By Nanette Asimov

Winning admission into the University of California’s most competitive majors — including computer science, engineering and business — is about as likely as hitting a home run your first time at bat.

Yet even those subjects are not the hardest to get into. That honor belongs to nursing, for which you might have to hit two home runs. In a row.

Just 1% of the nearly 6,000 yearly applicants to UC’s undergraduate nursing programs, at UCLA and UC Irvine, are permitted to walk through the door.

Nursing is also notoriously hard to get into at 17 of the 20 California State University campuses offering the program — even though hospitals across the state are short the equivalent of more than 40,000 full-time nurses, as UCSF reported in 2021. Nursing jobs pay well in California — typically around $120,000 — and thousands of brainy, compassionate students want in.

Magdalena Guerrero is one of them. The Cal State East Bay sophomore chose nursing while a high school freshman and never wavered.

“I love nursing so much,” said Guerrero, 19, who in October applied for next fall’s nursing program at the Hayward campus, a 12-minute commute from her Union City home.

“I’m super-competitive,” said Guerrero, a straight-A student who completed her nursing prerequisites last fall and sometimes spent 13 hours a day in the library, her head in the books from 8 a.m. to 9 p.m. “I loved it. I ate there — I brought my snacks. I love studying. I love the knowledge.”

‘Even more selective’ than Ivy League

The story of how and why Cal State East Bay rejected Guerrero’s nursing application is the story of why that major is the most crowded — and confounding — across all public universities in California.

“We’re even more selective than getting into Yale,” Mark Lazenby said of UC Irvine’s nursing school, where he’s the dean. (The Ivy League school took 6.53% of applicants last fall.)

“A lot of young people want to become nurses,” Lazenby said. “They want to do good with their lives. We hear this over and over again — that nursing can lead to gainful employment and a lot of career options. At the same time, it’s meaningful work that benefits society.”

By 2030, with every baby boomer locked into old age, the need for nurses will only skyrocket, he said. So what’s stopping California’s universities from welcoming every applicant?

Money is the driving factor

At UC Irvine and UCLA — which together admitted 118 nursing students out of 11,776 who applied in 2023, the most recent data available — the answer is money.

UC Irvine’s engineering school, for example, spends less than $10,000 a year to educate each student. The nursing school spends at least twice that amount, said Lazenby.

A lecture hall packed with engineering students needs but one professor. But in nursing, where the stakes are about patient survival, every group of 10 students needs a single, attentive instructor.

Also expensive: computerized mannequins, which reside in hospital simulation rooms and suffer sudden heart attacks and massive strokes. These cost a couple hundred thousand dollars each, Lazenby said.

At CSU, where 20 of the 23 campuses offer nursing, only Dominguez Hills, Monterey Bay and Northridge report no overcrowding.

Schools ration seats because it’s hard for them to hire enough qualified instructors.

“Anybody who comes to teach full time takes about a 50% pay cut compared to working at the hospital,” said Elaine Musselman, director of San Francisco State’s nursing school, which, like many CSU campuses, struggles with the hiring problem.

As a result, San Francisco State’s nursing school is offering admission to just 28 of its 328 applicants for next fall. That’s 8.5%, compared with the school’s 84% admission rate overall.

The campuses try to get around the problem by inviting full-time nurses to teach part time, maybe once a week.

Hosting by hospitals required

But another reason for the overcrowding is unique to nursing programs: They are required to partner with hospitals that are willing to host and teach students in actual health care settings. Engineering, business and computer science programs never encounter this issue.

“Nursing is very hands on, so they can’t just learn by the textbook,” Musselman said. “You need to work with real people.”

These are called clinical placements, and there aren’t enough of them. California has more than 140 nursing programs, many of them at community colleges or more costly private colleges, and all are competing for clinical placements.

About 15 years ago, hospitals generally paired one clinical instructor with up to 12 students at a time, once a week.

Today, hospitals tend to host no more than eight students at a time, which requires schools to arrange for placements twice a week so every student can participate.

