Australia’s nursing fast track lists six countries and India is not among them

India sends more nurses to Australia than any other country. It has done since 2021, when it passed the United Kingdom.

In April 2025, Australia opened a fast track that cuts nursing registration from nine to twelve months down to one to six. Six jurisdictions were named as comparable. India was not one of them, and eighteen months later the list has not changed.

The result is a two-speed system in the occupation where Australia’s shortage is deepest. A nurse trained in Spain can be registered in a matter of weeks. A nurse trained in Kerala, applying on the same day with the same years behind her, faces an examination pathway that costs close to $5,000 before travel and takes the better part of a year.

What the standard says, exactly

The document is the Nursing and Midwifery Board of Australia’s Registration standard, general registration for internationally qualified registered nurses. It was approved by the Australian Health Workforce Ministerial Council on 26 September 2024 and came into effect on 23 April 2025.

One correction worth making early, because it is widely reported wrongly. The standard covers registered nurses only. It does not cover midwives, and it does not cover enrolled nurses. The Board has said it supports extending it, but as things stand a midwife trained overseas gets nothing from it.

The fast track requires 1,800 hours of practice as a registered nurse, accrued since 1 January 2017, in what the Board calls an approved comparable international regulatory jurisdiction. That is roughly one year full time, calculated as 38 hours a week across 48 weeks.

The approved list, published as at April 2025, names the United Kingdom, Ireland, the United States, the Canadian provinces of British Columbia and Ontario, Singapore and Spain.

The list is not really a list of countries

Read the six entries together and the pattern is obvious once you see it. They are the members of the International Nurse Regulator Collaborative, minus New Zealand, which is already covered by trans-Tasman mutual recognition.

The Collaborative has nine members: the nursing regulators of British Columbia, Ontario, Spain, the United States, the United Kingdom, Australia, Ireland, New Zealand and Singapore. The Board’s own fact sheet is explicit that the approved list “is founded on strong evidentiary work and benchmarking commissioned by the International Nurse Regulatory Collaborative (INRC) from 2018 to 2023, of which the NMBA is a member”.

The Indian Nursing Council is not a member of that collaborative and has never been one. So India was not assessed and found wanting. India was never inside the room where the assessment happened.

That distinction matters for how this story should be read. The exclusion is not a judgment about Indian nursing education. It is the consequence of building an eligibility list out of an existing club’s membership, and then not going back to look at anyone else.

The Board’s 2023 consultation paper recommended the list “be limited to the NMBA-approved comparable jurisdictions” and used the phrase “at this time”. That consultation asked seven questions. Not one of them asked whether other countries should be added.

The pathway that does exist, and who it actually helps

An Indian-qualified nurse is not categorically shut out. The fast track has a second pathway, and it is worth understanding because migration agents routinely describe the standard as excluding Indian nurses outright.

A nurse who qualified in India on or after 1 January 2017 can use the fast track if she has passed a comparable jurisdiction’s registration examination, holds general adult registration in that jurisdiction, and has completed her 1,800 hours there. So a Kerala-trained nurse who worked four years in London arrives on the fast track. A Kerala-trained nurse who worked four years in Kochi does not.

What the standard excludes, precisely, is practice in India. It also excludes anyone who qualified before 1 January 2017 regardless of where they have worked since, and anyone whose United Kingdom registration is in mental health, children’s or learning disabilities nursing rather than adult nursing.

What the alternative costs, and how long it takes

Everyone else goes through the outcomes-based route the Board now calls the internationally qualified nurse and midwife assessment process, Stream B. It runs in stages: orientation, then a portfolio, then a multiple choice examination, then a clinical examination.

The multiple choice component for registered nurses is the NCLEX-RN, the United States licensure examination, delivered at Pearson VUE test centres. The clinical component is an objective structured clinical examination, and the Board is unambiguous that it is held in person in Australia only.

On the published fee schedule effective 18 September 2025, the assessment and orientation fee is $410 and the clinical examination is $4,000. General registration adds a $332 application fee and a $193 registration fee. That is $4,935 before the NCLEX-RN, whose fee is set by the American provider and paid separately, and before flights and accommodation for anyone sitting the clinical examination from outside Australia. A first review of an assessment decision costs $300, an internal review $575 and an external review $2,500.

The clock is unforgiving. A candidate has 180 days to sit the multiple choice examination after the portfolio stage, 120 days to pay the clinical examination fee, and 180 days after paying to schedule it. Results now take four to six weeks, improved from ten.

[Unverified] Neither the Board nor Ahpra publishes pass rates for either examination. There is no Australian figure for how many Indian-trained nurses pass, fail or abandon the process. The nearest available number comes from the American regulator, which reported that of 5,807 India-educated first-time candidates for United States licensure in 2024, 2,349 passed, a rate of 40.5 per cent. That is a United States figure for United States purposes and must not be read as an Australian pass rate.

The scale of what is being sorted

The numbers make the two-speed system visible.

In 2024-25, Ahpra registered 16,155 internationally qualified nurses. Of those, 12,037 came through trans-Tasman mutual recognition from New Zealand. Only 4,118 came through every other international route combined. In the same year 10,349 NCLEX-RN examinations were sat, including re-sits, and 3,300 nurses sat the clinical examination, a rise of 42.2 per cent, across sixteen examination cycles rather than the previous ten.

Ahpra’s own consultation paper records that between January 2020 and March 2023, the top three qualification countries for nurses going through the examination stream were India, the Philippines and Nepal. So the stream that requires two examinations and close to $5,000 is disproportionately the Indian stream, and the Board has known that since at least 2023.

