Capacity is clearly the biggest issue for ITMs. ITMs in all of the provinces where we conducted interviews called for an increase in the number of clinical placements by increasing the number of preceptors available. Some components of the integration process would not necessarily have to be taught by midwifery preceptors. Indeed, some aspects of the Canadian midwifery education programs are taught by faculty in other professions. This would release time for the midwifery faculty to focus on teaching core midwifery skills. Another example of the sharing of resources exists at the IMPP at Ryerson University. To keep costs low for the relatively small number of ITMs it assesses, it shares some of its simulation lab resources with other IEHP programs in the area. This is a win-win situation that not only increases integration capacity of its own profession but that of other health professions.

As for the existing bridging program, many participants had no idea what to expect, and were generally surprised at the demands of the program. To correct this lack of understanding of how the system in Canada works, they suggest that observation opportunities be made available to ITMs. Such opportunities provide a clear understanding of the work performed by midwives in Canada prior to an ITM choosing to go through the licensing process. Furthermore, ITMs would like to have access to others who have been through the process, who could act as mentors to help guide them. Finally, some feel that they need more time than the bridging program provides to adapt to the Canadian model of practice.