International Testing

Effective 10/1/2019

The Certified Medical-Surgical Registered Nurse (CMSRN®) exam is available to first level nurses practicing outside of the United States.

International testing and its fees are for eligible nurses who are currently practicing and will test outside of the US. Nurses who have experience or education outside of the US but are currently practicing and plan to test in the US, or military nurses serving overseas, are not considered international testing candidates.

NOTE: The CMSRN certification exam is based on practice in the medical-surgical nursing specialty in the United States. As such, the CMSRN exam is reflective of US practice, regulations, and culture.


International candidates are required to meet all eligibility criteria at the time of application:

  1. Hold a current, full, unrestricted license as a registered nurse (RN) in the US or its territories OR
    Hold a current, full, and unrestricted license as a first-level nurse in the country in which one's nursing education was completed and meet the eligibility for licensure as an RN in the US in accordance with the requirements of the Commission on Graduates of Foreign Nursing Schools (CGFNS) or World Education Services (WES)..

    1. If the candidate is licensed outside the US, the license must be verified for equivalency by CGFNS, WES or ERES prior to application. *
    2. If the candidate was educated outside the US, education must be verified for equivalency by CGFNS, WES or ERES prior to application. *
  2. Have practiced two calendar years as an RN/first-level nurse in a medical-surgical setting.
  3. Have accrued a minimum of 2,000 hours of practice within the past three years in a medical-surgical setting. Practice may include clinical, management, or education.

Refer to the domains of practice if you are unsure of your eligibility.


International testing outside of the United States is offered as computer-based testing (CBT) and the exam is delivery by Prometric.

Application and Fees

International candidates may apply online.

International candidates who have licensure or nursing education outside of the US must also submit a credential equivalency report from CGFNS, WES or ERES within 3 business days after submitting an exam application.*


  • Regular - $375
  • AMSN Member - $255
  • First Time Retake Discount - $75 discount off current application fee

Apply for the CMSRN Exam

Policies and Audit

All MSNCB certification policies, including extension, cancellation, appeals, and audit, apply to all candidates.

MSNCB performs a 10% random audit on international candidate applications. If audited, you and your supervisor will be notified by email and additional documentation will be requested. Audited candidates who do not respond or whose supervisors do not respond to the audit request will not be allowed to take the exam and applications will be denied. It is the candidate's responsibility to ensure that all requested audit information is sent and that their supervisor has returned the verification.


CMSRN certification is valid for 5 years, and certificants must apply for recertification. International candidates must meet all requirements and follow all current procedures for recertification.

*MSNCB reserves the right to request additional documentation following an agency's evaluation.