Philippines Mass Nursing Exodus: 28,000 Filipino Nurses Took US Licensure Exam in 2024

A recent St. Denis Medical episode titled "Salamat You Too" focused on the "Filipino Mafia" in nursing. Many viewers commented on social media about this representation of Filipino nurses, with some noting the importance and accuracy of depicting a high percentage of Filipino nurses in hospitals. But this representation is not just happening on T.V. – Filipino nurses have been coming to the U.S. for decades, and in greater numbers recently… but why?

In 2024, 28,258 Filipino nursing graduates took the U.S. licensure examination for the first time. This high number of examinees is attributed to the allure of higher salaries and better career prospects abroad, particularly in the United States. The trend highlights the ongoing issue of nurse migration from the Philippines, driven by insufficient compensation in their home country and better career prospects abroad.

The Philippines' Nursing Brain Drain

The substantial number of Filipino nurses pursuing licensure in the United States underscores a persistent challenge faced by the Philippine healthcare system. According to the National Council of State Boards of Nursing (NCSBN), a staggering 28,258 Bachelor of Science in Nursing (BSN) graduates opted to take the US licensure exam, an outflow that has increased substantially post-pandemic.

Source: NCLEX Examination Statistics published by NCSBN (https://www.ncsbn.org/)

It is estimated that 54% of first-time Filipino test-takers passed the US exam, while 36% of repeat takers succeeded. The next largest countries with significant numbers of nursing graduates taking the U.S. exam in 2024 included India (5,869), Kenya (3,740), Nepal (2,662), and South Korea (2,636).

 

This exodus of nurses is primarily attributed to the discrepancy in compensation between the Philippines and countries like the U.S. Entry-level government nurses in the Philippines currently earn a basic monthly salary of PHP40,208 (less than $700 per month in U.S. dollars), which pales in comparison to the potential earnings in developed countries. The allure of higher pay and improved living standards abroad has become a powerful motivator for many Filipino nurses to seek opportunities outside their home country.

Other reasons for the outflow of nursing talent include:

• High Demand for Nurses in the U.S. - like most countries, the U.S. is facing a significant nursing shortage due to an aging population, high rates of retirement among healthcare workers, and increased demand for healthcare services. This has led to active recruitment of foreign-trained nurses, particularly from countries with strong nursing education systems like the Philippines.
• Strong Historical and Cultural Ties - the Philippines has a long history of training nurses for international work, especially in the U.S. This stems from historical ties during the American colonial period, which established an American-influenced nursing education system. As a result, Filipino nurses are highly regarded in the U.S. for their skills, compassion, and adaptability.
• Visa Programs and Immigration Pathways - the U.S. has visa programs like the H-1B and EB-3 that cater to skilled workers, including nurses. These programs make it easier for qualified Filipino nurses to work in the U.S. Recent relaxations in visa restrictions and the prioritization of healthcare workers have made it more attractive for foreign nurses to pursue opportunities in the U.S. The new Trump Administration may choose to change these visa programs though.
• Pandemic Effects - the COVID-19 pandemic amplified the global nursing shortage, prompting the U.S. to fast-track the hiring of foreign-trained healthcare workers. Filipino nurses, already known for their resilience and adaptability, became a primary group sought by U.S. employers.
• Philippine Education System and Global Focus - nursing schools in the Philippines are oriented toward producing globally competitive graduates. Many Filipino nursing programs prepare students specifically for international licensure exams like the NCLEX.
• Increased Accessibility to NCLEX Testing - the establishment of NCLEX testing centers in the Philippines has made it more convenient for Filipino nurses to take the exam without traveling abroad. This has likely contributed to the increase in exam takers.
• Recruitment Efforts by U.S. Employers - healthcare organizations and staffing agencies actively recruit Filipino nurses through partnerships with Philippine schools and recruitment agencies, further fueling interest.

The Looming Nursing Crisis in the Philippines

The large number of Filipino nurses seeking licensure abroad comes at a time when the Philippines is facing a severe shortage of healthcare professionals. According to the World Health Organization, the country currently has an estimated 127,000 nurse vacancies. This shortage is expected to worsen in the coming years, with projections indicating that the number of unfilled nursing positions could reach a staggering 250,000 by 2030.

This impending crisis poses significant challenges for the Philippine healthcare system, potentially compromising the quality and accessibility of medical care for the population. The continued exodus of skilled nurses to other countries further exacerbates this problem, creating a cycle that is difficult to break without substantial reforms and investments in the local healthcare sector.

Legislative Efforts to Retain Nurses

In response to the ongoing nursing brain drain, Philippine lawmakers have initiated legislative measures aimed at improving the working conditions and compensation for nurses within the country. Two notable bills currently under consideration are House Bill No. 5276 and Senate Bill 2694. These proposed legislations seek to increase the basic pay of entry-level public nurses, with the goal of making local nursing positions more attractive and competitive.

By addressing the issue of insufficient pay, these bills aim to encourage more nurses to remain in the Philippines and contribute to the local healthcare system. The success of these legislative efforts could play a crucial role in stemming the tide of nurses leaving the country and help alleviate the growing nursing shortage.

Balancing Global Opportunities and Local Needs

The situation of Filipino nurses seeking opportunities abroad presents a complex dilemma. On one hand, these healthcare professionals have the right to pursue better career prospects and improved living standards. The remittances sent back by overseas Filipino workers, including nurses, contribute significantly to the Philippine economy.

On the other hand, the massive outflow of skilled nurses leaves a significant gap in the local healthcare system, potentially compromising the quality of care available to Filipino citizens. Striking a balance between allowing nurses to pursue global opportunities and meeting the healthcare needs of the local population remains a challenging task for policymakers and healthcare administrators.

As the Philippines continues to navigate this complex issue, finding sustainable solutions that address both the aspirations of nurses and the needs of the local healthcare system will be crucial. This may involve a combination of improved compensation packages, better working conditions, and opportunities for professional growth within the country.