The route for a midwife trained outside Canada: a regulator-approved bridging or assessment program, the Canadian Midwifery Registration Examination, and registration with the regulator in the province or territory where you will practise, including the separate Quebec equivalence route.
Applies in: across Canada
This guide covers one route only: a person who completed midwifery education outside Canada, who has not yet registered as a midwife in Canada, and who wants to practise as a registered midwife in Canada. It is not the domestic route for a student entering a Canadian baccalaureate midwifery program, and it is not a route for a nurse, a doula, or any other health profession to practise midwifery without meeting the midwifery regulator's requirements. Those are separate paths with separate education and examinations. Do not mix the steps: a nursing credential does not become a midwifery credential by passing the midwifery examination alone, and a bridging program completed for one province does not automatically satisfy another province's regulator.
Two kinds of bodies divide the work, and confusing them is the expensive mistake. The Canadian Midwifery Regulators Council, the CMRC, is the network of the provincial and territorial regulators. It sets the national competencies, administers the Canadian Midwifery Registration Examination, and approves educational and bridging programs in the harmonization sense described on its pages. The regulator in the province or territory where you will work licenses you. The CMRC states plainly that provincial and territorial regulators may have other requirements for registration beyond successful completion of the examination. This guide follows that order: destination regulator, bridging or assessment program, national examination, then the destination regulator's remaining requirements and registration.
Midwifery is regulated province by province and territory by territory, and health professionals are registered in the jurisdiction in which they work, as the CMRC states on its internationally educated midwives page. Registered midwives moving from one province to another apply under the Canadian Free Trade Agreement, but that mobility route is for people already registered in Canada. It is not the entry route for a midwife trained abroad who has never registered in Canada.
Start by naming the jurisdiction where you intend to practise, then open that regulator's internationally educated applicants page and read its approved-program list, its document list, and its fee schedule. The CMRC member list in the final FAQ question names the regulator for each jurisdiction. The three regulators covered in this guide illustrate how different the routes are even though they share the same national examination. Ontario requires completion of a College-approved bridging or assessment program before applying. Manitoba requires completion of one of its approved bridging programs first. Alberta runs a checklist built around credential assessment, a competency assessment tool, the national examination, and an objective structured clinical examination, with a prior learning and experience assessment program available. The same examination sits at the centre of all three, but the steps around it are set locally. Choosing a program before choosing a destination risks completing a program the destination regulator does not recognize for its registration.
The CMRC states the national eligibility rule for the examination in terms of these programs. Internationally educated candidates are eligible to write the Canadian Midwifery Registration Examination if they are in good standing in the final stage of a Canadian bridging or assessment program approved or recognized by one of the provincial or territorial regulatory authorities. That is the gate: enrolment alone is not enough, and a program approved in one jurisdiction may not be approved in another. The CMRC page on internationally educated midwives names the programs in general terms: English-language assessment and bridging programs at the University of British Columbia and Toronto Metropolitan University, a French-language bridging program with the Ordre des sages-femmes du Québec, and a prior learning and experience assessment program in Alberta, with a direction to contact the College of Midwives of Alberta for Alberta.
Manitoba shows how the approval works in practice. The College of Midwives of Manitoba states that all internationally educated midwives must first complete one of the approved bridging programs before applying for registration, and names two: the International Midwifery Preregistration Bridging Program offered by the R. Chang School of Continuing Education at Toronto Metropolitan University, designed to support applicants from across Canada with distance-based learning so that all or most of the program may be completed in Manitoba, and the Internationally Educated Midwives Bridging Program offered by the University of British Columbia, intended for midwives planning to practise in British Columbia, whose admission for Manitoba applicants may be limited or unavailable. Ontario's position is stated in the same mandatory form, with its own program list. The College of Midwives of Ontario states that all internationally educated midwives must first complete one of the College-approved bridging or assessment programs before applying, and its registration page names the International Midwifery Preregistration Bridging Program offered by the Chang School at Toronto Metropolitan University as one route to meeting the education requirement. The College also runs an Orientation and Assessment Pilot Program, described on its news page as assessing whether internationally educated midwives meet the qualification requirements to practise in Ontario, with three foundational assessment modules online covering practising midwifery in Canada and expected competencies, and states that successful completion of that program will be deemed to give equivalency to the qualifications of an Ontario Midwifery Education Program graduate and eligibility to write the examination. Each program has its own admission criteria, as the Ontario page warns, and completing a program successfully does not guarantee registration.
