Why internationally educated nurses fail the NCLEX more often

What NCSBN actually publishes about the gap

NCSBN releases an annual research brief, the NCLEX Examination Statistics, and the tables in it are the primary record. For 2025 and US licensure, Table 1 reports four groups. First-time US-educated candidates: 192,916 tested, 167,272 passed, 86.7 percent. Repeat US-educated: 42,513 tested, 52.7 percent. First-time internationally educated: 52,827 tested, 24,999 passed, 47.3 percent. Repeat internationally educated: 40,187 tested, 12,271 passed, 30.5 percent. That last row is the one people rarely quote and the one that matters most if you have already failed. Fewer than one in three internationally educated repeat candidates passed in 2025. If you have failed once and your plan is to sit again with the same preparation, that is the base rate you are sitting against. On the practical nurse exam the picture is different in shape and much smaller in volume: 397 first-time internationally educated candidates took the NCLEX-PN in 2025 and 53.7 percent passed, against 86.6 percent of 54,818 first-time US-educated candidates. The internationally educated PN population is small enough that year-to-year swings in that number mean little on their own.

The 2025 numbers moved for everyone, not for one group alone

A detail that gets lost when the internationally educated figure is quoted on its own: both groups fell in 2025. In 2024, first-time US-educated candidates passed the NCLEX-RN at 91.2 percent and first-time internationally educated candidates at 53.8 percent. In 2025 those became 86.7 percent and 47.3 percent. The US-educated rate dropped 4.5 percentage points and the internationally educated rate dropped 6.5. Repeat internationally educated candidates fell from 36.4 percent to 30.5 percent. So whatever changed in 2025, it did not only touch internationally educated candidates, and it is not evidence that international nurses got worse. NCSBN does not attribute the decline to any cause in the statistics brief itself. What the brief does record is that the NCLEX-RN passing standard rose to 0.00 logits in April 2013 and has been retained at 0.00 at every triennial review since, in April 2016, 2019, 2023 and 2026, so it did not move when the Next Generation NCLEX launched on 1 April 2023. The bar, in the exam's own measurement units, has been fixed for over a decade. That rules out one popular explanation. It does not rule in any other.

Your country of education changes the base rate a lot

NCSBN publishes Table 9, first-time internationally educated candidates by country of education. The spread is wide, and it is the single most useful table for calibrating your own odds. For 2025 and US licensure: the Philippines sent 22,793 first-time candidates and 45.8 percent passed. India sent 4,866 and 33.3 percent passed. Kenya sent 4,096 at 58.2 percent. South Korea sent 2,485 at 58.4 percent. Ghana sent 2,236 at 54.7 percent. Nigeria sent 1,983 at 54.4 percent. Canada, counted separately, sent 279 candidates educated in Canada testing for US licensure, at 84.6 percent. A candidate educated in India in 2025 faced a pass rate under half that of a candidate educated in Canada, 33.3 percent against 84.6. That is a fact about the aggregate, not about you, and it cannot tell you whether you personally will pass. What it can do is stop you comparing yourself to a friend from a different country and drawing a conclusion about your ability. Note also that these are country-of-education counts, not nationality counts.

What NCSBN does not publish, and why that matters to you

The 2025 NCLEX Examination Statistics breaks internationally educated candidates down by country of education and by calendar quarter. It does not break them down by English proficiency test or score, by years of clinical experience, by age, by whether the candidate used a review course, by whether they were tested inside or outside the United States, or by immigration route. So any sentence that begins with the claim that internationally educated nurses fail because of a specific factor is not coming from the NCSBN tables. It is coming from somewhere else, and you are entitled to ask where. The peer-reviewed literature on this specific question is thin. One of the few studies aimed directly at it, Montegrico and Chen in the International Journal of Environmental Research and Public Health in 2025, surveyed Philippine-educated nurses recruited through Facebook professional nursing groups. Of 328 who started the survey, 159 finished and 146 were analysed. The authors report that only two variables were significantly associated with first-attempt NCLEX success: passing the Philippine licensure exam on the first attempt, and working in a non-hospital setting. They also state in their own limitations section that the sample was a convenience sample, that first-time passers were overrepresented, and that findings cannot be generalised to internationally educated nurses as a population. A study that honest about its own limits is worth more than a confident blog post, and it still cannot tell you the cause.

