The EPA system for accepting nurse and certified care worker candidates is based on Economic Partnership Agreements (EPAs) concluded between Japan and Indonesia, the Philippines, and Vietnam. Under this framework, candidates for nursing and caregiving professions are accepted from these countries.

While the acceptance of Indonesian nurse and certified care worker candidates under this system has continued for nearly 20 years, many challenges have been identified.

This article focuses primarily on Indonesia and provides an overview of the EPA candidate acceptance system, the qualifications required to become a candidate, national examination results, and the challenges associated with the system.

What Is the EPA Nurse and Certified Care Worker Candidate Acceptance System?

System Overview

The Japan-Indonesia EPA (Economic Partnership Agreement) came into effect in July 2008. Based on this agreement, Japan began accepting candidates aiming to acquire national qualifications as nurses or certified care workers starting in fiscal year 2008.

Similarly, Japan also accepts nurse and certified care worker candidates from the Philippines and Vietnam.

The EPA candidate acceptance system allows foreign nationals who meet certain requirements to work or train at Japanese hospitals and care facilities for the purpose of acquiring national qualifications in Japan.

As an EPA-based framework, the primary objective of this system is not to fill labor shortages, but to strengthen bilateral diplomatic and economic ties. EPA nurse and certified care worker candidates are expected to obtain national qualifications and stay in Japan long-term. Candidates are required to make efforts toward passing the national examinations, while the accepting institutions (e.g., hospitals or care facilities) are obligated to provide training and support to help them achieve this goal.

Individuals employed under this program are granted a “Designated Activities” residence status. Before obtaining national certification, the status is “Designated Activities (Nurse Candidate)” or “Designated Activities (Certified Care Worker Candidate),” and changes to “Designated Activities (Nurse)” or “Designated Activities (Certified Care Worker)” after certification.

Sending Countries for EPA Nurse and Certified Care Worker Candidates

The countries currently sending EPA nurse and certified care worker candidates to Japan are Indonesia, the Philippines, and Vietnam.

Acceptance from Indonesia began in 2008, from the Philippines in 2009, and from Vietnam in 2014.

Coordinating Organization for the Acceptance of EPA Nurse and Certified Care Worker Candidates

The sole coordinating organization for accepting EPA nurse and certified care worker candidates is the Japan International Corporation of Welfare Services (JICWELS), a public interest incorporated association.

Institutions wishing to accept candidates must complete job registration and enter into employment placement agreements through the designated annual recruitment website operated by JICWELS. JICWELS handles all processes including matching, interviews, and training.

Maximum Number of Accepted Candidates

To ensure smooth acceptance and minimize the impact on Japan’s domestic labor market, a cap is set on the number of EPA nurse and certified care worker candidates accepted each year. The annual maximum is 200 nurse candidates and 300 certified care worker candidates from each country.

However, certified care worker candidates who are exempt from pre-arrival Japanese language training are not counted within this maximum quota.

How Indonesians Can Become EPA Nurse or Certified Care Worker Candidates

Requirements and Application Procedures

The requirements to become an EPA nurse or certified care worker candidate vary by country.

For Indonesian applicants, eligibility includes having graduated from a nursing program at a Diploma 3 (D3) level or higher educational institution and holding a valid nursing license in accordance with Indonesian law (i.e., possession of a Certificate III).

Requirements to Become an Indonesian EPA Nurse Candidate

• Must hold a Certificate III or higher from a nursing school in Indonesia or have graduated from a university nursing faculty within the country, and be a licensed nurse under Indonesian law
• Must have at least two years of clinical experience as a nurse
• Must have completed pre-arrival Japanese language training and attained approximately JLPT N4 level proficiency
• Must complete post-arrival Japanese language training and nursing orientation
• Must enter into an employment contract with a receiving institution in Japan through introduction by JICWELS

Requirements to Become an Indonesian EPA Certified Care Worker Candidate

Applicants must meet one of the following:

