September 01, 2022

IENs want more exam prep time: CNO survey

CNO is exploring the barriers applicants may encounter in their journey to registration. As part of this, we recently surveyed 3,343 internationally educated nurse (IEN) applicants who are currently eligible to write the registration exam, but who have not attempted to, or who attempted to write the exam but failed. Of those surveyed, 1,282 applicants responded.

Toronto, Ont. Sept. 1, 2022 – The College of Nurses of Ontario (CNO) protects the public by promoting safe nursing practice. This includes registering nurses who have the knowledge, skill and judgment to practice safely in Ontario, whether educated in Canada or internationally. One requirement of registration is successfully completing a nursing regulatory exam.

CNO is exploring the barriers applicants may encounter in their journey to registration. As part of this, we recently surveyed 3,343 internationally educated nurse (IEN) applicants who are currently eligible to write the registration exam, but who have not attempted to, or who attempted to write the exam but failed. Of those surveyed, 1,282 applicants responded.

“We want to understand why these applicants are not taking the opportunity to challenge the registration exam, and what factors may influence their decision,” says Carol Timmings, acting Executive Director and CEO, and Chief Quality Officer of CNO.

Survey findings

Survey results show that the leading reason for IENs not writing the exam is lack of time to prepare. Sixty per cent of survey respondents said this is the top reason.

Nearly 26% indicate that family and personal reasons are a contributing factor, and another 22% cite finances.

Twenty per cent of Registered Practical Nurse (RPN) applicants are nervous about writing the registration exam called REx-PN, while another 8% do not feel prepared to write the exam.

Of the 1,282 respondents, 86% plan to write the registration exam within the year. Less than 2% have not written the exam because they plan to close their application or they are uncertain about entering the work force because of the pandemic.

“The outcomes of this survey give us important information directly from applicants about why they’re choosing not to write the final registration exam,” says Timmings. “It’s important for us to identify barriers so we can work with government and system partners to find ways to remove barriers and support applicants to meet requirements fairly and equitably — while continuing to keep public safety as our most important priority.”

We will further analyze the results of the survey to better understand these barriers.

Increasing nurses in the system

The survey is part of CNO’s commitment to modernize our applicant assessment processes and is highlighted in CNO’s response to the directive from the Minister of Health, to support safe patient care.

Through our modernizing work, CNO has already broken records for registering IENs this year. Policy changes to the language proficiency requirement and collaborations like the Supervised Practice Experience Partnership have led to increased numbers of new nurses in the health care system. 

“We plan to continue this momentum as we collaborate with system partners and government to identify further system solutions to respond to the growing system demands,” Timmings adds.

Visit CNO’s Registration Totals at a Glance for detailed information on current registrations.

Article corrected Nov. 30, 2022, for data accuracy.

About CNO

The College of Nurses of Ontario (CNO) is the regulator of the nursing profession in Ontario. It is not a school or a nursing association. CNO acts in the public interest by:

  • assessing qualifications and registering individuals who want to practice nursing in Ontario.
  • setting the practice standards of the profession that nurses in Ontario are expected to meet.
  • promoting nurses' continuing competence through a quality assurance program.
  • holding nurses accountable to those standards by addressing complaints or reports about nursing care.

The College was founded in 1963. By establishing the College, the Ontario government was acknowledging that the nursing profession had the ability to govern itself and put the public's well-being ahead of professional interests.

For the latest information, please see our Nursing Statistics page.

Anyone who wants to use a nursing-related title — Registered Nurse (RN), Registered Practical Nurse (RPN) or Nurse Practitioner (NP) must become a member of CNO.

Frequently Asked Questions

Go to the public Register, Find a Nurse, to conduct a search for the nurse. Contact us if you can't find the person you are looking for.

All public information available about nurses is posted in the public Register, Find a Nurse, which contains profiles of every nurse in Ontario. Publicly available information about nurses include their registration history, business address, and information related to pending disciplinary hearings or past findings.

Unregistered practitioners are people who are seeking employment in nursing or holding themselves out as being able to practice nursing in Ontario, but who are not qualified to do so. They are not registered members of CNO. Only people registered with CNO can use nursing-related titles or perform certain procedures that could cause harm if carried out by a non-registered health professional. CNO takes the issue of unregistered practitioners seriously. See Unregistered Practitioners for more information.

To ensure procedural fairness for both the patient (or client) and the nurse, the Regulated Health Professions Act requires that information gathered during an investigation remain confidential until the matter is referred to the Discipline Committee or Fitness to Practise Committee. CNO will not disclose any information that could identify patients (or clients) or compromise an investigation. See Investigations: A Process Guide for more information.

Information obtained during an investigation will become public if the matter is referred to a disciplinary hearing. If a complaint is not referred to a hearing, no information will be available publicly.

See CNO's hearings schedule, which is updated as hearing dates are confirmed. Hearings at CNO are open to the public and the media. For details on how to attend a hearing, contact the Hearings Administration Team.

A summary of allegations and the disciplinary panel outcomes can be found on the public Register, Find a Nurse. Full decisions and reasons are also available.

Where a disciplinary panel makes a finding of professional misconduct, they have the authority to reprimand a nurse, and suspend or revoke a nurse's registration. Terms, conditions and limitations can also be imposed on a nurse's registration, which restricts their practice for a set period. Nurses can also be required to complete remedial activities, such as reviewing CNO documents and meeting with an expert, before returning to practice.

For detailed information see the Sexual Abuse Prevention section.

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