Registration Exam

About the Exam

The Canadian Midwifery Regulators Council sets and administers the online Canadian Midwifery Registration Exam (CMRE) twice a year. This exam is designed to assess Canadian-educated and internationally-educated applicants for midwifery registration to ensure they meet entry-level competency standards found in the Canadian Competencies for Midwives. The goal of the CMRE is to ensure that midwives gaining registration are competent practitioners providing a consistent standard of care across Canada. Note that provincial and territorial midwifery regulators may have other requirements for registration beyond successful completion of the CMRE.

Examination Dates and Fees

In 2024, the next exam date is October 30th.  This is an online exam with live remote proctoring.  Candidates who prefer to write the CMRE in a test centre can ask to do so.  Starting in 2024, the exam fee increased to $900 with a 5% annual increase for three years after that increase.  

Prior to the exam, registered candidates will get access to the online platform where the CMRE is hosted. They will be able to login and take a tutorial to become familiar with the exam platform and its functionality. 

Please complete the online CMRE Registration Form to register for the exam and contact if you need any additional information. The deadline to register for the October 30th exam is September 6, 2024 and withdrawals must be made by October 4, 2024.  

Examination Format

The examination consists of case-based and independent multiple choice questions. Exam questions are based on the Canadian Competencies for Midwives and the CMRE Blueprint outlines the topic areas and the relative weight of each topic area. 

In order to represent the range of care a Canadian midwife is expected to provide, slightly more than half of the questions will be set in an out-of-hospital setting with the remainder in a hospital setting. 


All candidates will have access to the exam items in both English and French. 

The CMRE values diversity and inclusion and endeavours to reflect these values in exam questions. Exam questions are analyzed and reviewed annually and, with each revision, the CMRE strives to reflect the diverse cultures, family arrangements and expressions of gender that Canadians exhibit and value. 

Exam Accommodations

Candidates needing extra time or any other exam accommodations must obtain and complete the CMRE Accommodation Request Form and submit it to with the Exam Registration Form. Exam accommodations must be pre-approved by the CMRE Committee. The request must show how the condition/disability/disorder interferes with the candidate's ability to take the exam, and how the requested accommodation addresses this. CMRC must ensure that the integrity of the exam remains intact. There is no fee for requesting an accommodation, however candidates are responsible for any costs associated with obtaining the supporting documentation. 

Candidate Statement of Understanding

Prior to starting the online exam, candidates must sign a Candidate Statement of Understanding. This statement addresses the confidential nature of the CMRE, exam invigilation, cheating, and the potential impact of testing irregularities. It is important to read this statement carefully. Conduct occurring before, during or after testing that violates principles detailed in the Statement of Understanding may result in invalidation of Examination results and/or other penalties, and will be reported to the Canadian Midwifery Regulators Council (CMRC) and provincial regulatory authorities. Unless an accommodation has been approved, candidates are allowed to bring only water in a clear container to the exam. No other food or beverages are permitted.

Examination Pass Score

The passing score for the CMRE is developed through a standard setting process that ensures that the pass mark accurately reflects the acceptable level of midwifery proficiency in Canada. Examination forms are validated and subject to a statistical check of reliability. The CMRE uses an item writing and standard setting procedure that promotes comparability and fairness across candidates, test forms and yearly administrations. Therefore, the specific passing score may change slightly from one sitting to the next.

Examination Results

Examinations score reports (Pass or Fail) are distributed within six weeks of the exam date. 

Examination Re-Scoring

All scores on the CMRE are carefully verified to ensure their accuracy, and scores of unsuccessful candidates undergo an additional verification process. A written, formal request for re-scoring may be submitted to the CMRE Administrator ( Candidates have fourteen days after the score release date to make their request. A $75 fee will be charged. 

Examination Re-Takes

Candidates are eligible to take the exam multiple times. After three (3) sittings, candidates must provide evidence of additional relevant education to the CMRE prior to registering again for the exam. All re-write fees are the same as initial fees. 

Technical Information

For more information about the CMRE consult the CMRE Technical Report 2023

Eligibility for the Exam

The CMRE is open to Canadian-educated and internationally-educated midwives. Canadian-educated midwifery candidates are eligible to write the CMRE if they have successfully completed or are currently enrolled in good standing of the final term of a Canadian Baccalaureate Midwifery Education Program approved or recognized by one of the provincial or territorial midwifery regulatory authorities. Internationally-educated midwifery candidates are eligible to write the CMRE if they are in good standing in the final stage of a Canadian bridging or assessment program approved or recognized by one of the provincial or territorial midwifery regulatory authorities. Please contact with any questions regarding exam eligibility.

Registration for the Exam

Follow these three easy steps to register for the CMRE: 

  1. Complete the online CMRE Registration Form (see Exam Dates and Fees above).
  2. Pay the $900 fee by INTERAC e-transfer to the CMRE Administrator at The registration form and payment must be completed by the exam registration deadline. 
  3. Additional information, including how to prepare for an online exam and how to book a start time, will be sent to you after registration closes. 


