Good afternoon, everyone.

Good afternoon. My name is Jean Daniel Jacob. I'm the executive director of the Canadian Association of Schools of Nursing. I am new in the position. I was appointed at the beginning of November. My previous role was as the director of the school of nursing at the University of Ottawa. While I will provide a pan-Canadian perspective on this issue, I also have some hands-on experience related to the admission of international students in nursing programs.

For context, the Canadian Association of Schools of Nursing, or CASN, is a national voluntary association that is located on the unceded territory of the Algonquin people. It represents baccalaureate and graduate education programs in nursing. These are entry-to-practice programs for registered nurses and nurse practitioners as well as programs that result in master's and Ph.D.s in nursing.

The organization's mission is to support the delivery of high-quality nursing education through accreditation of schools and their respective nursing programs; the creation of standards, resources and continuing education that promote excellence in teaching; and representing nursing education nationally, which is why I am before you today.

International students make up a relatively small percentage of enrolment in nursing programs. The most recent data we have comes from Statistics Canada prior to the pandemic. Around 2.6% to 4.7% of enrolments were from international students in nursing programs.

CASN collects information from schools of nursing each year on the number of applications, admissions and enrolments of students and graduates from nursing programs. Unfortunately, we currently do not monitor the number of applications and enrolments from international students. However, it is possible to look at the global effects of the reforms when considering their full impact on nursing programs, both direct and indirect.

Following the COVID-19 pandemic, Canada experienced an acute nursing shortage that continues to impact health care today. In response to this acute need for nurses, provincial governments called for an increase in nursing seats and compressed programs across Canada. This short-term provincial funding allowed the schools to respond to this crisis by increasing seats in most nursing programs, including registered or licensed practical nursing programs, registered nursing programs and nurse practitioner programs.

There's a direct tension between the provincial funding for nursing seats and regulatory reforms that impacts budgets at universities and colleges overall. The overall decreases in budgets end up affecting nursing schools and their programs by increasing the workloads of smaller numbers of faculties and staff and diminished supports and services to both professors and students—for example, in mental health services and writing centres.

It's important to mention that the international student cap and other related regulatory changes are felt more in rural communities and institutions. For example, some universities and colleges in Atlantic Canada have higher proportions of international students. Beyond the financial implications for schools, we can see in certain locations a reliance on international student nursing graduates in order to fill shortages in local health care institutions. This is particularly true of programs that operate in linguistic minority contexts and rely on international students to meet their increasingly diverse health industry and population needs.

Current reforms are therefore significantly affecting provinces' health human resource needs and the increasing vulnerability of precarious yet essential nursing programs. In the short term, the decisions affect the viability of programs through program closures, layoffs, hiring freezes and so on. In the long term, they affect the academic institutions' capacity to address the increasing needs of diverse populations.

It's also important to note that, overall, the current international enrolment doesn't even meet the new threshold set by the governments, suggesting a deterring effect on international students' willingness to study in Canada following the reform.

Another impact of the reform is on the number of master's and Ph.D. students in nursing. Canada has a shortage of Ph.D. and master's prepared nurses. Highlights from our national faculty and student survey show that, in 2023, schools were unable to fill 78 permanent and long-term contract faculty positions. Schools projected a need to hire 200 permanent and 110 long-term contract faculty positions in 2024. Seventy-seven permanent faculty retired in 2023. Roughly 40% of schools reported a lack of nurses with Ph.D.s or master's degrees applying to faculty positions.

Delivery of sustainable education programs and the creation of a sustainable workforce require careful consideration from institutions and provincial and federal governments. All students, including international students, should enter a nursing program that has the physical and human resources, including classroom space, lab equipment, clinical placements for high-quality educational experience, successful program completion and students who are well-positioned to pass the registration exam. Graduate education in nursing is required for most faculty positions within schools of nursing and, therefore, has a direct impact on the sustainability of the nursing workforce.

I'm happy to take some questions afterwards.

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