Recruiting New Registrants
Every year practice groups choose to be a mentoring site by applying for new registrant funding as part of their annual budget request. Normally, practice groups conduct interviews for new registrant spots well in advance of the expected budget approval, and some practices will make offers to graduates anticipating that approval will be granted. Practice groups should make these offers conditional on Ontario Midwifery Program (OMP) funding approval of a mentored spot.
In the past, some practice groups have chosen to take on new clientele for a new registrant in advance of approval of budgets, believing the chances of obtaining approval are high. This may be advantageous for clients receiving care since they do not have to wait until later in their pregnancies, but practice groups should be aware of the risks. In particular, midwives in the practice group will have to absorb that extra client load if the practice group does not get new registrant funding, if they do not find a new registrant interested in working in that practice, or if they are unable to obtain hospital privileges for an additional midwife in their hospital.
With the OMP being a “managed program,” midwives are dependent on a structured process that requires new registrants to await approval of placements for mentored spots prior to obtaining funding for insurance. While there is certainty that new registrant funding will be available each year, there is no certainty as to which practice groups will receive this funding. It is not possible to finalize a contract with a new registrant prior to Ministry of Health budget approval as the new registrant will be without liability insurance, and equipment for the new registrant only comes with budget approval.
While awaiting budget approval practice groups can:
- Inform the hospital(s) of the practice group’s intention to take on a new midwife. Find out what steps will need to be taken once she is registered and prepare for those steps; obtain applications for hospital privileges; and have the new registrant complete as much of the applications as she can prior to being registered.
- Suggest that the graduate to whom you have made a conditional offer prepare their documents for application to the CMO for registration and to the AOM for membership. These documents can be sent into the AOM ahead of budget approval, thereby decreasing the time to process the new registrant’s liability insurance once approval is received.
- If your practice group normally uses second attendants, consider having the graduate work as a second attendant.
Liability Risk for Grads Prior to Registration with CMO
As practice groups await notice of budget approval for new registrants, practice groups and soon-to-be new registrants must remember that graduates must not have any contact with clients to whom they will be providing midwifery care in any capacity prior to formal registration with the College of Midwives of Ontario and prior to confirmation of having professional liability insurance coverage.
Even being an observer at a client appointment puts the new registrant at risk. In the event that a future claim ensues, the new registrant would be without professional liability insurance coverage.
Liability Risk for Grads as Second Attendants
Some practice groups have decided to contract with a graduate to fill the role of a second attendant, while awaiting notice of budget approval for new registrants.
Second attendants are covered under the midwife’s professional liability insurance. However, there is the risk that a client could have expectations of the second attendant as if she were a registered midwife. In order to safeguard the liability coverage for the second attendant, the practice group and the second attendant must ensure that it is made very clear to all - the second attendant, the client, and all members of the practice group - that the second attendant must not provide midwifery care, advice or clinical care that could be seen to fall under the auspices of a registered midwife. The second attendant must only do the acts that an unregulated member of the public would be authorized to do.
Practice groups may find it beneficial to have a written policy about the role of grads as second attendants. This document could be shared with each new registrant, each member of the practice group and each client so that there is no confusion as to the role of the second attendant.
Note: New registrants can check out resources designed for them here.