1. Hold a Certificate III or higher from a nursing school in Indonesia
2. Be a graduate of a university nursing faculty in Indonesia
3. Hold a Certificate III or higher from another university or higher education institution in Indonesia and be certified by the Indonesian government as a caregiver

Additional conditions:

• Must have attained approximately JLPT N4 level proficiency after completing pre-arrival Japanese language training
• Must complete post-arrival Japanese language training and caregiver orientation
• Must enter into an employment contract with a receiving institution in Japan through introduction by JICWELS

Eligible applicants must submit the required documents to their regional Indonesian Migrant Worker Protection Center (BP3MI), undergo screening, and register as candidates. Afterward, interviews and matching are conducted by JICWELS, leading to the conclusion of employment contracts.

Examinations and Training

• Pre-arrival Japanese Language Training (6 months)
• Post-arrival Japanese Language Training (6 months)
• Introductory Nursing/Caregiving Training (approx. 10 days)
• Employment Guidance covering EPA objectives, immigration control, labor laws, social insurance, and consultation procedures

Training Exemptions

• Exemption from Pre-arrival Training: JLPT N4 or N3 holders (acquired after April 1, two fiscal years prior to matching)
• Exemption from Both Pre- and Post-arrival Training: JLPT N2 holders or those with 12+ months of Japanese education at a certified institution

Process for Accepting EPA Nurse and Certified Care Worker Candidates

1. The receiving institution registers job posting via JICWELS recruitment site
2. JICWELS reviews and screens the posting
3. Employment placement/support agreements are signed
4. JICWELS sends job details to sending organizations; recruitment and screening take place
5. JICWELS conducts interviews and orientations
6. Matching is conducted
7. Employment contracts are signed
8. Pre-arrival training is conducted
9. Candidates begin work/training in Japan

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Company Formation in Indonesia

Period of Stay for EPA Nurse and Certified Care Worker Candidates

• Nurse Candidates: 1-year stay, renewable twice (total 3 years); may attempt national exam up to 3 times
• Care Worker Candidates: 1-year stay, renewable 3 times (total 4 years); must take national exam in 4th year (1 attempt only)
• After Certification: Residence status changes to 3 years; renewable without limit; family accompaniment allowed

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National Examination Results for EPA Nurse and Certified Care Worker Candidates (Indonesia, Philippines, Vietnam)

This section presents the national examination results from the past three years for EPA nurse and certified care worker candidates. The figures include both first-time and repeat test takers who were current EPA candidates at the time. The total number for all EPA candidates also includes individuals who reentered Japan after returning to their home countries to retake the examination.

Nursing Examination

2022 (111th Exam)

Country	Examinees	Passers	Pass Rate
Indonesia	76	4	5.3%
Philippines	101	9	8.9%
Vietnam	90	24	26.7%
Total (incl. returnees)	370	45	12.2%

2023 (112th Exam)

Country	Examinees	Passers	Pass Rate
Indonesia	53	6	11.3%
Philippines	84	12	14.3%
Vietnam	84	42	50.0%
Total (incl. returnees)	335	75	22.4%

2024 (113th Exam)

Country	Examinees	Passers	Pass Rate
Indonesia	54	0	0.0%
Philippines	76	4	5.3%
Vietnam	58	10	17.2%
Total (incl. returnees)	294	17	5.8%

Source: Ministry of Health, Labour and Welfare, “Results of the National Nursing Examination for EPA Foreign Nurse Candidates”

Certified Care Worker Examination

2022 (34th Exam)

Country	Examinees	Passers	Pass Rate
Indonesia	448	122	27.2%
Philippines	380	96	25.3%
Vietnam	186	156	83.9%
Total (incl. returnees)	1,014	374	36.9%

2023 (35th Exam)

Country	Examinees	Passers	Pass Rate
Indonesia	538	343	63.8%
Philippines	435	238	54.7%
Vietnam	180	173	96.1%
Total (incl. returnees)	1,153	754	65.4%

2024 (36th Exam)

