New English Language Score Requirements for Healthcare Professionals Immigrating to the USA in 2026
The United States has updated its English language proficiency requirements for foreign healthcare professionals seeking immigration and employment opportunities. The new standards, published by the U.S. Health Resources and Services Administration (HRSA) in May 2026, introduce revised scoring systems across several internationally recognized English language examinations. These changes are particularly important for nurses, physical therapists, occupational therapists, and other healthcare workers planning to work in the United States.
Why the Change Matters
English proficiency is a critical requirement for healthcare professionals practicing in the United States. Effective communication directly impacts patient safety, clinical outcomes, and collaboration with healthcare teams. As a result, the U.S. government periodically reviews and updates accepted testing standards to ensure foreign-trained professionals possess the language skills necessary to provide safe and effective care.
The latest HRSA update reflects a modernization of accepted testing frameworks and score equivalencies while maintaining rigorous communication standards.
Who Is Affected?
The updated requirements apply to foreign healthcare workers who must demonstrate English proficiency as part of the immigration and credentialing process. The standards are categorized into three groups:
Occupational Therapists and Physical Therapists
Registered Nurses and other Bachelor's-level Healthcare Workers
Healthcare Workers in occupations below the Bachelor's degree level
Updated English Test Scores for 2026
IELTS (International English Language Testing System)
The revised minimum scores are:
Profession Category Overall Score Speaking Score
Occupational Therapists / Physical Therapists 6.5 7.0
Registered Nurses & Bachelor's-level Healthcare Workers 6.5 7.0
Sub-Bachelor's Healthcare Workers 6.0 7.0
Pearson Test of English (PTE)
The new PTE requirements are:
Profession Category Overall Score Speaking Score Other Sections
Occupational Therapists / Physical Therapists 55 76 62
Registered Nurses & Bachelor's-level Healthcare Workers 55 76 62
Sub-Bachelor's Healthcare Workers 47 76 52
Occupational English Test (OET)
Healthcare professionals can also qualify through OET with the following minimum scores:
Occupational Therapists, Physical Therapists, and Registered Nurses
Speaking: 360
Reading: 340
Writing: 350
Listening: 320
Sub-Bachelor's Healthcare Workers
Speaking: 360
Reading: 310
Writing: 290
Listening: 290
Cambridge English Qualifications
Accepted Cambridge examinations include:
B2 First
C1 Advanced
C2 Proficiency
Required scores:
Profession Category Overall Score Speaking Score
Occupational Therapists / Physical Therapists 169 194
Registered Nurses & Bachelor's-level Healthcare Workers 169 194
Sub-Bachelor's Healthcare Workers 161 194
TOEFL Internet-Based Test (Updated Scale)
The revised TOEFL iBT requirements are:
Profession Category Overall Score Speaking Reading, Listening & Writing
Occupational Therapists / Physical Therapists 4.5 4.5 3.5
Registered Nurses & Bachelor's-level Healthcare Workers 4.5 4.5 3.5
Sub-Bachelor's Healthcare Workers 4.0 4.5 3.0
What Has Changed from Previous Requirements?
One of the most significant updates is HRSA's adoption of revised score reporting formats for several examinations, particularly TOEFL and Cambridge English assessments. The new standards are designed to align with current testing methodologies and provide clearer benchmarks for evaluating communication skills in healthcare settings.
The update replaces score requirements that had largely remained in place since 2022, reflecting feedback gathered through federal review processes and public consultation.
Important Reminder for Applicants
Meeting the English language score requirement is only one component of the immigration and licensing process. Healthcare professionals must still satisfy additional requirements established by:
U.S. Citizenship and Immigration Services (USCIS)
State licensing boards
Professional credential evaluation agencies
Healthcare certification organizations
Passing an approved English language examination does not automatically grant eligibility to work or immigrate to the United States.
Final Thoughts
The 2026 HRSA update provides a clearer and more modern framework for assessing English proficiency among foreign healthcare workers. While the accepted tests remain largely unchanged, applicants should carefully review the new score requirements before scheduling an examination or submitting immigration documentation.
Healthcare professionals planning to pursue opportunities in the United States should ensure their test results meet the latest standards to avoid delays in credentialing, visa processing, or employment applications.
As demand for qualified healthcare workers continues to grow across the United States, staying informed about these updated requirements can help applicants navigate the immigration process more efficiently and improve their chances of success.