The scoring mechanic that changes what a wrong answer costs

The NCLEX is a computerised adaptive test. NCSBN describes the process directly: after each answer, the software estimates your ability, picks a content area for the next item, then selects an item difficult enough to give you roughly a 50 percent chance of answering correctly. That design has a consequence people are not told. The exam is engineered so that you feel like you are getting about half of it wrong. Feeling lost is the intended experience for every candidate, passing or failing. Candidates who take that feeling as evidence of failure and change strategy mid-exam are reacting to a feature. The exam runs between 85 and 150 items, with five hours allowed. In 2025 the average NCLEX-RN test length for first-time US-educated candidates was 103 items and the average testing time was 2 hours 14 minutes; 59.1 percent of them finished at the minimum item count. Since the Next Generation NCLEX launched, Multiple Response Select All That Apply items are scored polytomously, meaning partial credit. There are five clinical judgment item types: extended multiple response, extended drag and drop, cloze drop-down, enhanced hot spot highlighting, and matrix or grid. On a matrix item you can be right about three rows and wrong about one and still earn credit. Guessing whole rows to finish quickly throws that away.

Where the content may genuinely diverge from your training

The 2026 NCLEX-RN test plan sets the share of items drawn from each client needs category. Management of care is 15 to 21 percent of the exam, the largest single sub-category. Safety and infection prevention and control is 10 to 16 percent. Together, Safe and Effective Care Environment accounts for between 25 and 37 percent of the items you will see. Pharmacological and parenteral therapies is 13 to 19 percent, physiological adaptation 11 to 17 percent, reduction of risk potential 9 to 15 percent, and health promotion, psychosocial integrity, and basic care and comfort are 6 to 12 percent each. Management of care covers delegation, scope of practice, informed consent, advance directives, case management, and referrals. Those are legal and organisational rules of one health system, and they differ between countries in ways that clinical pharmacology does not. A nurse with ten years of ward experience abroad may know the drug and still answer wrongly about who is permitted to administer it or who the task can be assigned to. This is a plausible mechanism and it fits the test plan weights. It is not something NCSBN has measured and reported for internationally educated candidates, and I am not going to present it as the cause.

The rules that stop people before they ever reach the exam

Some internationally educated nurses never get to fail the NCLEX because a state board rules their education non-equivalent first. California is the clearest published example. Its guideline document EDP-I-35 sets out the requirement in California Code of Regulations section 1426: at least 18 semester units of nursing theory and 18 of nursing clinical, plus 16 semester units of behavioural and natural sciences and 6 of communication, covering five content areas of medical-surgical, obstetrics, paediatrics, geriatrics, and psychiatric-mental health. The rule that catches people is that theory and clinical practice in each of those five areas must have been completed concurrently, in the same instructional period. Nursing programmes in many countries teach a block of theory in one year and the corresponding clinical placement in another. That sequencing alone can produce a deficiency letter requiring you to complete named courses at a US institution before California will let you sit. California also notes that passing the CGFNS examination is not required for its licensure, though it will accept CGFNS-supplied transcripts. Requirements differ by state, so check the board where you intend to be licensed before assuming the exam is your obstacle. Separately, CGFNS VisaScreen, required under section 343 of the 1996 immigration act for an occupational visa, exempts you from an English exam only if your entry-level professional education was in the UK, Australia, Canada outside Quebec, New Zealand, Ireland, or the US, and English was the language of instruction including textbooks.

What to do differently before attempt two

Start with the document you already have and probably have not used. When a candidate fails, the nursing regulatory body sends a Candidate Performance Report. NCSBN describes it as identifying the failing performance, specifying how many items you were administered, and summarising your relative strengths and weaknesses against the test plan. It is written for the purpose of guiding study before a retake. Two things in it are worth an hour of your attention. First, the item count: if you were stopped at or near 85 items, the exam settled on an ability estimate quickly. If you ran to 150, the estimate stayed close to the standard the whole way. Second, the sub-category breakdown tells you whether your weakness was concentrated in management of care and safety, which is a rules-of-this-system problem, or spread across pharmacology and physiological adaptation, which is a knowledge problem. Those two failures need different remedies, and a generic question bank treats them the same. The retake policy allows eight NCLEX attempts a year with at least 45 test-free days between them, unless your regulatory body limits attempts further, so check your board rather than assuming. The registration fee is 200 US dollars, plus an additional 150 dollar international scheduling fee if you test at a centre outside the United States and its territories. At those prices, a rushed second attempt at 45 days is an expensive way to gather information you could get free from the report already in your inbox.

