Recertification challenges for Filipino Internationally Educated Nurses in Australia compared to Canada Dominic Diocera, RN, BA, BScN, MPH Centre for Health Policy, University of Melbourne
Context: nurse migration Table 1: Number of regulated nurses whose initial qualification was obtained outside of Australia and New Zealand, by jurisdiction of registration (2015). Jurisdiction Registered nurses (2015) Enrolled nurses (2015) Australia 45,541 1,108 New South Wales 13,444 244 Victoria 11,854 368 Western Australia 8,592 187 Queensland 7,573 217 South Australia 2,954 71 Australian Capital Territory 1,054 13 Northern Territory 841 11 Tasmania 438 13 Table 2: Number of regulated nurses whose initial qualification was obtained outside of Canada, by jurisdiction of registration (2016). Jurisdiction Registered nurses (2016) Licensed practical nurses (2016) Canada 26,710 6,706 Ontario 11,736 4,738 British Columbia 5,405 164 Alberta 3,356 839 Quebec 3,381 23 Manitoba 1,228 360 Saskatchewan 878 330 Nova Scotia 337 214 New Brunswick 144 22 Northwest Territories/Nunavut 82 0-9 Newfoundland and Labrador 80 0 Prince Edward Island 42 11 Yukon 41 0-9 Sources: Australian Institute of Health and Welfare. (2015). Health workforce data. Accessed from: http://www.aihw.gov.au/workforce-data/ on June 15, 2017; Canadian Institute for Health Information. (2016). Health Workforce Information. Accessed from: https://www.cihi.ca/en/access-data-reports/results?f[0]=field_primary_theme%3a2047 on June 15, 2017.
Nursing in the Philippines: a snapshot 4-year, baccalaureate degree 120 recognised nursing programs (2013) 28,504 nursing licensure examinees with 13,019 (45.7%) passers (2016) Between 2012 to 2016, 92,277 nurses have left the country (2016) PHP11,269 (approx. US$589) average monthly wage (2017) Source: Philippine Statistics Authority. (2017). Philippine Statistical Yearbook. Accessed from: https://psa.gov.ph/products-and-services/publications/philippinestatistical-yearbook; Professional Regulation Commission. (2013). List of FAAP Nursing Programs. Accessed from: http://www.prc.gov.ph/uploaded/documents/list%20of%20faap%20nursing%20programs.pdf; Philippine Overseas Employment Authority. (2016). OFW Statistics. Accessed from: http://www.poea.gov.ph/ofwstat/ofwstat.html; Professional Regulation Commission. (2016).
The case of Filipino nurses The Philippines remains one of the major source countries of nurses globally. Top destination countries between 1992-2010: Saudi Arabia, USA, UK, UAE, Singapore, Kuwait, Libya, Ireland, Qatar, Canada (Philippine Overseas Employment Agency, 2010). In Canada, 34.1% of IENs currently registered across all nursing designations are from the Philippines (Canadian Institute for Health Information, 2017). In Australia, the Philippines is the third most dominant source country; between 2008-2016, 14.5% of nurses who migrated through the General Skilled Migration + Employer Nominated Scheme and 14.9% of nurses who were granted Temporary Working visas (Subclass 457) are from the Philippines (Higgs & Hawthorne, 2017, forthcoming). While a dominant group, Filipino nurses have been found to experience significant challenges in professional integration and labour market outcomes.
The case of Filipino nurses Case study 1: Labour market outcomes (Hawthorne, 2006) Labour market outcomes for degree-qualified nursing migrants in Australia and Canada from select birth countries (arrival period: 1996-2001, in percentages). Destination Birth country Employed Number Own prof Other prof/ Management Other work S/Total Unemployed Not in labour force Canada USA 31.3 - - 31.3 - - 135 Eastern Europe 8.7 8.7-8.7 - - 49 Northwest Europe 32.2 - - 32.2 - - 81 India 22.2-25.4 47.6 - - 178 Other South/Central Asia 13.5-31.2 44.7 14.0 35.1 460 Philippines 21.8 2.7 51.2 75.6 7.6 15.1 2.160 Australia USA/Canada 37.4 7.3 7.3 52.0 3.7 44.2 163 Eastern Europe 32.6 0 21.0 53.6 7.0 39.5 43 Northwest Europe 45.2 2.1 10.3 57.6 2.1 40.4 146 India 66.2 0 6.2 72.4 9.2 18.5 65 Other South/Central Asia 49.1 5.7 17.0 71.8-28.3 53 Philippines 35.0 0 35.3 70.3 4.1 24.2 592 Source: Hawthorne, L. (2006). Labour migrant outcomes for migrant professionals: Canada and Australia compared. The University of Melbourne: Melbourne.
