Internationally Educated Midwives

Welcome to Midwifery in Canada

If you’re an internationally educated midwife (IEM) who wants to practise midwifery in Ontario, this page has all the information on how to become eligible and meet the requirements to apply for registration with the College of Midwives of Ontario.

This information is laid out to help internationally educated midwives:

• Become eligible to apply for registration with the College of Midwives of Ontario so you can begin practising,
• Achieve eligibility to write the Canadian Midwifery Registration Exam (CMRE),
• Participate in the College’s three-step competency assessment process based on the Canadian Competencies for Midwives.

In the video below, three IEMs who now practise midwifery in Canada introduce you to Canadian midwifery. The video goes over fundamental midwifery concepts, and the IEMs share their personal experiences of transitioning from midwifery in another international setting to practice in Canada.

Why should I register with the College? 

The College of Midwives of Ontario regulates midwives in Ontario, and to practise midwifery and use the title “midwife,” you must be registered with the College. The College ensures that families working with midwives in Ontario can expect safe and effective care during pregnancy, birth, and in the first six to eight weeks postpartum.

How do I register with the College?

Applicants can register with the College through three different streams, either as a graduate of Ontario’s Midwifery Education Programs, as an applicant from another province of Canada, or through a combination of international experience and Ontario orientation through the College’s Orientation and Assessment Pilot Program.

Internationally educated midwives who have not practised in Canada or attended one of Ontario’s Midwifery Education Programs must apply and complete the Orientation and Assessment Pilot Program to meet one of the requirements for registration to practise in Ontario.

Internationally educated midwives who successfully complete the College’s Orientation and Assessment Pilot Program will be deemed to have equivalency to the qualifications of an Ontario Midwifery Education Program graduate and be eligible to write the Canadian Midwifery Registration Exam (CRME), enabling internationally educated midwives to apply for registration with the College to practise in Ontario.

Successful completion of the Orientation and Assessment Pilot Program does not guarantee registration with the College. At the time of registration you will need to meet the registration requirements.

All midwifery applicants are required to submit a complete application to the College. Required supporting documentation include, but are not limited to:

• Midwifery academic credentials,
• Current clinical experience,
• Completion of the qualifying entry to practise examination (the Canadian Midwifery Registration Examination),
• Competency in neonatal resuscitation, emergency skills and cardiopulmonary resuscitation,
• Language proficiency to be able to become registered to practise midwifery in Ontario.

Introduction to the Orientation and Assessment Program

In this video, three internationally educated midwives who are practicing midwifery in Canada introduce you to the College’s Orientation and Assessment Process. They will introduce you to the three steps of this process and help you get started on your pathway to registration.

Eligibility for the Orientation and Assessment Pilot Program

There are five eligibility requirements which IEMs must meet to enroll in the orientation and assessment program. Before applying consider the following: 

• Are you a Canadian Citizen, Permanent Resident or authorized under the Immigration and Refugee Protection Act (Canada) to engage in employment in Canada? 
• Have you completed a recognized midwifery education program anywhere in the world? Can you provide a credential assessment report from an acceptable credential evaluation service?
• Have you completed an acceptable international language proficiency test with an acceptable score in all components?
• Have you practised as a midwife providing clinical care in the six years previous to your application? 
• Have you attended a minimum of 100 births as the midwife in charge? (Note: A maximum of 60 of these births can have taken place during your midwifery education. A minimum of 40 of these births must have taken place during your experience as a practising midwife after the completion of your midwifery education.)

If you are not eligible for the College’s Orientation and Assessment program, you may still be able to practise midwifery in Ontario if you are a graduate of one of Ontario’s Midwifery Education Programs.

Cost of the Orientation and Assessment Pilot Program 

Participants in the College’s Orientation and Assessment Pilot Program will pay $5800* to the College over the three steps. 

• Step 1. Application Fee: $400 (non-refundable) to be paid at the time of application submission.
• Step 2. Online assessment modules: $2250*, payable in three $750 installments before each module begins. 
• Step 3. Ten-day in-person comprehensive assessment intensive – $3150 payable before the in-person intensive begins 

*There are external courses required in Step 2, which may incur additional fees.  These courses are delivered independently from the College and payments are made directly to the external course providers.

