Overview
The Competency-Based Assessment Program is an assessment used to determine whether a midwife has the knowledge, skills, and judgment required to practise midwifery safely and effectively within the Canadian context. The assessment evaluates candidates’ competencies in alignment with the standards established by the Canadian Midwifery Regulators Council’s Canadian Competencies for Midwives.
The College of Midwives of Ontario (CMO) administers this assessment on behalf of provincial and territorial regulatory authorities that require it to evaluate a candidate’s competencies for their own regulatory purposes.
Eligibility criteria
Each provincial and territorial midwifery regulatory authority establishes their own eligibility criteria and determines if the Competency-Based Assessment Program is appropriate within their respective context. If this is the case, the regulatory authority will refer the candidate directly to the College of Midwives of Ontario. The CMO will follow up with the regulatory authority to confirm acceptance of the candidate and establish next steps for communication with the candidate regarding scheduling and accommodations (if necessary).
How is the Competency-Based Assessment Program delivered?
The competency-based assessment is a structured oral examination conducted virtually via videoconference by a panel of three assessors.
The assessment is a closed-book evaluation composed of eight evolving case scenarios.
Each scenario begins with a clinical case summary, including relevant client information such as demographic data, relevant health history, and presenting clinical concerns. Each case includes six to eight standardized questions and optional probes for use by the assessors to elicit more thorough responses. The approximate duration of the exam is three hours and includes a short break halfway through.
Timelines
The CMO will work with the candidate and the panel of three assessors to schedule a suitable time and date. The CMO will endeavour to complete the assessment within 30 business days of the referral.
Results
Results will be shared with both the candidate and the referring regulatory authority within approximately seven business days.
This is not a pass/fail assessment. Instead, the results provide recommendations to the referring regulatory authority regarding what may be required for the candidate to transition into practice safely and effectively. It is up to the regulatory authority to consider these recommendations, alongside any other relevant information, when making their decision.
Assessment fee
The assessment fee is $1200.00 (inclusive of HST).
The Competency-Based Assessment Program operates on a cost-recovery model*, meaning the fee is set to recover only the direct costs of delivering the program including compensating assessors for their time.
*In 2026, the College of Midwives of Ontario will offer a subsidized rate as the program launches for the first time. As such, the cost posted above does not reflect actual costs of the program.
Cancellation
This assessment requires significant coordination, including scheduling registered midwives who serve as assessors. For this reason, we have a strict cancellation policy.
Cancellations made more than five business days before the assessment are eligible for a full refund. Cancellations made within five days are non-refundable; however, if you reschedule your assessment, 50% of the original fee may be applied toward a new booking.
Appeal
Candidates may request an appeal of their examination result; however, an appeal cannot be submitted solely on the basis of dissatisfaction with the outcome. Appeals must identify specific grounds, such as a procedural irregularity, administrative error, or other factor that may have affected the fairness of the assessment.
The College of Midwives of Ontario serves solely as the administrator of the Competency-Based Assessment Program and does not hold decision-making authority for all program participants. Any further concerns beyond the administration of the assessment should be directed to the referring regulatory authority.
To initiate an appeal, candidates must submit a written statement that clearly outlines the reason(s) for the appeal, along with any supporting evidence or documentation within 30 business days of receiving the assessment results. Requests must be emailed directly to the CMO at qap@cmo.on.ca. Submissions received after the deadline may not be considered unless exceptional circumstances are demonstrated.
The CMO will acknowledge the appeal from the candidate within seven business days of receiving the request. The acknowledgement letter will outline the appeal process and the expected timelines.
If an appeal is granted, a fourth independent assessor will conduct an additional review of all relevant materials, including the candidate’s assessment results and each assessor’s observations. The review will take place within 30 business days of the acknowledgment letter. The costs associated with the appeal will be the responsibility of the candidate. If the procedure of administration is found to have negatively impacted the outcome, the candidate may be permitted to retake the assessment, at no cost. The referring regulatory authority will receive both the original results and the outcome of the appeal review.
Accommodation
The CMO is committed to providing accommodations for the Competency-Based Assessment Program in accordance with human rights legislation, based on protected grounds. Each request for accommodation will be reviewed on a case-by-case basis to ensure fair and equitable access, while upholding the validity, reliability and security of the assessment.
Candidates must request an accommodation at the time of scheduling their assessment by completing an accommodation form and attaching any supporting document. The form will be available on our website in the coming weeks. The request will be reviewed by the CMO within seven business days and additional information may be requested at this stage. The CMO will cover all costs associated with approved accommodations.
How can I prepare for the Competency-Based Assessment Program?
Unlike an objective structured clinical examination (OSCE) or a written exam, a structured oral examination assesses knowledge application, critical thinking, ethical and professional judgment, and communication skills. Candidates are expected to explain how they would handle a specific situation and articulate their reasoning.
The assessment recognizes that, in practice, candidates may act automatically and may not be able to list every action during the examination itself. For this reason, assessors may prompt candidates with questions to help elicit responses. However, prompting should be limited, as there is an important distinction between drawing out an answer that a candidate knows and providing assistance where the candidate does not have the required knowledge. In addition, the assessment does not expect candidates to know the answer to every question presented; rather, it measures how they respond in the moment and how resourceful they are in applying their judgment. The exam also assesses a candidate’s demonstration of inclusive midwifery care, which is defined as trauma-informed, client-centered, comprehensive, and compassionate care.
The assessment is intended to capture the candidate’s current and working knowledge, as opposed to testing them on a narrow set of topics; as such, preparation for the examination is not necessary.
Questions?
Please reach out to qap@cmo.on.ca should you have further questions which are not answered on our website.