MET is accepted by 34 U.S. state boards of nursing as proof of English proficiency for NCLEX-RN eligibility. This is MET's largest real-world use case globally. This guide covers everything internationally trained nurses need to know about using MET for U.S. nursing licensure — from state-by-state score requirements and TruMerit/CGFNS credential evaluation, to the in-person testing rule and a step-by-step application process.
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Why MET Matters for U.S. Nursing
With the United States facing a persistent and worsening nursing shortage, state boards of nursing have increasingly looked to internationally trained nurses to fill the gap. English proficiency is a non-negotiable part of that pathway, and the Michigan English Test (MET) has emerged as one of the most widely accepted English tests for nursing licensure in the U.S.
A total of 34 state boards accept MET, making it one of the most broadly recognized English tests for nursing licensure alongside TOEFL. Michigan Language Assessment has explicitly positioned MET to help ease U.S. nursing shortages by making licensure more accessible to internationally trained nurses, who often find TOEFL expensive and difficult to schedule.
MET is particularly popular with Filipino nurses, who represent one of the largest groups of internationally trained RNs in the U.S., but it is increasingly used by nurses from India, Nigeria, Kenya, and other countries. At roughly $150 per sitting, MET is meaningfully cheaper than TOEFL (typically $200+), and its grammar section is a genuine advantage for nurses who learned English formally in school. MET is also backed by HRSA (the federal Health Resources and Services Administration), which recognizes it for healthcare workforce programs aimed at strengthening the U.S. nursing pipeline.
Which State Boards Accept MET
Currently, 34 U.S. state boards of nursing accept MET as proof of English proficiency for NCLEX-RN eligibility. Acceptance is decided at the state level — there is no single federal nursing license in the U.S. — so you must confirm that the specific state where you intend to practice accepts MET before booking your test.
The table below lists confirmed states where MET acceptance has been verified. For states not appearing in this table, you should contact the board of nursing directly; many boards accept MET but publish their requirements in documents that are not always surfaced on the main homepage.
| State | Min MET Score | CEFR Level | Source |
|---|---|---|---|
| New Mexico | 59 | B2+ | State Records Center |
| Texas | Varies — check board | B2+ | Texas BON |
| Virginia | Varies | B2+ | Virginia BON |
| Arkansas | Varies | B2+ | Arkansas BON |
| Rhode Island | Varies | B2+ | RI BON |
| Alaska | Varies | B2+ | Alaska BON |
| Illinois | Varies | B2+ | IL BON |
| Missouri | Varies | B2+ | MO BON |
Last verified: July 13, 2026. State board websites were checked on this date. Requirements change — always confirm directly with your board before applying.
Note: Score requirements vary by state. The table above lists confirmed states — always verify directly with your state board of nursing for the most current requirements. New states are added periodically.
Score Requirements Explained
Most state boards require a minimum MET score between 55 and 65, typically mapped to CEFR B2 or higher. New Mexico — one of the few boards that publishes a single clear threshold — requires a MET score of 59 or above at B2+ level.
Each board sets its own thresholds, and there is no national minimum for nursing licensure in the U.S. Some boards only require a single overall MET score, while others set separate minimums for Listening, Reading, Writing, and Speaking. Always check your specific board's published English proficiency policy before booking.
Some boards accept MET scores purely for NCLEX-RN eligibility, while others may also require a credential evaluation through TruMerit (formerly CGFNS International). If your board requires credential evaluation, you will normally need both your MET score report and a TruMerit/CGFNS credential report to be issued before your application can proceed.
TruMerit, CGFNS & HRSA Explained
Internationally educated nurses applying for U.S. licensure will encounter three organizations that work together to verify qualifications and English proficiency. Understanding the role of each is essential to navigating the application smoothly.
| Organization | Former Name | Role | How MET Fits |
|---|---|---|---|
| TruMerit | CGFNS International | Credential evaluation for internationally educated nurses | Accepts MET as proof of English proficiency for VisaScreen and credential reports |
| HRSA | — | Federal health agency | Recognizes MET for healthcare workforce programs |
| State Boards of Nursing | — | Issue nursing licenses | 34 boards accept MET for English proficiency requirement |
TruMerit was previously known as CGFNS International — the organization behind the famous CGFNS Certification Program and VisaScreen. If your state board or employer asks for a "CGFNS report," they are now referring to a TruMerit report. MET is accepted by TruMerit as one of the recognized English proficiency tests for both VisaScreen applications and full credential evaluation reports, which means that a single MET test can satisfy the English requirement at both the federal immigration stage and the state licensure stage.
HRSA — the Health Resources and Services Administration — is the federal agency within the U.S. Department of Health and Human Services that funds and coordinates programs addressing healthcare workforce shortages. HRSA's recognition of MET is part of the broader federal effort to expand pathways for internationally trained nurses, which is why MET has been promoted so actively to internationally educated nurses in recent years.