When paying for another exam helps and when it does not

If a board has issued you a deficiency letter, no amount of NCLEX practice fixes it. You need the named courses, and that is an enrolment problem rather than a testing problem. If your obstacle is a visa credentials assessment rather than the licensure exam, the binding requirement is an accepted English test at the score CGFNS specifies for your profession, and CGFNS does not accept at-home versions of those exams. From 1 December 2024, applicants using PTE Academic must score 63 on the speaking section, with the overall 55 and the minimum 50 on other sections unchanged. If your board demands nothing further and your Candidate Performance Report shows a broad knowledge weakness, then structured content review is a reasonable purchase. If the report shows a narrow weakness in management of care, buying a full review course is buying eighty percent material you already know. There is no certification you can add that raises your NCLEX pass probability directly, and anyone selling one is selling something else. Spend on the specific gap the report names, and nothing else until you have read it.

What this does not fix

This post will not tell you why the pass rate gap exists. NCSBN publishes the gap and the country breakdown but no data on English scores, clinical experience, or preparation methods, and the peer-reviewed work on the question is small and self-selected. I report the documented numbers and name the mechanisms as untested hypotheses rather than causes.

Where an exam fits

• NCLEX-RN, if your state board has already ruled your education equivalent and the exam is the only remaining barrier
• NCLEX-PN, if you are considering practical nurse licensure as a faster route to working while you close an RN deficiency
• OET (Occupational English Test), if CGFNS or your state board requires proof of English and you were not educated in one of the exempt countries
• ATI TEAS 7 (Test of Essential Academic Skills), if a deficiency letter forces you into a US nursing programme that admits on TEAS scores
• HESI A2 (Admission Assessment Exam), if the US programme you need for deficiency courses uses HESI A2 rather than TEAS for admission

