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Registration Regulation

December 21, 2017

Note: This article was originally posted in our December 2017 newsletter, and has not been updated.

The College of Midwives of Ontario is proposing changes to O. Reg. 168/11 Registration Regulation.

The Registration Regulation sets out the requirements for obtaining and maintaining registration with the College of Midwives of Ontario. The College’s current Registration Regulation addresses:

• Acceptable routes of entry

• Non-exemptible and exemptible entry to practice requirements

• Classes of registration and each class’ specific requirements

• First year of practise requirements

• Initial and continuing competency requirements

• Active practice requirements

• AIT/Labour mobility requirements

• Requalification, reinstatement, suspension, and revocation

We have undertaken a comprehensive review of our Registration Regulation, policies, and processes, with the aim of improving the effectiveness and efficiency of our registration programs. We are proposing changes to the regulation so that we can better respond to best practices in regulation; remove barriers to the delivery of safe, timely and quality midwifery care; and improve client experience in the health care system.

The biggest change we are proposing to the Registration Regulation is to clinical currency.

We now measure clinical currency through our Active Practice Requirements (APR), and members must report how many hospital, out-of-hospital, and the overall number of births they’ve attend as the primary midwife over a specified period of time.

There is no current evidence that attending a certain number of births within a given time frame is a gauge of maintaining clinical skill or competence. In fact, the Society of Obstetricians and Gynaecologists of Canada, the College of Family Physicians of Canada, and the Society of Rural Physicians of Canada have issued a policy statement affirming that there is no correlation between attending a specific number of births and competence.

Given this, we propose removing APR from the Registration Regulation. Instead, we are considering requiring midwives to provide the College with evidence that they have practiced within a specified time period and are maintaining the necessary knowledge, skill, and judgment to hold a practicing certificate of registration.

This proposal to eliminate APR is also supported by the Health Professions Regulatory Advisory Council (HPRAC), who recommended revoking these requirements in 2008 in order to “provide flexibility for the CMO and ensure the involvement of other maternity care professions in developing joint standards for maternity care.”

We are also proposing changes to:

• Format and layout of the Regulation for ease of use

• Classes of Registration

• Applicant – Requirements for Issuance of a Certificate

• Disclosure requirements

• New Registrant requirements

• Registration card and wall certificate requirements

• Re-registration of former members

• Continuing Competencies

• Implications to resignations

• Revocation & reinstatement, etc

We will be in touch with midwives and members of the public in coming months to share more information about these upcoming changes.