Hey. Glad to hear that you are interested in Japanese nursing. As a Japanese RN, I wanna say thank you. Of course you gotta study general Japanese. But most medical terminologies are spoken/written in Japanese. You have to understand Chinese characters as well. also yes, we have some cultural issues. I would say they are even different depending on a area. Furthermore, espesially elderly is unique. They believe something that i dont believe. They use words that i dont use. Even as a native Japanese, I experienced some difficulties with them.Oh and salary is low compared to US nurses. But lots of work. lots, lots, lots of work. We sometime don't get enough appreciation we deserve. What I am really proud being a Japanese RN is I believe the quality of nursing care is the top class. I am 100% sure we do have the highest quality. I personally would not recommend people outside Japan to be a nurse unless they have lived in Japan and known what is like. I would recommend you to live there before you decide. You are young. You have lots of options. Hope you will find the best one!!