No bridging program duration, tuition figure, or clerkship length is stated in this guide beyond the Quebec certificate figures in Step 5, because no current program page for the University of British Columbia or Toronto Metropolitan University program could be verified on an official page. Secondary summaries that quote six to ten months or a tuition figure were not carried. Confirm the current length, delivery mode, admission criteria, and fees on the program's own page and with the destination regulator before you enrol or pay, and confirm in writing that the destination regulator will recognize that program for your application.
The Canadian Midwifery Registration Examination, the CMRE, is set and administered by the CMRC. It is designed to assess the entry-level competencies in the Canadian Competencies for Midwives, for both Canadian-educated and internationally educated applicants. The CMRC is careful about what the examination does: it does not ensure competency, but is an important and reliable tool used by regulators to permit entry to the profession after a baccalaureate program or a regulator-approved assessment or bridging program that incorporated regular assessments including written examinations and assignments, clinical placements, and objective structured clinical examinations.
The examination is offered twice a year. In 2026 the dates stated on the CMRC page are May 7 and October 29, with registration for the October examination opening August 2, 2026 and closing September 8, 2026. Those 2026 dates are stated here as the published 2026 sittings, not as future dates, and no 2027 sitting date is stated because none could be verified on a Council page. Confirm the next sitting and its registration window on the Council page before you plan around a date. The examination is online with live remote proctoring, and candidates who prefer to write in a test centre can ask to do so. Candidates receive access to the online platform before the examination and can take a tutorial to become familiar with it.
The format is stated on the Council page. The examination consists of case-based and independent multiple-choice questions, each with four possible answers and one best answer, with no penalty for incorrect answers. Approximately half of the questions are case-based, presenting a scenario followed by two to five questions on that case. Slightly more than half of the questions are set in an out-of-hospital setting, with the remainder in a hospital setting. The examination is 4 hours and 45 minutes in length, with one 30-minute break halfway through, for total seat time of 5 hours and 15 minutes. All candidates have access to the examination items in both English and French. The passing score is developed through a standard-setting process and may change slightly from one sitting to the next, so no numerical pass mark is stated in this guide. Score reports show pass or fail and are distributed within six weeks of the examination date. A formal request for re-scoring may be submitted within fourteen days after the score release date, with a $75 fee charged. Candidates may take the examination multiple times, but after three sittings they must provide evidence of additional relevant education to the CMRE before registering again, and all re-write fees are the same as initial fees. For 2026 the examination fee is $992.50, paid by INTERAC e-transfer to the CMRE Administrator as directed on the registration page, and the page states that the fee will increase by 5 percent annually in 2027. Confirm the current fee, payment details, and registration deadline on the Council page before you pay, and do not pay a fee quoted by a preparation course or a secondary summary.
Preparation should follow the Council's own study guidance. Review the Canadian Competencies for Midwives and the CMRE Blueprint, which outlines how many questions cover each general topic area, and study the standards and policies of the jurisdiction where you will apply, since only requirements that are the same across all Canadian jurisdictions are tested. The Council does not endorse any private preparation course, and the Midwifery Pre Exam Self Assessment, the PESA, is available through the bridging or assessment programs and regulators to candidates who are senior students or internationally educated midwives in Canadian bridging or assessment programs. Accommodations, including extra time, must be requested with the accommodation request form submitted with the registration form, pre-approved by the CMRE Committee, with no fee for the request itself, though candidates bear the costs of supporting documentation.
Passing the examination does not complete registration. The remaining requirements are set by the destination regulator, and the Ontario and Alberta examples below show the range. Read them as worked examples of two regulators, not as a national checklist, and read your own regulator's page for the list that governs you.
