2027 is almost here, and nursing is changing faster than at any time since the pandemic. New laws, new visa rules, new licensing tests and new staffing limits will shape where nurses work, how they qualify and what they are paid. Some changes open doors; others close them. If you are a nurse, a student or planning to work abroad, these are the twelve changes you need to know before the new year.
Imagine it is January 2027. One nurse in Lagos has already applied for UK jobs because she knows nurses keep a five-year route to settlement. A student in Hanoi has rushed her licence application before the new assessment deadline. A nurse in Riyadh is quietly building the precepting experience that will keep her valuable as Saudization grows. And a nurse in Manila, who did not follow the news, is still wondering why US employers stopped replying. The difference between them is not talent. It is information. This is that information.
1. The UK keeps a five-year settlement route for nurses
On 2 November 2026, the UK Home Secretary confirmed that registered nurses will keep a five-year route to indefinite leave to remain under the new “earned settlement” system, while most other migrants will wait ten years. At the same time, international recruitment has fallen sharply: around 10,961 internationally educated nurses and midwives joined the NMC register in the year to March 2026, roughly 47% fewer than the year before.
What it means: the UK is harder to get into, but more rewarding once you are there. Apply directly to NHS employers and never pay anyone for a job or a certificate of sponsorship. Is the NHS still recruiting international nurses?
2. The US: a $100,000 H-1B fee and a mixed picture at home
A new $100,000 fee on H-1B petitions has made that visa route much more expensive for employers, so most internationally educated nurses still rely on immigrant (green card) visas, with long waits. At home, the US announced a $275 million programme of loan repayments and stipends for nurses in nursing homes, but the 2024 nursing-home minimum staffing rule was repealed and nursing education funding is under pressure.
What it means: the US is still the biggest nursing job market in the world, but timelines are long. Plan for years, not months. US nursing policies explained
3. Saudi Arabia’s nursing workforce is changing
A study published in November 2026 forecasts that Saudi Arabia’s nursing workforce will grow from about 226,580 nurses in 2026 to about 340,000 by 2040, and that Saudi and expatriate nurses could reach rough parity around 2039. Saudization is real, but demand for experienced international nurses is not disappearing.
What it means: specialist skills, leadership and the ability to precept new Saudi nurses will matter more than ever. Read the Saudi forecast and our Middle East guide.
4. Vietnam: 2027 is the last year to get a nursing licence without the new assessment
Under Vietnam’s 2023 Law on Medical Examination and Treatment, licences now renew every five years, and a National Medical Council will assess new practitioners. Doctors face the assessment from 1 January 2027; nurses, midwives and assistant doctors from 1 January 2028. Nurses who apply by 31 December 2027 fall under the transitional rules.
What it means: if you are graduating in Vietnam in 2027, check your dates now. Nursing in Vietnam guide
5. Taiwan makes nurse-to-patient ratios law
In May 2026, Taiwan’s legislature amended the Medical Care Act to make nurse-to-patient ratios a legal requirement. When fully enforced, the law would limit night shifts in medical centres to 11 patients per nurse. Taiwan has around 300,000 licensed nurses but only about 190,000 working in nursing; the law aims to bring nurses back.
What it means: safe staffing laws are spreading. Nurses everywhere can point to Taiwan when they campaign for safe ratios. Nursing in Taiwan
6. South Korea’s Nursing Act reshapes nurses’ roles
After decades of campaigning, South Korea’s standalone Nursing Act took effect in June 2025, giving nurses their own legal framework separate from the Medical Service Act. It followed a period in which nurses took on expanded roles during a long dispute involving trainee physicians.
What it means: 2027 will show how the Act protects nurses’ expanded roles in practice. Nursing in South Korea
7. Malaysia weighs bringing in up to 15,000 Indonesian nurses
About 14,700 of Malaysia’s 84,000 public-sector nursing posts were unfilled in September 2025. In June 2026, Indonesia offered up to 15,000 nurses, and the government said it was considering the offer. Nursing groups pushed back, calling for Malaysian nurses to be hired and retained first, and for better allowances.
What it means: watch for decisions in 2027, and beware of agents selling places on schemes that do not yet exist. Malaysia’s nurse shortage
8. Indonesia’s lifetime registration
Indonesia’s 2023 Health Law made the nurse registration certificate (STR) valid for life, while the practice permit (SIP) is still renewed. Indonesia produces tens of thousands of nursing graduates a year, and more of them are looking abroad, to Japan, the Gulf and possibly Malaysia.
