Effects of International Student Cap on Schools of Nursing

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Effects of International Student Cap on Schools of Nursing

Brief to House of Commons Standing Committee on Citizenship and Immigration (CIMM)

Summary

Dr. Jean Daniel Jacob, Executive Director of the Canadian Association of Schools of Nursing (CASN), addresses significant challenges in Canadian nursing education, particularly concerning international students. International students play a role in meeting local health care needs, yet recent reforms threaten the sustainability of these programs. The COVID-19 pandemic worsened nursing shortages, prompting provincial funding to rapidly increase program capacity. Current reforms have created a context in which increased pressures on nursing programs are met with reduced resources for faculty and students. Nursing education in Canada faces faculty shortages, with many positions unfilled and retiring faculty members. Ultimately, the future of nursing education in Canada depends on sustained public funding and collaboration among education institutions, all levels of government, and communities to ensure programs remain adequately supported and capable of producing a diverse, well-prepared nursing workforce.

Jean Daniel Jacob, RN/IA, PhD
Executive Director | Directeur Général
Canadian Association of Schools of Nursing
Association canadienne des écoles de sciences infirmières
www.casn.ca

Effects of International Student Cap on Nursing Schools

Bon après-midi, good afternoon. My name is Dr. Jean Daniel Jacob, and I am the Executive Director of the Canadian Association of Schools of Nursing. I am new to the position, having been appointed at the beginning of November. My previous role was as Director of the School of Nursing at the University of Ottawa. While I will provide a pan-Canadian perspective on this issue, I also have hands-on experience related to the admission of international students into nursing education programs.

For context, the Canadian Association of Schools of Nursing—or CASN—is a national, voluntary association that represents baccalaureate and graduate education programs in nursing. These are the entry-to-practice programs for registered nurses and nurse practitioners, as well as programs that result in a master’s degree or PhD in nursing. The organization’s mission is to support the delivery of high-quality nursing education through accrediting schools and their respective nursing programs; creating standards, resources, and continuing education that promotes excellence in teaching; and representing nursing education nationally, which is why I am before you today.

International students make up a relatively small percentage of enrolments in nursing programs. The most recent data comes from Statistics Canada before the COVID-19 pandemic: 2.6% to 4.7% of enrolments were from international students.

CASN collects information from schools of nursing each year on the number of applications, admissions, enrolled students, and graduates from nursing programs. Unfortunately, we currently do not monitor the number of applications and enrolments from international students. However, it is possible to look at the global effects of the reforms when considering their full impact on nursing programs, both direct and indirect.

Following the COVID-19 pandemic, Canada experienced an acute nursing shortage, which continues to impact health care today. In response to this acute need for nurses, provincial governments called for an increase in nursing seats and compressed program options across Canada. This short-term provincial funding allowed schools to respond to this crisis by increasing seats in most nursing programs, including registered or licensed practical nursing programs, registered nursing programs, and nurse practitioner programs.

There is a direct tension between the provincial funding for nursing seats and regulatory reforms, which impact budgets at universities and colleges overall. These overall decreases in budgets affect nursing schools and their programs by increasing the workloads of smaller numbers of faculty and staff and diminishing support and services for both faculty and students (for example, mental health resources, writing centres).

The international student cap and other related regulatory changes are felt more in rural communities and institutions. For example, some universities and colleges in Atlantic Canada have higher proportions of international students. Beyond the financial implications for schools, certain locations rely on international student nursing graduates to fill shortages in local health care institutions. This is particularly true of programs that operate in linguistic-minority contexts and rely on international students to meet the increasingly diverse health industry and population needs. Current reforms are therefore significantly affecting provinces’ health human resources needs and increasing the vulnerability of precarious, yet essential, nursing programs. In the short term, the decisions affect the viability of programs (such as through program closures, layoffs, hiring freezes). In the long term, they affect the academic institution’s capacity to address the increasing needs of a diverse population.

Overall, current international enrolment does not even meet the new threshold set by the governments—suggesting a deterring effect on international students’ willingness to study in Canada following the reform. Nurses trained in our PhD and master of science in nursing programs affect the quality of nursing internationally and facilitates the mobility of nurses to come and work in Canada.

Another impact of the reforms is on the number of master’s and PhD students in nursing. Canada has a shortage of master’s- and PhD-prepared nurses. Highlights from CASN’s Student and Faculty Survey (CASN, 2024) show that:

  • In 2023, schools were unable to fill 78 permanent and long-term contract faculty positions. Schools projected a need to hire 200 permanent and 110 long-term contract faculty positions in 2024.
  • A total of 77 permanent faculty retired in 2023.
  • A total of 39.1% of schools reported a lack of nurses with PhDs or master’s degrees applying to faculty positions.

