How do I become a Nurse Practitioner in Ontario?

(in 2024)

The path to becoming a nurse practitioner will be unique to you. For those of you thinking of pursing a career as an NP, I hope to provide some guidance. If you want a general overview on how to become an NP in Canada, I suggest you read this post. If you plan on pursuing an NP career in Ontario, we will delineate what this journey looks like. Our focus will be on primary health care NP programs in Ontario. 

A Note on My Journey

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I completed my Bachelor of Nursing Science at Queen’s University and became a Registered Nurse in Ontario in 2015. I dabbled in various areas – mental health, addictions medicine, family medicine, pediatrics, and geriatrics. In 2018 I became restless so decided to pursue a Master of Science in Nursing degree (thesis stream) at the University of Ottawa. I worked as a nurse educator in a hospital while completing the master’s degree. I enjoyed the research focus, however shortly after that I was certain I wanted to be an NP. In 2020 I was accepted into the post-master’s NP diploma program at Western University and couldn’t be more thrilled. Prior to starting the program in 2021, I was fortunate enough to work part-time at a family health team, while enjoying my time on an inpatient addiction medicine unit. I’m a person that likes to plan (sometimes too far in advance), so I got a head start on preparing for the NP program, as I heard a steep learning curve was ahead (and I was right). For insights on how to prepare for this career path, read this post. Now, let’s get into the nitty gritty of how to become an NP in Ontario.

What NP programs are available in Ontario?

  1. Primary Health Care NP program (9 universities)

  2. Adult/acute care NP program (University of Toronto only)

  3. Pediatric NP program (University of Toronto only)

  4. Primary Health Care NP program - Global Health (University of Toronto only)

The College of Nurses of Ontario has a concise breakdown of available NP programs here.


Primary Health Care Nurse Practitioner Programs in Ontario

What is a primary health care NP?

Put simply, in Ontario, primary health care NPs are registered nurses with extended scope of practice. We have the ability to provide primary health care functions in health promotion, disease and injury prevention, rehabilitation, treatment, and other services (1). We can diagnose and treat acute illnesses and injuries, care for patients with chronic disease, prescribe medications, and order and interpret the results of diagnostic tests (1). NPs work autonomously and within interdisciplinary teams and serve to compliment (not replace) other professions (1).

Just like there are controlled acts authorized to RNs and RPNs, there are controlled acts authorized to NPs, some of which include diagnosing, ordering and interpreting tests, prescribing medications, performing a procedure below the dermis or mucous membrane, and setting or casting a fracture of a bone or dislocation of a joint. See the full list of controlled acts here.

As an NP working in family medicine, I see patients for acute illness (e.g. ear pain), chronic disease (e.g. managing diabetes), preventive care (e.g. cancer screening including pap tests). I perform procedures (e.g. skin biopsies), provide motivational interviewing (e.g. for smoking cessation), and palliative care – and the list goes on! It’s a challenging career with high reward, as it has enabled me to grow professionally and personally.

What primary health care NP programs are available in Ontario?

In Ontario, we have the Ontario Primary Health Care Nurse Practitioner Program which is offered through a partnership of nine Ontario universities and is funded by the Ministry of Health and Long-Term Care (2). All 9 universities follow the same primary health care NP curriculum, with a blended delivery model (online classes, synchronous and asynchronous approach). As a prospective student, you apply to your preferred university NP program. There are online components, and in-person tutorials and labs at each program site.

Most programs in Canada offer 2 primary health care NP streams:

1) Master of Nursing-Primary Health Care Nurse Practitioner (MN-PHCNP): This is a graduate nursing degree. It is 2 years full-time, or longer if you take it part-time. Curriculum includes 7 NP-focused courses, and additional masters-level courses (e.g. critical appraisal of evidence for nursing practice, foundations of nursing science, research courses). The master’s courses differ from university to university. Generally, the master’s courses are completed first, followed by the NP courses. See an example of the Western University course break down here.

2) Primary Health Care Nurse Practitioner post-master’s certificate/diploma (PHCNP): This is a post-master’s degree as the name implies. It is 1 year full-time, or 2 years part-time. To qualify for this program, you need to have at least a master’s degree first (a master’s in nursing science degree or nursing PhD is an accepted pre-requisite, however some programs may accept other master’s degrees). Most programs offer a part-time and full-time study option. Curriculum includes the 7 NP-focused courses. All universities in Ontario follow the same curriculum.

Here is a visual breakdown:

nurse practitioner journey image

What does the nurse practitioner curriculum include?

There are 7 courses that are organized by the Ontario Primary Health Care NP Program consortium.

