Are you an internationally registered nurse and wish to work as a nurse in Canada? Then you need to read this. This article will provide basic information on how to start your journey to being a nurse practitioner in Canada.
In Canada, as in most countries around the world with aging population, immigrant workers are an integral part of the workforce, particularly in the health care sector. According to Canadian Institute for Health Information (CIHI) in 2021, there were 459,005 regulated nurses eligible to practice – 312,382 registered nurses (RNs), 7,400 nurse practitioners (NPs), 132,886 licensed practical nurses and registered practical nurses (LPNs and RPNs), and 6,337 registered psychiatric nurses. 54.6% of these regulated nurses worked in a hospital, 13.7% worked in community health, 13.6% worked in a nursing home/long-term care, and 7.4% worked in other employment settings.
Some immigrants come to Canada to work in nursing or health care support occupations or a consequence of provincial and territorial policies aimed at recruiting foreign-trained nurses and health care support workers. There are a few barriers, however, that can hinder the integration of immigrants into the nursing workforce, in particular for registered nurses. These barriers are often related to recognition of foreign qualifications.
Statistics Canada reported the job vacancies in healthcare and social assistance increased to an all-time high of 150,100 in the third quarter of 2022. On a quarter-over-quarter basis, job vacancies rose in the third quarter for registered nurses and registered psychiatric nurses; nurse aides, orderlies and patient service associates; and licensed practical nurses. Together, these occupations made up the majority (69.2%) of all vacancies in health occupations in the third quarter of 2022.
Nursing in Canada includes three regulated nursing professions. You can seek a license to practice as (1) a Registered Psychiatric Nurse (RPN); (2) a Registered Nurse (RN); or (3) a Licensed Practical Nurse (LPN). The differences between the nursing professions are in the type of education and training required; and the scope of practice. Each province has its own policies and regulations. It is important for you to become familiar with the policies and regulations of the Regulatory Bodies in the province where you want to work. Your education and experience will be evaluated against these policies and regulations. Education and experience in any of the nursing professions can open the doors in Canada to related work in health care, including administration and management.
To become a Registered Nurse (RN), you must first complete an application with the National Nursing Assessment Service (NNAS). The NNAS is the single point of entry for all Internationally Educated Nurses (IENs) interested in practicing in Canada. They are responsible for collecting and processing all documents required for you to become licensed. These include documents about:
- identity (e.g., passport, birth certificate, driver’s licence)
- nursing education (e.g., verification forms, transcripts, course descriptions)
- nursing registration (e.g., verifications forms from all jurisdictions where you have been registered as a nurse)
- employment (e.g., verification forms from organizations where you have worked/volunteered within the past 5 years)
- language proficiency (e.g., test results)
The NNAS will review and assess your nursing credentials and determine if you are eligible to practice nursing in Canada. Your credentials will be verified and compared to Canadian standards. The results of your application will be submitted as an Advisory Report to the regulatory body in the province of your choice. Depending on your NNAS Advisory Report, you can apply as an RN to the province where you want to work. In 2022 alone, NNAS issued almost 12,000 Advisory Reports, most within eight weeks of NNAS receiving all documentation.
You are eligible to apply to NNAS if you have:
• Completed a post-secondary nursing education program (university or college) outside of Canada
• Never worked as a licensed nurse in Canada in the profession to which you are applying
Depending on the completeness of your application, the fees range from $650 to $970 (as of Sep 2021).
To provide you an idea, here are the additional steps you need to take in some Canadian provinces:
Nursing Regulatory Bodies in Canada
British Columbia College of Nurses and Midwives (BCCNM) – RN, LPN & RPN
On January 31, 2023, BCCNM will pilot a new registration process for internationally educated nurses (IENs) aimed at eliminating months – or even years – from the application journey. In B.C., the streamlined process will reduce barriers and delays by introducing more options for completing a credential evaluation and eliminating many upfront costs.
a) Apply to the B.C. College of Nurses and Midwives (BCCNM).
b) The BCCNM will refer you to the Nursing Competency Assessment Service (NCAS), which will review your application and determine if: You are eligible to take the national nursing exam and apply for provisional registration, which allows you to practice while preparing to write the national nursing exam; or Further assessment is required. You may be required to complete a competency assessment, which looks at your nursing skills, knowledge and practice and shows the BCCNM how it matches what they expect of a new BC graduate. You may be required to take a bridging course or a whole program.
c) Once you are eligible to do so, you will need to take the NCLEX-RN to be registered at the BCCNM and practice as an RN in British Columbia
a) Apply to the College and Association of Registered Nurses of Alberta (CARNA).CARNA will require you to take the AlbertaRegistered Nurses Assessment Program test(ARNAP), which is a one-day exam that tests yourknowledge, skills, judgement, languageproficiency, ethics, and client interaction skills.Fee: CAD1,900.
b) ARNAP will report your test results to CARNA,which will decide if you are Eligible, Not Eligible,or if you need to take and pass additional courses
c) Eligible applicants will then need to take andpass the National Council LicensureExamination to practice as an RN (NCLEX-RN)in Alberta.
