“At first I was scared,” he said. “But thanks to my preceptor and my leaders at St. Joseph’s, I felt fully supported. Every time I had a question, they answered it until I became confident enough to be on my own.” — Bryan Sanchez, RN
When Bryan Sanchez, RN — a nurse from the Philippines with more than a decade of experience — moved to Canada in 2019, he found himself working as a welder to support his family. “I'm not a choosy person,” he says. “So, I thought, why not try this welding thing? I applied and they accepted me.”
But the work was nothing like nursing. Sanchez’s boss, noticing his instinct to care for others, often reminded him not to treat the robots he worked with as patients. His desire to return to nursing never went away.
After three years, a friend told him about the Supervised Practice Experience Partnership (SPEP), a program delivered through a partnership between CNO, the Ministry of Health, Ontario Health and CNO-approved organizations. SPEP allows nursing applicants to demonstrate current knowledge, skill, judgment and language proficiency as part of the registration process. It is one of several ways eligible applicants may meet outstanding registration requirements, depending on their individual situation. Sanchez realized it could be his pathway back into the profession he loved.
He applied and was accepted. In fall 2023, he completed the required 140 hours at Parkwood Institute at St. Joseph’s Health Care London, gaining hands-on experience in a Canadian health care context.
“At first I was scared,” he said. “But thanks to my preceptor and my leaders at St. Joseph’s, I felt fully supported. Every time I had a question, they answered it until I became confident enough to be on my own.”
Sanchez successfully completed SPEP, became registered as an RN and was hired permanently by St. Joseph’s. Today, he provides care to patients with stroke, brain injury and spinal cord injury. “It’s very rewarding,” he says. “It’s very self-fulfilling as a nurse.”
SPEP candidates are not students
“It’s important to remember they're not students — they have an international nursing background,” she said. “They have unique skill sets, and our job is to figure out and support how those skills translate to Canadian health care.” — Charmaine Madrigal, RN
Photo L-R: Ancy Xaviar, RN and Charmain Madrigal, RN
CNO recognizes that pathways to registration can look different depending on an applicant’s background and professional history.
Sanchez’s story is one of thousands. According to a CNO Evaluation Report published in fall 2025, 4,183 applicants completed SPEP during the program’s first three years (2022–2024). Nearly all renewed their registration the following year, and 72% of surveyed employers hired their candidate after completion.
St. Joseph’s Health Centre Guelph is one of those employers. Its Clinical Learning and Development Specialist, Charmaine Madrigal, RN, is an internationally educated nurse (IEN) herself. She notes that SPEP gives IENs the structure they often struggle to find.
“When you come as an immigrant, nobody really sits you down and tells you, ‘This is what you have to do,’” she said. “There’s so much anecdotal information, but nothing formal.”
She explained that when she began her own journey as an internationally educated nurse, structured supports were limited, and many IENs relied on informal guidance. “We’ve come a long way since then,” she added, “and programs like SPEP are a big part of helping IENs transition into working in Canada.”
SPEP helps shift that landscape by pairing applicants with qualified preceptors, many of which at St. Joseph’s are IENs themselves, who have firsthand experience working in the Canadian system.
The approach has worked well at St. Joseph’s. To date, 26 SPEP candidates have completed placements there, and 10 were hired — nine of whom remain with the organization.
For Madrigal, success starts with mindset.
“It’s important to remember they're not students — they have an international nursing background,” she said. “They have unique skill sets, and our job is to figure out and support how those skills translate to Canadian health care.”
Preceptors make all the difference
“We also help with things like risk assessment, critical thinking—even the ethical base of a nurse’s practice." — Ancy Xaviar, RN
Through supervised practice, applicants receive structured support and feedback while demonstrating safe practice in Ontario’s health care system.
The cornerstone of SPEP is the dedication of preceptors who help IENs and nurses returning to practice meet their evidence of practice and language requirements.
One of those preceptors is Ancy Xaviar, RN, who works with Madrigal at St. Joseph’s. Like many of the candidates she mentors, Xaviar is an IEN, which helps her understand their perspective. She has supported applicants with everything from communication skills and documentation to technologies they may not have used in their home countries.
“We also help with things like risk assessment, critical thinking—even the ethical base of a nurse’s practice,” she said.
For Xaviar, the learning goes both ways. Some candidates come from environments vastly different from Canada’s. “We had one candidate who was a trauma emergency nurse in a war torn country in the Middle East,” she said, “so we looked at how that highly skilled practice translates here. How can you share that knowledge?”
Another strength of SPEP is the growing number of successful candidates who want to become preceptors themselves. Sanchez is among them. His preceptor was instrumental in his success, and he hopes to support future cohorts.
“For the next generation of nursing candidates, I definitely want to be a preceptor and pay that back,” he says. “I know how they feel. What they need is confidence and familiarity with the Canadian system — and I will make sure they reach that goal.”