  1. Roles and Responsibilities (online): this course focuses on the primary health care NP role, political landscape, ethical and legal issues etc. It can be completed as a summer course or is spread over two terms in the fall and winter.

  2. Pathophysiology (online): this course provides a broad overview of disease pathophysiology, broken into systems (e.g. hematology, endocrinology, etc.). It can be completed as a summer course, or during fall term. (I completed this course the summer before the full-time NP program started).

  3. Advanced Health Assessment and Diagnosis 1 (generally in person seminar): this course provides a broad overview of common primary health care presentations, while building on diagnostic reasoning and assessment skills.

  4. Advanced Health Assessment and Diagnosis 2 (generally in person seminar): as above.

  5. Therapeutics in Health Care 1 (generally in person seminar): this course provides a broad overview of treatments for common primary health care presentations.

  6. Therapeutics in Health Care 2 (general in person seminar): as above.

  7. Integrated Practicum: this course focuses on cementing knowledge and skills to get you prepared for your career as an NP. You will attend 1 seminar biweekly or weekly (in person or virtual), with the focus being your final clinical placements.

Course work includes assignments, essays, presentations, quizzes, exams, and objective structured clinical exams (OSCEs).

In addition to lectures and course work, your program will organize four clinical rotations (fall term, winter term, and 2 integrated practicum rotations). Clinical placements vary from university to university, and from student to student. For example, during my fall term I was at a nurse practitioner led-clinic, winter term I was in a rural emergency department and obstetrics outpatient clinic, and for integrated practicum I was at two different family health teams. Some programs will allow you to request specific placements if you have a preference.

What are the prerequisites to get into a primary health care NP program?

You need to have a bachelor’s degree in nursing with a minimum GPA set by the university, and an RN license in good standing with the CNO or equivalent as approved by the CNO. In general, programs will require 2 years full time of registered nurse experience at minimum. Some universities give preference for specific types of clinical experience. The table below provides more detailed information.  

Each university has a jurisdiction / geographic area in which their students must complete clinical placements. This means you will have to live within the geographic area of the university while completing the program. 

Typically, if an applicant does not meet admission criteria, the file is not reviewed by admissions. If there aren't enough applicants who meet the admission criteria, a secondary review of the applications might be completed (e.g review of applicants who are slightly below the minimum GPA). 

Application requirements: (most programs will require the following)

  • curriculum vitae

  • 2 references (one clinical and one academic)

  • Transcripts from all completed university programs

  • Proof of proficiency in the program's language of instruction, in the case of applicants whose first language is neither English nor French

  • Verification of employment hours

  • Proof of RN registration in good standing with the College of Nurses of Ontario

  • A statement of interest or personal essay

UniversityProgram OptionsAdmission Pre-RequisitesStudy Options
Lakehead UniversityMasters | Post-MastersBachelor of Nursing degree (BScN) or equivalent with a GPA 70% Full time: 2 years.
Evidence of current RN registration with the CNO or equivalent as approved by the CNOFlex/part time: up to 4 years to complete the program.
2 years full-time nursing practice (3,640 hours) within the last 5 yearsStart date: September
Preferences for clinical hours: Ontario residents, who’s work experience has been continuous, in the following areas – primary health care, ambulatory care, public health, community health, outpost nursing, emergency care, long term care
Applications open: fall (typically October) / Application deadline: February 1st
Laurentian UniversityMasters (French option available)BScN or equivalent with a GPA >75% Full time: 2 years
Evidence of current RN registration with the CNO or equivalent as approved by the CNOPart time: 3 years
Preferences for clinical hours: primary health care, ambulatory care, public health, community health, outpost nursing, emergency care, long term careStart date: September
Students who have already achieved a master's degree may receive credits for some of the courses in the program
Applications open: October | Application deadline: February 1st
McMaster University Masters | Post-MastersBScN with a minimum of the equivalent to a McMaster B+ average over the final 60 credits from an undergraduate nursing programFull-time only
Evidence of current RN registration with the CNO or equivalent as approved by the CNOMasters: 2 years
2 years full-time nursing practice (3,640 hours) within the last 5 yearsPost-masters: 1 year
Applications open: October 1st | Application deadline: January 31st Start date: September
Queen's UniversityMasters | Post-MastersBScN with a minimum overall average of BMasters: Full-time only
Evidence of current RN registration with the CNO or equivalent as approved by the CNOPost-Masters: Full-time and part-time options
2 years full-time nursing practice (3,640 hours) within the last 5 yearsStart date: September
Undergraduate courses in research methodology and statistics
Applications open: Fall (typically October) | Application deadline: February 1st
Toronto Metropolitan University Masters | Post-MastersBScN or equivalent with a GPA of 3.00 (B) overall in the last 2 years or 20 courses of study Masters: full-time 2 years, part-time up to 4 years
Evidence of current RN registration with the CNO or equivalent as approved by the CNOPost-masters: up to 3 years to complete the program
2 years full-time nursing practice (3,640 hours) within the last 5 yearsStart date: September
Strong preference given to candidates with continuous RN experience in a direct clinical practice setting
Applications open: fall (typically mid-October) | Application deadline: typically late January
University of OttawaMasters | Post-MastersBScN with a GPA of >70% (B)Full-time and part-time options available
Evidence of current RN registration with the CNO or equivalent as approved by the CNOStart date: September
2 years full-time nursing practice (3,640 hours) within the last 5 years
Preference given to Ontario residents
Applications open: fall | Application deadline: February 1st
University of WindsorMasters | Post-MastersBScN with a GPA of >70% (B)Full-time and part-time options available
Evidence of current RN registration with the CNO or equivalent as approved by the CNOStart date: September
2 years full-time nursing practice (3,640 hours) within the last 5 years
Preference given to Ontario residents
Applications open: fall | Application deadline: February 1st
Western University Masters | Post-MastersBScN with a GPA of GPA >78%Full-time and part-time options available
Evidence of current RN registration with the CNO or equivalent as approved by the CNOStart date: September
Internationally educated nurses may be asked to submit a World Evaluation Services report to confirm degree equivalence
Undergraduate preparation in research and statistics
2 years full-time RN practice experience (3640 hours) in the last 5 years in Canada
Applications open: mid-October | Application deadline: February 1st
York UniversityMastersBScNFull-time: 2 years
Evidence of current RN registration with the CNO or equivalent as approved by the CNOPart-time: 3-4 years
2 years full-time RN practice experience (3640 hours) in the last 5 years in CanadaStart date: September
Applications open: mid-October | Application deadline: mid-February

