Most Western countries face a healthcare staff shortage due to a growth in elderly populations driven by longer life expectancy. The number and proportion of people aged 60 years and older is increasing in many populations. In Western countries with decreasing fertility rates there will be even fewer young people who want to pursue healthcare professions. Due to globalization, it is easier for healthcare professionals to seek jobs in regions where they can best practice their skills. However, professional qualifications earned in one country may not be recognized or valid in another country and may require validation education to update the immigrant's education to meet the target country's standards. This is the case in Finland where universities of applied sciences offer validation education for health care staff. In this study we call this education ‘’validation education’’ in order to separate it from programmes leading to bachelor level professional degrees. Though the pass rate of this education is high, there are always some health care professionals who start the process but do not finish it for some reason either right at the assessment stage before starting their profession specific studies or during the actual study period. In our study we describe how health care staff seeking for validation education describe the challenges related to the education a) in the starting stage of the process b) at the end stage of their studies.

Participants invited to participate in the interviews were selected using a purposive sampling method from among students having entered a programme offered by a project called ‘’Validation pathway of healthcare professionals’’ and financed by the Service Center for Continuous Learning and Employment (SECLE). A research permit was applied from the educational institution and personal consent to participate was requested from the subjects in writing. Personal interviews were performed in two stages: at the beginning of the process and at the end stage of the process. The aforementioned sample (N=52) comprised (6/28), those who finally chose not to participate in the education and those who continued in the education (5/24). At the finalizing stage we interviewed 10 willing students out of 34 who were asked to participate. Interview data was analysed by using inductive thematic analysis.

In the starting stage of the process, challenges described were related to access and starting validation education, foreign language, access to information about education, decision of leaving home country, and prejudice and racism. At the finalizing stage of their studies, students of the validation education reported challenges related to coordinating with private life and the education, standards of validation education, foreign language, culture and practical organisation of the studies.

Many of the challenges reported in the beginning stage of validation education were the same as experienced at the finalizing stage. In order to facilitate the validation studies of health care professionals, attention should be paid to integrating students' civil life and studies, student friendly organisation of studies, continuing foreign language studies and facilitating integration in target country's study and work communities.

Keywords: health care, workforce, validation education, challenges