Preparation and Study Tools for the Exam

Study Tips

  1. The goal of the CMRE is to ensure that you are competent in all aspects of midwifery as outlined in the Canadian Competencies for Midwives. You are encouraged to review this document.  
  2. The CMRE Blueprint outlines the structure of the exam, including how many questions cover each general topic area. Review this closely to understand what is being covered and the standards used.
  3. If you are not familiar with multiple-choice questions, you should look for opportunities to practise taking exams in that format. 

Question Content

Each question is designed to test a specific entry-level competency from the Canadian Competencies for Midwives. Questions are developed by teams of experienced Canadian midwives and each question references least two valid, current resources. 

Multiple Choice Questions

The questions on this exam are in a multiple choice format. All questions have a stem and four possible answers. 

Candidates should select the ONE best answer to the question presented. You will receive one point for each correct multiple choice question. 

You should use your best judgment and try to answer every question as you are not penalized for incorrect answers (they receive 0 points).

Case-based Questions

Approximately 50% of the questions are case-based.  This means that a case, or midwifery scenario, is presented in a sentence or paragraph followed by between two to five questions.  All of these questions relate to the information provided in the case, and candidates must read the case to fully understand each question.  A sample case is below (and this case would be followed by specific questions):

  • Kiko, 32 yrs, is visiting the midwife for the first prenatal appointment in this pregnancy. Their first previous pregnancy, at 16 yrs, was a vaginal delivery at term. Four years ago, they had a cesarean section for breech presentation at 36 weeks.


The exam is 4 hours and 45 minutes in length. There is one 30 minute break halfway through the exam, therefore the total seat time is 5 hours and 15 minutes. Additional bathroom breaks are allowed if necessary, however no additional time is provided.    


Suggested Study Resources for the Exam

In preparing for the CMRE, candidates should ensure that the midwifery textbooks and other resources they are using are comprehensive and less than five years old. The textbooks should contain information that covers the full spectrum of knowledge required of the entry-level midwife as set out in the Canadian Competencies for Midwives. The CMRE Reference List may also be helpful. There is no single “best” text for review.

Candidates should also consult Canadian midwifery and maternity care resources such as the Association of Ontario Midwives, Society of Obstetricians and Gynaecologists of Canada and the BC Reproductive Care Program Clinical Practice Guidelines. 

We recommend that candidates study the standards and policies related to the provision of care (e.g. Consult and Transfer, Drug and Diagnostic Testing Schedules, etc.) in the jurisdiction where they will be applying to register, as appropriate. Only those requirements that are the same across all Canadian regulated will be tested on the CMRE.  

Candidates may also wish to review the Association of Ontario Midwives' Emergency Skills Workbook or the Regroupement les sages-femmes du Quebec's Formation en urgences obstetricales, as these workbooks reflect the generally accepted standard for emergency care for Canadian midwives.


Practice Exam (PESA)

The Midwifery Pre Exam Self Assessment (PESA) is a set of sample exam questions that form a short self-administered online test. All questions are in the style of the questions found on the Canadian Midwifery Registration Examination (CMRE). Some of the questions have been used in previous versions of the CMRE. Like the CMRE, the PESA is available in English and French.

The PESA allows users to obtain some direct experience with questions that mimic the format, style, language level, and difficulty level of questions on the CMRE. The specific set of questions has been chosen to also demonstrate the range of content and types of questions found on the CMRE. Finally, by taking the time-limited PESA, users can also experience the approximate pace of the CMRE.

Important Note: The PESA is NOT a comprehensive study tool and it is NOT intended to replace other study techniques (e.g. reading relevant texts, study groups, etc.)

Is it exactly the same as the CMRE?

Not exactly, as the PESA contains fewer questions than the CMRE. Although some questions were previously used on the CMRE, none will be included in future versions of the exam.

The PESA includes questions that are similar to those you will find on the CMRE. The PESA is designed to enable candidates to experience the type of entry-level multiple choice questions that are on the CMRE, including the proportion of questions from each competency area and the appropriate balance of different midwifery care scenarios such as hospital/out-of-hospital settings and normal/abnormal situations.

Who can use the PESA?

The PESA is used by internationally-educated midwives who are participating in a Canadian midwifery bridging/assessment program and by senior students of Canadian midwifery education programs. Canadian midwifery education programs, bridging/assessment programs and provincial/territorial regulators can provide the PESA code to these individuals.  

Getting Started

When you are ready to start using the PESA, click on “PESA login page” below, read and agree to the Terms of Use, and then follow the instructions carefully under “Is this your first time here”. You will create a user account and you will receive an automated email. If you don’t receive the email, please contact the CMRE Administrator at

PESA login page


CMRE Data Sharing

Only aggregate data from the CMRE exam is shared with Canadian baccalaureate midwifery education programs, bridging programs and assessment programs. The presentation of the data does not identify individual test takers.