The case of Filipino nurses Case study 2: Occupational English Test results (Hawthorne & To, 2013) Occupational English Test (OET) results by country of training (2011). Country of training No. of Passes Total Sittings No. of Candidates %Pass (Sittings) %Pass (Candidates) Average No. of Sittings United Kingdom 6 18 14 33% 43% 1.29 India 8 180 121 4% 7% 1.49 Nepal 4 23 15 17% 27% 1.53 Singapore 5 39 24 13% 21% 1.63 Germany 3 15 9 20% 33% 1.67 China 3 93 55 3% 5% 1.69 Japan 7 62 35 11% 20% 1.77 Philippines 21 404 193 5% 11% 2.09 S. Korea 1 62 28 2% 4% 2.21 Other countries 203 1,860 1,056 11% 19% 1.76 TOTAL 261 2,756 1,550 9% 17% 1.78 Source: Hawthorne, L. and To, A. (2013). English Language Skills Registration Standards: Australian and Global Comparative Assessment. Report prepared for the Australian Health Practitioner Regulation Agency. The University of Melbourne: Melbourne.
The case of Filipino nurses Other issues: Nurses, Inc. (Masselink & Lee, 2010) Commercialisation of nursing education From 40 nursing schools in the 1980s to 470 in the 2000s (Lorenzo et al, 2007). Nursing schools with <30% passing rate in the nursing licensure exam for 3 consecutive years to be phased out (CHED, 2011). A culture of migration (Massey et al, 1993) where migration becomes deeply ingrained into the repertoire of people s behaviours, and values associated with migration become part of the community s values (p.452).
Recertification processes for IENs: Australia Nursing and Midwifery Board of Australia/Australian Health Practitioner Regulation Agency Single or multiple qualifications English language proficiency English as primary language English through extended education Examination Registration criteria 1. Initial Registration 2. Accredited School 3. Accredited Program 4. Bachelor s Equivalent 5. Workplace Experience 6. Curriculum 7. Graduated with Qualification 8. Medication Management Diploma or lower Refused. Ineligible to register as Registered Nurse in Australia. Qualification Assessment Advanced Diploma, meets all registration criteria, except criterion 4. or Bachelor s Degree, meets criteria 1, 4, 5, and 7. or Bachelor s Degree, meets all criteria, except criterion 5. Advanced Diploma (Mental Health, Paediatric, or Disability), meets all other criteria. or Bachelor s Degree, meets all criteria, except criterion 8. Conditional Registration Bachelor s Degree, meets all criteria. Full Registration Referred to bridging programs Source: Nursing and Midwifery Board of Australia. (2017). Accessed from: http://www.nursingmidwiferyboard.gov.au/registration-and-endorsement/international/meetingthe-registration-requirements.aspx.
Recertification processes for IENs: Canada Steps Ontario Alberta First point of contact National Nursing Assessment Service National Nursing Assessment Service IEN nominates designation/province Registered Nurse* or Registered Practical Nurse* Registered Nurse* or Licensed Practical Nurse** If not directly equivalent, IEN must undertake a competency-based assessment Internationally Educated Nurses Competency Assessment Program (IENCAP) The Alberta Registered Nurse Assessment Program (ARNAP) If competency gaps are identified Bridging education/program Bridging education/program Conditional/provisional registration N/A Eligible for temporary permit to work as a graduate nurse Licensure examination NCLEX-RN NCLEX-RN Registration eligibility as registered nurse If all registration requirements are met, eligible for registration as registered nurse. If all registration requirements are met, eligible for registration as registered nurse. *Registered Nurse educational requirement Bachelor s Degree **Registered/Licensed Practical Nurse educational requirement - Diploma Sources: College of Nurses of Ontario. (2017). Registration requirements. Accessed from: http://www.cno.org/en/become-a-nurse/registration-requirements/ on June 15, 2017; College and Association of Registered Nurses of Alberta. (2017). Internationally educated applicants. Accessed from: http://www.nurses.ab.ca/content/carna/home/becoming-a-nurse-inalberta/registration-requirements/internationally-educated-applicants.html/ on June 15, 2017.
The nexus between recertification and migration for IENs AUSTRALIA CANADA migration Australian Nursing & Midwifery Council Department of Immigration & Border Protection employment recertification Nursing & Midwifery Board of Australia Australian Health Practitioner Regulation Agency migration Citizenship and Immigration Canada employment recertification Provincial Nursing Regulatory Bodies: College of Nurses of Ontario College and Association of Registered Nurses of Alberta College of Licensed Practical Nurses of Alberta
Bridging programs to facilitate recertification Bridging programs are are primarily designed to 1) support internationally educated workers to gain access to practice by satisfying foreign credential recognition requirements and 2) transition to the destination country s labour market. Filipino registered nurse (RN) qualification not recognised as equivalent to Australian and Canadian RN standards (with caveats) Assessment of qualifications is on a case-by-case basis Professional experience, nursing registration in other countries may be considered Filipino RNs can choose to be assessed as Registered Nurses and/or Registered/Licensed Practical Nurses in Canada
Recertification challenges for Filipino IENs Australia compared to Canada Access to bridging programs Migration status as determinant of eligibility Permanent and temporary residents can access bridging programs in Australia Only landed immigrants eligible in Canada (Ontario) Qualification equivalence RN to RN (Australia), RN to RN/LPN/RPN (Canada) Risk of de-skilling vs. opportunity to migrate/work
Thank you! Contact: Dominic Diocera Email: john.diocera@unimelb.edu.au
Copyright The University of Melbourne 2011