Nursing pays solidly in Japan — commonly ¥300,000–450,000 a month with night shifts — but the gate is the Japanese national nursing license, whose exam is in Japanese. For most foreign candidates the realistic comparison is nursing (high barrier, higher pay) versus caregiving (low barrier, lower pay).
Key facts
- Monthly (typical, w/ shifts)
- ¥300–450k
- Hard requirement
- Japanese national license
- Exam language
- Japanese (kokka shiken)
- Exam pass rate, everyone
- 88.3% (Feb 2026)
- Exam pass rate, EPA foreign candidates
- 8.5% — 20 of 234
- Main routes
- EPA / study in Japan
- Visa
- "Medical Services" status
The exam record for foreign nurses
Japan publishes the pass rate for EPA foreign nurse candidates alongside the overall figure every year. The gap is the single most important number on this page.
| Exam year | EPA candidates | Passed | EPA rate | Everyone |
|---|---|---|---|---|
| 2025 | 234 | 20 | 8.5% | 88.3% |
| 2024 | 285 | 53 | 18.6% | 90.1% |
| 2023 | 294 | 17 | 5.8% | 87.8% |
| 2022 | 335 | 75 | 22.4% | 90.8% |
| 2021 | 370 | 45 | 12.2% | 91.3% |
| 2020 | 335 | 70 | 20.9% | 90.4% |
Latest year by country
| Country | Sat | Passed | Rate |
|---|---|---|---|
| Vietnam | 46 | 11 | 23.9% |
| Philippines | 64 | 4 | 6.3% |
| Indonesia | 124 | 5 | 4% |
Official exam results · 第115回 (February 2026) · 厚生労働省 ↗
From gross to take-home — a sample payslip
| Line | Amount (monthly) |
|---|---|
| Gross pay (typical mid for this job) | ¥380,000 |
| Health insurance (≈5%) | −¥19,000 |
| Employee pension (9.15%) | −¥34,800 |
| Employment insurance (≈0.55%) | −¥2,100 |
| Withheld income tax (≈2–4%) | −¥9,500 |
| Resident tax (from year 2, ≈6%) | −¥22,800 |
| Take-home, year 1 (approx.) | ¥314,600 |
| Take-home, from year 2 (approx.) | ¥291,800 |
Path2Japan estimate from the typical mid salary above — rates shift slightly with income, dependents and municipality. Year 1 has no resident tax, so pay "shrinking" in year 2 is normal, not an error.
The license is the market
Japan’s nursing shortage is severe, wages rise steadily, and hospitals recruit hard — but none of that is accessible without the national license (看護師国家資格). That single fact shapes every foreign nurse’s strategy: the cost of entry is not clinical skill, which many candidates already have, but Japanese medical literacy.
Pay structure once inside
Base salaries start modestly (new-license grade ¥250,000–300,000) and the real money is structural: night-shift allowances, weekend differentials, specialization and years-of-service raises. University hospitals pay less base with better ladders; private chains pay more upfront. Compare against your city’s living costs — regional hospitals with dormitories often win on savings.
The exam is the market, and the numbers are public
Every March the ministry publishes two pass rates side by side: the national figure, and the figure for EPA foreign nurse candidates. In February 2026 they were 88.3% and 8.5%. Twenty people out of 234 passed.
That is not a fluke year. Across the eighteen years the programme has run, 739 of 6,124 candidates have passed — 12.1%. The best year on record was 2022, at 22.4%.
The exam is written for people who trained in Japanese. It is not a translation of a nursing exam; it is a Japanese-language exam about nursing, sat under time pressure, and clinical experience abroad does not compensate for reading speed.
Why Vietnamese candidates pass four times as often
The per-country split is the most useful thing in the whole dataset. Over the twelve years Vietnam has participated, its candidates average 34.1%. Indonesian candidates average 7.7%.
The difference is not aptitude. The Vietnamese programme screens for Japanese at roughly N3 before departure and adds about a year of language training on top; the Indonesian and Philippine tracks front-load less and expect more learning to happen on the job, in a hospital, while working.
If you are weighing this route, that is the lever you control. Arrive with the language and the exam is difficult; arrive without it and the exam is close to unwinnable within the years the visa allows.
Nurse vs caregiver — the honest fork
Same demographic driver, different games. Caregiving starts at N4 with lower pay and a license ladder measured in years; nursing demands near-native Japanese first and pays 30–50% more after. If you are already a licensed nurse at N2+, aim straight at the exam; below that, caregiving-first is not a detour — it is the route.
Japanese you will use on this page (tap ▶)
| 体温を測りますね。 Taion o hakarimasu ne. I am going to take your temperature. | |
| 点滴を交換します。 Tenteki o kōkan shimasu. I am changing your IV drip. | |
| お薬の時間です。 Okusuri no jikan desu. It is time for your medicine. | |
| おはようございます。今日もよろしくお願いします。 Ohayō gozaimasu. Kyō mo yoroshiku onegai shimasu. Good morning. Looking forward to working with you today. | |
| すみません、もう一度お願いします。 Sumimasen, mō ichido onegai shimasu. Sorry, could you say that once more? |
Audio synthesized with VOICEVOX:Meimei Himari at standard pace for shadowing; real conversations run faster and carry accents.
Common mistakes & warnings
- Foreign nursing licenses do not transfer — passing Japan's national exam is mandatory regardless of experience, and it demands roughly N1-level reading under time pressure. Over eighteen years of the EPA programme, 739 of 6,124 candidates have passed — 12.1%.
- Salary figures are indicative; night-shift count (typically 4–8/month) moves monthly totals by ¥40,000–80,000.
- Be wary of programs promising "nursing jobs" at N4 — those are caregiving positions being mislabeled. The two careers have different licenses, pay and visas.
Frequently asked questions
How much does a nurse earn in Japan per month?
A licensed nurse commonly earns ¥300,000–450,000 a month once night-shift allowances are counted, and shift count moves that by ¥40,000–80,000. That is pay for a licensed nurse — the licence, not the salary, is where most foreign nurses stop.
How hard is the Japanese nursing exam for foreigners?
In the February 2026 exam, 88.3% of all candidates passed and 8.5% of EPA foreign candidates did — 20 of 234. Across eighteen years the EPA figure is 12.1%. The exam is in Japanese and rewards reading speed as much as clinical knowledge.
Why do Vietnamese candidates pass far more often?
Over the twelve years Vietnam has taken part, its candidates average 34.1% against Indonesia's 7.7%. The Vietnamese programme requires Japanese to around N3 before departure and adds a year of language training; the others front-load less. Language preparation, not nursing ability, is what the gap measures.
What is the EPA nurse route?
Bilateral programs (Indonesia, the Philippines, Vietnam) bring licensed nurses to work as trainees while preparing for the national exam, with a limited number of years to pass. Pass rates are low but non-zero — language preparation before arrival is decisive.
Is experience abroad valued after I'm licensed?
Yes — once licensed, foreign-trained nurses compete normally, and chronic understaffing means hospitals hire on capability. Specializations (dialysis, OR, geriatric) add allowances.
What's the smarter path if my Japanese is N4–N3?
Enter caregiving now, build language on the job, and decide later between the caregiver national license and the nursing exam. See the caregiver salary page for that ladder.
Official sources
What this salary saves in each city: TokyoYokohamaOsakaNagoyaSaitamaChibaKyotoKobeFukuokaSapporo
This page provides general information only and is not legal advice. Immigration rules change; always confirm details with the official sources listed above before making decisions.