News and Updates

Changes for RNs Down Under and Up North

In June 2018, the Australian Health Practitioner Regulation Agency (AHPRA) 702,741 practitioners across all 15 professions were registered in 2017/18 an increase of 3.5% from 2016/17.

The highest number of successful registrants were from the Nursing profession- 370,319, more than half of all professions.

To practice as an RN in Australia, nurses educated and trained overseas must apply for and be registered with the Nursing and Midwifery Board of Australia (NMBA). 

After being assessed and evaluated, the successful Nurse Registrant – now considered an Internationally Qualified Nurse  (IQN)– may apply for a work or skilled migrant. 

For skilled migration, the IQN must comply with the skills assessment procedure through Australian Nursing and Mifwifery Council (ANMAC) before a visa could be issued by Australia’s Department of Home Affairs (formerly known as Department of Immigration and Border Protection (Australian Immigration Department).

Difference between ANMAC (immigration) and NMBA (registration) assessments

When assessing an IQN’s qualification, ANMAC takes into consideration work experience “which is then used to determine suitability for skilled migration.”

NMBA on the other hand only consider the IQN’s qualifications to establish that the “qualifications are substantially equivalent to an Australian qualification.”

While not normal, there are some applicants who “may be approved for skilled migration but do not meet the registration requirements of the NMBA.”

Registration changes for IQNs in 2019

Next year, AHPRA/NMBA announced changes in registration for Internationally Qualified Nurses and Midwives (IQNMs) the most significant of which is the reduction of qualification criteria from eight (8) to just three (3).  The 8 current criteria are:

1. Qualification (nursing education) makes applicant eligible to take the local nursing exam, and upon passing, practice as a Filipino RN,
2. The school issuing the nursing diploma is accredited by an “external assurance agency” in this case the Professional Regulatory Commission (PRC).
3. The program of study is “externally accredited” in the Philippine situation, the Commission on Higher Education (CHED) leading to a Nursing Diploma.
4. The applicant’s qualification is considered the equivalent of an Australian bachelor degree.
5. The program of study included a minimum of 800 hours of workplace experience providing exposure to a variety of healthcare settings. 
6. The curriculum of the applicant’s program of study focused on the various aspects of nursing practice and has contemporary nursing practice as its main focus, includes core health professional knowledge and skills and specific nursing practice knowledge and skills that:
   1. are based on current and best available evidence and
   2. are applied across the human lifespan and
   3. includes health/nursing research, health policy and evidence-based inquiry throughout the course content.
7. Applicant has. successfully completed all components of the program and have graduated with a qualificationThe education institution (nursing school) that provided the program of study, and confirmed the qualification, has certified that applicant has successfully completed an assessment in medication management including:
8. administration of medications (including calculationsb) pharmacokinetics (the study of the bodily absorption, distribution, metabolism, and excretion of drugs) and

RN applicants from the Philippines usually do not meet Criteria 4, 5 6 and 7.  The registration application is refused and the RN is referred to an authorized bridging program through an accredited institution/provider.

The bridging course could only be taken in Australia.

Until the changes are in place by 2019, the current registration procedures (below) remain in place:

• Ability assessed as meeting the registration requirements
• Ability to meet the immigration requirements
• Complete application form and provide all documentation to AHPRA
• NMBA will assess whether applicant meets the requirements for registration
• If successful, registration issued “in principle” or with conditions including taking bridging course and subsequent supervised practice. 
• Apply for immigration, usually in Australia since the Philippine RN completed the bridging course and complied with other registration requirements while in Australia.
• Obtain a work visa through a qualified Australian employer/sponsor;
• If eligible, pursue permanent residency for skilled migration through SkillSelect.
• Begin working as temporary migrant or permanent skilled migrant.

The NMBA announced that “In the second half of 2019, the NMBA will also transition to an outcomes-based assessment (OBA) for IQNMs who hold relevant but not substantially equivalent qualifications (and who meet the mandatory registration standards), replacing the current need for bridging programs for these applicants.”

After taking “an extensive research project to explore the factors and requirements to establish an OBA,” the NMBA recommends that:

• the overall assessment process includes both a cognitive and behavioural component 
• the cognitive assessment (computer-based multiple-choice questionnaire ) must be passed before the behavioral component is attempted. The behavioral assessment will be in the form of an objective structured clinical examination (OSCE). the knowledge and skills of an entry level Australian nurse or midwife, and
• an orientation program is established to orientate nurses and midwives to working in the Australian healthcare context. (Based on this recommendation, the NMBA will establish an orientation program for all IQNMs applying for registration in Australia.)

The orientation program has three parts:

1. An online assessment to introduce IQNMs to Australia and the Australian healthcare system.
2. Cover the diversity of the Australian culture and will be completed once registered with the NMBA and will be a condition of your registration until it is completed.
3. Provided by the IQNM’s employer, based on NMBA guidelines.

Bridging courses are offered by authorized educational institutions. This is the link that you may access for the latest list of institutions - https://www.nursingmidwiferyboard.gov.au/accreditation/approved-programs-of-study.aspx

The costs range from $12,000 to $15,000 Australian dollars. In addition, the applicant must provide evidence of funds available to him/her as well as to any dependents:  $19,830 for applicant; $6,940 for spouse/partner and $2,970 for a child and $8,000 for a child of school age.

How does Canada - Up North - compare?

A Filipino RN must first have his./her qualifications assessed by National Nursing Assessment Service (NNAS) as an Internationally Registered Nurse (IEN) intending to work/migrate as a nurse in Canada.  Then the IEN applies for registration with the specific province he/she intends to practice, e.g., British Columbia College of Nursing Professionals (BCCNP), formerly, the College of Registered Nurses in British Columbia (CRNBC), College and Association of Registered Nurses in Alberta (CARNA) or College of Registered Nurses in Manitoba.

The Nursing regulatory authority (College or Association) may then refer the IEN to take a Clinical Competence Assessment.

Since the clinical competence assessment must be taken in Canada, the logical pathway is for the IEN to take up a specialized related healthcare course (minimum of one-year diploma). As an international student, the IEN is authorized to work 20 hours a week while studying, and work full time when school is off session.  And, the partner/spouse may accompany and be allowed to work full time for the duration of studies.

The Nursing regulatory authority and immigration authorities off both countries require the RN applicant to provide an official result of language/English proficiency.  Australia requires a minimum of 7.0 in each IELTS component for Skilled Migrant, while Canada has a more flexible IELTS requirement of 6.5 in speaking, reading, writing and 7.54 in listening.

Changes are coming next year Down Under and Up North. Filipino Nightingales have at least six months to get ready.