After dreams crushed by Quebec's controversial nursing exam, this candidate is ready to quit

At 20 years old, Montrealer Gisèle-Rose Wagner may give up on her dream of becoming a nurse after wasting thousands of dollars and countless hours on a test she has been unable to pass.

Four times she's tried — and failed.

"I feel kind of hopeless because I have done it so many times," said Wagner.

"Usually you have three shots, but sometimes you can annul an exam for different reasons."

That's what Wagner did — annulling one failed attempt, hoping adjustments to the controversial exam in March would be enough for her to finally step into a role she has been striving for.

But she did even worse than before. The provincial group in charge of the exam, the Ordre des infirmières et infirmiers du Québec (OIIQ), has already said that it is giving everyone another chance, even if they already failed three times. But they will need to sit the exam again in September.

"We have put forward several flexibility measures to promote the success of students, without ever compromising the level of care offered to the Quebec population," said Luc Mathieu, head of the OIIQ, back in January.

Just over half the nursing students (53.3 per cent) who took the exam for the first time this spring passed, a success rate similar to that of last fall (51.4 per cent.) when the exam came under intense scrutiny for the high failure rate.

OIIQ spokesperson Marine Detraz said the success rate was 60.9 per cent among March 2023 candidates who sat the exam for the first time after taking a Quebec-based academic course.

Ready to give up

Regardless, Wagner is ready to throw in the towel and look toward a career in something like social work instead.

She has been working as a nurse candidate at Cite-de-la-Santé hospital in Laval, Que., north of Montreal. That income has helped cover the $640 cost to sit each exam, she said, but that doesn't include the money spent on book fees, tutoring and more.

Since 2018, the pass rate on the first attempt has generally been between 71 and 96 percent, compared to 51.4 per cent in September, according to the OIIQ.

An investigation by Quebec's commissioner of professions, André Gariépy, concluded that there were major problems with the September exam.

"The reliability level of the questions in the exam is pretty minimal, and for a high-stakes exam like this one, it should be much higher," he said

The report also concluded that the passing grade had been raised — from 50 to 55 per cent — without justification.

Gariépy said if the order had maintained the previous mark, more than 500 nursing students who failed would have passed. Wagner would have been among them, she said.

OIIQ to revise exam

Last week, OIIQ announced it is revising the exam in light of Gariépy's report. The OIIQ said it will now rely on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) as an assessment tool starting early next year.

Nearly all regulatory agencies in the United States and Canada use the NCLEX-RN, and it has been around since 1994, the OIIQ notes. It has tested over six million people, making it a proven measurement tool, the order said.

Mathieu said in a statement that the changes announced make it clear that the OIIQ "does not hesitate to question its ways of doing things."

"However, no compromise will be made on the protection of the public," he says. "The scarcity of labour is worrisome, but it is not a reason to lower the requirements to enter the nursing profession."

Still, even if there are changes to the exam, Wagner is feeling rejected and unmotivated to pursue her dream any longer. She questions why Quebec needed to break away from widely accepted standards and create its own exam that clearly led to a significant fail rate.

"It's something I always wanted to do, but right now, with everything that happened, yes I want it, but I am just exhausted," said Wagner. "I might just go do something else."