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Credit for Prior Study in Courses Leading to Registration as a Nurse
Australia has a high standard health care system. Nurses and midwives are educated in high standard education institutions in order to provide them with the education required for professional practice at the standard required in Australia.
United Nations Development Program (UNDP) issues Human Development Indices which seek to assess how an environment enables people to develop their full potential and lead productive, creative lives in accord with their needs and interests. The report for 2007/2008 ranks Australia third highest in the world. The UNDP included health expenditure per person in various countries, taking into account purchasing power of currency in each country and measured in $US to permit international comparison. Australia spends more than $US3000 per person on health each year. It is one of only twelve countries to do so. While spending a lot of money does not ensure good outcomes, there appears to be a correlation between expenditure and health outcomes.
In the UNDP's Education Index for 2007/2008, Australia was ranked equal highest in the world with Ireland, Denmark, Finland and New Zealand.
Sadly, many countries in the world do not have the resources to spend on the health of their people or on the education of their health professionals. Many countries, including countries in Asia, Africa and the Western Pacific spend less than one-tenth per person on health compared with Australia, and also much less on education.
Preparation for practice as registered nurses and midwives in Australia is achieved through courses in Australian universities, with correlating clinical practice and assessment in health, aged and other facilities and in the Australian community. Courses for the education of nurses and midwives in many other countries are quite different from the standard required for the education of nurses and midwives in Australia. Therefore many nurses and midwives from other countries require significant further education in Australia in order to be registered in this country.
The following guidelines relate only to education leading to registration as a nurse and are not necessarily extrapolated to the education of midwives or enrolled nurses. If there is a need for similar guidelines for midwifery or enrolled nurse education, then these may be developed in the future.
Some Australian universities have submitted courses which require prior nursing or other qualifications for entry and which enable students to complete the respective courses in approximately two years, rather than the usual three years. If the shorter courses have been submitted to the Nurses and Midwives Board and have been recognised by the Board, then registration as a nurse can usually be facilitated. When applying to the Nurses and Midwives Board, each applicant for registration must demonstrate prior achievement of appropriate course entry requirements together with completion of all subjects that comprise the recognised course.
Where a student undertakes an unrecognised course or part of a recognised course, then an application for registration will usually take longer to assess and will not be approved if it is not clear that the education is adequate for registration.
The following guidelines will assist students, who are proposing to undertake unrecognised courses in Australia or less than the full curriculum in recognised courses, and who will therefore not be entitled to facilitated consideration of an application for registration. The guidelines do not guarantee that the education will be considered adequate for registration and it remains preferable that students who are intending to apply for registration undertake all subjects in accord with the curriculum of a recognised course. However the guidelines suggest a minimum which will generally provide strong support for an application for registration.
Universities are encouraged to enrol students in all subjects in courses that have been recognised by the Nurses and Midwives Board. Where there is justification for enrolling cohorts of students in different, possibly shorter courses, a university may submit the different course for consideration by the Nurses Practice Committee, so that there can be certainty that the education will be adequate for registration and so that students will be able to have applications for registration facilitated.
To assist persons educated in other countries and aspiring to register as nurses in New South Wales without completing all subjects in a recognised course, the following guidance is offered to assist in identifying studies which will generally support an application for registration as a nurse. While the guidelines are intended to assist intending applicants for registration, these study patterns do not constitute recognised courses and do not guarantee registration.
Categories one, two and three refer to persons who have completed nursing courses in other countries and are registered/licensed by the applicable registration authorities in these countries.
Category four may include some persons who have undertaken part or all of a course in nursing or another discipline at high standard universities.
In summary
- if prior education was undertaken at a university which is considered by the Nurses and Midwives Board to be at the standard of Australian universities*, then either category one or category four may be applicable.
- if prior education in nursing included at least two years full-time equivalent education at post-secondary school level, then category two may be applicable.
- if prior education in nursing consisted of post-secondary education of less than two years full-time equivalent, category three may be applicable.
- if prior education in nursing was undertaken at secondary school level, then category three may be applicable.
* explained under category one below.
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1. Category One
This category is applicable when
- persons have completed a nursing course undertaken at a university which is considered by the Nurses and Midwives Board to be at the standard of Australian universities, and
- the course curriculum has permitted significant progress towards achievement of the Australian National Competency Standards for the Registered Nurse; and
- the course graduates have been registered/licensed to practise as "first level" or "professional" nurses (however titled) by the relevant registration/licensing authority in the state or country where the course was undertaken; and
- the course was completed less than ten years prior to enrolment in the nursing course at an Australian university recognised by the Board OR the person provides credible professional references attesting to practice as a first level nurse for at least three years in the ten year period prior to enrolment in an Australian university.
