Thérèse Rizk was considered a top nursing student at her school in Montreal and she was looking forward to getting to work in the provincial health-care system, which is in dire need of staff.
All she had to do was pass her licensing exam, which she wrote at the end of September.
With 13 years of experience as a licensed midwife and three more as a school nurse back in Lebanon, Rizk had every reason to be confident.
"I have very high [grades] …I worked hard," she said.
So imagine her surprise — and crushing disappointment — when she failed. And Rizk wasn't alone.
According to Quebec's professional order of nurses (known by its French acronym, the OIIQ), 54.6 per cent of students failed the licensing exam written at the end of September. For those who took the test for the first time, the failure rate was 48.6 per cent — the highest rate recorded in four years.
Since 2018, the success rate for first-time test takers has fallen between 71 and 96 per cent.
"The exam was not what we are studying in school," said Rizk, who completed a 10-month professional integration program at the CÉGEP du Vieux-Montréal — specifically made for people who had nursing credentials from outside of Quebec.
"It doesn't make sense … it was ridiculous," she said.
Exam doesn't reflect reality of studies, teacher says
Joseph Oujeil teaches nursing at CÉGEP du Vieux Montréal and CÉGEP André-Laurendeau. He said Rizk was his best student.
"It was a surprise for me and many of my students, and I'm talking about brilliant students with really good marks," said Oujeil.
Marie-Soleil Robinson, another student who failed the exam in September, said only seven of her 30 classmates passed.
Oujeil said this failure rate is not a normal situation and it comes at a terrible time as Quebec faces a nursing shortage.
"I think the average results need to be looked at," Oujeil said, suggesting the order makes 50 per cent the passing grade rather than 55 per cent.
He said students told him the exam "doesn't reflect the real reality of what we're teaching them in school or during their studies and it also doesn't reflect what they've seen in their clinical training."
Rizk wants to see the grades revised. Otherwise, she'll be back at the exam table in March after even more money and months spent studying.
"It's not fair," she said.
Pandemic to blame, says OIIQ
A spokesperson for Quebec's order of nurses, Chantal Lemay, said the exam has been practically the same for years.
What has changed, she added, is the environment students are learning in.
"We believe that the pandemic had something to do with how well students were able to consolidate what they had learned during their training," said Lemay.
Even if the Quebec government is struggling to fill ever-widening gaps in nursing staff across the province, Lemay said the OIIQ is not going to lower its standards.
"Our mandate is to protect the public and to do so, we have this exam," Lemay said.
The Quebec government has been struggling to recruit nurses throughout the pandemic as overworked staff quit in droves.
Tens of thousands have moved to the private sector, left the province or quit the profession altogether.
Emergency rooms and other hospital departments throughout the province have been forced to close or limit hours due to the nurse shortage. And forcing nurses to work long overtime hours each week to make up for the shortage has only led to more burnout.
28,000 new nurses needed in Quebec in next 5 years
Last year, Quebec launched a historic recruitment mission abroad to recruit 4,000 nurses and social workers.
But the situation remained dire in early 2022, forcing Premier François Legault to ask government employees to volunteer to work in hospitals to make up for losses.
Along with offering incentive programs to attract private sector employees to the public system, Quebec announced in February a $65-million investment to recruit and train about 1,000 nurses from francophone countries to work in seven regions of the province where the nursing shortage is most acute.
Health Minister Christian Dubé also set aside $750 million over five years to train and hire a few thousand administrative assistants to ease the burden on nurses.
Regardless, a government study on health care last April found that graduation, immigration and other measures will not meet the province's needs.
The study found that 28,000 new hires will be needed over the next five years.