ASIA NEWS NETWORK
Ralph Villar was among 27,000 students who passed the Nursing Board Exam in June. After studying at one of Manila's best nursing colleges, he expected to walk into a job. Instead, he found the market 'overflowing with nurses'.
After applying unsuccessfully to private and government hospitals for two months, he had to do part-time work in an office to get by. Some of his classmates now temp in call centres.
"I was so confident when I passed the board exam," he told a television programme on the nursing glut.
More and more nurses now find themselves facing the same dilemma. As many as 100,000 are unemployed, or at least not employed in the profession, according to nurses' groups.
The more familiar picture of hospitals losing nurses and other medical professionals in a brain drain is happening, but it is the experienced ones who are going overseas.
Nursing colleges have mushroomed in recent years on rising demand for Filipino health workers from hospitals and clinics in rich countries. But too many graduates are chasing too few training jobs in hospitals to get a few years' experience, a prerequisite for a career abroad.
Jedegal International, a recruitment agency in Manila's Ermita district, has plenty of jobs abroad on its order books.
But it is having trouble filling them, despite the growing glut of nurses who are either unemployed or taking temporary jobs in other professions while applying to local hospitals for jobs.
"The demand from Singapore is really high right now, but we just don't get enough qualified applicants," Jedegal's manager Jane Pamidan told me. "It's really hard to find experienced nurses as most of those applying are recent graduates."
What's more, the demand for nurses from hospitals abroad can be fickle.
"One of the problems we're encountering is a slowdown from the United States and Britain because of visa policy changes there," said Dr Carmelita Diviniagracia, president of the Association of Deans of the Philippine Colleges of Nurses.
Both countries are among the largest employers of Filipino nurses.
In Britain, they have come to epitomise the Filipino overseas worker in the same way that domestic helpers have in many wealthy Asian countries, though that perception is fast changing as more skilled and professional Filipinos work abroad.
Iconic as the Filipino nurse may be, she--and, increasingly, he--is coming up against tough competition from health workers in other developing countries.
Take Singapore's Parkway Health, which owns the Mount Elizabeth, Gleneagles and East Shore hospitals. Forty per cent of its nurses come from countries such as the Philippines, China, Burma, India and Malaysia.
The situation is not entirely gloomy. Demand from the Middle East remains buoyant, say recruitment agencies, while Japan will take more Filipino nurses once a free trade agreement is ratified by the Philippine Senate.
Still, more nurses than ever before are graduating: 65,000 nurses were registered last year, a figure the Philippine Nurses Association (PNA) predicts will rise to 100,000 annually in a few years.
It is worried that despite the generally buoyant demand for Filipino nurses overseas, this country is producing far more than it can employ at home and abroad.
The PNA estimates that there are currently between 80,000 and 100,000 unemployed nurses; Dr Diviniagracia puts the number at around 40,000.
Nursing abroad has long been a ticket to greener pastures for young women from middle-class households. Their families often make heavy financial sacrifices--including getting into debt--to pay the tuition fees. The cost of a four-year nursing course is around 300,000 pesos (US$6,443)--a tidy sum, considering the monthly income of these households is between 15,000 and 30,000 pesos.
"I know it's going to be harder to find a hospital here to get experience, and students are less confident about the prospects," said 25-year-old Jorgem Leonen, a third-year nursing student at Global City Innovative College in Manila's upmarket Fort Bonifacio district.
"This is a very costly degree and my family's helping me, so I'm willing to work my guts out to succeed. I want to see the world and nursing is my ticket," she said.
There are now nearly 460 accredited nursing colleges across the Philippines, many more than a decade ago.
The bar to getting a nursing licence is set to a high standard that has given Filipino nurses a respected name internationally. Students must get a minimum average score of 75 per cent in the Board exam, and not less than 60 per cent in any paper.
The top colleges, often attached to hospitals and universities, generally achieve high pass rates.
"But many of the others are not performing well and the authorities should really close them," said PNA national president Leah Samaco-Paquiz.
In a 2005 survey of 263 nursing colleges by the Professional Regulation Commission, only 111 had at least half of their students pass the licensing exam, according to reports.
The rest fell below that level. Another survey showed 19 colleges had no students passing at all.
There is now a moratorium on new colleges opening and higher education institutions starting new nursing courses. But, along with nursing groups, the recruitment industry wants the authorities to close down the dud colleges.
These are typically over-enrolled with students given hardly any ward time in hospitals. Related Learning Experience, as the module is called, is the 'backbone of any nursing course', as one student wrote on a local nursing blog recently.
Tackling the dwindling opportunities for graduate nurses to get on-the-job experience is the other solution to the nursing glut, says Dr Samaco-Paquiz.
It will be tough. This country's overloaded government hospitals are the best training ground for nurses to hone their practical skills. But budget cuts and the exodus of experienced medical staff overseas have closed wards and entire hospitals in recent years. Private hospitals, meanwhile, can be picky about taking new nurses, said Ms Leonen.
Increasingly, recruitment agencies are seeing rising numbers of graduate nurses looking for other jobs overseas - a heartbreaking end to the dream of a nursing career.
As Jedegal's Ms Pamidan said: "We're able to offer them positions as caregivers in Taiwan and Canada; some are even taking jobs as domestic helpers in Hong Kong."