The number of applicants to nursing courses in Scotland has fallen by 24% compared with the same point last year.
University admissions service UCAS said that by January, 5,070 people had applied to study nursing in Scotland this year, compared to 6,690 in 2022.
The drop is the biggest of any UK nation and has increased concerns about an NHS staffing crisis.
The Scottish government says up to 1,000 more applications could be made for funded courses starting in autumn.
Health Secretary Humza Yousaf said nursing students in Scotland are offered “the most generous support package in the UK”.
It comes after the Royal College of Nursing paused a strike announcement following talks with the Scottish government over a backdated pay deal.
Although the application rate could increase in the coming months, the acceptance rate for undergraduate nursing courses fell by 8% in 2022 compared to the previous year.
Eileen McKenna, RCN Scotland associate director, said the figures were “very worrying” at a time when there are more than 4,600 vacancies for registered nurses in Scotland.
“The Scottish government must act now to ensure nursing is seen as an attractive and rewarding career,” she said.
“They need to reward today’s experienced staff with a fair pay rise and demonstrate that a career in nursing shouldn’t come with a personal financial sacrifice.
“They need to ensure nursing students have adequate financial support to allow them to prioritise their education and cope with the rising cost of living.”
The new UCAS figures show applications fell by 18% in England, 17% in Northern Ireland and 22% in Wales – an 18% decline overall across the UK since January 2022.
It is the second consecutive year that nursing applicants have decreased across the UK, while in Scotland, applicant numbers have fallen from 7,920 in 2021.
The decline in nursing course applicants has been linked to the increased demand for nurses during the Covid pandemic, causing applications to soar.
But the RCN has said the current rate is still below pre-pandemic levels.
Mr Yousaf said: “Funded places on undergraduate nursing and midwifery courses have doubled in the last decade and we would hope to see further applications to these courses up to the deadline, which could be up to an extra 1,000 based on previous years.
“Scotland offers the most generous support package in the UK, with the nursing and midwifery student bursary raised to £10,000, free tuition and support with placement expenses, uniforms, disclosure and health checks.”
The health secretary added that talks were continuing with nursing unions on a new pay deal.
Opposition figures pointed to record levels of vacancies in Scotland’s NHS, with an estimated 6,000 nursing and midwifery posts unfilled.
‘Poor working conditions’
Scottish Conservative health spokesman Dr Sandesh Gulhane called on Mr Yousaf to resign.
He said the decrease was unsurprising “when would-be students are hearing of the intolerable strain nurses are under in our SNP-mismanaged health service”.
Scottish Labour health spokeswoman Jackie Baillie said: “Until nursing is properly valued by the Scottish government, these problems will continue.
“The SNP must act now to ensure that nursing is still seen as the rewarding career that it has always been.”
Scottish Liberal Democrat leader and health spokesperson Alex Cole-Hamilton called on the Scottish government to invest in workforce planning.
He added: “Pay disputes and poor working conditions have taken a heavy toll on the mental health of nurses.
“No wonder many potential applicants will look at the state of Scotland’s nursing sector and turn away.”