Ontario's requirements are set out on the College of Midwives of Ontario registration page. All applicants for a general certificate must meet the education requirement through a degree from an Ontario Midwifery Education Program, completion of the International Midwifery Preregistration Bridging Program, or application as an inter-provincial applicant, with the Orientation and Assessment Pilot Program deemed to give equivalency as described in Step 2. Applicants must have completed the CMRE. They must complete the College's Jurisprudence Course, offered online as a handbook of 11 lessons with an online module and open-book examination questions, which takes about four hours on average, requires all questions to be answered correctly, and allows unlimited attempts. They must submit a Vulnerable Sector Check that is an original issued within 6 months of the date a complete registration application is submitted, covering all names used, and they must answer disclosure questions and submit letters of standing from bodies where they are or have been licensed or registered in any profession. They must provide evidence of current personal protection against professional liability, a non-exemptible requirement, often obtained through the Association of Ontario Midwives by way of HIROC, effective on the date of registration. They must demonstrate entitlement to work in Canada. The College states that it will process complete applications within 10 business days, with more detailed timelines in the Registration Handbook. Applicants must also submit certificates showing successful completion of training in neonatal resuscitation within the previous 12 months and emergency skills and cardiopulmonary resuscitation within the previous 24 months. Applicants who have written the examination but have not received results may be eligible for a transitional certificate, valid for up to 90 days, to practise while under the supervision of a registrant holding a general certificate, revoked when the applicant is notified of a pass and issued a general or supervised certificate, or of a fail. No Ontario registration fee figure is stated in this guide, because no fee schedule figure could be verified on an official page.
Alberta's route is organised as a three-part checklist by the College of Midwives of Alberta. Part 1 requires an education credential assessment from an independent service such as World Education Services or the International Qualifications Assessment Service, sent directly by that service, a completed application with a current photo, a non-refundable application fee of $1,500, government-issued identification, proof of citizenship, residency, or employment authorization, official transcripts and certificate or diploma sent directly by the program, course syllabi, evidence of any midwifery examination completed outside Canada, detailed practice experience and birth numbers for the past one year and past five years with employer verification, a competency assessment tool, evidence of mandatory competencies in cardiopulmonary resuscitation valid for 2 years, fetal health surveillance valid for 2 years, emergency skills valid for 2 years or equivalent, and neonatal resuscitation including endotracheal tube intubation valid for 1 year, completion of the sexual abuse and sexual misconduct module, a restricted activity survey, the CMRC self-assessment survey, and English language proof where English is not the applicant's first language or the midwifery education was not completed in English: IELTS Academic 7.0 overall with a minimum of 7.0 per component, or TOEFL internet-based 95 total with 25 minimum in speaking and 21 minimum in other components, with alternative proof accepted as set out in the Labour Mobility Regulation. The jurisprudence examination is currently suspended while it goes through review and update, as the checklist states. A police information check with vulnerable sector check conducted within 6 months before submission of the complete application is required, with a police check from the country of residence for applicants still outside Canada or recently arrived. Part 2 requires completion of the CMRE with evidence uploaded to the applicant's profile, and completion of the objective structured clinical examinations recommended by the College. Part 3, once the Registrar or Registration Committee approves the application or approves it with conditions, requires evidence of professional liability insurance, with insurance applied for only once all Part 1 and 2 requirements are completed and a registration number has been issued, and payment of practice permit fees, currently $4,550 for the entire year, adjusted according to the month practice begins. Complete applications may take up to 10 business days to be processed. Alberta midwifery services are publicly funded through Alberta Health Services, and the checklist recommends contacting Alberta Health Services about appointment and privileging, since Alberta Health Services is responsible for approving insurance once a position is secured. The Alberta figures in this paragraph are stated as they appear on the checklist; confirm them on the College's current checklist before you pay, since fee and language schedules change.
For every other jurisdiction, the same discipline applies: open the regulator's internationally educated page, work through its document list, and confirm language, jurisprudence, criminal record check, insurance, and fee requirements there. Do not carry an Ontario or Alberta requirement into another jurisdiction on assumption, and do not assume that a requirement satisfied for one regulator satisfies another.
