College of Midwives of Ontario

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Internationally Educated Midwives

Application Period Closing April 15

Applications for the Orientation and Assessment Pilot Program will be accepted until April 15, 2023.
Please visit the site in the fall for updates on the pilot program.

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:

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

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?

All midwifery applicants are required to show proof of:

  • Midwifery qualifications,
  • 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.

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 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 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 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 IEMs to apply for registration with the College to practise 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 formal structured midwifery education program anywhere in the world? Can you provide evidence of completion in the form of a World Education Services (WES) Program Assessment Report? 
  • Have you or will you complete an International English Language Testing System (IELTS) academic test (or equivalent test) with a score of seven or above 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) 
  • Step 2. Online assessment modules: $2250*, payable in three $750 installments before each module begins. 
  • Step 3. Fourteen-day in-person comprehensive assessment intensive – $3150 payable before the in-person intensive begins 

*There are external courses required in Step 2, and those courses will require additional payment 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 nine 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). The CMRE is typically offered twice a year. Most IEMs will be able to complete the process within a year to 18 months. 

We anticipate the first 10-day in-person comprehensive assessment intensive will be held in fall 2023, in advance of the CMRE’s fall 2023 sitting.

General Questions About the Orientation and Assessment Program

Applicants have a maximum of 18 months to complete the program. However, the Orientation and Assessment process is self-paced and flexible to increase access to registration for IEMS. The time that the program takes will depend on your availability, your speed in completing assessment requirements, and your learning and orientation needs. The process can be completed in as little as four months.

There are many excellent online resources to help IEMs become oriented to midwifery in Canada.

McMaster University published a Canadian Midwifery Education Textbook in 2019. This is a three-volume interactive digital textbook used in many Canadian midwifery education programs, which provides multiple scenarios and quizzes. It is called Midwifery: An Interactive Approach to the Theory & Evidence of Practice. This book can be purchased online through the McMaster University website.

The University of British Columbia has a website for their midwifery education program which includes a resource section titled Books and Theses. In this section you will find information about all the resources utilized by midwifery students in the UBC midwifery education program. These texts and articles are all available online.

We encourage you to search online for Canadian midwifery resources related to the topics you are interested in and access the websites of the Canadian Association of Midwives and the Colleges and Professional Association websites for midwifery in Canadian provinces and territories.

No. Midwifery services in Canada are essential health services provided by a universal, publicly funded healthcare system, managed by each province. There is no private obstetric or midwifery care in Canada.

Midwives who are registered to practice in one Canadian jurisdiction may apply to register in another Canadian province or territory. This is because Canada has the Canadian Free Trade Agreement which reduces labour mobility barriers for workers by protecting the rights of certified professionals to move between provinces. If you are interested in practising elsewhere in Canada you should contact other provincial regulators directly to find out their registration requirements.

No. The eligibility requirements for all IEM applicants, including midwifery teachers, include clinical practice within the six years immediately preceding your application.

No. In Ontario, midwifery, nursing, and medicine are distinct professions, each with their own professional regulatory Colleges, processes for registration and licensure, and distinct educational programs. You may wish to review the College of Physicians and Surgeons of Ontario’s website, or the College of Nurses of Ontario’s website for information.

Three Steps of the Orientation and Assessment Pilot Program

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

Learn more

Online Assessment Modules and Continuing Education

Learn more

In-Person Consolidation and Assessment Intensive

Learn more

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 
  • Refugee (Protected Person with the ability to work in Canada) Status

Requirement #2: Proof of Credential Assessment

Provide evidence of completion of a formal structured midwifery education program in the form of a World Education Services (WES) Program Assessment Report or an equivalent education assessment report.

Requirement #3: Proof of Language Proficiency

Provide an Academic International English Language Testing System (IELTS) Exam Report with scores of 7 or greater in each section (or equivalent test as accepted for immigration purposes), or the French equivalent Test D’evaluation De Francais (TEF) Report.

Requirement #4: Proof of Birth Attendance

Provide evidence of having attended 100 births 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.

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 Protected Person status
  • A program assessment report from World Education Services
  • A copy of your Academic IELTS exam report with scores of 7 or above in all sections
  • 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

To be granted registration to practise in the general class, you must satisfy requirements set out in the Registration Regulation relating to education, clinical experience, and a qualifying examination. Applicants may be registered in the supervised class if they satisfy the education and examination requirements but require a period of supervision to remedy deficiencies in their clinical experience.

With respect to education, applicants must complete a baccalaureate degree in health sciences (midwifery) from a university in Ontario, or qualifications that are equivalent to such a degree, as determined by the Council or by a body or bodies designated by the Council.

