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Internationally Educated Midwives Question and Answer

If you are an internationally educated midwife (IEM) who is looking to apply for the College of Midwives of Ontario’s Orientation and Assessment Program please first review our overview of the program here, and more details about the three-step process here. If you have questions about the program, please read on. If your questions are not answered here, contact and College staff will be in touch shortly.

Step 1 Questions

Question: Why do I have to complete the College’s Orientation and Assessment Program? 

Answer: In order to be registered to practise in the General class, an applicant must satisfy requirements set out in the Registration Regulation relating to education, clinical experience, and a qualifying examination. An applicant 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, the Registration Regulation states that an applicant 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.  

Question: I have applied for Permanent Residency, Protected Person status, or Canadian Citizenship and I am waiting to hear back. Do I meet the requirement?

Answer: 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.

Question: I previously received a midwifery education assessment report from a different education assessment agency, will that be accepted by the College?

Answer: 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 assessments agencies.  

Question: Why does the College require an Academic International English Language Testing System (IELTS) Exam Report with scores of seven or greater in each section from applicants?

Answer: 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, available in most countries of the world, and many resources exist online to help internationally educated professionals prepare for testing.

Question: Is it possible to repeat the IELTS test?

Answer: 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.

Question: Can I demonstrate language proficiency another way?

Answer: 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 in their test was equivalent to seven or above in all sections of the Academic IELTS with your application.

Question: How do I demonstrate that I have attended 100 births?

Answer: 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 Questions

Question: Will I have to attend regular lectures to complete the modules? Are they in person?

Answer: 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.

Question: How long will each module take to complete?

Answer: 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 up to nine months.

Question: How will the College assess my understanding of the material?

Answer: 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.

Question: How do I pass the completion exam and move forward in the process?

Answer: 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.

Question: If I do not receive 70% on my first attempt, can I try again?

Answer: 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 wait period applied before being able to retake the exam.

Step 3 Questions

Question: How often and where are the College’s in-person assessment intensives offered?

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

General Questions

Question: How long is the College’s Orientation and Assessment process?

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

Question: How much does it cost to complete the entire Orientation and Assessment program?

Answer: Participants in the College’s Orientation and Assessment 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

Note: The external courses required in Step 2 will require additional payment directly to the course providers.

Question: How do I learn more about midwifery in Canada to help me prepare?

Answer: There are many excellent online resources to help IEMs orient 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.

Question: Once I have registered, can I practice privately and/or set up my own private clinic?

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

Question: After I complete the College of Midwives of Ontario assessment process and pass the CMRE can I practise anywhere in Canada?

Answer: 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. You can also contact other provincial regulators directly to find out their registration requirements. 

Question: I am a midwifery teacher in another country, but I have not practiced clinically for the past six years. Am I eligible to apply for assessment?

Answer: No. The eligibility requirements for all IEM applicants, including midwifery teachers, include clinical practice within the past six years.

Question: I am an internationally educated physician (IEP) who delivered babies as an obstetrician. Can I apply for the Orientation and Assessment program?

Answer: No. In Ontario, midwifery, nursing, and medicine are distinct professions, each with their own professional regulatory Colleges routes to 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.