Willow Health Media · Migration Brief

Global Trends in Nurse Migrations

A first detailed view of how the world's nurses are moving, where they train, where they work, and what's happening to the corridors that connect them. Based on the 2025 TruMerit Nurse Migration Report.

5.8M global shortage 1 in 7 nurses abroad 20,048 US-bound applicants · FY2025
Migration Pattern · 6 major corridors mapped

The world's nurse migration corridors.

Most flows run South to North, but a few cross-currents matter. Filipino and Indian nurses increasingly stop in the Gulf en route to the US, a mediated route created by visa retrogression, and African source countries are rising fast.

Major migration flows

Arrows show direction. Thicker arrows indicate larger known flows. Senders shown in rust, receivers in green, transit hubs in dashed amber. Hover for details · Click a highlighted country to isolate its flows · Double-click to jump to its corridor row · Scroll on the map to zoom.
Major sending country Major receiving country Transit / mediated hub
Philippines India Kenya West Africa Gulf transit Eastern Europe Canada
TruMerit VisaScreen FY2025 · WHO Report on Global Health Worker Mobility, 2023

Major corridors, ranked

01PhilippinesUnited States47% of US-bound applicants in FY2025. The single largest corridor in the world.Largest
02India / PhilippinesPersian GulfSaudi Arabia and the UAE are top transit hubs. ~3% of US-bound nurses pass through.Mediated
03Kenya & NigeriaUnited States & UKKenya alone now sends 11% of US applicants, up from 8% the year before.Rising
04IndiaUnited KingdomThe UK is the top destination for migrant nurses globally. India is a major source.Established
05CanadaUnited States9% of US-bound applicants. Most use the TN visa under USMCA.Stable
06South / Southeast AsiaAustralia & JapanSoutheast Asia's foreign-educated share now 24.87%, the highest of any WHO region.Growing
The mediated route
When direct migration to the US is blocked by visa retrogression, nurses don't give up, they detour. Filipino and Indian nurses spend years working in the Gulf, drawing salaries there, until their American visa entry date arrives. Saudi Arabia and the UAE are now among the top 5 countries where US-bound nurses are licensed but not educated.

The 2025 picture, in numbers

The world is short 5.8 million nurses, but the burden isn't shared. Roughly 78% of all nurses serve countries containing less than half the world's population, and rich countries continue to recruit from regions that can least afford it.

Methodology note: Aggregate figures from the WHO State of the World's Nursing 2025. US-specific data drawn from TruMerit's VisaScreen® applications, FY2025. Once a VisaScreen certificate is issued, TruMerit cannot track whether the migrant ultimately arrived in the United States.
5.8M
Aggregate global nursing shortage (2023)
Projected to 4.1M in 5 years
1 in 7
Nurses practising in a country other than where they trained
Rising trend
4.6B
People without access to essential health services
Half the global population
78%
Of all nurses serve countries with under half the world's people
▼ Distribution gap

Foreign-educated nurse share by region

Recent years (2021-2024) versus 10-year average · Europe & Southeast Asia only (source data available)
TruMerit analysis of WHO National Health Workforce Accounts data

Top destination countries

For migrant nurses, 2023
As of 2023, the United Kingdom and United States are the top two destination countries for migrant nurses. Germany, Australia, and Saudi Arabia are also significant destinations. No comparable ranked index data is available in the source report.
WHO Report on Global Health Worker Mobility, 2023
Headline
Europe's nurse density is roughly five times higher than Africa's or the Eastern Mediterranean's, and the gap is widening. The Global South is increasingly subsidising the aging populations and care needs of the Global North.

Three dynamics shaping the next decade

8%
Native-born share, UAE nurses
Roughly 90% of the Emirati nursing workforce is imported
3%
Mediated migrants
Stop in Gulf countries en route to the US
1 in 3
New graduates train in
The Americas or Europe, not where shortages are worst
94%
WHO member states
Report acting on workforce sustainability

Where US-bound nurses train.

The Philippines still dominates by a huge margin, but its share is slipping, and Kenya has just leapt past Canada to become the second-largest source country.

Top 5 countries of education

Share of US-bound VisaScreen applicants, FY2025 vs FY2024
TruMerit VisaScreen application data, fiscal years 2024-2025
47%
Philippines share of FY2025 applications
▼ from 51% in FY2024
11%
Kenya share of FY2025 applications
▲ from 8% in FY2024
9%
Canada share, now in third place
Overtaken by Kenya
5% & 5%
India and Nigeria, tied for fourth
India backlogged on EB visas
The shift
Kenya has overtaken Canada as the second-largest source of US-bound nurses. African source countries are becoming a more significant share of the pipeline, even as the US imposes visa pauses on 75 countries, including high-volume senders like Ghana and Nigeria.

Most US-bound nurses come on green cards.

Permanent residency dominates at 72.3% of FY2025 visas, but the H-1B share, at 12%, is the one to watch given recent fee changes and selection-process reforms.

Visa categories used

FY2025 VisaScreen applicants
TruMerit VisaScreen application records · FY2025

What each visa type means

In plain language

EB-3 (green card), Permanent residency, employment-based. The route most nurses take.

TN visa, Expedited work authorisation for Canadian and Mexican professionals under NAFTA/USMCA.

H-1B, Temporary specialty-occupation visa. Now subject to a $100,000 fee on new applications.

Other, A residual mix including dependents, exchange visas, and special categories.