Common questions

Sources

1. 01First-time internationally educated candidates taking the NCLEX-RN for US licensure in 2025: 52,827 tested, 24,999 passed 47.3 percent
   NCSBN, 2025 NCLEX Examination Statistics (Table 1) checked 2026-08-28
2. 02First-time US-educated candidates taking the NCLEX-RN for US licensure in 2025: 192,916 tested, 167,272 passed (86.7 percent). Repeat US-educated: 42,513 tested, 22,404 passed (52.7 percent) 86.7 percent first-time, 52.7 percent repeat
   NCSBN, 2025 NCLEX Examination Statistics (Table 1) checked 2026-08-28
3. 03Repeat internationally educated NCLEX-RN candidates for US licensure in 2025: 40,187 tested, 12,271 passed 30.5 percent
   NCSBN, 2025 NCLEX Examination Statistics (Table 1) checked 2026-08-28
4. 042024 NCLEX-RN for US licensure: first-time US-educated 186,760 tested at 91.2 percent, first-time internationally educated 58,995 tested at 53.8 percent, and repeat internationally educated 40,082 tested at 36.4 percent 91.2 / 53.8 / 36.4 percent
   NCSBN, 2024 NCLEX Examination Statistics (Table 1) checked 2026-08-28
5. 052025 first-time NCLEX-RN pass rates by country of education, US licensure: Philippines 22,793 candidates at 45.8 percent, India 4,866 at 33.3 percent, Kenya 4,096 at 58.2 percent, South Korea 2,485 at 58.4 percent, Ghana 2,236 at 54.7 percent, Nigeria 1,983 at 54.4 percent, Canada 279 at 84.6 percent 33.3 percent (India) to 84.6 percent (Canada)
   NCSBN, 2025 NCLEX Examination Statistics (Table 9) checked 2026-08-28
6. 06NCLEX-PN 2025: 397 first-time internationally educated candidates, 213 passed, against 86.6 percent for 54,818 first-time US-educated candidates 53.7 percent vs 86.6 percent
   NCSBN, 2025 NCLEX Examination Statistics (Table 12) checked 2026-08-28
7. 07NCLEX-RN passing standard history: raised to 0.00 logits in April 2013 from -0.16, and retained at 0.00 in April 2016, April 2019, April 2023 and April 2026, so it did not change when the Next Generation NCLEX launched on 1 April 2023 0.00 logits since April 2013
   NCSBN, 2025 NCLEX Examination Statistics (Introduction, Setting the Passing Standard) checked 2026-08-28
8. 08Computerised adaptive testing selects each next item at a difficulty giving the candidate approximately a 50 percent chance of answering correctly about 50 percent chance per item
   NCSBN, 2025 NCLEX Examination Statistics (Introduction, Computerized Adaptive Testing) checked 2026-08-28
9. 09NCLEX format: minimum 85 items, maximum 150 items, Select All That Apply scored polytomously with partial credit, and five clinical judgment item types 85 to 150 items, five item types
   NCSBN Support, What is the current format and item types for the NCLEX? checked 2026-08-28
10. 102026 NCLEX-RN test plan weights, effective 1 April 2026: management of care 15 to 21 percent, safety and infection prevention and control 10 to 16 percent, health promotion and maintenance 6 to 12 percent, psychosocial integrity 6 to 12 percent, basic care and comfort 6 to 12 percent, pharmacological and parenteral therapies 13 to 19 percent, reduction of risk potential 9 to 15 percent, physiological adaptation 11 to 17 percent management of care 15 to 21 percent
    NCSBN, 2026 NCLEX Examination Candidate Bulletin checked 2026-08-28
11. 11NCLEX registration fee is 200 US dollars for US licensure, plus an additional 150 US dollar international scheduling fee for candidates testing at a centre outside the United States and its territories; the retake policy allows eight attempts a year with at least 45 test-free days between them $200 plus $150 international scheduling fee; 45 test-free days
    NCSBN, 2026 NCLEX Examination Candidate Bulletin checked 2026-08-28
12. 12California prelicensure content under CCR 1426: not less than 58 semester units, comprising 18 semester units of nursing theory, 18 of nursing clinical, 16 of behavioural and natural sciences and 6 of communications, across five content areas (medical-surgical, obstetrics, paediatrics, geriatrics, psychiatric-mental health), with theory and clinical practice in each area completed concurrently. Passing the CGFNS examination is not required for California licensure, though the Board accepts CGFNS-supplied transcripts 18 theory + 18 clinical + 16 science + 6 communications, taken concurrently
    California Board of Registered Nursing, EDP-I-35 guideline checked 2026-08-28
13. 132025 summary statistics for first-time US-educated NCLEX-RN candidates: average test length 103 items, 59.1 percent took the minimum number of items, 20.5 percent took the maximum, average testing time 2 hours 14 minutes, against an allotted five hours 103 items average; 59.1 percent at minimum; 2 hours 14 minutes
    NCSBN, 2025 NCLEX Examination Statistics (Table 3) checked 2026-08-28
14. 14When a candidate fails, the nursing regulatory body sends a Candidate Performance Report, which identifies the performance as failing, specifies the number of items administered, and gives a summary of the candidate's relative strengths and weaknesses based on the test plan, intended to guide study before a retake item count plus test-plan strengths and weaknesses
    NCSBN, 2026 NCLEX Examination Candidate Bulletin (Candidate Performance Report) checked 2026-08-28
15. 15Montegrico and Chen (2025) surveyed Philippine-educated nurses recruited by convenience sampling through Facebook professional nursing groups: 328 started the survey, 159 completed it, and 146 were analysed (44.5 percent completion rate). Of the 146, 79.5 percent had passed the NCLEX-RN on the first attempt. Only two variables were significantly associated with first-attempt passing: passing the Philippine licensure examination first time (Fisher's p = 0.001) and working in a non-hospital setting (Fisher's p = 0.026). The authors state the sample was a convenience sample in which first-time passers were overrepresented and that the findings cannot be generalised to the internationally educated nurse population n = 146; two significant variables
    Montegrico J, Chen ZJ, Association Between Academic, Initial Licensure, Employment Factors, and NCLEX-RN Performance of Philippine-Educated Nurses, International Journal of Environmental Research and Public Health, 2025, 22(4), 653 checked 2026-08-28
16. 16CGFNS VisaScreen, required under Section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 for an occupational visa, exempts an applicant from an English proficiency exam only if entry-level professional education occurred in the United Kingdom, Australia, Canada (except Quebec), New Zealand, Ireland or the United States and English was the language of instruction including textbooks. Effective 1 December 2024, applicants using PTE Academic must score 63 on the speaking section; the overall score of 55 and the minimum of 50 on other sections are unchanged. CGFNS does not accept at-home versions of English Language Proficiency exams PTE speaking 63 from 1 December 2024; six exempt jurisdictions
    CGFNS International, VisaScreen: Visa Credentials Assessment checked 2026-08-28

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