Part of our Nursing Councils of the World series. Last checked: November 2026.
Taiwan has around 300,000 licensed nurses, yet only about 190,000 are working in nursing, according to figures cited in Taiwan’s legislature in 2026. The gap reflects a familiar global story: heavy workloads, night shifts and pay that does not match the pressure. In May 2026, Taiwan’s legislature responded by amending the Medical Care Act to make nurse-to-patient ratios a legal requirement, one of the most significant staffing laws in Asia.
This guide explains how nurses qualify in Taiwan, the national licensing exam, the new staffing law, Taiwan’s nursing associations, and what foreign nurses should know.
Imagine a night shift in a Taipei medical centre where you are responsible for 15 patients, two of them deteriorating. You go home exhausted and think about quitting, like many of your classmates already have. Then the legislature passes a law that, when fully enforced, would limit night shifts in medical centres to 11 patients per nurse. It is not perfect, but for the first time, the number is law.
Who regulates nursing in Taiwan?
Nursing in Taiwan is governed by the Nursing Personnel Act, under the Ministry of Health and Welfare (MOHW). Licensing examinations are conducted by the Ministry of Examination under the Examination Yuan. Taiwan distinguishes between registered professional nurses (護理師) and nurses (護士), with separate examinations.
Becoming a nurse in Taiwan
- Education: complete a recognised nursing programme, such as a five-year junior college programme, a two-year technical programme after junior college, or a four-year university bachelor’s degree.
- National licensing exam: pass the professional and technical examination for nurses conducted by the Ministry of Examination.
- Licence: receive a nursing licence from the MOHW.
- Practice registration: register to practise with the local health authority where you work, and join the local nurses’ association, as generally required for practising nurses.
- Renewal: practice registration must be renewed periodically, with continuing education credits.
The national licensing exam
- Frequency: held more than once a year, with extra sessions added in recent years to help address shortages.
- Subjects: five subjects covering basic medicine, fundamentals of nursing, medical-surgical nursing, maternal and paediatric nursing, and psychiatric and community health nursing.
- Pass standard: an average of 60 points.
- Reweighting: in 2023, the Ministry of Examination reduced the weighting of the preclinical (basic medicine) section from 20% to 10%, after data showed candidates averaged only 40 to 50 points in that subject. Nurses’ unions argued that the real problem was working conditions, not the exam.
- Language: Chinese.
The 2026 nurse-to-patient ratio law
In May 2026, Taiwan’s Legislative Yuan amended the Medical Care Act to make nurse-to-patient ratios statutory, using the ratios the MOHW set as targets in March 2024:
| Hospital level | Day shift | Evening shift | Night shift |
|---|---|---|---|
| Medical centres | 1:6 | 1:9 | 1:11 |
| Regional hospitals | 1:7 | 1:11 | 1:13 |
| District hospitals | 1:10 | 1:13 | 1:15 |
- Penalties: fines from NT$50,000 to NT$250,000 for district hospitals, NT$200,000 to NT$1 million for regional hospitals and NT$1 million to NT$2 million for medical centres. Hospitals penalised three times without sufficient improvement can be suspended for up to a year.
- Review: the ministry must review the ratios every three years.
- Implementation debate: days after the vote, Taiwan’s top health official proposed delaying mandatory enforcement by two years, drawing opposing views from nursing unions and hospital associations. Check the latest status, as implementation timing may change.
Taiwan’s nursing associations
- Taiwan Nurses Association (TWNA): the national professional and academic association and Taiwan’s member of the International Council of Nurses. It promotes nursing education, research, specialist nursing and international exchange.
- Nurses’ associations federation: local nurses’ associations in each city and county form a national union of nurses’ associations, which handles membership for practising nurses, continuing education and professional representation.
- Labour unions: independent unions, such as hospital unions and nursing and healthcare workers’ unions, campaign on staffing, pay and working conditions, and played a major role in the ratio law debate.
Taiwan also recognises nurse practitioners, who complete specialist training and examinations and work in collaboration with physicians in hospitals.
Can foreign nurses work in Taiwan?
Foreign-educated nurses who want to practise as nurses in Taiwan must have their qualifications recognised and pass the Taiwanese licensing exam in Chinese, then meet work permit requirements. This route is rare. Taiwan does recruit large numbers of foreign care workers, mainly from Indonesia, the Philippines and Vietnam, for long-term care and home care under its migrant worker programmes, but these are caregiver roles, not licensed nursing roles.
Nursing education in Taiwan
Taiwan’s nursing education system offers several entry points: five-year junior college programmes that students enter after junior high school, two-year technical programmes that upgrade junior college graduates to a bachelor’s level, and four-year university bachelor’s degrees. Master’s and doctoral programmes train nurse practitioners, educators, researchers and leaders. Clinical training is concentrated in teaching hospitals, which are graded as medical centres, regional hospitals and district hospitals, the same categories used in the new staffing law.
Why nurses leave, and what is being done
Surveys and union campaigns in Taiwan point to the same reasons nurses leave clinical practice: heavy patient loads, frequent night shifts, rotating schedules, workplace violence and pay that does not reflect responsibility. In response, the government and hospitals have tried:
- Higher night-shift allowances funded through the national health insurance system.
- Three-shift staffing ratio targets linked to hospital funding, now strengthened by the 2026 amendment to the Medical Care Act.
- Programmes to encourage licensed nurses who are not practising to return.
- Additional licensing exam sessions and exam reforms to increase the supply of newly licensed nurses.
Nurses’ unions continue to argue that sustainable staffing requires better pay and conditions rather than simply more licence holders.
Nurse practitioners in Taiwan
Taiwan’s nurse practitioners (專科護理師) complete specialist training and a national certification examination, then work in hospitals in collaboration with physicians, particularly in internal medicine and surgery. Their numbers grew significantly as hospitals responded to physician workload limits, and their scope and supervision rules continue to be refined.
Lessons for nurses elsewhere
Taiwan shows both the power and the limits of staffing legislation. Writing ratios into law gives nurses a clear standard and enforcement tools, but hospitals must still recruit and retain enough nurses, and governments must fund them. Nurses campaigning for safe staffing in other countries can learn from Taiwan’s coalition-building between unions, professional associations and lawmakers.
Frequently asked questions
Does Taiwan have a nurse-to-patient ratio law?
Yes. In May 2026 the Medical Care Act was amended to make ratios statutory, such as 1:6 on day shifts in medical centres, though implementation timing has been debated.
Why is there a nursing shortage in Taiwan?
About 300,000 people hold nursing licences, but only about 190,000 practise, largely because of workload, night shifts and pay.
Is the Taiwan nursing exam in English?
No. It is conducted in Chinese.
But will the law keep nurses in the profession?
Ratios are only effective if hospitals can recruit enough nurses to meet them and if enforcement is real. Nurses’ groups argue that pay, night-shift allowances and respect matter as much as numbers. Taiwan’s experience will be closely watched by nurses across Asia campaigning for safe staffing. See our global guide to safe staffing and nurse-to-patient ratios.
Your next step: Compare Taiwan’s ratios with the staffing on your own ward this week, and share the comparison with your unit manager or union representative.
Related: Nursing in Japan · Nursing in South Korea
Sources: Taipei Times (15 November 2023; 9 May 2026); Focus Taiwan/CNA (11 May 2026); Ministry of Health and Welfare (Taiwan); Ministry of Examination; Taiwan Nurses Association. Rules change; check official sources.
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