In-Person Testing Requirement
MET Digital (at-home, remote proctoring) is NOT accepted for U.S. nursing licensure. Only MET taken at an authorized test center or Prometric center counts toward your nursing licensure application, regardless of which state board you are applying to.
This is the same rule that applies to MET for Australian visas — in-person testing is mandatory. The rationale is simple: state boards of nursing require a high-assurance, identity-verified testing environment, and remote proctoring does not currently meet that bar for licensure purposes.
The good news is that MET is available at authorized test centers in 170+ countries worldwide, including the Philippines, India, Nigeria, Kenya, and many others. Test center availability and booking slots vary by location, so it is worth booking early, especially in regions with high demand from internationally trained nurses. When you book, confirm that the test center offers the 4-skill MET (Listening, Reading, Writing, and Speaking) and not a variant that omits any skill your board requires.
Step-by-Step Application Process
Using MET for U.S. nursing licensure involves several steps, many of which can be worked on in parallel. Below is the typical sequence for an internationally educated nurse.
- Verify your state board accepts MET (check the table above and confirm on the board's official website).
- Confirm the required MET score threshold for your state — some boards publish a single overall minimum, others set per-skill minimums.
- Book your MET test at an authorized in-person test center. Do not book MET Digital if your goal is licensure — only in-proctored scores will be accepted.
- Take the 4-skill MET (Listening, Reading, Writing, Speaking) on your scheduled test date.
- Request score reports be sent to your state board and to TruMerit (if your board requires credential evaluation). Michigan Language Assessment can send official score reports directly to designated recipients.
- Complete credential evaluation through TruMerit/CGFNS — this typically involves submitting your nursing transcripts, license verification from your home country, and your MET score report.
- Apply for NCLEX-RN registration through your state board of nursing, attaching your MET score and TruMerit report where required.
- Pass the NCLEX-RN exam to receive your license to practice as a Registered Nurse in that state.
MET vs TOEFL for Nursing Licensure
Most internationally trained nurses choosing an English proficiency test weigh MET against TOEFL iBT. Both are accepted by many state boards, but they differ in important ways.
| Feature | MET | TOEFL iBT |
|---|---|---|
| Cost | ~$150 | ~$200+ |
| Duration | 155 min | ~200 min |
| Sections | 4 separate | 4 (integrated) |
| Speaking | Recorded, 10 min | Recorded, ~17 min |
| Grammar section | Yes (25 questions) | No |
| Nursing licensure | 34 state boards | 50 state boards (broader) |
| Results turnaround | ~5 business days | ~6 days |
| At-home accepted | No (for licensure) | Yes (but check board) |
Bottom line: MET is cheaper, faster to schedule, and faster to score, but TOEFL has broader acceptance across all 50 state boards. If your target state accepts MET, it is the more affordable and convenient option. If you are applying to multiple states or are unsure where you will eventually practice, TOEFL offers more flexibility — at a higher cost.
Common Questions
Can I take MET at home for nursing licensure?
No. Only scores from in-person, proctored test centers are accepted for U.S. nursing licensure. MET Digital (remote, at-home proctoring) is not accepted by state boards of nursing, even if the at-home version is otherwise a valid MET test.
Is MET accepted in all 50 states?
No. Currently 34 states accept MET for nursing licensure English proficiency. Check the table above and verify with your specific state board before booking your test, as acceptance can change over time.
What MET score do I need for nursing?
It varies by state. New Mexico requires a minimum of 59 (B2+). Most state boards expect a score at CEFR B2 or higher, typically in the 55–65 range. Some boards set separate per-skill minimums for Listening, Reading, Writing, and Speaking. Always check your specific board's published threshold.
Do I still need TruMerit/CGFNS?
Most internationally educated nurses need credential evaluation regardless of which English test they take. MET satisfies the English proficiency portion of the requirement — it does not replace the need for credential evaluation if your board or employer requires one. Check whether your state board mandates TruMerit/CGFNS, a VisaScreen, or a specific credential report before you start.
How long are MET scores valid?
Typically 2 years for nursing licensure purposes, but some boards apply different validity windows. Always confirm with your state board, and avoid letting too much time pass between your test date and your application submission.
How to Prepare
The best way to prepare for MET is to practice all four skills under realistic conditions. Our free Listening, Reading, Writing, and Speaking practice tests mirror the official MET format and include AI-powered scoring. MET's grammar section (25 questions) is unique among English proficiency tests accepted for nursing licensure — practice grammar specifically, as it can lift your overall score meaningfully. The writing section includes email and essay tasks relevant to healthcare communication, so familiarize yourself with structured, professional writing before test day.