Can I work while I’m completing the NP program?

This depends on many factors. One should weigh personal responsibilities, work-life balance, completing the program full-time versus part-time. In general, it’s possible to work while enrolled in the program, but this is up to your comfort level. Personally, I completed the full-time post-masters NP certificate and did not work. The course content, paired with clinical rotations were very intensive, and I was able to immerse myself in the program and get the most out of it. That being said, circumstances differ, and you need to do what works best for you. It’s important to highlight that regardless of the program, it is a steep learning curve and lots of the learning is self directed. If you are seriously considering this next step in your career, our post on how to prepare for NP school will be helpful.

Is there a virtual Nurse Practitioner program?

Athabasca University (based out of Alberta) offers a Master of Nursing nurse practitioner degree online program. Course content differs from the Ontario consortium curriculum. It is a 33-credit online graduate program, that prepares students to work in primary health care settings. You can take up to 5 years to complete the program. Students are responsible for arranging their own clinical placements.

Where can I work as a primary health care NP?

You can generally work in any area. This degree will give you the most flexibility (compared with acute care or pediatric NP programs). Primary health care NPs work in community settings (e.g. clinics, community health centers, long-term care homes), hospital settings (e.g. emergency departments, inpatient units) – basically everywhere. The NP role is forever evolving in our health care system. Job descriptions, responsibilities, and scope do vary significantly depending on where you land a job.

 

Key Take home Points:

  1. Do your research on NP programs.

  2. Don’t hesitate to reach out to university admissions offices to ask questions about the program or admission process.

  3. Talk with nurse practitioners who have been through this process already.

  4. Think about what you want out of your career (Do you want a serious challenge with career growth potential?)

  5. The NP program (and career in general!) is intense and will probably be the steepest learning curve of your life. Don’t let this intimidate you – prepare yourself in advance.

 

References/Readings:

1. Government of Canada. [2006]. Nursing Issues: Primary Health Care Nurse Practitioners [Internet]. [cited 2024 May 15]; https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/nursing/nursing-issues-primary-health-care-nurse-practitioners.html

2. Ontario Primary Health Care Nurse Practitioner Program [Internet]. [2019]. The Ontario Primary Health Care Nurse Practitioner Program: An Overview. [cited 2023 Oct 2]; https://np-education.ca/about/

University Websites / Program Information

Lakehead University

Laurentian University / Contact: MScN-NP@laurentian.ca

McMaster University / Contact: gradson@mcmaster.ca

Queen’s University / Contact: nursing@queensu.ca

Toronto Metropolitan University / Contact: mbkraay@torontomu.ca

University of Ottawa

University of Windsor / Contact: ssingh@uwindsor.ca

Western University / Contact: gradnurs@uwo.ca

York University / Contact: gradnurs@yorku.ca

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