The pandemic’s massive nurse burnout is only part of the reason for limiting the student groups, although this is changing as COVID recedes. Another reason is the domino effect of hospitals increasingly sending patients home to recuperate instead of admitting them. Those who stay tend to be sicker, which in turn leaves nurses with less time to help students, Musselman said.

‘It’s awful’: No leniency for application glitch

This is the world into which thousands of California students hope to enter each year, including Guerrero, the Cal State East Bay sophomore.

Last semester, as she completed her last two pre-nursing requirements, earning an A in both human anatomy II and microbiology, Guerrero’s excitement grew. She beat the deadline for submitting her application for next fall’s nursing program, then waited for April, when she expected good news to arrive.

Instead, she heard from the administration on Feb. 17. She had just finished a psychology class and had sat down to do homework when she noticed the email.

“I was super excited,” she said.

But the message contained bad news. It said Guerrero had been disqualified because her transcript lacked her two final prerequisites — the ones she had aced. In her exuberance, Guerrero had sent in her application a shade too early.

If it had been any other major at Cal State East Bay, a school that — like many CSU campuses — is losing enrollment, administrators would have bent over backward to fix the glitch and help the stellar student join her preferred major.

“But this is how narrow the bottleneck is for nursing,” said Monika Eckfield, chair of Cal State East Bay’s nursing department. “If we make an exception for her, then we have to it for hundreds of others.”

Guerrero felt devastated.

“I felt something inside of me kind of, like, broke,” she said. “I blamed myself over and over. The letter took away my spark. I’m just now getting on my feet.”

Guerrero said she recognizes that nursing is “so overcrowded they couldn’t give me a second chance.” Still, she said, “I wish they could have been more lenient. I can’t imagine how many students are going through the same thing. It’s awful.”

A search for solutions

UC Irvine turns away 99% of nursing applicants: 5,800 students last year. Lazenby, the dean, called on the state to invest more money not only in traditional nursing education, but also in the kind of research-intensive schooling that UC provides to its nursing students. All professors have doctorates and teach their students to interpret medical research or to become researchers themselves. Many students go on to graduate school and become hospital leaders.

“The state has to decide whether it’s going to invest in research-intensive nursing education, because it is costly,” Lazenby said. “Yet, the value of human lives should not be pitted against that cost. We shouldn’t say, ‘We’ll educate nurses on the cheap.’”

It’s a hope that became a little less likely after Thursday, when UC system President Michael Drake announced that the university was in such financial jeopardy that a systemwide hiring freeze was necessary. One reason, he said, was a proposed 8% funding cut from the state, which Gov. Gavin Newsom has also recommended at CSU. However, improving state finances could erase that problem.

More of a problem, Drake said, is the potential loss of hundreds of millions of dollars in research funding that Trump administration officials are threatening to withhold from universities — as they have already done at Columbia University — to punish what they have said was an insufficient response against pro-Palestinian protesters on campus last year.

Meanwhile, the state’s public universities are strategizing to figure out how to enroll more nursing students.

At San Francisco State, a 2023 partnership with Sutter Health to guarantee clinical placements for eight students over four semesters “allowed us to increase our enrollment by 25%,” Musselman said.

While Cal State East Bay accepted just 48 of its roughly 500 nursing applicants for next fall, Eckfield said she hopes that will improve with a pending reorganization of scattered programs — nursing, kinesiology, social work, public health, speech and hearing — into a single College of Health.

“So even if students come in with the intention of (entering) the nursing program, if they don’t get in, they’ll see that it’s not the end of the road for them. They can stay and finish out their bachelor’s degree,” Eckfield said.

Still determined

Guerrero has no intention of giving up nursing.

Cal State East Bay has a different nursing program at its Concord campus — 90 minutes from Guerrero’s home — and she is about to apply there for spring 2026. She could reapply to the closer Hayward campus, but the earliest she could get in would be fall 2026.

“What if I didn’t get into Hayward a year from now?” Guerrero said. “Because nursing here in California is so competitive, I cannot miss an opportunity.

“I understand that I’m young. But at the same time, I have this passion, this spark. I’m willing do anything — even if it takes an hour and 30 minutes on BART,” she said. “Nursing is everything to me.”