High-Paying Healthcare Jobs in the USA: Pay, Licensing and Visas

Healthcare is one of the few US sectors where demand for workers keeps growing year after year, and some of its roles are among the best paid in the country. For foreign-trained nurses, therapists and doctors, it can also be a realistic route to living in the United States. The catch is that licensing, not the job search, is usually the longest part of the journey.

This guide sets out the best-paid healthcare occupations using the latest official pay data, explains what each one requires, and matches them to the licensing steps and visa routes that foreign-trained professionals actually use. It replaces our older list of individual job adverts, which went out of date quickly.

Where the pay data comes from

All salary figures here come from the Bureau of Labor Statistics (BLS) Occupational Outlook Handbook, which the US Department of Labor publishes. At the time of writing, September 2026, its latest pay data is for May 2025, and its job outlook covers 2025 to 2035.

The figures are median annual wages. Half of workers in the occupation earned more and half earned less. New arrivals often start below the median, and pay varies a lot by state and city.

The highest-paying healthcare jobs

Source: BLS Occupational Outlook Handbook, pages accessed September 2026.

Physicians and surgeons

Doctors are the best-paid group by a wide margin. Within the overall median of USD 275,930, BLS figures show large differences by specialty: pediatric surgeons at USD 559,030, cardiologists at USD 496,010, radiologists at USD 420,860, anesthesiologists at USD 391,490, family medicine physicians at USD 244,180 and pediatricians at USD 210,040.

BLS expects about 22,100 openings for physicians and surgeons each year over the decade, many to replace people who retire or leave the occupation.

Advanced practice nurses

Nurse anesthetists, nurse midwives and nurse practitioners are advanced practice registered nurses (APRNs). They need at least a master's degree in an advanced practice nursing field, plus a registered nurse licence. BLS projects employment across the group to grow 36% from 2025 to 2035, with nurse practitioners growing fastest at 41%.

Pharmacists, physician assistants and therapists

These roles pay well without medical school, but every one of them needs a graduate degree and a state licence. Physician assistants need a master's degree. Pharmacists need a Doctor of Pharmacy (Pharm.D.). Physical therapists need a Doctor of Physical Therapy.

Registered nurses

Registered nursing pays less than the roles above but has by far the most jobs and the clearest immigration route for foreign-trained staff, which we explain below. The BLS median for May 2025 was USD 97,550.

Licensing for foreign-trained health workers

In the US, each state licenses health professionals. You can't practise just because you're qualified at home, and employers generally won't sponsor you until they're confident you can be licensed.

Nurses

Foreign-educated nurses usually need to:

1. Have their education and licence evaluated, according to the rules of the state board of nursing where they want to work.
2. Pass the NCLEX-RN, the national nursing licensure exam.
3. Obtain a licence from that state board.
4. Meet English requirements, often through an approved test.

Each state board sets its own rules, so check the board for the state you're targeting before you book anything.

Doctors

International medical graduates usually need certification from the Educational Commission for Foreign Medical Graduates (ECFMG). ECFMG says this includes passing Step 1 and Step 2 Clinical Knowledge of the US Medical Licensing Examination (USMLE), plus meeting clinical and communication skills requirements, which for most applicants includes the Occupational English Test (OET) Medicine.

The Accreditation Council for Graduate Medical Education (ACGME) requires international graduates entering accredited residency programmes to be ECFMG certified. Most doctors then complete a US residency before they can get a full state licence, even if they're experienced specialists at home.

Therapists, pharmacists and other professionals

Physical therapists, occupational therapists, speech-language pathologists, pharmacists and physician assistants each have their own credential evaluation and licensing exams. Start with the licensing board for the state where you want to work, and ask exactly which evaluation it accepts.

Health care worker certification

US immigration law requires most foreign health care workers, other than physicians, to present a health care worker certification before getting a visa. USCIS says it covers nurses, physical and occupational therapists, speech-language pathologists, audiologists, medical technologists, medical technicians and physician assistants.

The certificate confirms that your education, training, licence and experience are comparable to a US worker's, that your English meets the required level, and that you've passed a predictor test or the licensing exam. The Commission on Graduates of Foreign Nursing Schools (CGFNS) issues the best-known version, called VisaScreen. The requirement no longer applies once you're a permanent resident.

