Japan's national health professional exams: one regulator, one language, one sitting a year

Medical and health education in Japan

Medicine in Japan is a six-year undergraduate degree taught in Japanese at roughly 80 university faculties. The Ministry of Education, Culture, Sports, Science and Technology (MEXT) approves the schools, and the Japan Accreditation Council for Medical Education (JACME) evaluates programmes against international standards. Dentistry and the practising pharmacy route also take six years. Nursing takes three years at a college or specialist school, or four at a university.

Graduation is the eligibility rule for the national exam, and the licence is issued by the Ministry of Health, Labour and Welfare (MHLW). What is distinctive is the order of the gates: since 2023 the pre-clinical computer-based test and OSCE (共用試験) are a legal requirement for students, and after licensing new doctors must complete two years of initial clinical training (臨床研修), placed through a national matching system. Dentists complete one year. Confirm current rules with MEXT and the MHLW.

A national exam in one language, once a year

Japan is the cleanest example of a single-language system. The MHLW runs the national examinations for doctors, nurses, public health nurses, midwives, pharmacists, dentists, physiotherapists and the other health professions in one annual cycle. Sittings run from late January to late February, and results follow in March. If you miss a sitting, you wait a year.

That timing shapes everything. Final-year students sit the exam weeks before graduation, so the real preparation period is the final year, not the months after it. Foreign-trained candidates have a harder calendar still, because their eligibility must be recognised before they can apply.

Who needs a licensing exam in Japan

• Japanese-trained graduates: sit the national exam in their final year. Graduating from an accredited school is the main eligibility rule.
• Doctors trained abroad: need MHLW eligibility recognition or must pass a preliminary exam (予備試験), and must also pass a Japanese-language medical proficiency assessment (日本語診療能力調査).
• Foreign-trained nurses: need MHLW eligibility recognition. Candidates from Indonesia, the Philippines and Vietnam also enter through Economic Partnership Agreement (EPA) programmes.
• Foreign pharmacists and dentists: follow an eligibility recognition route, with a preliminary exam for dentists.

Doctors face one more rule that is easy to miss. Since 2023 the pre-clinical computer-based test and OSCE (共用試験) have been a legal requirement for students, so the national exam is the second of two gates, not the first. After licensing, residency placement is by matching, with no national entry exam.

Doctors: 医師国家試験

Regulator: MHLW. The exam is 400 MCQ items, five options each, over two days, and includes a block of required items (必修).

The 120th exam took place on 7 and 8 February 2026. 9,139 candidates passed, an overall rate of 91.6% and 94.7% for new graduates. The gap between the two figures is the useful signal: first-time candidates from Japanese schools pass at a very high rate, so the exam punishes missed preparation more than it rewards extra preparation.

1. Complete the six-year programme and the pre-clinical CBT and OSCE.
2. Apply to the MHLW for the February sitting.
3. Sit the two-day exam, including the required block.
4. Register as a physician after results in March, then enter residency through the matching system.

Nurses and public health nurses: 看護師国家試験

The nurse exam has 240 MCQ items in a single day: 50 required items and 190 general and situational items. In the 115th exam on 15 February 2026, 52,666 passed, a rate of 88.3%. The pass line was 40 of 50 on the required block and 166 of 249 on the general block, measured against that year's scoring. Those figures change annually, so treat them as the shape of the rule, not a target.

It is the largest health exam in the country by volume. The separate public health nurse exam (保健師) had 7,467 examinees in 2026. Eligibility rests on graduating from an accredited nursing school or university. Foreign-trained nurses must have their eligibility recognised first.

Midwives: 助産師国家試験

Midwifery in Japan is a nurse-first pathway: candidates already hold a nursing qualification and complete a midwifery programme. The exam has about 75 MCQ items worth 144 points over one day. In the 109th exam 2,040 passed, a 99.7% rate, with a pass mark of 87 of 144. The cohort is small and the exam is a gate rather than a filter.

Pharmacists: 薬剤師国家試験

This is the exam where preparation matters most. It has 345 MCQ items covering required, theory and practical sections, over two days, held on 21 and 22 February 2026 for the 111th sitting. 8,749 passed, an overall rate of 68.49%. New graduates passed at 86.25%, which means repeat candidates passed at a far lower rate. Candidates come from six-year pharmacy programmes. If you are retaking, build a plan around weak sections, not another full read-through.

Dentists: 歯科医師国家試験

The dentist exam has 360 MCQ items over two days. In the 119th exam, held 31 January to 1 February 2026, 1,757 passed, an overall rate of 61.9% against 80.2% for new graduates. Candidates are graduates of Japanese dental schools. Foreign graduates use eligibility recognition or a preliminary exam.

Physiotherapists: 理学療法士国家試験

The physical therapist exam has 200 MCQ items in one day, split between general and practical sections. In the 61st exam on 23 February 2026, 11,156 passed, a 89.7% rate. The pass rule had two parts: 167 of 277 points on the general section and 41 of 117 on the practical section. The occupational therapy exam runs the same day. Radiographers, clinical laboratory technologists and emergency life-saving technicians sit their own MCQ exams of about 200 items each, with results published in March.

Exams in Japan compared

Language and recognition

There is no English edition of any national exam, and no automatic recognition of foreign qualifications. A foreign doctor's Japanese must be good enough for the written exam and for the separate medical proficiency assessment. Expect to study clinical vocabulary in Japanese, not only translate from English.

The EPA route for nurses is the best-established recognition programme, and it comes with language training. It is not open to everyone: it applies to candidates from the partner countries listed above.

What the required block changes

The 必修 block is the feature most foreign readers misunderstand. It tests practice-critical knowledge, and a candidate can fail by missing its separate pass line even with a good overall score. Your study plan needs a dedicated pass over required-style items, treated as a safety check rather than one more topic list.

Last reviewed October 2026