IMPP - Frequently Asked Questions (FAQ)

Here are some of the most frequently asked questions about the International Midwifery Pre-registration Program (IMPP).

Completing the Program

What is the successful completion rate of the IMPP?
Between 2003 and 2021, 80 percent of internationally educated midwives (IEMs) who began the IMPP have successfully completed it.

If I complete the program, am I likely to find a midwifery job in Canada?
Between 2003 and 2021, 90 percent of IEM graduates found midwifery positions in Canada within three months of completing the IMPP. However, graduates often have to relocate to find midwifery positions.

Can I complete the IMPP on my own schedule?

No. The IMPP is offered annually on a schedule which ensures that graduates can write the CMRE as soon as they finish and interview for a job in Ontario at the same time as the annual graduation of MEP students.

What is the CMRE (mandatory national midwifery exam) pass rate for IMPP graduates?

The CMRE pass rate for IMPP graduates is 99 percent.

Can I practice in all Canadian provinces and territories if I complete the IMPP and pass the CMRE?

IMPP graduates practice in all provinces and territories where there is regulated midwifery and midwifery positions are available. The regulatory College of Midwifery in each province or territory sets the requirements for registration. The Agreement on Internal Trade requires provinces to allow midwives to move freely and practice in other provinces once midwives become general registrants, after their first year of practice in Canada.

Can I choose where I complete the IMPP clerkship?

The IMPP asks participants to provide three geographic choices for clerkship locations in Ontario and tries to match the available clerkships to participants’ requests, but this is beyond the IMPP’s control and IEMs often must relocate for their clerkships because of limited placements.


How many places are there in the IMPP each year?

The IMPP accepts up to 20 qualified IEM applicants each year.

I am a midwife practicing in another country. I am not a permanent resident of Canada, a refugee in Canada, or a Canadian citizen. Can I come to Canada on a visitor or student visa to take the IMPP?

No. Government funding requirements mandate that IMPP participants be permanent residents, refugees, or Canadian citizens. The IMPP cannot accept applications from IEMs in other countries wishing to use visitor or student visas.

Why do I need to have my G2 or G driving licence to begin the IMPP?

IMPP participants must complete a 16-week clinical clerkship in the Canadian winter which involves high-risk driving situations, such as snow and ice, and they must be able to respond as quickly as first responders to client calls. Canadian midwives rely on cars to transport themselves and their equipment to home visits, hospitals, birth centres, and clients’ homes for births at all hours of the day and night. IMPP participants must be confident to drive on highways and rural roads.

Financial Matters

How much does the IMPP cost?

The total cost of tuition for IEMs is $7,000. Resources such as books and other learning materials cost $300–$500. Participants must have a car 24/7 during the 16-week clerkship, a computer, and a cellphone, and if they need to move for the clerkship, they may need to pay rent for approximately four months, depending on living arrangements.

Is there financial support for IEMs who become IMPP participants, like OSAP?

The IMPP is not an OSAP-eligible program. However, some participants apply for low-interest loans from loan programs such as Windmill Microlending for skilled immigrants and refugees in Canada and/or apply for government bursaries, such as the Ontario Bridging Program Assistance Program (OBPAP), in years when these are available. Applicants must plan to pay for the IMPP themselves and to spend nine months not employed.

What is the income level for Canadian midwives?

Midwifery income levels are different between provinces and within provinces; this is related to client caseload and other variables. The range is between approximately $70,000 for starting level and approximately $120,000 for midwives after five years of experience; this is based on years of experience in Canada, caseload volume, hours, and other factors.

Can I work while I am in the IMPP?

There are a limited number of weeks before and/or after the clerkship and before the CMRE, depending on the timing of the clerkship, when a participant may be employed. It is not possible to be employed during the full-time Intensives or during the full-time clerkship.

Resources for Applicants

The Association of Ontario Midwives website, Canadian Association of Midwives website, and other provincial midwifery websites are valuable sources of information. 

You will want to become familiar with Canadian birth-related issues and the healthcare system – there are many scholarly articles available online. Even more important is to review material about childbirth from the general public’s perspective in order to understand cultural norms, attitudes, and behaviours around childbirth in Canada. Much is now available online and on YouTube. Start with issues like debates over appropriate C-section rates; positions in labour; attitudes to and systemic support for breastfeeding, home birth, and water birth; attachment parenting; perineal integration; female sexuality in the postpartum period; neurodevelopment of the newborn and suggested movements for babies; humanizing hospitals; care for preterm babies; understanding obstetric violence; counselling techniques to promote informed choice, including trauma-based counselling, addictions counselling, and grief counselling; exercise in pregnancy; support groups for parents with disabilities; and care for transgender people.

A helpful Canadian resource is McMaster University's three-part Comprehensive Midwifery e-textbook:

  • Volume 1: Professional Roles
  • Volume 2: Normal Pregnancy, Birth, Postpartum & Newborn Care
  • Volume 3: Management of Complications

Visit McMaster’s Midwifery Program E-Book Resources website to purchase this resource.

The 7th Edition of the Textbook of Neonatal Resuscitation (2016) can be purchased from the Canadian Paediatric Society website.

Myles Textbook for Midwives (17th Edition; 2020, Elsevier) or Varney’s Midwifery (6th Edition; 2019, Jones & Bartlett Learning) may also be helpful. Much information is now found online. The Cochrane Library database on childbirth and midwifery research is helpful, as are general Internet searches on Canadian reproductive, early parenting, and midwifery topics.

The University of British Columbia – Continuing Professional Development (UBC–CPD) offers the following valuable resources:

The UBC–CPD Midwifery courses are wide-ranging and current.

Other online resources include helpful videos, lectures, and events.

Professional English Language Fluency Resources

Midwifery in Canada requires an advanced level of English language fluency. It is your responsibility to ensure that you are able to function at this high level of fluency.

If English is a late-acquired, additional language for you, we strongly encourage you to fully immerse yourself in English-language environments and to take advantage of Ontario's many English language training resources. One textbook specifically developed out of this program to help IEMs communicate competently as Canadian midwives is Professional English for Obstetricians, Nurses and Midwives (2nd Edition; 2019, Iorek Publishing).