Time Commitment for the Orientation and Assessment Pilot Program

Internationally educated midwives enrolled in the Orientation and Assessment Pilot Program may spend up to five months completing the College’s online assessment modules, 10 days in the in-person comprehensive assessment intensive, and then will be eligible to take the Canadian Midwifery Registration Exam (CMRE).

For those in the second cohort of the program, all of the online assessment modules and external courses must be completed by March 8, 2024 to be eligible to attend the intensive scheduled end of March, 2024. The CMRE will be held at the beginning of May, 2024.

General Questions About the Orientation and Assessment Program

Three Steps of the Orientation and Assessment Pilot Program

Step 1: Meet Eligibility Requirements and Apply to Enroll in the Orientation and Assessment Program

To be eligible for admission into the orientation and assessment program, you must demonstrate you meet each of the following criteria.

Requirement #1: Eligibility to work in Canada

Provide evidence issued by the government of Canada of one of the following: 

• Canadian Citizenship 
• Permanent Resident Status 
• Authorization under the Immigration and Refugee Protection Act (Canada) to engage in employment in Canada.

Requirement #2: Proof of Credential Assessment

Provide evidence of completion of a recognized midwifery education program anywhere in the world in the form of a credential assessment report from an acceptable credential evaluation service.

Requirement #3: Proof of Language Proficiency

Provide evidence meeting the language proficiency requirement. The language proficiency tests and minimum scores currently approved by the College are: 

English 

International English Language Testing System (IELTS) – Academic Format
Reading – 7	Writing – 7	Listening – 7	Speaking – 7
International English Language Testing System (IELTS) – General Format
Reading – 7	Writing – 7	Listening – 7	Speaking – 7
Canadian English Language Proficiency Index Program (CELPIP)
Reading – 9	Writing – 9	Listening – 8	Speaking – 9

French 

Test d’Evaluation de Français (TEF)*
Reading – 248-262	Writing – 371-392	Listening – 280-297	Speaking – 371-392
Test de connaissance du français (TCF Canada)*
Reading 524-548	Writing  – 14-15	Listening – 503-522	Speaking – 14-15

Please note the following: 

• The minimum acceptable score in all four domains of the test (reading, writing, speaking, listening) must have been met;
• Test scores must have been achieved within the period of 24 months prior to the application for Orientation and Assessment Pilot Program; and 
• When test scores are combined from more than one sitting, the scores must be from the same test provider, completed at least 30 days apart.

Requirement #4: Proof of Birth Attendance

Provide evidence of having attended 100 births. You will be required to share contact information from your supervisor so that we can verify these numbers. You must have acted in the role of the most responsible professional managing the delivery at all these births. 

A maximum of 60 of these births can have taken place during your midwifery education. 

A minimum of 40 of these births must have taken place during your experience as a practising midwife after the completion of your midwifery education.

Requirement #5: Proof of Work as a Midwife Outside Canada

Provide evidence of having worked as a midwife outside of Canada providing clinical care in the previous six years from the time of application. You will be required to share contact information from your supervisor so that we can verify.

Application Process for the Orientation and Assessment Program

When you apply to enroll in the Orientation and Assessment program, you need to submit the following documents to the college: 

• The completed application form
• A copy of your permanent resident card, or proof of Canadian citizenship or Authorization under the Immigration and Refugee Protection Act (Canada) to engage in employment in Canada.
• A credential assessment report from an acceptable credential evaluation service showing completion of a recognized midwifery education program.
• Proof of English-language or French-language fluency. Please see above for accepted tests.
• Payment of $400

There is a non-refundable Application Fee of $400. All documents must be submitted in one package; partial packages will not be accepted. Please keep original documents for your records as the College will not be returning any submitted documents.

Orientation and Assessment Program – Application Form

Questions About Eligibility and Applying for the Orientation and Assessment Program

Step 2: Online Assessment Modules and External Courses

Online Assessment Modules

After submitting your application, and being accepted into the Orientation and Assessment Program, you must successfully complete all Orientation and Assessment modules required by the College.

There are three foundational modules to be completed sequentially:

• Prenatal,
• Intrapartum, and
• Postpartum Midwifery Care, including primary care of the newborn until six to eight weeks.

Each module contains information about practising midwifery in the Canadian context, with overviews of expected Canadian competencies and an introduction to key components of the Canadian healthcare system. These modules are not educational courses.

