B. APPLICATION FORM

Section 1: Personal Information

Personal contact information is used by the Council for direct contact with members, and is not released to the general public. The Council does maintain a public roster that includes all practice and professional information on each member.

It is important that you keep the Council informed of any changes to your contact information so that we may contact you regarding your application and registration.

• In Section 1 print your full current legal name. If any of the documentation you are providing with your application is in any name other than your current legal name, you must provide documentation to prove the change of name.
• Please attach Schedule 1 to your application if you have ever been known by any other names.
• Where indicated, print your name exactly as you wish it to appear on your certificate of registration. Your last name must be your current legal last name. Registration documents can be issued in your current legal name only, but you may choose how you would like your given names to appear, for example: Elizabeth J. Midwife, Liz Jane Midwife, E. Jane Midwife. Your name as it appears here will be used in all Council communication regarding your membership, including:

• MRCNS website
• Notification of registration to the province’s Vital Statistics Branch Birth Registry and Department of Health
• Letters of conduct requested by regulators or hospitals.

Section 2: Citizenship, Legal Entitlement to Work in Canada

In order to be eligible for registration you must be either a Canadian citizen, a permanent resident of Canada or authorized under the Immigration Act (Canada) to engage in open employment in Canada. You must submit proof of your citizenship, residency or employment authorization along with your application.

Section 3: Professional Registration

In this section, you must list all current and previous professional registration including international registrations, registrations in other Canadian provinces or territories, and registrations in other regulated health professions. Midwives who are or have been registered in other Canadian provinces or territories will need to arrange for letters of professional conduct to be delivered to the Registrar directly from the regulatory body. You will need to sign a consent form to release this information, and complete the request form as required by your regulatory body. For those registered in other jurisdictions or professions copies of your registration certificates or other proof of registration must be attached to your application.

Section 4: Midwifery Education

Registered midwives in Nova Scotia must hold a baccalaureate degree from a Canadian university midwifery education program; or have educational qualifications equivalent to this degree.

Please list all of your midwifery education as indicated, and include notarized copies of all degrees, diplomas and certificates earned in these programs. If you are applying for registration as a midwife for the first time since graduating, please attach one original Record of Clinical Experience and arrange for your university to send an official transcript directly to the Registrar.

Registered midwives in Nova Scotia must also complete the Canadian Midwifery Registration Examination (CMRE). Please arrange for the exam results to be sent to the MRCNS.

Section 5: Clinical Experience

According to the Regulations, criteria for an active-practicing (clinical) licence are: At least the following practice hours or experience:

• 1125 hours or attendance at 40 births in the clinical practice of midwifery in the 5 years immediately before their application, or
• 450 hours or attendance at 12 births in the clinical practice of midwifery in the year immediately before their application

The clinical practice of midwifery is defined in the Regulations as the provision of antepartum, intrapartum, postpartum and newborn care as a primary care provider. In accordance with the definition of midwifery practice in the Act, midwives may practise either within or outside of a hospital setting.

In accordance with the requirements of the Act, the Regulations and the policies of the Council, midwives who do not fully meet clinical experience requirements may be issued a provisional licence.

Please answer all questions pertaining to your midwifery experience. Please complete and attach Schedule 2 to assist the Registrar in determining and verifying your clinical experience. You will also need to provide three references. At least one of your referees should be able to verify your clinical practice experience.

Section 6: Competency Assessment / Bridging Programs

If you have successfully completed a competency assessment and /or bridging program approved by the Council, you may be eligible for registration. Based on the results of the assessment, the Registrar may issue an active-practicing (clinical) licence or a provisional licence.

Please make arrangements to have your final report sent from the assessment program directly to the Registrar, if this has not already been done on your behalf.

Section 7: Continuing Competencies

The Council requires that all registrants in the active-practicing (clinical) class be certified in:

• Neonatal Resuscitation annually. The minimum standard is the Canadian Pediatric Society Neonatal Resuscitation Provider course, including endotracheal intubation
• Cardiopulmonary Resuscitation every 2 years. The minimum standard is the Canadian Heart and Stroke Foundation Basic Life Support (level C) for Healthcare Providers
• Emergency Skills in Obstetrics every 2 years. Courses approved by the council are:

• Emergency skills courses/assessments conducted as part of or in conjunction with an approved Canadian university midwifery education program
• Ontario Association of Midwives or Canadian Association of Midwives Emergency Skills Workshop (ESW)
• Society of Obstetricians and Gynecologists of Canada Advances in Labour and Risk Management (ALARM)
• Managing Obstetrical Risk Efficiently (MORE ^OB )
• College of Family Physicians of Canada Advances in Life Support in Obstetrics (ALSO)

Certified instructors of these courses will meet these requirements, provided they have taught at least one course within the time frame required for currency.

Midwives are also required to successfully complete Opioids and Benzodiazapines: Safe Prescribing for Midwives offered through UBC Continuing Professional Development, Faculty of Medicine.

Please attach proof of current certification or instructor status in these continuing competencies.

Section 8: Disclosure of Past Proceedings

Questions in this section refer to all previous experience, including experience in another profession or experience that occurred outside of Nova Scotia, or outside of Canada. All questions must be answered “yes” or “no”. For every “yes” answer, you must provide a detailed explanation on an additional sheet of paper attached to the application.

Section 9: Certification of Application

You must ensure that this section is signed and witnessed properly. The witness must be over 18 years of age. The witness is attesting to the fact that they witnessed you signing the form, therefore they must sign at the same time that you do.