While most of the people who take the TOEFL take it for school, the TOEFL has work-related-uses too. Kate has already mentioned that TOEFL is needed for some professional certifications. TOEFL is especially important for medical certifications in the United States. Medical professionals need to use language fluently, often in high pressure situations. Without good English skills, nurses could fail to respond correctly to news of a medical crisis, pharmacists could give out the wrong pills, and doctors could misunderstand important patient information.
Because of this, U.S. Citizen and Immigration Services has minimum TOEFL requirements for certain groups of health care professionals. Occupational and physical therapists need a TOEFL iBT of at least 83. Registered nurses, speech language pathologists, audiologists, clinical laboratory scientists, and physician’s assistants must have an iBT score of 76 or higher. Licensed practical nurses and medical laboratory technicians are visa-eligible with a minimum score of 71.
Medical licensing in the United States is done by state governments, not the national government. State licensing also requires proof of English ability. Rules vary from state to state and also vary by profession. The state of Arizona requires a TOEFL iBT score of 76 for licensed nurses. The Texas Board of Nursing sets the bar higher, requiring foreign nurses to have a TOEFL of 83. Iowa licenses acupuncturists if they have a TOEFL iBT of 79. Ohio asks foreign educated physicians to have score at least 90 on the iBT.
All of this can be quite confusing. Fortunately, there are free resources to help foreign health care professionals understand American licensing rules. The American Medical Association has a lot of really good resources on its website. These include a list of phone numbers for each state medical licensing office, and contact information for the AMA’s Department of International Medical Graduate Services. Recently graduated physicians who want to do their medical residency in the United States can contact the Educational Commission for Foreign Medical Graduates. The ECFMG helps residents understand and meet TOEFL requirements and other residency rules. The Commission on Graduates of Foreign Nursing Schools can help nurses understand TOEFL requirements in different states. It may also be useful to contact USCIS directly for visa questions.
If you haven’t taken the TOEFL at all, you may want to weigh different testing options. In some cases, it may be possible to take the Test of Spoken English, the IELTS, or other English assessments instead of the TOEFL. Medical professionals who do already have a high TOEFL score have a great asset in their journey to U.S. licensing and employment.