Internationally educated midwives can demonstrate equivalence to an Ontario degree through the successful completion of the College’s Orientation and Assessment Program, leading to the possibility of registration without having completed an Ontario midwifery degree.

If the Canadian government’s decision on your status is expected to occur within nine months, you may provide documentation of your immigration application in process and submit your Orientation and Assessment application.

To register with the College and work as a midwife in Canada you must be eligible to work, either as a Permanent Resident, Protected Person, or Canadian citizen. You must become eligible to work in Canada within two years of completing the assessment process and writing the CMRE, or you might be required to repeat the assessment process.

The College will determine whether we can accept the report. Please send the report as part of your application package for us to consider. The College will not accept reports from private assessment agencies.

The Academic IELTS exam is the gold standard in English language proficiency testing for health professionals.

Midwives in Canada must have a high level of professional language and communication fluency and proficiency in a range of communication domains including information sharing, arranging consultations for care outside of scope, communicating emergency management, counselling, cross-cultural communication, facilitation of informed choice and informed consent.

They must be able to function competently in academic environments for ongoing professional education, continuous review of academic midwifery and medical literature, and to be able to present in conference and hospital rounds settings.

The IELTS test is accessible and available in most countries of the world, and there are many resources online to help internationally educated professionals prepare for testing.

You may take the Academic IELTS as many times as you need to demonstrate the required language fluency requirement. A previous IELTS report utilized for immigration purposes will be considered valid by the College.

If your immigration process involved a different academic language fluency test, you can submit a different report if your test scores were equivalent to an Academic IELTS score of seven or greater in each section.

For the College to consider another test, you must submit a letter from the testing agency confirming that your score on their test was equivalent to seven or above in all sections of the Academic IELTS with your application.

On the application form, we will ask you to provide the name and contact information of two or more supervisors who can confirm your clinical experience. The College will contact your supervisors to verify this information.

Step 2: Online Assessment Modules and Continuing Education

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.

You can work at your own pace, provided you complete each module in three months. All three modules must be completed in nine months. The modules are all completed on your own time and completely online.

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 installments before each module begins. You may choose to withdraw from a module and will receive a partial refund if the request is made within two weeks of starting the module.

External Online Courses

After you have finished the three foundational modules, you must successfully complete the following externally provided online courses. These courses enable participants to prepare for demonstration of the Canadian Competencies for Midwives required for entry to practice, including the ability to meet the non-exemptible requirements of continuing competence in neonatal resuscitation and emergency skills:

These external courses must be completed after you have passed the College’s three online modules. The online exam for the NRP, MESP and Fetal Heart Monitoring courses 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.

Each external course may have a cost which must be paid directly to the provider.

Questions About Assessment Modules and Continuing Education

All three assessment modules will be completed online, with no in-person attendance. All work is done independently. There are no assignments to be submitted or graded, and there are no instructors.

The timeline for module completion is flexible. You are permitted up to three months to complete each of the three modules, but it may take you just a few weeks, depending on the amount of time each week you can give to the Orientation and Assessment process. The maximum time range to complete all three modules is nine months.

At the end of each module, there will be a formal completion assessment. The assessment will be a two-hour multiple-choice exam, administered online.

You must successfully complete each module sequentially, with a minimum score of 70% on each of the three completion exams to proceed to Step 3, the in-person assessment intensive.

If you are unable to achieve a passing score on any module exam on your first attempt, you will be permitted a second opportunity to take the exam. You must retake the exam within one calendar year after your first attempt. Applicants who wish to take a third attempt will have a waiting period applied before being able to retake the exam.

Step 3: In-Person Consolidation and Assessment Intensive

Following the online modules and external courses, you must successfully complete the 10-day in-person intensive course. The intensive includes clinical skills practice, written exam review, and comprehensive assessment.

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

The content of the intensive will include both universal testing for all participants and individualized remedial opportunities. We will share more detailed information on the activities that will be part of the intensive course shortly.

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.
IEMs may have individualized opportunities during the intensive to give extra attention to areas of challenge.

If you are unable to pass the intensive requirements after your first attempt, you will be permitted a second attempt, which must take place within one calendar year after the first intensive.

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

Questions About In-Person Intensive

The two-week in-person intensive for the pilot program will be offered in the fall in Toronto.

Submit Your Orientation and Assessment Application

Note: Applications for the Orientation and Assessment Pilot Program will be accepted until April 15, 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.

Submit your application

  • 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
    • World Education Services or equivalent credential evaluation of the formal midwifery program
    • Proof of English-language fluency: IELTS or equivalent language proficiency report with a score of seven or higher.
  • Please mention the Orientation and Assessment program in the message field.

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