Many institutions in other countries, although titled "universities" are not considered to have the standards of Australian universities. At this time and subject to review in the future, the Nurses and Midwives Board will utilise information from Australian Education International - National Office of Overseas Skills Recognition (AEI-NOOSR) and will accept the universities in the first list (however titled) for each country provided that the institution is not also listed in another category. The first list of higher education institutions is sometimes referred to as "section 1 universities" or "quality universities". However where an institution is also listed in a second category such as "Higher Education Section 2" or "Technical and Vocational Education", it cannot be presumed that the institution is all at the highest level and it would be prudent to regard the institution as being at the lower of the categories unless other conclusive information can be ascertained.
Some persons who have completed some courses in "Section 1" universities may be eligible for registration in New South Wales without undertaking any further education, however some persons may have completed courses at a lower level than an Australian bachelor degree or their courses may have omitted significant components required in the education of registered nurses in this State.
Persons in this category should undertake at least one year full-time or full-time equivalent of university study in a university recognised by the Nurses and Midwives Board to provide education for registered nurses. At a minimum, the course should consist of one-third of the subjects/credit points that constitute a three-year course recognised by the Nurses and Midwives Board for the education of registered nurses, and the one year of study must include
- an introduction to the Australian health care context including the health needs of Aboriginal and Torres Strait Island people, and
- final year subjects which include clinical nursing practice and assessment against the ANMC competency standards for the registered nurse.
If the person's education in the other country did not include any of the following, then these should also be included in the course studied in the recognised university in Australia:
- medical and surgical nursing (both theory and practice) (also see note) and
- mental health nursing (both theory and practice) and
- aged care nursing (both theory and practice) and
- community nursing or primary health care nursing (both theory and practice)
Examples of students in this category could include
- registered nurses from the United Kingdom who have been educated in a university but at lower than degree level and/or without preparation for practice with the full range of clients required in New South Wales.
- persons holding degrees in nursing from some (but not all) universities in Iran and permitted to practise nursing in that country.
- persons holding degrees in nursing from one of the top group of universities in China and registered by the applicable registration body.
Category One does not include persons educated as nurses in the Philippines. Most students enter university in the Philippines after only ten years of schooling so that the first years of higher education are considered to be more like years eleven and twelve of secondary school in Australia. On available information, the standard course taught in all education institutions in the Philippines is not considered to permit significant progress towards achievement of the Australian National Competency Standards for the Registered Nurse. At this time, nurses educated in the Philippines should be considered under Category Two, if eligible.
Category One does not include persons educated as nurses in India. Although there are some high standard universities in India, it has not been possible to confirm that any of these universities is recognised by the Indian Nursing Council to conduct nursing courses. The Indian Nursing Council is the body which, under Indian legislation, grants recognition for international purposes. Therefore all nurses educated in India should be considered under Category Two.
- In some countries, particularly China, nursing schools, other trade and vocational level schools, secondary schools and pre-schools may be attached to universities. Attachment to a university is not the same as being a faculty or school within a university. "Attached" schools are often at secondary school level or, sometimes, at post-secondary level but not higher education.
- In documents from some countries, including China, reference is made to schools of nursing in a teaching hospital of a university. Some translations may imply that the hospital-based school was located in the university. In some instances, hospitals and hospital nursing schools are located on or adjacent to a university campus but this does not bring the nursing school under the academic auspices of the university.
- In some countries, nursing courses are conducted at varying levels and documents may not always be clear about the level of the institution at which the course was undertaken. In China nursing courses may be undertaken at secondary school level, post-secondary vocational level, various types of higher education, and at university level. There is also wide diversity in university standards and not all universities are considered to be at the standard of Australian universities.
- Even the AEI-NOOSR listing may be open to different understandings. For example, at the time of preparation of this document, the National Taichung Nursing College in Taiwan is listed as both a Higher Education Institution Section 1 and a Technical and Vocational Education Institution. When one looks closely at the institution's education offerings, there are no degree level qualifications and it offers only three diploma courses, two in nursing and one in beauty therapy. It is very difficult to understand how it could have been considered a Section One Higher Education Institution and its inclusion is perceived as an almost-certain error. Thus, even in using the AEI-NOOSR listings as a reference, prudence is warranted.
- Where AEI-NOOSR lists an organisation in two categories e.g. as a Higher Education Section 1 Institution and a Technical and Vocational Education institution, prudence dictates that there be a presumption courses may be at the lower level unless it can be clearly demonstrated otherwise.
