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228Chapter 10 – Profession of MidwiferyThe International Midwifery Pre-registration Program (IMPP) is a ninemonth, part-time bridging program. It provides internationally-educatedmidwives with skills assessment, information about midwifery practice inOntario, clinical placements, mentoring and a final pre-registration exam.The IMPP is intended for experienced international midwives, fluent inEnglish, who have practised midwifery within the past five years. It is not are-education or retraining program. According to the CMO submission, theIMPP program has six years of experience partnering with the MEP in thedelivery of MEP-equivalent curriculum for internationally-trained midwives.There is no national accrediting institution for Canadian midwiferyprograms at the present time. However, a National Midwifery AssessmentStrategy is currently underway to assess and facilitate the entry-to-practiceof internationally-trained midwives.The CMO has three classes of registration: general, general with conditionsand supervised. Registrants in the general class practise with norestrictions on their registration. To be registered, all applicants mustprovide proof of graduation from an MEP or IMPP program or status as aregistered midwife in another jurisdiction. They must also have currentcertification in cardiopulmonary resuscitation, obstetrical emergency skillsand neonatal resuscitation.Maintaining RegistrationTo be an active practice registrant (APR), the CMO’s registration regulationsrequire members to report birth attendance numbers. Requirements varywith years of active practice. If members do not meet or fail to report theiractive practice numbers, whether in the initial two-year period or insubsequent five-year periods, they are required to take an IndividualizedRequalification Program as set out by the CMO’s Registration Committee.Ontario midwives must also certify every two years in cardiopulmonaryresuscitation, obstetrical emergency skills and neonatal resuscitation. 14Members are also expected to maintain clinical competency regarding drugregulations as part of routine professional development. Members arerequired to participate in continuing education as part of the CMO’s qualityassurance program.Quality AssuranceThe CMO’s quality assurance program contains seven components, whichinclude: the provision of clinical information, continuing education andprofessional development, peer case review, quality of care evaluation,self-assessment, random practice audits and remediation.14HPRAC Review of the Scope of Practice of Midwifery. September 2008: 89.HPRAC Critical Links January 2009