How Internationally Educated Nurses can practice Nursing in Canada

How to Become a Registered Nurse in Canada

This post summarizes the procedure on nursing registration in Canada for foreign-trained Registered Nurses. Application as a Licensed Practical Nurse (LPN) or as a Registered Psychiatric Nurse (RPN) are not covered here.

Unlike the National Council of State Boards of Nursing of the U.S., each province and territory of Canada has its nursing regulatory body. Hence, each province may set nursing registration standards that are different from others. Regardless of the requirements, though, all Registered Nurses, or RNs, must show competence in the five practice areas of

• Administration
• Clinical care
• Education
• Policy
• Research.

Contents of this post:

• Nursing Assessment
  • Provincial Regulatory Bodies
  • Important points regarding your NNAS application
  • IVC tips to make the most of your NNAS application
  • General NNAS Requirements
  • Procedure for Nursing Registration in Canada
• NCLEX-RN Passing Rates For Philippine Nursing Graduates

Nursing Assessment

As an Internationally Educated Nurse, or IEN, you must first set up an account with the National Nursing Assessment Service. You cannot register with a provincial regulatory body directly.

Once you have submitted your documentary requirements and paid the fees, the assessment service (or NNAS) will forward your application to the Commission on Graduates of Foreign Nursing Schools, known as CGFNS. CGFNS is a nonprofit credentials evaluation organization contracted to compile, evaluate, and validate the credentials of IENs like you. With your packet in hand, CGFNS will verify the documents’ authenticity and compare these documents to Canadian standards.

Once CGFNS has completed its assessment, NNAS will send your completed file to the nursing regulatory body to which you are applying. The latter will eventually decide on your eligibility to work as a nurse in the province.

Provincial regulatory bodies

Therefore, before anything else, you must decide in which province you would like to settle. Once you have done so, register with that province or territory.

The  regulatory authority for registered nurses per province are as follows:

Province	Regulatory Authority for RNs
Alberta	College and Association of Registered Nurses of Alberta, or CARNA
British Columbia	British Columbia College of Nursing Professionals, or BCCNP
Manitoba	College of Registered Nurses of Manitoba, or CRNM
Ontario	College of Nurses of Ontario, or CNO
New Brunswick	Nurses Association of New Brunswick, NANB
Newfoundland and Labrador	College of Registered Nurses of Newfoundland and Labrador, or CRNNL
Nova Scotia	Nova Scotia College of Nursing, or NSCN
Prince Edward Island	College of Registered Nurses of Prince Edward Island, or CRNPEI
Saskatchewan	Saskatchewan Registered Nurses Association, or SRNA

Important points regarding your NNAS application

Your NNAS account will be active for up to 12 months from the date you submitted and paid your main order application. You must, therefore, submit all required documents within this period. The Main Application order closes for two reasons:

• NNAS issues an Advisory Report
• You did not provide all the documentary requirements.

As you can see from the table above, if you do not submit the required documents to NNAS within 12 months for the first time, you can reactivate it. You can only apply for reactivation once, and it should be within 12 months of the expiry date. After the second expiration, you will have to purchase another Main Order Application and pay the full fee for another Advisory Report.

If you still cannot comply with the requirements after reactivation, your Main Application Order will expire. You will then have to pay the full fee. Moreover, when your main application order expires, all other service orders will follow suit no matter when you paid for these.

NNAS may issue another Advisory Report to the same provincial regulatory body you chose for up to two years after the original submission. Beware, though. You will be shouldering all costs of the second report.

If your Main Application Order is still valid and you want to be evaluated for another group, purchase the additional incremental order.

IVC tips to make the most of your NNAS application.

The entire process of credential evaluation should be within 12 months. These are our tips to ensure NNAS processes your application packet faster:

1. Take any language proficiency test first. Then submit the results if these are within the acceptable range of test scores.
2. Before opening an account with NNAS, gather your academic and professional credentials.
3. If needed, have your documents translated by an official translator. 
4. NNAS only accepts credit card payments. Be sure that payments are up-to-date so you can use it to pay fees.
5. Except for the appeal, NNAS has a no refund policy. Apply to the NNAS if you are sure that you can submit the needed documents within 12 months.