- Even in countries with education systems largely similar to that in Australia, not all higher education institutions, even those identified as "universities" or similarly titled, are necessarily considered to be at the standard of Australian universities and the standing of each institution should be checked individually.
Thus, in considering the study pattern for intending students, it is recommended that decisions be conservative. It should be presumed that courses were undertaken at the lower levels unless it can be demonstrated that the education was (a) undertaken at a higher level institution, and (2) at the higher level of qualifications.
Where it is desired to make a case that, notwithstanding the views of AEI-NOOSR, a particular institution is similar to Australian universities, it would be necessary to refer to the Board's document Characteristics of Australian Universities and provide evidence that the particular institution reflects the identified characteristics. Supporting documentation such as university annual reports, university handbooks, and/or documents issued by government or accrediting organisations should accompany any submissions regarding education institutions. |
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2. Category Two
Category two includes persons
- who have completed a nursing course at post-secondary level and of at least two years full-time or full-time equivalent duration, and
- have been registered/licensed to practise as "first level" or "professional" nurses (however titled) by the relevant registration/licensing authority in the states or countries where the courses were undertaken; and
- the courses were completed less than ten years prior to enrolment in the nursing course at an Australian university recognised by the Board
OR
the person has practised as a nurse (not necessarily first level) for at least three years in the ten year period prior to enrolment in an Australian university.
The education may have been undertaken at a university not considered to be sufficiently similar to Australian universities or the education may have been undertaken at technical/vocational level. However the education must have been undertaken at post-secondary school level.
Persons in category two are required to undertake a further two years full-time or full-time equivalent education in an Australian university recognised by the Nurses and Midwives Board to provide education for registered nurses. At a minimum, the course should consist of two-thirds of the subjects/credit points that constitute a three-year course recognised by the Nurses and Midwives Board for the education of registered nurses, and the two years of study must include
- sufficient biological sciences and behavioural/social sciences and
- an introduction to the Australian health care context including the health needs of Aboriginal and Torres Strait Island people, and
- medical and surgical nursing (both theory and practice) (also see note) , and
- mental health nursing (both theory and practice), and
- aged care nursing (both theory and practice), and
- community nursing or primary health care nursing (both theory and practice), and
- final year subjects which include clinical nursing practice and assessment against the ANMC competency standards for the registered nurse.
Examples of students in this category could include
- a person who has completed a post-secondary nursing course in China and is registered as a nurse in China;
- a person who has completed a nursing course in India and is registered as a Registered Nurse (RN) by the Indian state or territory nursing board in the state or territory in which the course was undertaken;
- a person who has completed a nursing course in the Philippines and has been registered as Registered Nurse (RN) by the Nursing Board of the Philippines (which operates within the structure of the Professional Regulation Commission in the Philippines);
- persons educated as nurses in some countries of western Europe such as Germany and France, and registered with the appropriate authority;
- persons educated as nurses in some countries of Africa such as Nigeria, Ghana, Zimbabwe and South Africa and registered with the relevant nursing board/council as registered or first-level nurses (however titled).
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3. Category Three
Category Three includes persons who have
- completed nursing courses of less than two years full-time equivalent at post-secondary level
OR
completed nursing courses at secondary school level; and
- have been registered/licensed to practise at any level by the relevant registration/licensing authorities, if applicable, in the states or countries where the courses were undertaken; and
- the courses were completed less than ten years prior to enrolment in the nursing course at an Australian university recognised by the Board
OR
the persons provide credible professional references attesting to practice as nurses (not necessarily first level) for at least three years in the ten year period prior to enrolment in an Australian university.
This category also includes persons educated as second level nurses recognised by a nurse registering authority (i.e. enrolled nurse, licensed practical nurse, vocational nurse, technical nurse etc. however titled).
This category also includes many nurses educated in Eastern European countries and in China.
Persons in this category are required to undertake a further two and a half years full-time or full-time equivalent education in an Australian university recognised by the Nurses and Midwives Board to provide education for registered nurses. At a minimum, the course should consist of five-sixths of the subjects/credit points that constitute a three-year course recognised by the Nurses and Midwives Board for the education of registered nurses, and the two and a half years of study must include
- sufficient biological sciences and behavioural/social sciences and
- an introduction to the Australian health care context including the health needs of Aboriginal and Torres Strait Island people, and
- medical and surgical nursing (both theory and practice) (also see note) , and
- mental health nursing (both theory and practice), and
- aged care nursing (both theory and practice), and
- community nursing or primary health care nursing (both theory and practice), and
- final year subjects which include clinical nursing practice and assessment against the ANMC competency standards for the registered nurse.