The modules are all completed online and will require you to manage your time effectively to meet the deadlines.

The College will be able to assess your experience based on your completion of the modules. At the end of each module, there will be a two-hour multiple-choice exam that you will complete online. You must score at least 70% on each of the three completion exams to proceed to Step 3, the in-person assessment.

The online assessment modules cost $2250, payable in three $750 instalments before each module begins. If you choose to withdraw from a module, you will be eligible to receive a partial refund if the request is made within two weeks of starting the module. Please note that if you withdraw partway through the program and wish to practise midwifery at a late date, you will be required to complete all program components at that time. You can not receive partial recognition for modules already completed.

External Online Courses

As part of the second module, you must successfully complete the following external courses, in addition to the content covered in the module.  These courses are delivered online and enable participants to prepare for demonstration of the Canadian Competencies for Midwives required for entry to practice.

Completion of these external courses will not only enable candidates to meet the program requirement but will also allow them to meet some registration requirements (neonatal resuscitation and emergency skills) as long as they are completed within the acceptable timeframe set out by the College:

• Canadian Pediatric Society Neonatal Resuscitation Program (NRP)
  This program includes an online education and testing component followed by an in-person clinical competency assessment which will take place at the in-person intensive during Step 3. The online course component and exam takes 3-7 days to complete, depending on your needs.
• University of British Columbia (UBC) Midwifery Emergency Skills Program (MESP)
  This program includes an online education and testing component followed by an in-person clinical competency assessment which will take place at the in-person intensive during Step 3. The online course component and online written exam takes 3-7 days to complete, depending on your needs.
• Fetal Heart Monitoring – UBC Fundamentals of Fetal Health Surveillance Online Manual
  This program includes an online education and testing component followed by an in-person clinical competency assessment which will take place at the in-person intensive during Step 3. The online course component and online written exam may takes 3-7 days to complete, depending on your needs.
• Cultural Safety – San’yas Anti-Racist Indigenous Cultural Safety Training Program
  This program includes online education. IEMs will go to the San’yas Anti-Racist Indigenous Cultural Safety Training Program website and sign up for the Ontario Core Program. The course is completed independently online and there is no in-person assessment/component.

The online exam for the NRP must be completed within 25-30 days of the first day of the in-person intensive (Step 3). If you have completed these courses previously, you must re-take them to ensure the exam is completed in the 25–30-day window.

A cost may be associated with each external course. Please note that these courses are delivered independently from the College and payment are made directly to the external course providers.

Questions About Assessment Modules and Continuing Education

Step 3: In-Person Consolidation and Assessment Intensive

The 10-day in-person Consolidation and Assessment Intensive costs $3150, which is payable before the course begins.

Following the online modules and external courses, you must successfully complete the 10-day in-person intensive course. The intensive includes clinical skills practice, an online comprehensive exam, and the in-person components of the above-listed external courses.

For the pilot program, the College will offer the in-person intensive prior to the Canadian Midwifery Registration Exam (CMRE).

The content of the intensive will include both universal testing for all participants and individualized remedial opportunities.

You must successfully complete all included components and pass all assessments to complete the College’s Orientation and Assessment Process and move on to write the CMRE. There is an additional cost to register with the CMRE to take the exam.

Questions About In-Person Intensive

Submit your Application for the Orientation and Assessment Pilot Program

Note: Applications for the Orientation and Assessment Pilot Program will be accepted starting on September 8, 2023 and will close on October 20, 2023.

To apply for the Orientation and Assessment program, you must submit your signed application form and supporting documents in the secure deposit box below. We will only review complete applications so please ensure all of your documents and the application form are included. You will also need to pay your $400 application fee once you have submitted your documents.

If you send an incomplete application or an application without the $400 application fee, the College will not review your documents and will delete your correspondence for privacy reasons.

A complete application includes:

• Application Form
• Supporting Documents:
  • Ability to work in Canada. Please provide one of the following:
    • Proof of Canadian Citizenship
    • Permanent Resident documentation
    • Authorization under the Immigration and Refugee Protection Act
  • Evidence of completion of a recognized midwifery education program anywhere in the world in the form of a credential assessment report from an acceptable credential evaluation service.
  • Proof of English-language or French-language fluency. Please see above for accepted tests.