At 31 March 2026 there were 421,539 registered nurses holding general registration in Australia.

What the workforce researchers found

The Australian National University’s National Centre for Health Workforce Studies published an analysis in April 2024 using OECD data. It recorded 59,665 overseas-trained nurses practising in Australia as at 2021, about 17 per cent of the workforce, with roughly 80 per cent trained in the United Kingdom, India, the Philippines and New Zealand.

Its central finding on source countries was blunt: historically most international nurses were trained in the United Kingdom, but India took first place in 2021.

The same authors, whose number includes Mark Cormack, the former chief executive of Health Workforce Australia, made the structural point directly. They wrote that migrant nurses qualified in the United Kingdom and New Zealand gain easier entry as nurses in Australia compared with migrant nurses qualified in India. They also noted that between 40 and 50 per cent of Australia’s foreign-trained nurses come from lower-middle-income countries, which carries obligations under the World Health Organization’s code of practice on international recruitment.

Settlement Services International, through its Activate Australia’s Skills campaign, published modelling in August 2025 putting the number of underutilised migrant nurses already in Australia at 16,430. That figure comes from the campaign and its economic consultants rather than from the Australian Bureau of Statistics, and should be attributed that way.

What the people responsible said

Mark Butler, the Minister for Health, framed the reform when it was announced in January 2025. His words were that for too long highly educated nurses with experience from countries like the United Kingdom, Canada and Ireland have been left waiting on red tape approvals.

Read the sentence again for which countries it names. It is a fair description of who the reform was designed for, and it is not a slip.

Adjunct Professor Veronica Casey AM, the Board’s chair, put the rationale in workforce terms, saying the standard has the potential to reduce workforce pressures on health services across Australia. The Board also stated that since 2021-22, more than 5,000 internationally qualified nurses from approved comparable jurisdictions have been granted registration.

The Australian Nursing and Midwifery Federation’s position is supportive rather than critical. Its Victorian branch recorded that the federation supports the development of a streamlined approach for internationally qualified registered nurses, and supports extending it to midwives. Anyone writing about this should not imply the union opposes the standard, because it does not.

[Unverified] No named Indian-trained nurse, union official or academic could be found on the public record criticising the exclusion of India from the approved list. That absence is itself notable in a debate this consequential, and it is a gap this masthead intends to fill through direct interviews.

Two documents that were promised and have not appeared

When the standard was announced, the Board committed to a review one year after implementation, to evaluate its impact and identify opportunities for further improvement. Implementation was 23 April 2025, so that review fell due around April 2026.

[Unverified] No outcome of that review has been published. The Board’s own page for the 2023 public consultation, which closed on 20 October 2023, still marks the consultation report as forthcoming, nearly three years later. The Board’s current consultations page, reviewed on 21 July 2026, lists no open consultation on this standard.

Neither absence proves anything on its own. Together they mean that the one mechanism through which the approved list could be expanded has produced no visible output, at a point when the standard has been operating for sixteen months and Indian nurses remain the largest cohort in the slower stream.

Those are answerable questions. What did the one-year review find. When will the 2023 consultation report be published. Has any assessment of Indian nursing regulation been undertaken since. Made in India Magazine has put them to the Board.

What a nurse reading this should take from it

If you trained in India and have practised only in India, the fast track is not available to you, and no amount of experience changes that. Budget close to $5,000 in Australian fees, plus the American examination fee, plus travel to Australia for the clinical examination, and plan for a process measured in months rather than weeks.

If you trained in India in 2017 or later and have since registered and worked in the United Kingdom, Ireland, the United States, British Columbia, Ontario, Singapore or Spain, check the second pathway carefully, because you may qualify for the fast track and be unaware of it. Registration in the wrong division of the United Kingdom register is the trap most likely to catch people.

And if the shortage is as serious as every government statement says it is, the question that follows from all of this is not whether Indian nurses are good enough. It is why the country that supplies more of them than anyone else has never been asked.

Sources

Every date, figure and quotation in this article is drawn from the sources below. They are listed so you can check the record yourself.

• Nursing and Midwifery Board of Australia, "Registration standard, general registration for internationally qualified registered nurses"
• Ahpra, "Registration standard, general registration for internationally qualified registered nurses, April 2025"
• Ahpra, "Approved list of comparable international regulatory jurisdictions"
• Nursing and Midwifery Board of Australia, "October 2025 newsletter"
• Nursing and Midwifery Board of Australia and Ahpra, "Media release, faster registration for internationally qualified registered nurses"
• Australian Nursing and Midwifery Journal, "Overseas nurses fast-tracked to work in Australia"
• Australian Nursing and Midwifery Federation Victorian Branch, "New general registration standards for internationally qualified registered nurses"
• Ahpra, "Annual report 2024/25"
• Nursing and Midwifery Board of Australia, "Fees"
• Nursing and Midwifery Board of Australia, "Multiple choice question exam"
• Ahpra, "Public consultation paper, registration standard for internationally qualified nurses and midwives, September 2023"
• International Nurse Regulator Collaborative, "About"
• Australian National University National Centre for Health Workforce Studies, "Foreign-trained doctors and nurses in Australia, past and present"
• National Council of State Boards of Nursing, "2024 NCLEX examination statistics, research brief volume 94"
• Ahpra, "Nurse and midwife registration data table, March 2026"
• Settlement Services International and Activate Australia's Skills, "The productivity fast track"
• Nursing and Midwifery Board of Australia, "Current consultations"
• Journal of Transcultural Nursing, "Transition experiences of Indian nurses into the Australian mental health system"