Introduction: Many foreign-educated physicians (FEPs) are transitioning to licensed registered nurses (RNs) in the United States, a process that helps decrease the nursing shortage. There is a gap in knowledge regarding how they transform from medical to nursing professionals. This information could assist FEPs to effectively transition into the nursing role. Method: The purpose of this grounded theory study was to discover a substantive theory explaining the process of FEPs experience as they transition from their original role as physicians in their country of origin to their new role as registered nurses in the United States. A total of 22 FEPs were recruited for the study and participated in individual and focus group interviews. Results: The basic social process identified in this study was the: acculturating pathway to practice, which provided an in-depth description of the dynamic process of FEPs and their integration, socialization, and transition into nursing as a second career. The three categories that explained this process were practicing, transitioning, and reconciling. Conclusion: The substantive theory allows for an understanding of the factors that influence this group of nursing professionals. This is an essential component of retention, patient care, and improvements in academic and healthcare institutions.