Exam retakes hard on Japan's foreign nurse trainees

Samaria Siahaan attends to a patient at a hospital in Toyonaka, Osaka Prefecture. She realised her wish to become a certified nurse in Japan, and now hopes to work at intensive care units to acquire more skills.

Foreigners who come to Japan to become certified nurses based on economic partnership agreements (EPAs), but who have returned to their countries after failing to pass the national nursing certification exam are given a second chance to retake that exam.

However, over the past four years, only five applicants have passed the exam after retaking it, because individuals face heavy burdens, such as travel expenses, and it is difficult for them to adequately prepare for the exams by themselves.

An Indonesian nurse, who retook the exam using this system and passed it last year as a result of hard work, said, "I hope for more support for people who are not giving up on their dreams."

Low pass rate

Of the 27 foreign nurse candidates in the EPA programme who retook this year's national nursing certification exam, only three passed. The examination pass rate stood at 11.1 per cent, compared to the overall pass rate of 7.3 per cent.

Since fiscal 2008, 839 foreign nurse candidates have come to Japan from three countries - Indonesia, the Philippines and Vietnam, according to the Health, Labor and Welfare Ministry.

Among them, 154 candidates passed the national exam, while 436, almost half of all EPA candidates, have already returned home, including the 27 who passed the national exam. While the system allowing candidates who have returned home to retake the exam began in fiscal 2011, only 62 have done so. Of these, only five have been successful.

To support foreign nurse candidates who hope to take the exam again, the government holds mock exams in the candidates' countries and offers an opportunity to study on the Internet.

However, it is difficult for them to continue studying on their own in Japanese. In addition, candidates are required to come to Japan to retake the exam, meaning they have to pay for travel, accommodation and other necessary expenses on their own, in principle. These conditions impose heavy economic and mental burdens on candidates, making them think twice before retaking the exam.

Insufficient support

Samaria Siahaan, a 30-year-old Indonesian woman, who came to Japan on the EPA programme in 2009, worked at a hospital in Kagoshima Prefecture for about four years while studying. However, she failed the national exam and returned home in July 2013. While she knew that she could retake the exam, she said: "I didn't have money, and I believed I couldn't study on my own. So I abandoned hope at first."

Several months after returning to Indonesia, she learned through an acquaintance about a support programme for EPA candidates hoping to retake the exam, which was offered in the country by the Japan Asia Medical Nurse Association (JAMNA), a public interest incorporated foundation. JAMNA offers study support for three months before the exam and offers about ¥800,000 (S$9,112) for transportation, accommodation and other expenses for each candidate.

There were about twice as many applicants as places for the programme, but Siahaan was admitted after passing a screening test. She studied until late at night every day and passed last year's national exam.

However, only a few people were able to receive such support after returning home. According to JAMNA, dozens of foreign nurse candidates are hoping to retake the national exam every year in Indonesia alone, but only two organisations provide such support programs for fewer than 20 candidates. In the Philippines, no organisation supports foreign nurse candidates, and only six retook the exam, according to JAMNA.

Delay in resuming work

Even if they can pass the national exam, they cannot resume work immediately in Japan because it takes time to conclude an employment contract with a place of work or to obtain a visa. The Indonesian nurse said it took 11 months for her to work again in Japan.

"I had to postpone my trip to Japan many times, and I felt such despair," she said.

JAMNA official Tatsuya Hirai, 51, said: "Many foreign nurse candidates return home full of disappointment, and they can't retake the test even if they wanted to. Accepting foreign nurses will help revitalise the medical front in Japan. The government should enhance support measures for these candidates, such as enabling them to retake the exam in their own countries."

Foreign nurse candidates

Japan has accepted foreign nurse candidates from Indonesia since fiscal 2008, the Philippines since fiscal 2009 and Vietnam since fiscal 2014, based on economic partnership agreements.

The nurses are allowed to continue working in Japan if they pass the national nursing certification exam within three years after coming to Japan in principle. There is a special exception to extend the deadline by one year. However, they have to return home if they fail the national exam.