Changes made by the nursing regulatory body last year have created additional hurdles for internationally educated nurses, who are struggling to meet the regulator’s new “safe practice” rules and face multiple delays in restarting their nursing careers.

The new OSCE test was introduced in March 2013 as an entry test for internationally educated RNs before they can go on to write the registration exam. However, the College said 2012 saw a spike in registrations, and last year’s number only reflected the norm.

“Our preliminary analysis of that spike is that applicants were trying to get their registrations completed before new registration rules took effect Jan. 1, 2013,” said college spokesman Bill Clarke.

The test requires nurses to interact with patients played by actors in 12 test scenarios. As of August, 1,673 foreign-trained nurses had taken the OSCE and only 25 per cent were successful in demonstrating the 100 competencies in the assessed scenarios. Nurses who have taken the OSCE say the college offers limited information about the exam with no course or textbook to prepare for it.

Not only does high demand mean that some candidates must wait as long as nine months to sit for the test, those who fail and don’t want to repeat their entire education in Canada have only one choice: compete for one of 50 spots at York University’s 20-month-long Bachelor of Science in Nursing program designed for internationally trained nurses.

“The OSCE exam is really hard. There is no study guide. You can’t prepare and study for it. If this is the way they prefer to license us, at least send us quickly to the OSCE and open more bridging programs to get us on track,” said Margarita Pasynkovsky, an operating room nurse from Israel.

a recent review of the nursing college’s registration process by Ontario’s Office of the Fairness Commissioner (OFC), released this summer, found that “some internationally educated applicants do not receive adequate explanation about their shortcomings on the OSCE.” And since there are no appeals or repeat tests allowed, “it leaves applicants with no option but to proceed to bridging education if they wish to continue with their RN application. It is unclear why, regardless of the number of gaps identified in the OSCE, applicants who want to proceed with their RN application must take an entire bridging program. There is no sound justification for the ‘one size fits all’ approach,” the report says.

The college said it brought in the OSCE test for foreign RN applicants because it is an objective tool to evaluate competencies. At York University, administrators received 400 applications for its bridging program for foreign nurses for its 2015 class, a 224-per-cent increase from the year before. But the program’s capacity has not caught up to demand.

Ryerson University has a two-year program to help individuals transition from registered practical nurses to RN, but it requires an approved one-year bridging program from another college to qualify for its degree program.

Ontario fairness commissioner Jean Augustine said she encourages professional regulators to consult her office for guidance before registration changes are made. The college said it is concerned about the situation and has been working with groups such as the Council of Ontario Universities to develop programs that will address the nurses’ competency gaps.

Internationally educated RNs licensed in Ontario: Historical Snapshot

2004:  1,532

2005:  1,114

2006:  249

2007:  326

2008:  309

2009:  336

2010:  380

2011:  421

2012:  645

2013:  268

Source: The Star