Study Finds Only 35 Percent Of Immigrant Nurses Originally Intended To Work In Nursing

Canada’s health care system is relying more than ever on internationally educated nurses, but a new joint study by Immigration, Refugees and Citizenship Canada and Statistics Canada shows that intentions at the time of immigration do not always match employment outcomes. Using data from the Integrated Permanent and Non-permanent Resident File linked to the 2021 Census, the study followed economic principal applicants admitted between 2010 and 2020, aged 18 to 54, who said they intended to work as nurses. It found that about 63 percent actually worked in nursing in 2021, while roughly one-quarter were in lower-skilled jobs or not working at all, and that Canadian work experience before becoming a permanent resident was a decisive factor in whether they reached their goal.

At the same time, the study looked at everyone who worked as a nurse in 2021 and found that only 35 percent had originally declared nursing as their intended occupation, while 65 percent became nurses later, after immigration. This underscores how dynamic immigrant career pathways are, especially in a sector facing critical shortages.

Nursing shortages and immigrant intentions

The backdrop is a sustained staffing gap. In nursing and residential care facilities, the job vacancy rate stood at 7.7 percent in the third quarter of 2022 and improved to 4.6 percent by the third quarter of 2024. Over the same period, the all-industry vacancy rate fell from 5.6 percent to 3.2 percent. With an aging population and post-pandemic burnout, these numbers highlight why the federal 2025-2027 Immigration Levels Plan prioritizes economic immigration to fill critical roles in health care.

For the first research question, the study focused on 12,651 economic principal applicants who, at admission between 2010 and 2020, had self-reported an intended occupation in nursing. This group included nursing coordinators and supervisors, registered nurses and registered psychiatric nurses, and licensed practical nurses.

Their eventual jobs in 2021 were grouped into six categories: staying in nursing, other skilled health, lower-skilled health, skilled non-health, lower-skilled non-health, and not working in 2020 and 2021. Overall, 63.4 percent stayed in nursing occupations, 1.9 percent moved to other skilled health roles, 13.4 percent were in lower-skilled health jobs, 9.7 percent were in skilled non-health occupations, 7.8 percent held lower-skilled non-health jobs, and 3.9 percent did not work in either 2020 or 2021.

Different nursing intentions led to different outcomes. Among those who intended to work as licensed practical nurses, 74.0 percent were in nursing roles in 2021, compared with 61.0 percent of those who intended to become registered nurses and registered psychiatric nurses, and 54.6 percent of those who had aimed to be nursing coordinators or supervisors. The narrower scope of practice and shorter training pathway associated with practical nursing appears to make alignment more achievable, even though the study notes that once sociodemographic factors are controlled for, these differences are no longer statistically significant.

From a consulting standpoint, this confirms what practitioners often see: the more complex and regulated the role, the more vulnerable it is to licensing delays, bridging requirements and mismatches between overseas credentials and Canadian standards.

Why Canadian work and study experience are so powerful

One of the clearest findings is the impact of Canadian work experience before permanent residence. Among intending nurses with such experience, 80.9 percent were actually working in nursing by 2021, compared with 53.3 percent of those without it. In absolute terms, 4,596 of the 12,651 had Canadian work experience before admission, while 8,055 did not. The alignment gap of roughly 28 percentage points not only persisted after adjusting for age, gender, education, language and other factors, it became even larger in the multivariate analysis.

Canadian study experience also helped. Immigrants with prior Canadian study experience had an alignment rate of 84.3 percent, versus 59.2 percent for those who had never studied in Canada. Here, 2,087 had Canadian study experience and 10,564 did not. The raw difference is about 25 percentage points, but the study shows that less than one-third of this advantage remained after adjusting for characteristics, largely because many who had studied in Canada had also worked here beforehand. In practice, study and work pathways are closely intertwined.

Immigration category also mattered, but mostly because of its link to Canadian experience. Among intending nurses:

• Federal Skilled Worker Program applicants had a 61.2 percent alignment rate
• Provincial Nominee Program applicants had 63.8 percent alignment
• Canadian Experience Class applicants had 86.8 percent alignment
• Other economic class applicants had 37.5 percent alignment

On the surface, the gap between the Canadian Experience Class and the Federal Skilled Worker Program is 26 percentage points, but once Canadian work experience and other covariates are considered, the difference shrinks to about 4 percentage points and is no longer statistically significant. In other words, what really makes the difference is prior Canadian work, not simply the label of the immigration stream.

For nurses considering economic immigration pathways, the study indirectly points toward some common eligibility elements to plan for:

• Demonstrable skilled work experience in a recognized health occupation
• Post-secondary nursing education at college or higher level, matching regulatory requirements
• Proven ability in English or French through approved language testing
• Sufficient settlement funds or qualifying employment, depending on the program
• Meeting medical, criminal and security admissibility criteria

From an immigration practice angle, economic candidates who can combine Canadian work and study with one of these programs are significantly more likely to end up working in nursing rather than drifting into lower-skilled roles.

Who actually becomes an immigrant nurse in Canada

Among immigrants admitted between 2010 and 2020 who were working as nurses in 2021, only about one third had actually indicated nursing as their intended occupation at admission (35%), while about two thirds moved into nursing after becoming permanent residents (65%). In simple terms, most immigrant nurses in 2021 did not originally come to Canada with nursing as their stated career goal.

Those who had intended to work as nurses were mostly economic principal applicants (95.2% the clear higher end), while among those who had not planned on nursing, only 34.9% were economic principal applicants (the lower end). The rest of this second group were more often economic spouses and dependants, family class immigrants or refugees. This shows a clear split: planned nurses are typically the main economic applicants, while later-entry nurses more often arrive through family or accompanying routes.

Age at admission also separates the two groups. Nurses who did not originally intend to work in nursing were generally younger. In that group, 19.0% were between 18 and 24 years old (about 19% the higher end for that age band), compared with only 3.0% in the intending-nurse group (about 3% the lowest end). This fits the idea that younger newcomers are more likely to retrain in Canada and then choose nursing.

Education levels are strong in both groups, with a majority holding at least a bachelor degree. Among those who intended nursing, about 64% had a bachelor degree (their main education level), while just over half of those who switched into nursing later did so (55.1%). A key difference is where the top credential was obtained: 17.3% of intending nurses earned their highest education in Canada, compared with 32.6% among nurses who moved into the profession after arrival (about 33% the higher end). This highlights how Canadian education is a major gateway into nursing for many newcomers who did not start out in this field.

Language patterns are broadly similar, with a large majority in both groups reporting English as their only official language at admission (94.5% among intending nurses and 87.2% among later-entry nurses). However, the share without English or French is roughly double among those who did not plan for nursing, which can add extra steps in licensing and integration.

Pre-admission Canadian work and study experience appears at similar levels in both groups, with just under half having worked in Canada before landing and about one fifth having studied in Canada. The real difference shows up after immigration in job quality. Around 80.6% of nurses who had planned nursing were working full time (about 81% the higher end), compared with 68.8% among those who had not originally targeted nursing (about 69% the lower end between the two groups). Their average weekly earnings were also higher, at 2,418 dollars compared with 1,740 dollars.

From an immigration consulting perspective, this pattern suggests that those who plan for nursing from the beginning, obtain economic principal applicant status and organize their licensing steps early are more likely to secure full-time, better paid positions. At the same time, there is strong potential among spouses, dependants, family-class immigrants and refugees who move into nursing later, provided they receive more structured support with Canadian education, language and licensing so they can reach similar stability and income levels as those who arrived with a clear nursing plan.