Quebec does not follow the bridging-program-to-CMRE sequence described in Steps 2 and 3. Its route is an equivalence application to the Ordre des sages-femmes du Québec, the OSFQ, and this section states only what the OSFQ page states. The page covers candidates trained outside Canada other than in France or Switzerland, who have separate mutual-recognition routes, and it states that only an equivalence request received through the Order's portal will be considered. Forms and documents received by email will not be accepted, no document is to be sent by post, and originals are to be kept by the applicant. Immigration steps to come and work in Quebec are not the Order's responsibility, and applicants are directed to the Ministère de l'Immigration, de la Francisation et de l'Intégration.
The first required action is to create a user account and complete the equivalence request form that matches the applicant's situation, through the Order's portal. The mandatory documents are: the comparative evaluation of diplomas from the Ministère de l'Immigration, de la Francisation et de l'Intégration, for which the Order notes that the majority of requests are treated within 6 months given the high number of requests; the completed diploma and training equivalence request form, downloaded directly in the portal, with a letter of interest of 500 to 1000 words explaining interest and motivations for joining midwifery practice in Quebec; a certified true copy of an official photo identity document; an up-to-date curriculum vitae; a certified true copy of training diplomas; a copy of the permit or authorization of legal aptitude to practise midwifery from each country where the applicant practised; school records with detailed descriptions of theory courses, including hours or credits and transcripts, and detailed descriptions of placements, including objective, content, hours, and transcripts; signed official attestations from employers describing relevant midwifery work experience, including job title, employment dates, and approximate numbers of follow-ups and births, with proof of a private practice permit for self-employed applicants; and attestations of continuing education activities. The second required action is to complete the admission form steps through to payment of the invoice, which includes the file-opening and analysis fees, with the fee schedule on the page below that statement. The third required action is to check email and the portal file within 48 to 72 hours, since the applicant can follow the state of the request throughout the admission process through personalized online access.
On receipt of an equivalence request, the Order's admission service evaluates the documents and determines whether the file is complete, communicates the information to the candidate, and submits the file for analysis by the Order's Admission Committee, which may ask the candidate to attend an interview in objective structured clinical examination form, pass an examination, or complete a placement, in order to formulate an appropriate recommendation. The Committee's recommendations on prescribed compensatory measures go to the Order's Board of Directors. Two outcomes exist. Partial recognition of the equivalence of training leads to enrolment in the personalized certificate in midwifery practice in Quebec at the Université du Québec à Trois-Rivières, whose successful completion gives complete equivalence of training. That program lasts six months, comprising three months of theory activities and 15 weeks of placement, with an additional placement possible if needed, and university fees of approximately $4,000 payable to the university. Refusal of recognition of diploma or training equivalence means enrolling in the bachelor's program in midwifery practice at the same university, lasting three years, in order to practise as a midwife in Quebec. Following a partial-recognition recommendation, the Order sends notification through the portal of the official letter filed in the applicant's record, also transmitted to the university in anticipation of the next cohort of the personalized certificate, then the candidate attends a mandatory virtual information session, registers on the student midwives register of the Order's roll to be in good standing during the certificate placements, successfully completes the certificate, and registers on the Order's roll with payment of the annual dues to be authorized to practise in Quebec as a midwife. The Order states a processing time of 2 to 3 months from receipt of a complete file, with other delays to be expected for immigration and certificate availability, notes that the certificate is generally offered every two years subject to a minimum number of candidates, and states that an incomplete equivalence request cannot be processed, is kept for one year, and is then closed and destroyed if no document is added. Permanent residency is no longer required to join the personalized certificate program. No French-language requirement, fee figure for the equivalence application itself, or CMRE requirement is stated for Quebec in this guide, because the OSFQ page does not state those items, and the Quebec route must not be filled in from the other provinces' steps. Confirm the language, fee, and examination position on the Order's portal before you apply.
Language evidence is set by the destination regulator, not nationally. Alberta's checklist states the IELTS and TOEFL figures quoted in Step 4 for applicants whose first language is not English or whose midwifery education was not completed in English. Ontario's page does not state a language-test figure, and no language-test figure is stated for any other jurisdiction in this guide. Confirm the accepted tests, minimum scores, and validity period on the destination regulator's page, and confirm that the result will still be current when the regulator reads the file.