General NNAS requirements

As mentioned above, NNAS has to:

• Confirm your identity
• Evaluate your nursing education through CGFNS
• Verify your employment history and licensure in your country of practice
• Assess and verify your language competency in either French or English.

So, essential nursing registration requirements include, but are not limited to, documents regarding your:

• identity (e.g., passport, birth certificate, driver’s license)
• nursing education (e.g., verification forms, transcripts, course descriptions)
• nursing registration in Canada requires verifications forms from all jurisdictions where you registered as a nurse
• employment (e.g., verification forms from organizations where you have worked/volunteered within the past five years)
• language proficiency (e.g., test results)

These are the minimum scores you must achieve per language test:

Test	Speaking	Writing	Reading	Listening	Vocabulary and Grammar
IELTS Academic	7	7	6.5	7.5	N/A
CELBAN	8	7	8	10	N/A
TEF*	5 (349)	4 (271)	4 (181)	5 (280)	4 (145)

Test results are valid for two years. So, be sure to submit the results as soon as possible.

Procedure for nursing registration in Canada

We outlined the procedure that you must follow to gain nursing registration in Canada to eventually practice. Also included are some specific requirements for the provinces. 

Step 1.  Create an online account with NNAS. 

Once you have set up your online account, you must tender payment for your Main Application Order and other requests.

The next table lists the NNAS fees in U.S. Dollars.  You will have to prepare a little bit more since NNAS may add sales taxes to the costs. The first item you must order is the Main application Order.

Service you are Purchasing	What it is for	Fee Amount in USD
Main Application Order	This is the first NNAS application type. Select RN registration and one province for your application	650
Evaluation for an Expired Main Application	If you do not submit the required documents to NNAS within 12 months after paying your Main Application Order, you can reactivate it within 12 months of the expiry date.  You may only do this once. After the first time, you will have to pay the full fee.	180
Advisory Report for another province	The fee is for an incremental order if you want to apply to a second province.	55
Evaluation for a different nursing group	You tender payment only if you want NNAS to evaluate your credentials for another nursing group, such as LPN or RPN	220
Documentation Translations	If you send NNAS documents not written in English or French, NNAS will translate these, at your request.  The cost is per page.	85
Appeals	File an appeal if you feel that your assessment was misrepresented or under-evaluated. This fee will be refunded if your appeal is successful.	500

Step 2:  Apply for nursing registration in canada.

Remember when we asked you to choose where you would like to practice? That is a crucial step since NNAS will issue an Advisory Report to the province’s regulatory body.

Once you receive your positive Advisory Report from NNAS, you can apply to the regulatory body in the province of your choice. Some provinces may require more assessments and courses. It could, therefore, take up to another 12 months for a provincial nursing body to decide on your eligibility.

You will have to tender payment in Canadian Dollars (CAD). Each province sets its own fees, so you will have to look it up, depending on where you intend to practice.

Step 3:  Wait for the results of the province’s assessment.

All you can do is wait. The registration body will contact you with the decision and give further instructions. There are several outcomes such as the following:

• You are immediately eligible to apply for an RN permit.
• A second assessment is required.
• You are ineligible to proceed with registration in the province.

Some provinces have special instructions or nursing registration requirements. Here are some examples.  

• Generally, RN regulatory authorities require 1,125 nursing practice hours in the last five years. Saskatchewan, Alberta, and Nova Scotia also require 450 hours in the most recent year of practice. Moreover, instead of the minimum practice hours, you may provide evidence that you graduated from an approved nursing education program, or completed an approved nursing re-entry program.
• The College and Association of Registered Nurses of Alberta may request that you undergo a second assessment and defer your application. Deferment is until you finish the Alberta Registered Nurse Assessment Program (or ARNAP) or a bridging course.
• The British Columbia College of Nursing Professionals (BCCNP) may refer you to the Nursing Community Assessment Service, or NCAS. The referral usually means that you need a Substantially Equivalent Competency Assessment. 
• If you took the June 2006 NLE, the College of Registered Nurses of Manitoba (CRNM) would request proof that you completed the special voluntary examination. The Philippine Department of Labor and Employment (DOLE), authorized the exams for Parts III (3) and V (5).  Also, you should have achieved a score of at least 75% for these sections.  
• The College of Nurses of Ontario (CNO) requires proof that you practiced nursing OR graduated from a nursing program within the past three years. 
• The regulatory authorities of New Brunswick, Newfoundland and Labrador, and Saskatchewan may require nurses from certain countries to complete a Substantially Equivalent Competence or SEC assessment.

