Almost 90% of nurses from the Philippines have failed English tests which are part of a hospital's bid to fill hundreds of vacancies.
Medway Maritime Hospital in Kent said 52 out of the 59 candidates had failed one or more of the listening, reading, writing and speaking tests.
According to a Freedom of Information (FOI) request 202 nurses are being recruited from the Philippines.
The NHS trust said the failed candidates intend to re-sit the tests.
The other candidates are still taking the tests or awaiting the results.
The hospital hopes the first of these will begin work later this year.
James Devine, executive director of the Medway NHS Foundation Trust said: "As part of our own selection process, we ensure that candidates are able to communicate effectively with patients and each other.
"All non-EU trained nurses are also required to pass additional tests required by the Nursing and Midwifery Council before taking up employment, and we currently have a number of potential nurses either awaiting results, or in the process of undertaking these tests."
The Medway Messenger discovered 241 nurses from the Philippines were offered jobs, of which 202 candidates had accepted positions at the hospital.
A spokesman for the NHS trust said a "rigorous screening process" was underway to ensure the candidates have "excellent clinical skills and a very high standard of spoken and written English".
"It is likely that some of those nurses will unfortunately not reach the required pass rate", he said.
Overseas candidates are required to achieve a score of at least seven out of a possible nine in all the parts of the test.
"The failed candidates intend to re-sit the test," the spokesman said.