Navigating Nurse Licensing Requirements in Canada
Canada faced a nursing shortage before the onset of COVID-19, and the pandemic exacerbated the crisis. The Government of Canada projects that there will be 155,400 open nursing positions by 2031. Recruiting and licensing internationally educated nurses (IENs) have become one way to address this challenge.
This article discusses how to navigate nurse licensing requirements in Canada. Please note that the licensing process for nurses in Quebec is not included in this article because of the province’s unique set of requirements.
Underemployment of Internationally Educated Nurses
In 2020, it was reported that 47 percent of internationally educated health care professionals were unemployed or underemployed (statistics Canada 2020). The 2023 Statistics Canada data shows that 69% of Internationally Educated Healthcare Professionals were employed compared with 87% of Canadian Educated Healthcare Professionals.
This means that many internationally educated health care professionals are underemployed or unemployed in Canada. Nursing regulators in different provinces have also reported a backlog in licensing IENs.
Reforms in IEN Licensing
The Canadian government, nursing regulators, and other stakeholders recognize the urgency of the situation as well as barriers to practice IENs face. As such, these entities are actively working towards streamlining and expediting the licensing process for IENs.
There have been developments in provinces like Nova Scotia and Alberta, where innovative measures have been implemented to address the nursing shortage. For example, in Nova Scotia, expedited pathways are available for nurses licensed in Australia, India, New Zealand, Nigeria, the Philippines, the United Kingdom, or the United States. This has significantly reduced the licensure processing time to weeks rather than years.
Moreover, in some provinces, nursing licenses obtained in one province are recognized in another. This allows nurses to seek employment opportunities across Canada with ease. Ontario, for instance, has introduced new “as of right” rules, enabling health care workers registered in other provinces to work in Ontario without having to undergo additional steps of re-registration.
Nova Scotia issues conditional licenses to individuals, enabling them to practice nursing before passing the NCLEX or while they are enrolled in bridging programs. Nurses registered in another province are also granted a conditional license to practice while applying for the Nova Scotia nursing license. In some provinces, evidence of practice can be established through mentorship programs and clinical hours to make it easier for newcomers. In Ontario, language proficiency can be established by having worked in an English- or French-speaking health care facility if applicants do not have successful results on one of College of Ontario’s approved language proficiency test
With the ongoing reforms in provinces, we are starting to see some positive changes. For example, out of 12,385 new registered nurses in Ontario in 2022, 5,124 (nearly half) were IENs. This number is expected to surpass 6,000 in 2023.
Types of Nursing Licenses
In Canada, there are four regulated professions or occupations in nursing:
- Nurse Practitioner
- Registered Nurse (RN)
- Licensed Practical Nurse (LPN)
- Registered Psychiatric Nurse
As far as academic requirements are concerned, a Nurse Practitioner usually requires a master’s degree in nursing. An RN usually requires a four-year bachelor’s degree in nursing. An LPN requires two to three years of college nursing education, and the scope of practice is usually more limited than that of an RN.
In Ontario and Quebec, an LPN is also referred to as a Registered Practical Nurse. The Registered Psychiatric Nurse profession exists in British Columbia, Alberta, Saskatchewan, and Manitoba and usually requires a 2.5-year diploma program or 4 years of baccalaureate education at a college or university level.
Pathways to IEN Licensure
Certain Canadian provinces will hire applicants directly from their country. Some health authorities of provincial governments have embarked on direct recruitment trips to the Philippines and other countries to hire nurses directly with conditional job offers. But the majority of IENs arrive in Canada on their own and work with provincial nurse regulators to obtain their licenses and seek employment afterwards.
If you are currently living in another country but intend to relocate to Canada, make sure you have prepared all your documentation including educational documents as well as licensure and a notarized form of identification or ID that might be needed for the licensure process when you arrive in Canada. You can also contact the CARE team who could help you navigate the nursing licensure process.
Once you have completed the permanent residence process, refer next to the step-by-step guide that corresponds to your nursing specialization. These guides are provided by the provincial nursing licensing bodies. In certain provinces, such as Ontario, the nursing bodies have been combined, while others have separate bodies for Registered Nurses (RNs), Licensed Practical Nurses, Psychiatric Nurses, and Health Care Aides. Alberta, for instance, currently maintains separate licensing body for each category.
Nursing Regulatory Bodies
Below is a list of regulators corresponding to each province for different categories of nursing. Visit these websites directly to learn about specific licensing requirements.
