IEN Survey Report Press Release

TORONTO, March 27, 2024 (GLOBE NEWSWIRE) -- Internationally educated nurses (IENs) play a critical role in strengthening the health care workforce across Canada. However, a newly released report from World Education Services, Counting on Care: A Survey of Internationally Educated Nurses Not Working as Nurses in Ontario, indicates that among IENs living in the province but not working as nurses, as many as half have not yet applied for registration. Another 6 percent say they do not intend to.

WES also found that skills underutilization among this group of IENs is acute: Among respondents who had obtained jobs, nearly 1 in 5 (19 percent) indicated that their current employment does not make any use of their nursing education and training.

The new report is based on a fall 2023 survey of Ontario-based IENs who are not working as nurses; this group is seldom represented in health care workforce data. Among more than 750 survey respondents, some 50 percent said they intended to apply for nursing registration but had not yet begun the process. Factors that delayed their progress include financial barriers as well as the length of time and lack of clarity around the registration process.

Just last week, the College of Nurses of Ontario (CNO) approved a motion to move forward a significant policy change that has the potential to accelerate registration for many IENs, and in recent years, Ontario has introduced a number of additional policies and programmatic changes to support IENs’ ability to practice. As a result, the number of newly registered IENs in Ontario more than tripled between 2020 and 2022, from 1,609 to 5,125.

However, a lack of comprehensive health workforce data still makes it difficult to effectively design targeted supports that reach the entire population of IENs living in the province. “The survey results provide evidence to support a focus on those IENs who have not yet even begun the registration journey,” said WES Board member Paolo Varias. “Support for IENs tends to be more readily available in later stages of their registration process,” he continued. “We need long-term solutions that will address needs at every stage of their journey.” Now the associate director of clinical and support services for the Regional Municipality of Niagara’s Seniors Services Division, Varias arrived in Canada as a highly qualified IEN. Like many survey respondents, he faced barriers to registration. It ultimately took him two years to receive his RN designation.

“This latest WES report provides government and health system stakeholders with additional information that’s needed to measure the effectiveness of solutions intended to reduce systemic barriers to registration while also supporting the rigorous standards needed to protect public health,” said Shamira Madhany, Managing Director, Canada and Deputy Executive Director, WES. “By shining a light on those IENs who have not even begun the process of registration, it also helps to fill gaps in workforce data about internationally educated nurses,” she continued.

Internationally educated nurses who advocate solutions to reduce barriers say that despite progress on the issue, more can be done. “The journey to registration can be lonely and frustrating,” said Sibylle Ugirase, an IEN originally from Rwanda who registered as a nurse in Ontario only after navigating a lengthy process. “Over the past few years, significant changes have occurred for IENs in Ontario. However, the province still has to shorten processing times and consider the financial costs associated with registration. Many IENs are unemployed or underemployed – and some IENs cannot access provincial supports due to their immigration status. This is a critical issue to consider when developing programs.” Ugirase is now a manager of nursing programs at Collège Boréal.

A full copy of Counting on Care: A Survey of Internationally Educated Nurses Not Working as Nurses in Ontario can be found on

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About World Education Services 
Founded in 1974, World Education Services (WES) is a non-profit social enterprise that supports the educational, economic, and social inclusion of immigrants, refugees, and international students. From evaluating academic credentials to shaping policy, designing programs, and providing philanthropic funding, we partner with a diverse set of organizations, leaders, and networks to uplift individuals and drive systems change.