This month, Indonesian and Filipino nurse candidates under the bilateral Economic Partnership Agreement (EPA) will join their fellow Japanese counterparts in sitting for the national nursing examination.

The national exam has been widely criticized as a major stumbling block in securing the prospect for EPA candidates to work permanently in Japan as accredited nurses. The critics charged that the low passing rate (11.3 percent and 9.6 percent in 2012 and 2013 respectively) is due mainly to the language barrier. Some even called for the exam to be administered in English or other languages.

Due to external pressures, the Ministry of Health, Labor and Welfare responded by lengthening the time of the exam for EPA candidates and affixing hiragana to kanji characters to lessen the burden of memorization.

The Ministry of Justice took extra steps by allowing a one-year visa extension to third year candidates who show potential of passing the exam, and easing the seven-years working restriction previously imposed on accredited foreign nurses.

Considering the fact that Japan faces a shortage of over 40,000 nurses, primarily in suburban and rural areas where salaries are lower and less attractive to Japanese nurses, current policy efforts by the ministries are, unfortunately, inadequate.

Tweaking the exam format will unlikely lead to a higher passing rate. It is not the recognition of characters but the comprehension of sentences that enables the examinee to answer correctly. Extending the exam time will do very little for the same reason.

While easing restriction on the number of years foreign nurses are allowed to work contributes to job security, this is a benefit that can only be enjoyed after passing the exam. The EPA candidates who leave their jobs and family back home and migrate to Japan are therefore confronted with uncertainties and an insecure future.

Such inadequacies are reflective of the authorities’ reluctance to admit the need for foreign labor and thus consider the EPA candidates as part of a serious measure to overcome the shortfall, preferring instead to see them as part of an exchange program where their eventual return are replaced by new batches.

The maximum visa period of four years is thus viewed as a means to regulate the intake of foreign nurses and avoid strong criticisms from domestic interest groups who oppose such intakes.

First, if there is any seriousness in overcoming the labor shortage and in prioritizing the welfare of foreign nurses in Japan, the visa period should be lifted or allowed further extension. This not only benefits the facilities that have invested in and spent long hours helping the candidates get accustomed to their new environment and prepare for the exam but also reduce wastage of taxpayers’ money.

The candidates should not be treated as commodities with fixed expiration dates but be allowed to stay and pursue their professional careers should the facilities express readiness to continue hiring and supporting them.

Furthermore, the success or failure of the EPA program should not be based entirely on the national exam. The exam is only one of various factors.

EPA nurses who have passed the exam are not immediately exonerated from language constraints at work, which arguably increases due to a higher responsibility that they need to shoulder as qualified nurses.

There is also the design and execution of the EPA program that needs to be considered. In the past, EPA candidates were sent to Japan with little Japanese language ability and poor training plans. Candidates found it extremely challenging to juggle between studies and work.

Learning from experience, the program has been slightly improved with Indonesian and Filipino nurses now required to attend language classes for six months and pass JLPT (Japanese Language Proficiency Test) N5 (the easiest level) in their home countries and another six months of lessons in Japan.

Meanwhile, Vietnam, which will be sending its first batch of EPA candidates to Japan this month, has upped the ante by requiring its nurses to attend 12 months of language training and pass a higher level of JLPT N3 prior to departure.

It is too early to tell how effective these changes are and whether they are enough, but they are definitely positive developments that contribute to the enhancement of a candidate’s ability to adapt and settle in faster.

Receiving facilities play a crucial role. Due to a lack of stringent guidelines, the designing of detailed training plans for supporting EPA candidates are left to individual facilities. Discrepancies in the details and methods of execution would logically affect the candidates’ speed and level of learning and hence preparation for the exam, and their overall mental and physical well-being.

EPA nurse candidates that receive proper backing and guidance from the facilities that they are attached to would arguably have a better chance of succeeding (including passing the national exam) than those who are required to work long hours due to staff shortages, receive poor support or fail to concentrate on their studies due to work exhaustion.

The EPA program should not be treated as a simple exchange program offering opportunities for EPA nurses to gain some working experience in Japan but rather as part of a long-term measure for resolving Japan’s nursing shortage.

Making the latter a clear policy choice will also ensure better treatment and working conditions for the candidates.

Benny Teh Cheng Guan is a senior lecturer at the School of Social Sciences, Universiti Sains Malaysia, Penang, and a visiting research fellow at the Graduate School of Biomedical Sciences, Nagasaki University.

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