Becoming accredited as an internationally educated nurse in Canada

Edana Robitaille
Published: November 4, 2023

Canada is experiencing a shortage of healthcare professionals. This impacts Canadians and newcomers alike through longer wait times for care that is sometimes not up to a professional standard due to overworked and burned-out staff.

Recent job vacancy data from Statistics Canada shows that as of May 2023, there were 134,500 vacant positions in Canada's healthcare and social assistance sectors. This number represents a steady decrease in vacancies since a high of 151,200 in January 2023 but is still the employment sector with the highest rate of job vacancies.

Statistics Canada also recently released a study showing that throughout the COVID-19 pandemic and into 2022, Nurses who reported working overtime in 2022 averaged an extra 8.6 hours above their normal schedule per week. This is an increase of 1.9 hours, compared with the 2019 average.

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One measure recently taken to help fill urgent gaps in Canada’s workforce, and take some of the pressure off workers, is the introduction of category-based selection rounds of invitations for Express Entry candidates. There are six categories through which Express Entry candidates with in-demand attributes can receive an Invitation to Apply (ITA). One category is for healthcare workers.

Still, even after receiving an ITA and arriving in Canada as a healthcare professional, such as a nurse, must get an accreditation or a license in the Canadian province they choose to settle in. This is because healthcare is a provincial responsibility.

Because healthcare is provincial, the licensing and accreditation process can vary depending on the province. Each province has its own nursing college through which an internationally educated nurse (IEN) must be licensed. If the IEN moves to another province later, they will typically need to go through another licensing process.

Starting the accreditation process

Once an IEN arrives in Canada they need to reach out to a provincial college of nursing, which acts as a regulatory body. Depending on the type of nursing license required, there may be different colleges depending on the type of license required. For example, the Canadian Nurses Association shows that in British Columbia, Ontario and Nova Scotia, all categories of nurses are regulated by a single college. In all other provinces and territories, each nursing category has its own regulatory body. Their site lists those here.

Most colleges require that IENs start their journey by completing an assessment through the National Nursing Assessment Service (NNAS). This assessment will verify an IEN’s credentials in comparison with Canadian standards and provide IENs with an Advisory Form that must be included with their application to a provincial regulatory body.

An NNAS assessment requires notarized identity documents, a Nursing Education Form, Nursing Practice/Employment Form, and Nursing Registration Form. These are all forms sent by third parties. For example, the education form will be sent to NNAS directly from the educational institution where you received your education.

Quebec, and the territories of Nunavut, the Northwest Territories and the Yukon do not use NNAS and have individual assessment methods.

Once the fee is paid and the assessment is complete, you can then apply to the provincial regulatory body for the province you plan to practice in and complete any necessary education or bridging programs to meet provincial licensing requirements.

What are provinces doing to help?

One of the greatest obstacles to getting accredited as an IEN has been the amount of time it takes to complete the assessments, applications, and necessary coursework to become licensed.

In response, some provinces have taken measures to speed up the process and get qualified nurses to work.

In May this year, Nova Scotia introduced a streamlined approach for IENs from seven countries including:

  • Philippines
  • India
  • Nigeria
  • United States
  • United Kingdom
  • Australia
  • New Zealand

Registered nurses from these countries who are considered in “good standing and good character” will be eligible for registration and licensing in Nova Scotia immediately. These nurses will not need any additional requirements, other than passing the national entrance exam.

Alberta announced in February that it is investing more than $15 million to train and support more IENs. The new funding includes $7.8 million for students to access up to $30,000 in bursaries. The remaining investment is to create 600 new seats for nurse bridging programs in three Alberta universities.

British Columbia is now covering application and assessment fees for IENs, which can cost more than $3,700 and Ontario has introduced several new rules that came into effect in January such as:

  • Requiring health regulatory colleges to comply with time limits to make registration decisions;
  • Prohibiting health regulatory colleges from requiring Canadian work experience for the purpose of registration, with some exceptions such as when equivalent international experience is accepted; and
  • Accepting language tests approved under the Immigration and Refugee Protection Act (IRPA) to reduce duplicate language proficiency testing for immigrants to Canada.

Further, As of June 28, 2023, NNAS’s introduced a new expedited credentialing service for IENS. With this new service, NNAS Advisory Reports will be released within 5 business days of all documents being received. Those applying to the following regulatory bodies are eligible:

  • 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, and
  • The College of Licensed Practical Nurses of Manitoba.
  • The Saskatchewan Association of Licensed Practical Nurses
  • The College of Licensed Practical Nurses of Newfoundland & Labrador

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