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4. Category Four
Category Four includes persons who have undertaken some or all of a nursing or other course at an Australian university or at a university which, although located in another country, is considered to be at the standard of Australian universities. Many institutions in other countries, although titled "universities" are not considered to have the standards of Australian universities. At this time and subject to review in the future, the Nurses and Midwives Board will utilise information from Australian Education International - National Office of Overseas Skills Recognition (AEI-NOOSR) and will accept the universities in the first list (however titled) for the country provided the institution is not also listed in another category. The top higher education institutions are sometimes referred to as "section 1 universities" or "quality universities". However where an institution is also listed in a second category such as "Higher Education Section 2" or "Technical and Vocational Education", it cannot be presumed that the institution is all at the highest level and it would be prudent to regard the institution as being at the lower of the categories unless other conclusive information can be ascertained.
Generally, if a person has undertaken part or all of a nursing or other course at one of these universities within seven years prior to enrolment in, or ten years prior to completion of studies in, an Australian university recognised by the Nurses and Midwives Board to provide educational preparation for registered nurses, then the person may be given credit for any subjects in the Australian nursing course if it can be shown that 80% of the content and learning objectives were encompassed in one or more subjects studied and passed at the high-standard international university.
If more than seven years has elapsed between prior study and commencing a course in an Australian university or ten years between prior study and completing the course in an Australian university then, with the below-mentioned exception, the person should undertake all subjects in the recognised course at the recognised Australian university. If the studies were undertaken outside the above timeframe but the person demonstrates significant professional application of professional learning within the period prior to enrolment in an Australian university, then it may be possible to continue to consider the prior studies as having retained currency (for example a person who completed a pharmacy degree fifteen years ago but has been practising pharmacy for at least three years within the ten year period immediately prior to enrolment in a nursing course in an Australian university).
Persons who have qualified as medical practitioners or other health professionals in Australia or other countries prior to commencing a nursing course in a university recognised by the Nurses and Midwives Board, may be considered under Category Four, if
- prior education was undertaken at an Australian university or, in another country, a university which is considered by the Nurses and Midwives Board to be at the standard of Australian universities and
- the prior course was completed less than ten years prior to enrolment in the nursing course at an Australian university recognised by the Board OR the person provides evidence of registration and credible professional references attesting to practice in the relevant health profession for at least three years in the ten year period prior to enrolment in an Australian university.
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General Notes
These notes are intended to assist decision-making in regard to enrolment in a university course under the above categories.
As noted above, under Category One, attachment of a school to a university is not the same as being a faculty or school within a university. Courses are conducted at varying levels and documents may not always be clear about the level of the institution at which the course was undertaken, and not all universities are considered to be at the standard of Australian universities.
Further, there are institutions with similar names. For example, someone who does not speak English as a first language and is not familiar with Australia, may not appreciate that the University of Sydney and the University of Technology Sydney are separate institutions. It may not be appreciated that organisations currently using the title "Sydney College" (such as Sydney College of Business and IT, Sydney College of Skin Care, Sydney College of Divinity, Sydney College of English, Sydney Community College and Sydney International College of Business) are not the same as Sydney College of Advanced Education which was formerly recognised to conduct nursing courses and has since been incorporated into the University of Sydney. So, even trying to make allowances for previous names of organisations or fore-runner institutions can easily lead to errors for those who are not familiar with subtle variations in name, especially when relying on translations from another language about institutions in foreign systems.
A hospital-based nursing school operated in a "university teaching hospital" is very different from the faculty of nursing within a university. Again, if unfamiliar with the language and system in another country, and if reliant on translations, it can be very easy to make errors.
Therefore it is recommended that, in considering the study pattern for intending students, decisions be conservative. It should be presumed that courses were undertaken at the lower levels unless it can be demonstrated that the education was undertaken at a higher level institution.
The information in this document relates to consideration of credit for prior study in the context of graduates intending to seek registration as nurses. The information is applicable for registration purposes, irrespective of any different policies or rules which universities may use for academic or other purposes. |
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This document was subject of consultation between representatives of the Board and Deans/Heads of Schools of Nursing and Midwifery during 2008 and replaces a previous document. This document was issued in December 2008. |
Notes on particular countries
The following notes are subject to change as additional information becomes available. Some of the institutions have previously been known by other names and the AEI-NOOSR website may record such changes.
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