d) Provisional permits allow you to work as a graduate nurse (GN) under certain conditions while you work to meet the requirement of writing and passing NCLEX-RN exam. If you apply for a provisional permit, it will be issued for a maximum of six months at a time. It may be renewed once, to allow you to practice for a total of 12 months within two years of completing your education program.
a) Complete the Online Assessment for RN Eligibility with the CRNS.
b) Upload a copy of your birth certificate and government issued photo ID (and marriage certificate, if applicable).
c) Complete Verification of Original Registration/Licensure Form from the country you obtained your basic nursing education.
d) Complete the Verification of Current or Most Recent Registration/Licensure Form and send it to the registration body of the province or country where you’ve most recently registered as a RN.
e) Complete the Consent Form to Obtain Employment Verification Information and send the required document by email as an attachment to firstname.lastname@example.org.
f) Once your Assessment for RN Eligibility has been reviewed by a Nursing Advisor you will be contacted with next steps to continue the process.
a) Once your NNAS advisory report has been generated, you can begin the application process in Manitoba. The first step is to open a file. To open a file you will need to submit the following 4 requirements together and at the same time:
- The internationally educated nurse application form
- Application fee: $483.00 CAD
- Clinical Competence Assessment (CCA) fee: $336.00 CAD
- Copy of valid photo identification
b) Applicants are required to demonstrate English language proficiency to be approved to write the NCLEX-RN or approved for RN registration if the NCLEX-RN has already been written.
c) The College will review your file when it is complete, and all required documents have been received.
d) If nursing education comparability is determined, you are eligible to continue in the application process and will be referred for a Clinical Competence Assessment (CCA). Applicants who also meet the additional criteria outlined in College PolicyAA-7, will be provided with the option to complete either a CCA or the full complement of courses in the Nurse Re-entry Program (NREP) at RRC Polytechnic.
e) Once you have completed the assessment (CCA or NREP), your results are sent to the College, generally within four weeks. You will then need to take andpass the National Council LicensureExamination to practice as an RN (NCLEX-RN)in Manitoba.
College of Nurses of Ontario (CNO) – RN & LPN
a) Apply to the College of Nurses of Ontario (CNO).
b) Upon application to the CNO, pass theassessment of the Internationally EducatedNurses Competency Assessment (IENCAP). Fee:CAD1,500, with optional review classes at anadditional cost of CAD300-400.
c) The IENCAP will evaluate if you establishedequivalency to practice as an RN(“Demonstrated”); if you need remediation(“Partially Demonstrated,” that means you willtake and pass additional courses); or if you needcomplete retraining (“Not Demonstrated”).
d) Once you are eligible to do so, you will need to take the NCLEX-RN to practice as an RN in Ontario.
Completing the registration process can take anywhere from 3 – 18 months. The Temporary Class is an option for RN or RPN applicants to practice nursing while they complete their remaining registration requirements for the General Class.
Nova Scotia College of Nursing (NSCN) – RN & LPN
NSCN is scheduled to launch a new state-of-the-art registrant portal on January 31, 2023. Your nursing program must have provided theory and clinical instruction in adult medicine and surgery. If you graduated from a specialized program (eg. psychiatry/mental health, pediatrics, midwifery) you are not eligible for registration unless you also have general nursing preparation.
a) In order to become licensed as a nurse in Nova Scotia, you must apply and pay the fee to 2 different organizations:
- National Nursing Assessment Service (NNAS) to complete the first part of your application
- Nova Scotia College of Nursing (NSCN) to complete the final part of your application
b) Pass the RN and / or NP Jurisprudence Exam.
c) Pass the NCLEX-RN® Exam
a) In order to practice as a registered nurse (RN) in New Brunswick, you must be registered with the Nurses Association of New Brunswick (NANB). Application and registration fees is about $1,000.
In New Brunswick, registered nurse education programs are at the post-secondary (university) level after 12 years of elementary and secondary schooling. Registered nurse education includes theory and clinical instruction in medical, surgical, obstetrical (maternal/newborn), pediatrics (child health), psychiatric (mental health) as well as gerontology and community health nursing.
b) Once your application is approved, you will then be required to complete a 10-week online Pathways to Licensure program. The cost is $250.00 (plus tax).
c) Once you have completed the Pathways to Licensure program, you will be required to complete the online Jurisprudence module and test.
d) Once all of the above has been completed/approved, you will be considered an applicant equivalent to a New Brunswick Educated practical nursing student and will follow the student application process. You will be able to apply for a Graduate Practical Nurse License.
e) Once you have a GPN (Graduate Practical Nurse License) you will then be able to apply and pay for your CPNRE (Canadian Practical Nurse Registration Exam).
Prince Edward Island
a) Apply for registration with College of Registered Nurses of Prince Edward Island (CRNPEI).
b) The College of Registered Nurses and Midwives of Prince Edward Island (CRNMPEI) Staff will review your application and NNAS Advisory Report and you may be referred for a Competency Assessment or a Bridging Program.
c) CRNMPEI will refer you to the Registered Nurse Professional Development Centre (RNPDC) for a competency assessment and/or an RN Bridging program as required.
d) Applicants will need to apply to RNPDC for a competency assessment and/or enroll in the RN Bridging program if required.