Work authorization is a separate gate from registration. Ontario requires proof of Canadian citizenship, permanent residency, or authorization under the Immigration and Refugee Protection Act to engage in employment in Canada. Alberta requires a copy of a Canadian passport, Canadian birth certificate, permanent resident card, or valid work permit. Quebec's Order states that immigration steps are not its responsibility. Registration does not create immigration status, and immigration status does not create registration. Plan the two processes in parallel, and coordinate expiry dates: criminal record checks, language results, letters of standing, and mandatory competency certificates all carry validity periods stated by the regulator, and a document that expires before the file is complete can force a repeat step. Alberta's checklist warns expressly that coordination matters so that a document does not expire before all requirements are received and approved.
This guide states no bridging program tuition or duration figure for the University of British Columbia or Toronto Metropolitan University programs, no 2027 CMRE sitting date, no Ontario, Manitoba, or other provincial registration or licence fee, no salary or wage figure for midwives in any jurisdiction, and no timeline for completing the full recognition route beyond the regulator processing times quoted above, because no official page stating those figures could be verified, or because the figure sits on a program or regulator fee schedule that changes. It states no French-language test figure for Quebec and no language-test figure for any jurisdiction other than Alberta, for the reasons given in Steps 5 and 6. Where a figure was cut, the guide points to the page that owns it instead of carrying a secondary source's number. Confirm every fee, deadline, and validity period on the regulator, program, or examination page that owns it, on the day you apply or pay.
For the routes stated on the regulator pages, yes, in substance: the Canadian Midwifery Regulators Council states that internationally educated candidates are eligible for the Canadian Midwifery Registration Examination if they are in good standing in the final stage of a Canadian bridging or assessment program approved or recognized by a provincial or territorial regulator, and the College of Midwives of Ontario states that internationally educated midwives must first complete one of the College-approved bridging or assessment programs before applying, while the College of Midwives of Manitoba states that all internationally educated midwives must first complete one of the approved bridging programs before applying for registration. Alberta takes a different shape: its checklist is built around an education credential assessment, a competency assessment tool, and an objective structured clinical examination recommended by the College, with a prior learning and experience assessment program available. Experience abroad is evidence inside those processes, not a substitute for them. Do not book the examination or plan a move on the assumption that years of practice alone will be treated as equivalent.
Yes. The Canadian Midwifery Regulators Council names English-language assessment and bridging programs at the University of British Columbia and Toronto Metropolitan University, a French-language bridging program with the Ordre des sages-femmes du Québec, and a prior learning and experience assessment program in Alberta, and directs internationally educated midwives interested in Alberta to contact the College of Midwives of Alberta. Manitoba approves two programs: the International Midwifery Preregistration Bridging Program at Toronto Metropolitan University, which is designed to support applicants from across Canada and offers distance-based learning, and the Internationally Educated Midwives Bridging Program at the University of British Columbia, which is intended for midwives planning to practise in British Columbia and for which admission for Manitoba applicants may be limited or unavailable. Approval of a specific program as a route to registration may vary from jurisdiction to jurisdiction, so confirm with the destination regulator that the program you choose is approved for that jurisdiction before you enrol.
The Canadian Midwifery Registration Examination is set and administered online by the Canadian Midwifery Regulators Council twice a year, with live remote proctoring and a test-centre option on request. It consists of case-based and independent multiple-choice questions, with four possible answers and one best answer, about half of the questions case-based, and slightly more than half set in an out-of-hospital setting. The examination is 4 hours and 45 minutes, with one 30-minute break halfway through, for total seat time of 5 hours and 15 minutes, and candidates have access to the items in both English and French. Score reports show pass or fail and are distributed within six weeks of the examination date. For 2026 the examination fee stated on the Council page is $992.50, and the page states that the fee will increase by 5 percent annually in 2027, so confirm the current fee on the Council page before you pay. Candidates are eligible to take the examination multiple times, but after three sittings they must provide evidence of additional relevant education before registering again. No 2027 sitting date is stated in this guide, because no 2027 date could be verified on a Council page.
