Strengthening Workforce Development to Address Critical Health Care Shortages in Guam

Impact

• Established a territory-wide workforce development coalition through the Governor's executive action.

• Expanded nursing education capacity, increasing projected graduates by 25–35 additional Registered Nurses (RNs) annually.

• Created new career pathways and entry-level positions to rebuild the environmental health workforce.

• Strengthened coordination across government, healthcare, and academic partners.

Background

Guam faced critical workforce shortages across health care and environmental health systems following the COVID-19 pandemic and Typhoon Mawar. The nursing workforce declined due to burnout, migration to higher-paying off-island positions, and limited clinical training capacity. At the same time, the Environmental Health Division workforce dropped by 85 percent. Local leaders identified the need for a coordinated, long-term workforce strategy to rebuild capacity and create sustainable career pathways for Guam residents.

Recovery

Through a collaborative, whole-of-government approach, ASPR partnered with Guam to launch the Governor’s Health and Social Services Workforce Development Collaborative. The coalition brought together hospitals, government agencies, academic institutions, and professional organizations to align workforce development efforts and address system-wide challenges.

• To address the nursing shortage, ASPR facilitated a partnership with all three major hospitals and local colleges and universities to expand clinical training opportunities and standardize requirements. They launched new academic programs, including an accelerated registered nurse program and a master’s-level nursing program, to build a pipeline of future educators. Hospitals also incentivized advanced practice nurses to serve as adjunct instructors and strengthen faculty capacity.

• To strengthen environmental health capacity, partners created new education and career pathways, including a summer bootcamp for high school graduates and structured internship and employment tracks tied to academic progression. Government agencies also updated position classifications and incentives to improve recruitment, retention, and career advancement within the Environmental Health Division.