Newfoundland & Labrador
a) Complete the College’s Provisional Registration Application and pay the processing fee ($172.50). With your application to the College, you will be required to submit copies of your Birth Certificate, Government issued photo ID, Legal change of name document (e.g. marriage certificate) if you have changed your name.
b) You will receive a letter of decision regarding your eligibility for registration within 2-4 weeks of receipt of all required documents.
c) If you meet Education requirements and currency of practice requirements: Eligible for interim license and NCLEX-RN exam. If you meet the education requirements but does not meet currency of practice requirements, you may be eligible for interim license with Conditions (IL-C) to participate in Supervised Practice Experience Program (SPEP) with NL employer to gain currency of hours (450 hours), OR may be required to complete IEN bridging/re-entry program.
Canada Immigration Pathways for Internationally Educated Nurses
1. Express Entry
Express Entry is an online point-based system that manages immigration applications for the federal government. Nurses can apply either through the Federal Skilled Worker Program (FSWP) or Canadian Experience Class (CEC).
Nursing falls into one of three categories in the Canadian government’s National Occupation Classification (NOC). Registered nurses and registered psychiatric nurses fall under NOC TEER Category 1 and the code is 31301. Nurse Practitioners also fall under TEER Category 1 under code 31302. Licenced practical nurses NOC 32101, fall under TEER Category 2.
These codes and skill categories are important in determining which immigration programs you are eligible for, what other criteria you must meet for a particular program. Keep these in mind as you learn more about Canadian immigration programs for nurses.
a) Federal Skilled Worker Program (FSWP)
The FSWP requires an applicant to have at least one year of continuous work experience within the past 10 years in a skilled occupation (TEER Categories 0-3). The work experience may have been completed abroad. In addition, the applicant also must score a Canadian Language Benchmark (CLB) 7 in English or French on all four language competencies. In order to be eligible to enter the pool of candidates, one must have at least 67 out of 100 score on the six-factor test that assesses candidates’ education level, language skills, and whether they have a job in Canada.
b) Canadian Experience Class (CEC)
The CEC is for skilled workers who have Canadian work experience and want to become permanent residents. The applicant must have at least one-year skilled work experience (TEER Categories 0-3). in Canada in the past three years before submitting their application. There is no education requirement for the Canadian Experience Class. Applicants must score CLB 7 for TEER 0 or TEER 1 jobs or CLB 5 for TEER 2 or TEER 3 jobs.
2. Provincial Nominee Program (PNP)
Provinces and territories in Canada can nominate individuals and families who wish to settle in their province or territory based on criteria set by the province. The first thing you need to do is apply to the PNP in the province or territory where you want to settle. You must have the skills, education and work experience you will need to settle in Canada and support yourself and your family.
The province or territory will assess if you meet their economic or labour market needs. After the province or territory approves your application, your next step is to apply for permanent residence. The province or territory will let you know whether you must apply through the Express Entry system or through regular application process.
Some provinces can nominate nurses through the PNP pathways:
a) British Columbia Skills Immigration Stream – Health Care Professional Category
Health care workers are in demand across British Columbia. If you are a physician, nurse, psychiatric nurse or allied health professional, you may be eligible to under this program. You can apply to the BC PNP through the Skills Immigration – Health Care Professional category if you have a job offer for an indeterminate full-time position from one of B.C.’s five regional health authorities or the Provincial Health Services Authority. You must be registered with the College of Registered Nurses of BC, or the College of Registered Psychiatric Nurses of BC. You must have a minimum of two years of directly related work experience. If you are working in a TEER Category 2/3 occupation, you must submit a language proficiency test result showing you have obtained a minimum score equal to or greater than a benchmark 4 under the Canadian Language Benchmark 2000 (CLB) in all four competencies: listening, speaking, reading and writing.
b) Saskatchewan International Skilled Worker: Employment Offer Category (Healthcare Worker EOI)
This stream is for skilled workers who have been working for at least six months (780) of full-time (30+ hours per week) for the employer offering you the permanent job and have a temporary work permit as Physician, Nurse and Other health professional.
To be eligible, you must have a valid work permit and have a permanent, full-time job offer from: The Saskatchewan Health Authority; The Saskatchewan Cancer Agency or Another publicly funded health employer; and have a valid SINP Job Approval Letter.
c) Ontario Express Entry Human Capital Priorities stream
You must have a valid profile in Immigration, Refugees and Citizenship Canada’s (IRCC’s) Express Entry system and receive a Notification of Interest from Ontario before you can apply online to be nominated by the Ontario government for permanent residence.
For work experience, you must decide if you want to be assessed under the Federal Skilled Workers Program or Canadian Experience Class. You must have a Canadian bachelor’s, master’s or PhD degree or its equivalent in another country. You must also be able to understand, read, write and speak either English or French at a Canadian Language Benchmark (CLB) level 7 or higher.
Contact us to discuss your eligibility for these immigration pathways.