What it means: lifetime registration does not mean lifetime learning is optional; employers and permits still expect it. Nursing in Indonesia
9. Sri Lanka plans to recruit 13,600 nurses by 2029
Nearly 2,800 Sri Lankan nursing officers migrated between 2022 and early 2025. In response, the government plans to recruit 13,600 new nursing personnel between 2025 and 2029, has approved 3,000 extra student places and, in May 2026, appointed 515 BSc nursing graduates.
What it means: countries that lose nurses are starting to fight back with recruitment and training. Nursing in Sri Lanka
10. Japan’s language barrier stays high
In Japan’s 2026 national nursing examination, 88.3% of all candidates passed, but only 24.4% in the category that includes Economic Partnership Agreement and other foreign-qualified candidates. The exam is only in Japanese.
What it means: Japan is rewarding but slow. Language is the real licence. Nursing in Japan
11. Licence renewals: the deadline nobody remembers
Renewal cycles range from every year (Kenya, Ghana) to every three years (Nigeria, Uganda), five years (Pakistan, and now Vietnam) and six years (Nepal), each with different CPD rules. Every year nurses lose shifts and pay because a licence quietly expired.
What it means: before 1 January, put your renewal date and CPD target in your calendar. Licence renewal by country
12. The global shortage is not going away
The World Health Organization estimates there are roughly 29 million nurses worldwide and a shortage measured in millions, falling hardest on Africa, South-East Asia and the Eastern Mediterranean. Rich countries recruit, poorer countries train, and the gap between them is widening.
What it means: nurses have more power than they realise. Skills, experience and the willingness to move are valuable everywhere. The global nursing shortage explained
At a glance: 2027 for nurses
| Country or area | Change | Who it affects most |
|---|---|---|
| United Kingdom | Five-year settlement route kept for nurses; fewer international hires | Nurses planning to move to the UK |
| United States | $100,000 H-1B fee; $275m nursing-home programme | International nurses; nursing-home nurses |
| Saudi Arabia | Saudization; workforce growing to about 340,000 by 2040 | Expatriate nurses in the Gulf |
| Vietnam | Nurses’ competency assessment from 2028 | 2027 graduates |
| Taiwan | Legal nurse-to-patient ratios | Hospital nurses |
| South Korea | Nursing Act in force | Nurses in expanded roles |
| Malaysia | Possible Indonesian nurse recruitment | Malaysian and Indonesian nurses |
| Indonesia | Lifetime STR | Indonesian nurses |
| Sri Lanka | Recruitment of 13,600 nurses by 2029 | Students and new graduates |
| Japan | Low pass rate for foreign candidates | EPA and foreign nurses |
Your 2027 checklist
- Check your licence expiry date and CPD progress.
- If you plan to move abroad, choose one main destination and one backup.
- Book your English or language test early.
- Gather certified copies of your certificates, transcripts and good-standing letters.
- Learn one new specialist skill this year; specialists move faster.
- Join your national nurses’ association; laws are changing and your voice matters.
- Never pay anyone for a “guaranteed” job abroad.
But which change matters most for you?
That depends on where you are and where you want to go. A nurse in Accra planning for the UK, a student in Hanoi finishing in 2027 and a nurse in Kuala Lumpur waiting for better allowances will each read this list differently. What they share is this: the nurses who do well in 2027 will be the ones who know the rules before everyone else. Keep this list, share it with your colleagues, and follow Nursing Media Network for updates as each change unfolds.
Your next step: Pick the one change on this list that affects you most, open the full guide linked under it, and write down one action you will take before 31 December.
Sources: UK Home Office statement on earned settlement (November 2026); NMC register data; US federal announcements (October 2026); BMC Nursing (November 2026); Vietnam Law No. 15/2023/QH15; Taiwan Legislative Yuan (May 2026); Republic of Korea Nursing Act; The Star (June 2026); Free Malaysia Today (April 2026); Indonesia Law No. 17 of 2023; Ministry of Health Sri Lanka; Daily Mirror (May 2025); Japan Ministry of Health, Labour and Welfare; World Health Organization. Full source lists are in each linked guide. Rules change; check official sources.
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