In 2012, Fatoumata Fofana left a successful health care career in her home country of Mali to join her husband Salifou in New York City. Fatoumata keenly recalls feeling overwhelmed when she arrived in the U.S., a feeling that would persist throughout her decade-long journey to rejoin the nursing profession. With support from WES Global Talent Bridge partner Welcome Back Initiative through its New York City Welcome Back Center, Fatoumata is regaining both confidence and opportunities in her career.  

“When I arrived at the airport, I couldn’t follow what people were saying to me,” Fatoumata recalled of her first moments in New York City. “Even the gate numbers—I had to ask them to write it down. I could understand English on paper, but I couldn’t understand the American accent.”  

Fluent in French and Bambara, Fatoumata studied health sciences in Mali. She completed degrees in both nursing and microbiology, and worked for four years as a licensed nurse before she transitioned to a role in a laboratory. She eventually landed a research testing position with an internationally recognized global health center that develops vaccines.  

With more than seven years of clinical and research experience, plus multilingual skills, Fatoumata was optimistic about her career prospects when she left Mali for the United States. But she quickly learned that her challenges in New York would include English barriers and more. Her credentials, including her nursing license, were not recognized by state licensing boards. Relicensing as a nurse would require her to repeat much of her training and pass the National Council Licensure Examination (NCLEX).  

“The major challenge with the NCLEX was the English, not the medical jargon or the technical concepts,” she explained. “You may never be able to pass those tests if you don’t understand what [the questions] are asking.”  

Fatoumata simultaneously enrolled in English classes and a medical assistant certification program, taking her first steps toward accessing employment in the U.S. health sector. In 2016, she began an entry-level job at a community health organization. Three years later, she decided to once again explore her options for rejoining the nursing profession.  

Aware of the critical nursing shortages in New York and beyond—along with a growing awareness of the ways that a multilingual, culturally competent health workforce is linked to strong communication and patient health outcomes—Fatoumata knew that her training and skills were needed. Yet systemic barriers continued to limit her opportunities—along with those of an estimated 165,000 other immigrants and refugees who hold international health credentials but are unemployed or underemployed in the U.S. More underemployed immigrant and refugee health workers hold nursing degrees than other types of health credentials.  

“I took my credentials—including my nursing license—to a local university, and they told me that I should do a social work program, even though I wasn’t interested in social work. Then I applied for a different nursing program and was on a waiting list for months.”  

In 2020, just before the start of the COVID-19 pandemic, Fatoumata connected with the New York City Welcome Back Center, a program that supports health workers who hold credentials earned abroad. The center provides services that help these workers reestablish their careers in the U.S.  

“The program felt too good to be true. I had to try it to believe it. There are so many immigrants in the U.S. with good credentials and skills, but they don’t know that programs like this exist,” Fatoumata said.  

Via Welcome Back, Fatoumata joined more than 40 students, many of them internationally trained nurses like her, in a cohort-based program that provided career-aligned English instruction, support in preparing to take the NCLEX, and hands-on assistance navigating New York’s complex occupational licensing requirements. As Fatoumata’s cohort launched during the COVID-19 pandemic and social distancing protocols, all courses were held online. Welcome Back also provided technical support, including laptops and internet connections.  

The tailored support was instrumental in boosting Fatoumata’s confidence. She soon believed that she could, in fact, successfully navigate the process. “They told me, ‘the day you have your certificate in hand, the struggle will all be worth it.’”   

Fatoumata approached preparing for the exam with encouragement from Welcome Back staff and her cohort colleagues. She knew that others had taken the NCLEX multiple times before passing it, and she understood that repeated attempts could be part of her experience as well. 

“I had to go through this process to learn English, to understand the social and cultural differences between the U.S. and Mali, and to work as a medical assistant first, to regain my confidence.”  

Fatoumata passed the NCLEX on her third attempt. With a New York nursing license in hand, she applied for multiple positions—and received multiple offers. She now works for a human services non-profit that supports children and adults who have intellectual disabilities. Her work involves home visits and follow-up care via videoconferencing, giving her a flexible schedule that allows her to care for her own family, including her two young children. 

“Nursing is about caring, and I’m excited to be able to care again. I’m very grateful for the Welcome Back program,” Fatoumata says. “I’m also more confident than ever. I tell myself, ‘I have a BSN already—why not be a nurse practitioner?’ One day, maybe I will.”  

The New York City Welcome Back Center is administered through City University of New York’s LaGuardia Community College. It is part of the national Welcome Back Initiative which is a founding member of IMPRINT, a coalition based at WES. Learn more via the WES Global Talent Bridge U.S. Program Map, a directory of more than 100 programs and services that foster the economic and professional development of internationally trained immigrants and refugees.