Posted on September 21, 2007

To Stem Nursing Shortage, State Plans to Send Bilingual Students to Mexico

Keith Darcé, San Diego Union-Tribune, September 16, 2007

With nursing schools in California falling several thousand graduates short of meeting demand each year, state labor officials are seeking help in an unlikely place.

If all goes as planned, as many as 40 bilingual Californians now stuck on nursing school waiting lists will begin classes in January at a college in Guadalajara, Mexico—apparently the first attempt by any state to outsource nursing education to another country.


Some critics, however, worry that nurses trained in Mexico won’t learn the same skills—especially those involving technology—as their U.S.-educated counterparts.

“Wouldn’t it be better to take those bilingual (students) and help them get into nursing school here?” said Lorie Shoemaker, chief nurse executive for Palomar Pomerado Health District, the operator of two North County hospitals. “I think the money could be better served keeping it here at home.”

The Mexico program is the latest of numerous attempts—some unorthodox—by the state and the health care industry to address what has become a chronic shortage in nursing school graduates.


The program, which could begin as soon as January, will be open to students who speak English and Spanish and are waiting to be admitted into a California nursing school program, said Leach, the workforce development agency’s assistant secretary for policy and program development.

The students will spend their first year attending classes and doing clinical work in Guadalajara, which is Mexico’s second-largest city with a population of 3.6 million. They will return to California for clinical training before heading back to Guadalajara for their final year of studies.

Once they graduate, the students could be required to work for a period of time—possibly two years—in a bilingual community in California where their language and health care skills are most needed.


The cost for educating and housing each student in Mexico will be about $20,000, or about half the cost of providing the same education in California, Leach said.


The agency hasn’t worked out how to pay for the program, though Leach said funding sources likely will include the state, private contributors (such as hospitals) and the students whose fees will be “nominal.”

The agency is considering two colleges in Guadalajara to host the program, said Leach, declining to name them.

It’s also unclear how the students will be treated by California’s nurse licensing board once they graduate.


Not everyone sees the program as an answer to the state’s shortage of nursing graduates.

“Why there and not here?” asked Sally Brosz Hardin, dean of the University of San Diego’s Hahn School of Nursing and Health Science. “Why not provide the resources to provide the faculty we need and pay them what they deserve, so that we can educate the students here?”


The program is an indictment of the state’s commitment to maintaining an adequate work force of nurses, said Donna Fox, a regulatory policy specialist for the California Nurses Association.

“This illustrates very dramatically how underfunded California’s nursing education system is,” she said. “We think it’s a real shame that prospective RN’s can’t get educated in their own communities.”