Country	Examinees	Passers	Pass Rate
Indonesia	189	42	22.2%
Philippines	155	33	21.3%
Vietnam	177	153	86.4%
Total (incl. returnees)	521	228	43.8%

Source: Ministry of Health, Labour and Welfare, “Results of the 36th National Certified Care Worker Examination for EPA Foreign Candidates”

Retaking the Examination After Failing

EPA candidates who fail the national examination in their final year of residence may be granted a one-year extension as special-case candidates, allowing them one additional attempt. Additionally, even if they return to their home country, they may reenter Japan on a “Temporary Visitor” visa or other legal status to retake the exam. Switching to the “Specified Skilled Worker (i)” residence status is also possible.

Reasons for the Low Pass Rates Among EPA Candidates

While the overall pass rate for Japan’s national nursing exam hovers around 90%, and the certified care worker exam around 70%, EPA candidates consistently show significantly lower pass rates. The main reason for this is the difficulty of mastering the Japanese language, which has a unique script and grammar, and is full of technical terminology in both nursing and caregiving fields.

Vietnamese candidates tend to have higher pass rates than their Indonesian and Filipino counterparts due to stricter entry requirements. While Indonesians and Filipinos are expected to reach JLPT N4 level after 6 months of pre-arrival training, Vietnamese candidates undergo 12 months of training and are required to have passed JLPT N3 before arrival. This means they arrive in Japan with a higher level of proficiency, improving their chances of passing the exams.

Challenges in Accepting Indonesian EPA Nurse and Care Worker Candidates

Systemic and Institutional Issues

Purpose of the Program vs. Workforce Demand

Although the EPA framework is intended to promote bilateral relations, not solve labor shortages, in practice, many receiving institutions accept candidates primarily to fill labor gaps. In some facilities, EPA candidates work alongside technical intern trainees, specified skilled workers, and international students—making it difficult for staff to distinguish between different programs and roles.

Support Systems at Receiving Institutions

Receiving hospitals and care facilities are obligated to support EPA candidates in preparing for national exams, but in reality, the support provided varies widely. Some institutions ensure study time, assign mentors, and offer training. Others provide no support and treat EPA candidates merely as supplemental labor.

Issues such as unpaid overtime, harassment, and bans on religious garments like the hijab have also been reported.

Barriers to National Certification and Employment

Difficulty of Passing the National Exam

Despite government efforts—such as adding furigana to kanji and extending exam time—pass rates remain low and inconsistent.

High Barriers to Application

Application requirements for Indonesian candidates are strict. Nurse candidates must have at least two years of clinical experience. Leaving a secure position in Indonesia to risk failing the exam in Japan is a difficult decision. If they fail, candidates must return home and restart their careers.

Care worker candidates must also have graduated from a nursing school or university program, making the pool of eligible applicants smaller than for the Specified Skilled Worker program, which only requires vocational training. Many candidates hesitate to apply due to the potential disruption to their careers.

Language Barriers

Even after one year of intensive Japanese training, many candidates struggle with dialects, honorific language, name readings, and communicating with elderly or disabled patients. Even successful candidates may eventually return home due to ongoing language difficulties in the workplace.

Employment After Returning Home

Those who return to Indonesia—either due to failing the exam or not adapting to the workplace—often find that their time in Japan has created a career gap. With outdated local experience and advancing age, it can be difficult to re-enter the healthcare field. Many end up taking unrelated jobs.

There are growing calls to establish a framework that allows Japanese work experience to be recognized in the Indonesian job market.

A Program Fraught with Challenges

The EPA system is meant to enable candidates from Indonesia, the Philippines, and Vietnam to train, obtain national certification, and contribute to Japan long-term. However, it faces serious challenges: uneven support, low pass rates, difficult career paths, and conflicts with other labor programs.

Improving the system to ensure mutual benefit for candidates and Japanese institutions is essential.

For businesses interested in introducing or hiring personnel from Indonesia, please contact PT. TRICRUISE MARKETING INDONESIA.