia and Ontario use the REx-PN exam. Every other province uses the Canadian Practical Nurse Registration Examination (CPNRE). 

For NPs, the exam varies based on your stream of practice. Your provincial college will confirm which exam applies to you. 

Step 3: Register With Your Provincial College 

Once your credentials and exam results are verified, you apply for registration with the provincial college. Each province has its own requirements, and the timeline and complexity vary. 

Typically, the process includes validation of education documents, language proficiency, and proof of recent practice. In addition, you may also need to appear for a jurisprudence exam. You will also need proof of your immigration status or authorization to work in Canada. 

Fast-Track Pathways for US Nurses 

Two provinces—British Columbia and Ontario—have reduced barriers for US-trained nurses. 

British Columbia 

In March 2025, the BC College of Nurses and Midwives announced a streamlined registration process for US-registered nurses. US nurses now apply directly to the college, skipping the third-party credential assessment.  

The college reviews education, exam results, employment history, and regulatory records through a US national database. This cut the processing time down from four months to just a few days.  

Ontario 

Ontario introduced an “As of Right” exemption in June 2025. This allows US-licensed nurses to start working in Ontario health settings immediately, without full registration. You then have six months to complete the registration process with the College of Nurses of Ontario.  

To qualify, you need an active US licence in good standing, no professional misconduct or disciplinary history, and valid Canadian immigration status. 

Work Permit Options for Nurses in Canada 

If you’re not yet a permanent resident or citizen of Canada, you need a work permit to practise. The fastest and most accessible route for US nurses is under CUSMA. 

CUSMA Work Permit (For US Citizens) 

The Canada-United States-Mexico Agreement (CUSMA) lists registered nurses among the professions that can enter Canada on an LMIA-exempt work permit. This means your Canadian employer doesn’t need a Labour Market Impact Assessment (LMIA) before hiring you. 

To qualify as a CUSMA professional, you need: 

• A pre-arranged job offer from a Canadian employer 

• The appropriate education and licensing for the role 

• US (or Mexican) citizenship 

Your employer will submit a job offer through the IRCC Employer Portal and pay a compliance fee. You’ll receive an offer of employment number, which you include in your work permit application. The work permit is typically valid for the duration of your contract, up to three years, and is renewable. 

US citizens can apply for CUSMA work permits at the port of entry to Canada. However, make sure you have all the necessary paperwork with you, including the job offer, offer of employment number, your education credentials, nursing license, if applicable, and proof of citizenship.  

Other Work Permit Options for Nurses in Canada 

If you’re not a US-citizen, another potential route would be an employer-specific work permit. Nursing is in high demand across Canada, and employers in many regions are motivated to hire internationally trained nurses.  

In such a situation, the employer will need an LMIA that confirms there is a shortage of qualified nurses in the area, and based on that, they can make you a job offer. You will then apply for a work permit using that job offer. 

Canadian PR Programs for Nurses 

If you’re an internationally trained nurse interested in moving to Canada permanently, there are several pathways worth knowing about. 

Express Entry 

Several of Canada’s federal economic immigration programs are delivered through the Express Entry system. To enter the Express Entry pool, you need to meet the criteria for at least one of the three underlying programs: the Federal Skilled Worker Program (FSW), the Canadian Experience Class (CEC), or the Federal Skilled Trades Program (FSTP). 

Candidates in the pool are ranked based on their Comprehensive Ranking System (CRS) scores. Periodically, IRCC conducts draws to invite top-ranking candidates to apply for PR. 

Healthcare and Social Services Category-Based Selection 

In 2023, Canada introduced category-based selection through Express Entry for qualified candidates in certain occupational and other categories to apply for permanent residence.  

Registered nurses (NOC 31301), registered psychiatric nurses (NOC 31301), nurse practitioners (NOC 31302), and licensed practical nurses (NOC 32101) all qualify under the healthcare and social services category. 

You need at least 12 months of full-time work experience in an eligible nursing occupation within the last three years. This does not need to be Canadian experience. This opens the pathway to nurses outside Canada who have foreign nursing experience. 

In 2025, IRCC issued 14,500 invitations through this category. In February 2026, a single draw invited 4,000 candidates with a CRS score of 467. 

Canadian Experience Class (CEC) 

If you move to Canada on a work permit first, a year of full-time skilled work in Canada makes you eligible for the CEC. Many nurses follow this two-step path: come on a work permit, gain Canadian experience, and then pursue PR through CEC. 

Provincial Nominee Programs for Nurses 

Provincial Nominee Programs (PNPs) offer another route to permanent residence, and several have streams specifically designed for healthcare workers. Some PNP programs are delivered through the Express Entry system, while others are managed by the province directly. 

For PNP programs through Express Entry, getting a provincial nomination adds 600 CRS points to your profile, which effectively guarantees an invitation to apply. 

Alberta’s AAIP Dedicated Health Care Pathway and Saskatchewan’s Health Talent Pathway are worth researching if you’re targeting those provinces. Ontario, BC, and Nova Scotia also prioritize healthcare occupations under the Employer Job Offer Stream, BC Skills Immigration, Nova Scotia Skilled Workers Stream, respectively. 

Starting the Process: Moving to Canada as a Nurse

The licensing and immigration tracks are separate, but they need to move at the same time. Start your provincial licensing process as early as you can, so you can begin working in Canada sooner. 

For US-trained nurses, the path to working in Canada is much simpler. Registered nurses don’t need to take the NCLEX-RN again, and some provinces offer expedited registration pathways as well. 

In addition to a provincial license, you need valid immigration status in Canada. Evaluate whether you qualify for permanent residence directly, based on your foreign experience and credentials. If not, getting a job offer and a work permit can help you get qualifying experience. 

Your pathway will depend on many factors, including your country of citizenship, whether you have Canadian experience, and whether you want to move to Canada permanently.