The University of Hawaiʻi at Hilo is growing its nursing program to help plug a statewide nurse shortage that hits hardest on the neighbor islands, expanding its incoming class from 30 to 40 students this year and building a new pipeline straight out of local high schools. The school plans to admit 50 students next year, a 67% jump in enrollment over two years.
Central to the growth is a new High School Direct Entry pathway that lets qualified Hawaiʻi high school graduates reserve a seat in the nursing program before they even start college, according to the University of Hawaiʻi. Students accepted into the pathway skip the usual competitive reapplication process sophomore year — as the university puts it, “They won't have to reapply during their sophomore year.” Instead, they lock in a spot early and spend their first two years working through prerequisite coursework before the nursing curriculum begins in earnest.
That early security comes with strings attached. Direct-entry students must maintain a GPA of 3.0 or higher every semester during their freshman and sophomore years, and under program rules published by UH Hilo's nursing department, all prerequisite courses in years one and two must be completed with a grade of C or better before students can start the nursing program in the fall of their third year. The same page notes applicants need a minimum high school GPA of 3.0 or higher at the end of junior year to qualify in the first place. According to the program's own FAQ, a grade of C-minus or lower in any prerequisite makes a student ineligible to remain in the pathway altogether.
Faculty Funding Fuels the Bigger Classes
The jump from 30 to 40 incoming students this year didn't happen on its own. Five new faculty positions funded by the state Legislature helped grow the class, per the university's announcement, building on a 2022 round of state funding that gave UH Hilo $532,150 to fund 12 positions in its School of Nursing, as previously reported by UH Hilo's chancellor's office. The expansion also extends beyond Hawaiʻi Island: the program includes 10 nursing students based in Waiʻanae on West Oʻahu.
Jeanette Ayers-Kawakami, director of UH Hilo's School of Nursing, said rural areas have a greater need for nurses, and university officials describe the expansion as especially important for neighbor island communities where shortages are more severe. UH Hilo bills itself as the only baccalaureate nursing program on the outer islands, offering what its own program materials call rural clinical learning experiences in a smaller community setting, per UH Hilo. The four-year nursing pathway includes clinical training in rural communities, community health projects, and hands-on practice in a simulated hospital environment.
One Hilo Grad's Path Into the Program
Dylan Yanazaki, a Hilo High School graduate, is among the first students admitted through the direct-entry pathway. Yanazaki said she would like to contribute to the solution on Hawaiʻi Island and hopes to stay there to care for local families, according to Hawaii News Now.
The urgency behind stories like hers traces back to grim staffing math. Pandemic burnout and retirements have added pressure to Hawaiʻi's nursing workforce. A projection puts Hawaiʻi's registered-nurse workforce at 88% of need in 2036. The Hawaiʻi Center for Nursing also noted that the workforce has improved compared with 2021, even as projected gaps remain. Separately, UH estimated Hawaiʻi had about 1,000 current nurse vacancies, with demand projected to grow by 110 additional positions annually through 2030.
Not every official account agrees on the scale of the problem. A 2026 Hawaiʻi House resolution cited data suggesting there is, in fact, an adequate number of registered nurses in the islands to meet existing demand, according to state legislative records — a conclusion that sits uneasily alongside the workforce reports describing persistent shortages and neighbor island strain.
Capacity Limits Beyond Hilo
Clinical-placement competition and difficulty hiring faculty can constrain how quickly nursing schools statewide grow. More than 70% of the state's registered nurses had a primary practice location in Honolulu County as of the Hawaiʻi Center for Nursing's 2023 workforce report, compared with just 13% in Hawaiʻi County, 10% in Maui County, and 4% in Kauaʻi County — a lopsided distribution that underscores why neighbor island training pipelines matter.
UH Hilo isn't alone in trying to widen the pipeline. UH Mānoa has developed two programs aimed at training more nursing educators: a 36-credit master's degree in nursing education and leadership that can be finished part-time in three years or full-time in two, and a graduate certificate in nursing education, according to UH Mānoa. Neighbor island students in that Mānoa program can complete their practicum experience in their home communities rather than relocating to Oʻahu. Statewide, UH System nursing programs educated and trained 59% of the 442 students who graduated from Hawaiʻi nursing schools in the prior academic year, per the university.
Healthcare and social-assistance employment in Hawaiʻi is projected to grow 11.2% over the next decade, a trend the Honolulu Star-Advertiser has tied directly to the state's need for more training capacity. For now, UH Hilo's School of Nursing — which offers BSN, RN-to-BSN and Doctor of Nursing Practice degrees and is approved by the Hawaiʻi State Board of Nursing — is betting that catching students like Yanazaki before they even leave high school is one way to keep more future nurses close to home.