Delivery of sustainable education programs and the creation of a sustainable workforce require careful considerations from institutions and provincial and federal governments. All students, including international students, should enter a nursing program that has the physical and human resources, including classroom space, lab equipment, and clinical placements, for a high-quality educational experience, successful program completion, and strong positioning to pass the registration exam. Graduate education in nursing is required for most faculty positions within a school of nursing and therefore has a direct impact on the sustainability of the nursing workforce.

Post Appearance Information

Health Care Needs Projections: During the meeting, information was shared with respect to projected needs for the education sector in nursing across Canada based on CASN’s annual student and faculty survey data. In addition to the information provided, it was requested that CASN share information of the projected clinical nursing human resources needs in Canada.

The most recent and commonly cited source regarding the nursing shortage in Canada is from 2019 (pre-pandemic), projects a need for over 100,000 nurses nationwide by 2030 (Sheffler & Arnold, 2019). Post-pandemic projections are likely higher. We are looking forward to the publication of the SET study (Supply of Education and Training) which will hopefully update some of these projections.

Other Key Highlights From Selected Resources

Financial Impacts

  • Based on the reforms, Ontario universities are projecting financial losses of over $300 million in 2024–25 compared with 2023, and if trends continue, this number would double to more than $600 million the next year. This impact amounts to almost $1 billion in only the first 2 years (Council of Ontario’s Universities, 2024a).
  • Government budget cuts to education have negatively affected academic institutions’ reliance on other sources of revenue. As the Council of Ontario’s Universities (COU) reports, “with a long history of responsibly supporting international students, Ontario’s universities have only modestly increased international student enrolment over the years, while providing comprehensive services to all students” (2024a, para. 3). Before federal changes, international students constituted under 20% of students at Ontario universities (COU, 2024a).
  • Extended tuition cuts and freezes as well as multiple years of elevated inflationary costs, Ontario universities face considerable financial strain. Even accounting for the provincial funding for science, technology, engineering, and mathematics (STEM) in 2023–24, 10 universities in Ontario face over $300 million in deficits in 2023–24. As COU reports, “these deficits are expected to increase in 2024–25, and do not include the impact of recent changes to international student study permits” (2024a, para. 4).

Applications to Ontario Universities

  • Applications by international students in 2023 and 2024 fell significantly below the cap and the allocations to provinces, indicating that the brand of Canadian education has fallen, affecting research partnerships and the attraction of global talent. Students speak of negative experiences.
  • Ontario universities were assigned 35,788 study permits for 2024–25, but 29% of those remain unused, meaning that current international enrolment does not meet the governments’ low threshold (Keung, 2024).

Graduate Programs

  • Ontario’s allocation of just 16% of international study permits to universities for 2024–25 has limited universities’ ability to recruit top students from other countries (COU, 2024b).
  • The federal government’s announcement on including graduate and PhD students under the cap “will add further complexity to the application process for these students and risk discouraging more highly skilled students from applying to Canada” (COU, 2024b, para. 4). This decision could affect advanced degrees in fields such as health care, engineering, artificial intelligence, and life sciences. As COU reports, “we cannot afford to lose the vital talent, innovation and research our province needs” (2024b, para. 4).
  • The College of Nurses of Ontario​​ (CNO) requires permanent residence or citizenship to practice nursing (n.d.). Many international students in nursing are seeking permanent residence. The cap affects the ability of programs to address health workforce shortages.
  • International students with no funding package will have to demonstrate $20,000 in cash. Given that university administration is assessing files on a case-by-case basis, this means students must submit evidence of insufficient funding and then wait for visas to be declined to be eligible for support (Woolf, 2023).

Recommendations to the CIMM

Addressing the following areas can enhance the overall capacity of nursing education to meet the diverse needs of the health care system and the population.

  • Assess the impacts of regulatory reforms on the supply of future nurses: Provincial governments need to consider long-term strategies to address the nursing shortages. As such, there is a dire need to assess both the direct and indirect impacts of regulatory changes on international student admissions and their implications for nursing programs, especially in rural and linguistic-minority contexts.
  • Support public education: Provincial governments need to prioritize and invest in public education for nursing as it serves as the bedrock of a robust and effective health care system. Creating systems that rely on additional funding sources to ensure operational functioning are a threat to essential programs, such as nursing. As such, sustained and sufficient funding of nursing programs (graduate and undergraduate) is needed to ensure adequate numbers of faculty, students, resources, and support services.

About the Canadian Association of Schools of Nursing

The Canadian Association of Schools of Nursing (CASN) is the national voice for nursing education, research, and scholarship and represents baccalaureate and graduate nursing programs across Canada. CASN’s mission is to lead nursing education and nursing scholarship in the interest of healthier Canadians.

For more information:

Canadian Association of Schools of Nursing
Website: www.casn.ca

References

Download CASN ED’s brief to the CIMM