New accreditation path will get more foreign-trained health-care professionals working in Manitoba: province
The Manitoba government is developing a new path to accreditation that it says will help all internationally educated health-care professionals to work in their field, including the nurses dealing with what one NDP cabinet minister calls the worst accreditation process in the country.
Labour and Immigration Minister Malaya Marcelino said the province will develop an accreditation stream exclusively for foreign-trained health-care workers living in the province.
“People don’t just come off of a plane anymore to try their luck to be a nurse. They’ve already been recruited in other provinces and in other jurisdictions all over the world,” she told CBC News in an interview last month.
“That’s another reason why — and because of the equity concerns — that we have to come up with a pathway [to accreditation] for Manitobans, because they’re already here anyway.”
Marcelino’s office provided few details details, but said regulatory bodies would still be responsible for accreditation under the new government-run pathway.
Each health-care profession has a licensing and registration body that recognizes foreign credentials, but the processes are often criticized as lengthy, expensive and onerous.
In particular, Marcelino blasted the College of Registered Nurses of Manitoba for not doing enough to accredit nurses.
Manitoba “unfortunately is, I want to say, the worst jurisdiction currently for accreditation for internationally educated nurses,” she said.
“That is the hole that we’re climbing out of.”
‘Some opportunity’ for alternative
Deb Elias, chief executive officer and registrar at the nurses’ college, said the regulator is continuing to improve its processes, but thinks there is “definitely some opportunity” in the new pathway proposed by the government.
One idea the college is considering is more frequently waiving the clinical competence assessment, or CCA — a days-long exam widely condemned for being too challenging — and replacing it with another assessment of prior learning. The CCA finds that most internationally trained nurses need more education.
“If we’re focusing on [internationally educated nurses] who’ve lived in Manitoba for a period of time and haven’t been engaged in the registration process … depending on the amount of time that they’ve been out of practice, it may be difficult for them to go through an assessment like that,” Elias said.
Monika Matera had six years of nursing education in her home country of Germany, but now works at a mine in northern Manitoba — including a short stint underground.
She’s never stopped wanting to be a nurse.
“Even though I am not working as a nurse for 16 years now, I hope they give people like me a chance,” Matera said, though she doesn’t believe the province’s new pathway will be enough.
Matera long considered a life in Canada the dream, captivated by television images of winter, bears and the beauty of the North.
It wasn’t a surprise, then, that she ended up in Thompson a few years after her 2007 arrival in Winnipeg.
Eventually, Matera felt her English had become good enough that she could work as a nurse. She submitted some of her paperwork, but she didn’t have hundreds of dollars to spare for registration.
“I didn’t have the money to pay it, and nobody could really tell me if I will get accepted,” Matera said.
She’s struggled since to afford further education while working low-paying jobs, including on and off as a health-care aide, in a northern community with a high cost of living.
Now, she figures if she wanted to work as a nurse, she’d have to redo much of her schooling because so much time has passed — but she doesn’t know that for certain.
“Apply here, apply there, ask them, ask him. And really, I never got an answer from anybody. And that’s what makes me frustrated,” Matera said.
She’s not alone. Matera said she knows of a cleaner who was a doctor in his home country and health-care aides who used to be nurses.
“I saw … that everybody in this country needs nurses,” she said.
“Then help somebody like me.”
Hundreds of foreign-trained nurses: minister
Marcelino said there are “hundreds and hundreds and hundreds” of foreign trained nurses in Manitoba who want to work in their field.
Some appear to be bypassing the provincial college altogether.
In the first 10 months of 2023, the College of Registered Nurses of Manitoba certified just seven internationally trained nurses through its processes, according to information provided by the college to CBC.
But many more internationally and domestically educated nurses took an indirect path to certification by registering in other provinces that have eased their registration requirements.
Manitoba’s college — like other regulators — has to honour registration decisions made elsewhere in Canada.
As of the end of last September, 450 labour mobility applications resulted in nurses being registered in Manitoba in 2023, according to the college — nearly double the total from all of 2022. Some of those applications include people who moved into the province.
Marcelino alleged many nurses aren’t bothering with certification in Manitoba when other provinces have fewer barriers.
“No one’s trying anymore,” the labour minister said. “Why would you try when you know that you’re gonna fail? So that’s how bad our accreditation system is as it relates to nursing.”
Tough standards are imposed to ensure health-care professionals are sufficiently trained, said Arthur Sweetman, the Ontario Research Chair in Health Human Resources.
But it’s clear something needs to change in Manitoba if the path of least resistance for applicants is through a different province, he said.
“If you want people in Manitoba and you have nursing shortages in Manitoba, making the direct path easier is going to help the population,” he said.
Elias, the college’s CEO, acknowledged that applicants are finding other registration processes easier.
“People tend to go with the route that makes sense for them.”
The college is working to make improvements to its licensing processes and communicate recent changes it’s made, she said, such as lowering benchmark scores in English proficiency tests and letting applicants skip the clinical competence assessment to take a year-long nurse re-entry program instead.
“Being known as one of the tougher colleges isn’t a reputation that we want to have,” said Elias.
“We want to be welcoming for all applicants and really invite internationally educated nurses to apply through us, because we want to work with them.”
While Thompson’s Matera enjoys operating a conveyor at the mine where she works, she’s never given up hope of becoming a nurse — specifically to help elderly patients, like her mother and grandmother did in their own nursing careers.
She hopes to juggle part-time nurse schooling with her full-time job. She doesn’t want to leave Thompson.
“I will always be a nurse in my heart. It doesn’t matter what I do.”
Manitoba labour minister Malaya Marcelino says action is needed to get more internationally educated health-care professionals working in the province. In particular, Marcelino said improvements are needed from the College of Registered Nurses of Manitoba, which she says is responsible for the worst accreditation process in the country.
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