Yes, and the profession is regulated across the country. The Canadian Midwifery Regulators Council (CMRC), the network of Canada's midwifery regulators, says health professions including midwifery are regulated by authorities in each province and territory, and that you register in the one where you work. So you need two separate permissions. Registration with that regulator lets you practise: CMRC says registered midwives may use the title and carry out the tasks the law restricts to midwives. Permission to immigrate, for example as a permanent resident (PR), with the right to live in Canada permanently, comes from Immigration, Refugees and Citizenship Canada (IRCC), the federal immigration department. Neither one replaces the other. Your province also shapes the route: Ontario and British Columbia want a Canadian bridging or assessment program completed before you apply, while Alberta's college assesses your application itself and then asks for the national exam and a clinical exam.

Getting licensed as a midwife in Canada

The national exam is the Canadian Midwifery Registration Exam (CMRE), an online multiple-choice exam that CMRC sets for applicants educated in Canada and abroad, with every question available in English and French. After three sittings you must show evidence of further education before registering for it again, and CMRC notes that regulators may add requirements of their own. How you reach the exam depends on the province:

• Ontario: the College of Midwives of Ontario requires internationally educated midwives to complete a College-approved bridging or assessment program before applying. One is the International Midwifery Preregistration Bridging Program at Toronto Metropolitan University's Chang School: coursework designed to take six or nine months, then a clerkship of 12 to 16 weeks in a midwifery practice. The College adds that finishing a program does not by itself secure registration.
• British Columbia: the BC College of Nurses and Midwives (BCCNM) requires the Internationally Educated Midwives Bridging Program at the University of British Columbia before you apply for a licence. The university then confirms your competency certifications, such as neonatal resuscitation, and you take the CMRE.
• Alberta: the College of Midwives of Alberta assesses applications itself, using an education credential assessment from WES or IQAS, its competence assessment tool and evidence of your practice. If its Registration Committee supports you, the next steps are the CMRE and an objective structured clinical examination (OSCE), a practical test of clinical skills.

For French speakers, CMRC also points to a French-language bridging program with the Ordre des sages-femmes du Québec, Quebec's midwifery regulator.

Immigration routes for midwives

Express Entry is the online route IRCC uses to handle PR applications from skilled workers under its federal programs. Your profile gets a Comprehensive Ranking System (CRS) score, and at each round of invitations IRCC invites the top-ranked eligible candidates to apply. Our Express Entry guide walks through each stage, from profile to invitation.

For category rounds, IRCC keeps a list of health and social services occupations that includes the group "physician assistants, midwives and allied health professionals". When a round targets that list, IRCC ranks only the candidates who fit it and invites the highest-ranked. You fit with at least 12 months of full-time work in one listed occupation within the past three years, or an equal amount of part-time work, gained in Canada or abroad; the time does not have to be continuous. IRCC adds that you must meet the minimum criteria for Express Entry, including being eligible for a program it covers. Our guide to category rounds has more on how they work.

A province or territory can also nominate you for PR, and a nomination attached to an Express Entry profile brings 600 extra points. Our provincial nominee guide covers the basics. The midwives' occupation group appears in:

• British Columbia: the Health Authority stream's list of eligible occupations; among other requirements, that stream asks for a full-time offer, with no end date, from a health authority employer in the province. The group is also on the health care list that B.C.'s provincial nominee program uses when it targets invitations to apply.
• Saskatchewan: the Health Talent Pathway, whose requirements include a permanent, full-time health job offer in the province and eligibility for any licence the job needs there, and the international healthcare worker pool, where a profile lets Saskatchewan health employers find you but does not count as an application.

Is midwifery in Canada the same job you do now?

Perhaps not, and CMRC says so directly: it describes key differences between midwifery in Canada and in other parts of the world. Registered midwives in Canada are autonomous health professionals who provide continuity of care, so clients can get to know their midwife before the birth and have a familiar caregiver with them in labour, and care continues until at least six weeks after the birth. The national exam reflects the range of care a Canadian midwife is expected to provide: CMRC sets slightly more than half of its questions in settings outside hospital. BCCNM, for example, says UBC's bridging program helps midwives educated outside Canada understand and meet the expectations of the province's model of practice.

Can you practise before you pass the national exam?

In some provinces, with limits. The College of Midwives of Ontario offers a transitional certificate to applicants who meet every other requirement and have written the CMRE but are waiting for the result: you practise under the supervision of a midwife who holds a general certificate, for up to 90 days. BCCNM says you may be eligible for provisional licensure while you prepare for the CMRE, and that you may not practise until your name is listed in its online directory. In Alberta, professional liability insurance is a registration requirement, and the College says the provincial office that approves it does so only once you have secured a midwifery position.

A common mistake midwives make

Planning to begin with the national exam. CMRC says internationally educated midwives become eligible to write the CMRE when they are in good standing in the final stage of a Canadian bridging or assessment program that a provincial or territorial regulator has approved or recognized. So the exam comes near the end of the process, not the start, and it is the regulator in the province where you want to work that decides which program or assessment leads you there. CMRC itself points you to that regulator for general information.

First steps

1. Choose your province and find its regulator on CMRC's page about midwifery in Canada.
2. Read that regulator's page for people educated abroad, such as Ontario's, British Columbia's or Alberta's.
3. Compare your practice with the Canadian model of care that CMRC describes.
4. Count your midwifery work in the past three years against IRCC's 12-month rule for category rounds.
5. If you prefer British Columbia or Saskatchewan, read the Health Authority stream or the Health Talent Pathway requirements.