Visa routes that fit healthcare roles

EB-3 and Schedule A for nurses and physical therapists

USCIS lists professional nurses and physical therapists in Schedule A, Group I. That means the Department of Labor has already decided there aren't enough US workers in these occupations, so the employer doesn't need to go through the usual PERM labor certification. The employer files the green card petition directly with USCIS.

You still need a permanent, full-time job offer, and you have to wait until a visa number is available. The monthly Visa Bulletin from the State Department shows the wait, which depends on your category and country of birth. Our guide to the easiest EB visas for permanent residency explains how the categories compare.

H-1B for degree-level roles

The H-1B is for specialty occupations that need at least a bachelor's degree in a specific field. It works for many physicians, pharmacists and therapists, but it's often a poor fit for registered nurses, because many nursing jobs don't require a bachelor's degree. H-1B rules and employer fees changed repeatedly in 2025 and 2026, so read our explainer on what an H-1B visa is and check the USCIS page before relying on it.

Doctors: J-1 and the Conrad 30 program

Many international medical graduates train on a J-1 exchange visitor visa, which usually requires them to return home for two years after training. The Conrad 30 program lets each state request up to 30 waivers of that requirement per federal fiscal year. In return, the doctor agrees to work full time in H-1B status for at least 3 years in an area with a shortage of health professionals, or serving patients from such areas.

Costs and money to plan for

The employer pays its own petition and legal costs for most work visas and green cards. You'll still face significant personal costs:

• Credential evaluations and certification such as VisaScreen or ECFMG.
• Licensing exams, such as the NCLEX-RN or USMLE, often taken more than once.
• English tests accepted by your state board or certifying body.
• Visa application fees, medical exams and travel to your consular interview.
• Relocation: flights, a rental deposit, furniture and transport until your first pay cheque.

Once you arrive, apply for a Social Security number, open a US bank account and start building a credit history. Many hospitals offer employer health insurance, but check when coverage starts and what it costs you each month. Federal income tax applies, and many states add their own income tax, so compare take-home pay rather than headline salary.

If you'll send money home, compare the full cost of each transfer, including the exchange rate margin.

Scams and contracts to watch

Healthcare recruitment attracts both genuine agencies and bad actors. Watch for:

• Guaranteed visa or green card promises. Only USCIS and the State Department decide.
• Upfront "processing" or "placement" fees for a job offer.
• Contracts with large breach penalties. Some nurse recruitment contracts require you to repay large sums if you leave early. Read every clause and get independent advice before signing.
• Job offers without a licence plan. A real employer will ask about your NCLEX or licensing status.
• Fake government websites that charge extra for forms that are free or cheaper on official sites.

Check fees and forms on uscis.gov and travel.state.gov, and never hand over your passport or original documents to a recruiter.

Step by step: from foreign-trained to working in the US

1. Choose your occupation and target state, and read that state board's licensing rules.
2. Start credential evaluation with the body your board or ECFMG requires.
3. Pass the licensing exams, such as the NCLEX-RN or USMLE steps.
4. Take an accepted English test.
5. Apply for a health care worker certification, unless you're a physician.
6. Find an employer that sponsors, such as hospitals that already hire internationally educated staff.
7. Let the employer file the petition, whether EB-3, H-1B or another route.
8. Apply for your visa at a US embassy or consulate once the petition is approved and a visa is available.

If you're weighing up care roles instead, our guide to caregiver jobs in the USA with visa sponsorship covers that route. For a broader look at top-paying careers, see the highest-paying jobs in the USA.

Your checklist

• Target occupation chosen and BLS pay checked for your state
• State licensing board rules read
• Credential evaluation started
• Licensing exam booked or passed
• English test taken
• Health care worker certification applied for, if required
• Employer confirmed as a genuine sponsor, with a written offer
• Contract read in full, including any repayment clauses
• Budget covering exams, visa costs and relocation
• Visa Bulletin checked for your category and country of birth

US healthcare offers some of the country's best-paid and most secure careers, but the path runs through licensing first. Get your credentials recognised, pass your exams and choose the visa route that fits your profession, and the job offers become far easier to secure.