British Columbia
British Columbia College of Nurses and Midwives (BCCNM)—RN, LPN, RPN
Alberta
College of Registered Nurses of Alberta (CRNA)—RN
College of Licensed Practical Nurses of Alberta (CLPNA)—LPN
College of Registered Psychiatric Nurses of Alberta (CRPNA)—RPN
Saskatchewan
College of Registered Nurses of Saskatchewan (CRNS)—RN
Saskatchewan Association of Licensed Practical Nurses (SALPN)—LPN
Registered Psychiatric Nurses Association of Saskatchewan (RPNAS)—RPN
Manitoba
College of Registered Nurses of Manitoba (CRNM)—RN
College of Licensed Practical Nurses of Manitoba (CLPNM)—LPN
College of Registered Psychiatric Nurses of Manitoba (CRPNM)—RPN
Ontario
College of Nurses of Ontario (CNO)—RN, LPN
Nova Scotia
Nova Scotia College of Nursing (NSCN)—RN, LPN
New Brunswick
Nurses Association of New Brunswick (NANB)—RN
Association of New Brunswick Licensed Practical Nurses (ANBLPN)—LPN
Prince Edward Island
College of Registered Nurses and Midwives of Prince Edward Island (CRNMPEI)—RN
College of Licensed Practical Nurses of Prince Edward Island (CLPNPEI)—LPN
Newfoundland and Labrador
College of Registered Nurses of Newfoundland and Labrador (CRNNL)—RN
College of Licensed Practical Nurses of Newfoundland and Labrador (CLPNNL)—LPN
Northwest Territories and Nunavut
Registered Nurses Association of the Northwest Territories and Nunavut
Yukon
Yukon Registered Nurses Association
Each licensing body normally has its own set of requirements which are somewhat standardized. These requirements often include the following:
- Nursing education
- Registration examination (NCLEX or Rex-PN/CPNRE)
- Language proficiency (CELBAN, IELTS, and others)
- Evidence of practice
- Jurisprudence exam
- Authorization to work
- Past offences and findings
- Health and conduct
Assessment Services
National Nursing Assessment Services (NNAS)
NNAS is the starting point for IENs interested in becoming licensed or registered in Canada. The NNAS advisory report will usually include an individual curricular assessment which compares the nursing curriculum applicants completed to the Canadian entry to practice competences. Please refer to the website of Nursing Regulatory Bodies for a more detailed requirement regarding NNAS advisory report.
Nursing Community Assessment Service (NCAS)
NCAS evaluates the educational credentials, language proficiency and competencies of IENs looking to practice in British Columbia and the Maritime provinces in Canada.
Language Proficiency Exams
For valid English or French language proficiency test results, each province and its respective licensing bodies accept different language tests. The most used test providers are International English Language Testing System (IELTS) and Canadian English Language Benchmark Assessment for Nurses (CELBAN).
Different provinces also require different expiry dates of the language test results. Generally, exam results are valid for two years, but recently there has been a trend to extend that time. Ontario, for example, recently announced that applicants can extend the expiry date if they have an ongoing application. Nova Scotia also relaxed its requirements regarding the expiry date of language requirements. If your score has expired, please see the Nova Scotia College of Nurses. It will work with you to find appropriate pathways to registration and licensure.
Registration Exams
The respective licensing body will conduct a comprehensive review of your qualifications and competencies to determine if you need to complete a bridging program (usually 12 to 18 months) or take the National Council Licensure Examination (NCLEX) for RN or LPN, or the Canadian Nurse Practitioner Examination (CNPE). NCLEX can be taken in other countries. Please check the list of countries that offer NCLEX to see if your location is on the list.
Upon successfully passing the NCLEX or CNPE and meeting all regulatory requirements of provincial regulatory bodies, you will be granted full licensure to practice as a nurse in Canada. In Ontario and British Columbia, the entry to practice exam for RPN and LPN is the Regulatory Exam-Practical Nurse (REx-PN).
Remember, each province may have specific requirements and processes, so it is crucial to consult the respective provincial nursing licensing body for the most accurate and up-to-date information.
Steps to Take After Obtaining Your License
After you obtain your license, you can start to look for a job, especially in a clinical environment. Some provinces even allow you to start working with a conditional license while you pursue permanent licensure. There are provinces with partnership programs as part of their IEN career pathway between the regulators and the employers. These partnership programs offer applicants the option of completing supervised practice experience to demonstrate their current nursing competency, skills, and language proficiency.
Ontario, for example, has a Supervised Practice Experience Partnership (SPEP) program between College of Nurses of Ontario (CNO), Ontario Health, and CNO-approved organizations. The pathway also offers mentorship programs, career coaching, and “shadowing” opportunities as well as interview preparation and résumé writing workshops.
There are IEN support groups in different provinces and on social media. The local settlement agencies also receive funding from different levels of government in Canada to support IENs and other newcomers with their settlement process and help them integrate into Canadian society.
Professional development is crucial to stay ahead of the curve as a nurse in Canada. Becoming a member of the Canadian Nurses Association will grant you access to professional development courses, including 23 diverse clinical specialization certificates. The organization helps its members stay current with the latest technologies and competitive in the local job market.
The cost of licensure
The fee will vary by province. For instance, in British Columbia, it could take up to $25,000 and four years to go through the complete process to become an RN. In British Columbia and Manitoba, bursaries are available for IENs who are navigating licensing requirements in those provinces. In Manitoba, starting in 2021, the Internationally Educated Nurses (IENs) project has been supporting eligible IENs with financial assistance of up to $23,000 to pursue registration. The grants do not have to be repaid.
Additionally, microlending organizations, such as Windmill Microlending and SEED Winnipeg, may be able to provide funding to IENs who lack credit history and who are navigating the licensing process. There are also government-funded programs and courses that are offered at no charge to newcomers. For example, Kwantlen Polytechnic University now offers Introduction to Professional Communication for Internationally Educated Nurses to any permanent residents living in British Columbia who possess a nursing license from their source countries.
Final Notes
As you navigate the licensing requirements to become a nurse in Canada, remember the importance of adaptability and agility. Embracing these qualities will prove invaluable as you pursue your goal. Amid the challenges and triumphs, keep in mind the wealth of resources that stand ready to assist you. Remain persistent, remain open to growth, and trust in your ability to achieve your goal of becoming a licensed nursing professional in Canada.
Related Reading
Starting a Health Care Career in Canada
Navigating the Professional Occupational Licensure Process in Canada