Step 4:  Sit for the NCLEX-RN

Once the provincial nursing regulatory agency allows you to sit for the NCLEX-RN, schedule your exam. You will have to prepare payment in Canadian Dollars using either a credit, debit or prepaid card.

At the time of this post, the fee is $360.  An additional international scheduling fee of $150 plus VAT may be levied on you wherever applicable. 

If you decide to change the province where you are applying to practice after tendering the initial payment, you will have to pay an additional $50.

You should receive confirmation of your NCLEX-RN registration within two after submitting your registration. If you don’t within this period, you should call the NCLEX Candidate Services and check your registration status.  Do not submit another NCLEX registration and fee before calling.

The nursing college may also send you an interim registration or temporary class for you to practice until you successfully pass the NCLEX-RN.

Step 5:  Receive your exam result.

If you pass, you will have to pay for practicing registration. The provincial regulatory agency may also ask you to submit the results of a language proficiency exam.

There are two approved language English exams – the Canadian English Language Benchmark Assessment Services (CELBAN) and the IELTS. You must get the minimum score in your chosen test, as listed below.

Test	Speaking	Reading	Writing	Listening
CELBAN	8	8	7	10
IELTS	7	6.5	7	7.5

Step 6:  Confirm your registration status. Start your RN practice in Canada.

The NCLEX-RN and Nursing Registration in Canada

Canadian regulators adopted the NCLEX-RN® in 2011 as the test that entry-level nurses in Canada must take to practice as a nurse in Canada. So, if you already passed the NCLEX-RN exam, Canada should be an immigration option for you. However, passing the test is the first step if you are an internationally educated nurse or IEN. You must still meet specific requirements from the province where you intend to practice.

So, in addition to the registration exam, you must pass a separate jurisprudence exam. This exam evaluates your knowledge and understanding of the laws, regulations, and College by-laws. You must know the practice standards and guidelines governing the nursing profession in the province where you intend to practice.

NCLEX-RN Passing Rates For Philippine Nursing Graduates

Are you going to sit for the NCLEX-RN anytime soon? If yes, take heart! The results for registered nurses from the Philippines is generally satisfactory.

In 2019, the U.S. National Council of State Boards of Nursing published the results of the NCLEX-RN in four quarters. The first table is for BSN graduates who took the exam for U.S. Registration.

USA Test-Takers	Jan-Mar	Apr-Jun	Jul-Sep	Oct-Dec	Total
Number of Applicants	4,814	5,064	5,173	5,989	21,040
Passed	2,292	2,353	2,499	2,425	9,569
Philippines Applicants	2,815	3,067	3,086	3,504	12,472
Philippines Passed	1,400	1,472	1,587	1,447	5,906

This second table summarizes the exam results in the same period for exam takers for Canadian  registration.

Canada Test-Takers	Jan-Mar	Apr-Jun	Jul-Sep	Oct-Dec	Total
Number of Applicants	257	255	276	295	1,083
Passed	161	157	178	143	639
Philippines Applicants	100	78	100	104	382
Philippines Passed	77	57	67	58	259

Results of NCLEX-RN for the past two years

Candidates applying for US licensure outnumbered their Canadian counterparts 19:1.  While there were fewer test-takers in Canada, though, the percentage of passers is higher compared to the USA NCLEX-RN candidates.

• For US licensure.
  • The overall passing rate was 45.48%.
  • Of the test takers, 59.28% were educated in the Philippines.
  • The passing rate for Filipino RNs was 47.35%
• For Canada licensure.
  • The overall passing rate was 59%.
  • Of the test-takers, 35.27% were educated in the Philippines.
  • 36 successful test-takers were Filipinos, who made up 35.78% of the pool of passers.
  • The passing rate for Filipino RNs was 40.53%.