Ontario requires registration with the College of Midwives of Ontario to practise midwifery and use the title midwife, and the College states that completing a bridging or assessment program successfully does not guarantee registration: you must meet the registration requirements in place at the time of your application. The College requires the Canadian Midwifery Registration Examination, completion of its Jurisprudence Course, which is offered online with a handbook of 11 lessons and an open-book examination that must be answered with 100 percent correct answers, a Vulnerable Sector Check accepted only if it is an original issued within 6 months of the date a complete application is submitted, evidence of current personal protection against professional liability, which is a non-exemptible requirement, and proof of entitlement to work in Canada by Canadian citizenship, permanent residency, or authorization under the Immigration and Refugee Protection Act. Complete applications are processed within 10 business days. Applicants who have written the examination but have not received results may be eligible for a transitional certificate, valid for up to 90 days, to practise under the supervision of a registrant who holds a general certificate. The 60-birth clinical experience figures on the College page sit in the section for graduates of an Ontario Midwifery Education Program, and this guide does not carry them into the internationally educated route.
Quebec follows its own process, and this guide states it only from the Ordre des sages-femmes du Québec page. An application for equivalence is made only through the Order's portal: forms and documents received by email are not accepted, nothing is sent by post, and originals are kept by the applicant. The required documents include the comparative evaluation of diplomas from the Ministère de l'Immigration, de la Francisation et de l'Intégration, for which the Order notes that the majority of requests are treated within 6 months, the completed diploma and training equivalence form with a letter of interest of 500 to 1000 words, certified copies of identity and diplomas, a current curriculum vitae, a copy of the permit or authorization to practise from each country where you practised, detailed school records for theory courses and placements with hours, and signed employer attestations describing relevant work experience. The Order's Admission Committee analyses the file and may ask the candidate to attend an interview in objective structured clinical examination form, pass an examination, or complete a placement. Partial recognition leads to enrolment in the personalized certificate in midwifery practice in Quebec at the Université du Québec à Trois-Rivières, a six-month program of three months of theory and 15 weeks of placement, with university fees of approximately $4,000 payable to the university. Refusal of recognition means enrolling in the three-year bachelor's program in midwifery practice at the same university. The Order states a processing time of 2 to 3 months from receipt of a complete file, with further delays possible for immigration and certificate availability, and notes that the certificate is generally offered every two years subject to a minimum number of candidates.
The Canadian Midwifery Regulators Council lists a member regulatory authority for every province and territory: the British Columbia College of Nurses and Midwives, Northwest Territories Health Professional Licensing, the College of Midwives of Alberta, the Government of Nunavut Professional Practice, the Saskatchewan College of Midwives, the College of Midwives of Manitoba, the College of Midwives of Ontario, the Ordre des sages-femmes du Québec, the Midwifery Regulatory Council of Nova Scotia, the Midwifery Council of New Brunswick, the College of Registered Nurses and Midwives of Prince Edward Island, the College of Midwives of Newfoundland and Labrador, and the Government of Yukon Professional Licensing and Regulatory Affairs. That Council list governs coverage for this guide. Job Bank's page for NOC 31303, which groups physician assistants, midwives, and allied health professionals, lists registration as required for midwives in Nova Scotia, New Brunswick, Quebec, Ontario, Manitoba, Saskatchewan, Alberta, British Columbia, the Northwest Territories, and Nunavut, omitting Prince Edward Island, Newfoundland and Labrador, and Yukon. The omission does not override the Council list. Confirm the current registration requirement, and whether registration must precede any practice, with the regulator named for the jurisdiction where you will work, because each regulator sets its own requirements beyond the national examination.
Figures that could not be verified on an official page were cut from this guide: bridging program tuition and duration figures for the University of British Columbia and Toronto Metropolitan University programs; any 2027 CMRE sitting date; Ontario, Manitoba, and other provincial registration and licence fees; all salary and wage figures; any French-language test figure for Quebec; and any language-test figure for a jurisdiction other than Alberta. Check the Council, program, and regulator pages linked above for current figures and steps before you apply or pay.