Canada’s healthcare system is currently grappling with a shortage of professionals, which profoundly impacts the health and well-being of Canadians and newcomers. The existing medical workforce is overwhelmed and exhausted, leading to long wait times and subpar quality of care for individuals.

Job vacancy data from Statistics Canada reveals that, as of May 2023, Canada’s healthcare and social assistance sectors had 134,500 open positions. Although this figure has a steady decline from a peak of 151,200 vacancies in January 2023, this sector still commands the highest job vacancy rates.

Another study by Statistics Canada highlights that nurses were severely working overtime during COVID-19 and subsequently till 2022. In 2022 alone, nurses clocked 8.6 hours more per week on average than their regular schedules. Compared to the 2019 average, this indicates a significant increase of 1.9 hours.

To ease the burden and pressure on existing employees and to address the ongoing labor crisis, initiatives like the category-based draws in Express Entry for ITAs are taken. There are a total of six Express Entry categories through which eligible candidates can get ITA. One such category is dedicated to healthcare professionals.

In Canada, healthcare is managed and taken care of by the provinces. That is why, even after receiving an ITA and moving to Canada as a healthcare professional, such as a nurse, an Express Entry candidate must get accreditation or licensing in the particular Canadian province they wish to settle in.

As stated above, healthcare is managed by the provinces; hence, the licensing and accreditation procedures are unique and varied for every province.

Every province has its own nursing college or a regulatory body that takes care of the licensing of Internationally Educated Nurses (IEN). If an IEN plans to relocate to a different province later, he/she must go through a different licensing procedure unique to that province.

What Is The Accreditation Process For IENs In Canada?

Upon landing in Canada, an IEN needs to contact a provincial college of nursing. The college acts as a governing body that oversees the licensing of IENs. The specific college to contact will vastly depend upon the type of nursing license required by an IEN. For instance, according to the Canadian Nurses Association, every nursing category in British Columbia, Ontario, and Nova Scotia is regulated by a single college. On the other hand, the remaining provinces and territories have separate regulatory bodies for each nursing category.

Most of these nursing colleges require that IENs initiate their journey of becoming accredited nurses by completing an assessment and evaluation process conducted by the National Nursing Assessment Service (NNAS). The sole aim of this assessment is to evaluate an IEN’s credentials against Canadian standards and requirements. Post successful evaluation, an IEN gets an Advisory Form from NNAS. This is a very crucial and important document that needs to be included with the application to the appropriate provincial regulatory body.

For the purpose of NNAS assessment, an IEN needs to submit notarized identity documents along with a Nursing Education Form, a Nursing Practice/Employment Form, and a Nursing Registration Form. These forms are usually sent by third parties. The education form will, for example, be sent to NNAS directly by the educational institution where an IEN received nursing education. 

It is worth noting that Quebec and the territories of Nunavut, Yukon, and the Northwest Territories have their own unique and individual assessment methods and do not use the NNAS framework.

Following completion of the NNAS assessment and payment of the applicable fee, an IEN can apply to the provincial regulatory body of the province where they intend to practice. An IEN may also need to undergo any necessary training, education, or bridging programs to meet the requirements of provincial licensing. This ensures that IENs meet the criteria for practicing medicine safely and effectively in their chosen province.

How Are Provinces Contributing To Solving This Problem?

So, making sure IENs are good to go in terms of practicing medicine safely and all in the province they choose is a big deal. But one might wonder, how are the provinces actually dealing with this whole situation?

Well, one major headache for IENs trying to get accredited in Canada is the crazy amount of time it takes to get through all the assessments, applications, and extra training needed to snag that license.

But, now some provinces are stepping up to the situation and trying to make things smoother. Take Nova Scotia, for instance. In May 2023, they rolled out this fast-track solution specially made for IENs from seven countries, like the Philippines, India, Nigeria, United States, United Kingdom, Australia, and New Zealand.

Now, if nurses from these countries have a “good standing and good character,” Nova Scotia is giving them the green light for registration and licensing. No need to jump through extra hoops and formalities after passing the entrance exam.

Similarly, Alberta announced in February that the province will be allocating an investment of more than $15 million towards the education, training, and support of IENs.

Out of this funding, $7.8 million has been earmarked to facilitate students applying for bursaries up to $30,000. The remaining funds will be used to broaden the nurse bridging program at three Alberta universities by 600 new seats.

On a similar note, British Columbia has decided to cover the high application and assessment fees for IENs, which usually go north of $3,700.

Also, Ontario brought in several new rules in January to streamline and simplify the entire accreditation process for IENs.

Mandating health regulatory colleges to stick to prescribed time limits to process registration decisions

Barred health regulatory colleges from asking for Canadian work experience as a pre-requisite to registration, albeit with some exceptions, such as when equivalent international experience is recognized

Recognizing language tests approved under the Immigration and Refugee Protection Act (IRPA) to minimize redundant language proficiency tests for newcomers to Canada

Additionally, NNAS introduced, on June 28, 2023, an expedited and improved credentialing service for IENs. Under this new arrangement, after receiving all necessary documents, NNAS will send Advisory Reports, typically within 5 business days.

This facility is available to IENs submitting their applications to any of the following regulatory bodies:

• The Nurses Association of New Brunswick
• The College of Registered Nurses and Midwives of Prince Edward Island (PEI)
• The College of Registered Nurses of Saskatchewan
• The College of Licensed Practical Nurses of Manitoba
• The Saskatchewan Association of Licensed Practical Nurses
• The College of Licensed Practical Nurses of Newfoundland & Labrador