The H-1B problem
Twelve percent of FY2025 nurse applications used H-1B visas. From September 21, 2025, new H-1B petitions face a $100,000 fee. From February 2026, the random selection lottery is replaced by a weighted system favouring higher-paid roles, a structure that disadvantages nurses.

Europe and Southeast Asia are absorbing more.

The traditional US-and-UK monopoly on migrant nurses is loosening. Foreign-educated share of the workforce is climbing fast in Europe and Southeast Asia, while it has dropped in the Eastern Mediterranean and African regions.

Foreign-educated nurse share of regional workforce

Recent (2021-2024) versus 10-year average · Europe & Southeast Asia only (source data available)
TruMerit analysis of WHO National Health Workforce Accounts data
8.01%
Europe foreign-educated share, recent
▲ from 5.96% (10-yr avg)
24.87%
Southeast Asia foreign-educated share, recent
▲ from 20.15% (10-yr avg)
8-10%
Native-born share of UAE nursing workforce
Built on imported labor
Foreign-educated share, Eastern Med & Africa
Dropped over 10 years
A shift in destinations
Europe and Southeast Asia are picking up the slack as the United States and United Kingdom become less welcoming. The UAE has built a regional health-tourism strategy on imported nursing labor, only 8-10% of its nursing workforce is Emirati.

Indian nurses wait twelve years for a green card.

Visa retrogression, when more applicants apply in a category than visas available, has created multi-year backlogs. The November 2025 Visa Bulletin shows the worst delays sitting on India's EB-2 and EB-3 categories.

Years of backlog by country and visa category

November 2025 Visa Bulletin · gap between cutoff date and present
U.S. Department of State, Visa Bulletin for November 2025

Final action dates by country, November 2025

Country EB-1 EB-2 EB-3
India 15 Feb 22 01 Apr 13 22 Aug 13
China (mainland) 22 Dec 22 01 Apr 21 01 Mar 21
Philippines Current 01 Dec 23 01 Apr 23
Mexico Current 01 Dec 23 01 Apr 23
Other Current 01 Dec 23 01 Apr 23
Mediated migration
Approximately 3% of FY2021-2024 US-bound nurses took a mediated route, usually licensed in Saudi Arabia or the UAE while waiting out US visa retrogression. Many work in well-paying Gulf countries for years before their American entry date arrives.

Eighty-eight percent of certificates are for nurses.

TruMerit certifies nine healthcare professions for US occupational visas. Registered Nurses dwarf every other category combined, clinical lab scientists are a distant second, and the rest are in the low hundreds or single digits.

Certificates issued by profession

FY2025 new orders · log scale to keep smaller categories visible
TruMerit VisaScreen FY2025 new-order issuance by professional category

The big two

01Registered NursesRN, by far the largest category16,887
02Clinical Lab ScientistsCLS, distant second2,237

Smaller specialties

03Physical TherapistsPT141
04Speech Language PathologistsSLP111
05Clinical Lab TechniciansCLT15
06Physical Therapy AssistantsPA14

Ethical recruitment, where it works.

TruMerit's Alliance for Ethical International Recruitment surveyed nurses recruited through certified ethical agencies. The results are mostly positive, but with one notable gap.

Ethical recruitment outcomes

Share of surveyed nurses reporting positive experience, by issue area
Alliance for Ethical International Recruitment Practices · 2025 survey
90%
Reported positive recruitment experience
Among certified ethical recruiters
97%
Received contract with adequate review time
Strong contracting practice
82%
Recruiter regularly communicated and addressed concerns
Communication gap of 18%
72%
Knew job location before arriving in the US
28% arrived without knowing
The location gap
Even among ethical recruiters, 28% of nurses don't know where they'll be working before they board the plane. That's the single largest weak point in an otherwise strong picture, and an obvious place to focus contracting reform.

Eight policy recommendations.

The report concludes with eight recommendations, each addressing a specific failure point in the global nurse migration system. They range from highly actionable to ambitious-but-vague.

REC 01

Permanent global forum

Create a multilateral, multistakeholder body dedicated to nurse migration. No such forum currently exists despite migration being inherently transnational.

REC 02

Bilateral agreements

Use bilateral agreements as model frameworks for nurse migration that respect nurses' rights, provide an ethical baseline, and deliver mutual benefit to sending and receiving countries.

REC 03

Portable credentials

Enable digital, portable, recognisable skills and rapid identification of competencies, so nurses' qualifications travel cleanly across borders.

REC 04

Standardised terminology

Develop a global, harmonised nursing terminology to enhance the visibility of nursing work, improve quality of care, and make qualifications comparable across systems.

REC 05

Better data sharing

Improve collection, treatment, and sharing of nurse migration and workforce data. Today's data is patchy enough to prevent serious cross-country analysis.

REC 06

AI-aware fraud detection

Build credentialing systems that combine human expertise with AI fraud detection. Gartner expects 1 in 4 candidate profiles to be AI-fabricated by 2028.

REC 07

Global certifications

Promote globally recognised certifications that validate the knowledge, skills, and qualifications of nurses against shared frameworks rather than fragmented national ones.

REC 08

Ethical recruitment tools

Develop tools and policies, like certification programs, to ensure ethical recruitment practices align with global standards. Survey data shows certification works.

Most actionable
Recommendations 3, 5, 6, and 8 are the easiest to start on, they have working models already (the EU's Union of Skills, TruMerit's Alliance code, AI fraud-detection tooling). Recommendations 1 and 7 are aspirational; they need political will that doesn't currently exist.