Certified International Midwife- CIM

Entry-Level Midwife Training Requirements

If you are training as an Entry-Level Midwife under an IRM-registered preceptor, the following requirements apply:

• Your training must include both clinical training with an IRM-registered preceptor and didactic education through a midwifery program of your choice.

• The minimum timeframe for your combined didactic and clinical training must span at least 3 years. However, please keep in mind that 3 years is the absolute minimum. In most cases, it will take 4-5 years to complete the clinical phases with a preceptor and meet the didactic education requirements before qualifying to sit for the CIM board exam.

• We strongly recommend that you gain experience by training under multiple preceptors and, if possible, in multiple countries, to broaden your skills and exposure to diverse maternity care settings.

• Once you have submitted your Phase 1 paperwork, you have a maximum of 8 years to complete your training.

• The following requirements apply to students who registered in 2023 or later. If you registered prior to 2023, you can be grandfathered into the requirements from the time of your registration, provided you have remained an active and continuously training student with a CIM-registered preceptor since your initial registration.

• Once you have submitted initial registration and phase 1 payment, you are grandfathered under the requirements and fees valid at the time of registration.

               Phase 1

• Submit IRM initial registration and initial 1/3 total fee to register as a student. This payment is made when registering to start phase 1.
• Download and save the phase 1 packet 
• 25 births in assisting role
• 25 prenatal/antenatal exams in assisting role
• 25 newborn exams in assisting role
• 50 postpartum/postnatal exams in assisting role
• Exams do not have to be associated with the same client that was logged for the attended births
• BLS CPR certification 
• NRP, HBB or equivalent certification
• Submit completed phase 1 paperwork prior to moving to phase 2
• Receive a passing score of at least 75% on the pre-exam that will be administered by your preceptor PRIOR to moving from assistant to junior primary under supervision

                  Phase 2

• Download and the save the phase 2 packet and skills checklist
• 25 births in junior primary under supervision role with 7 continuity of care, spanning 3 trimesters and postpartum care
• Continuity of care births must have a total of 4 prenatal and 2 postpartum exams each
• 1 minimum Prenatal/Antenatal exam for each non continuity birth 
• 1 minimum Postpartum/Postnatal exam for each non continuity birth
• 20 newborn exams in the first 24 hours 
• Skills list checked off by preceptor
• Submit phase 2 paperwork and pay the 2nd installment 1/3 fee installment prior to moving on to phase 3

                Phase 3

• Download and save the phase 3 packet
• 25 births in senior primary under supervision role 
• Minimum of 7 prenatal/antenatal exams spanning 3 trimesters for 20 of the births
• Minimum of 3 postpartum/postnatal exams for 20 of the births
• Minimum of 20 newborn exams in the first 24 hours, for 20 of the births
• 7 births are required to be in a low resource setting and must be out-of-hospital
• 20 Well Woman/Gynecology unique primary care exams
• 20 hours of breastfeeding support in a minimum of 10 dyads 
• Proof of formal training in NASG
• Proof of formal Pharmacology for Midwives education
• Proof of IV therapy for Midwives education
• Receive a passing score of at least 75% on final exam
• Final exam is timed, proctored and comprised of 500+ questions 
• 5 letters of recommendation; 3 from prior clients and 2 from a practicing Midwife that you have worked directly with (1 must be your registered preceptor)
• Submit proof of completion of a Midwifery didactic education program 
• Submit completed phase 3 paperwork 
• Pay final 1/3 fee installment with submission of phase 3 paperwork,  prior to CIM exam scheduling
  

Requirements for already certified or licensed Bridge Midwife applicants:

• Current RM, LM, CM, CNM, CPM or other foreign certification equivalent or Jurisdiction Midwifery License
• Submit the completed initial registration and full exam fee.
• Proof of current NRP, HBB or equivalent 
• Proof of current BLS CPR
• 75 primary births minimum: 25 must have continuity of care spanning 3 trimesters and postpartum - must have charts for all. Audits will be performed. 
• 7 of the 75 primary births required, must be in a low resource setting and 4 must be out-of-hospital - must have charts or other proof for all, audits may be performed. 
• Proof of 20 hours of breastfeeding support  
• Proof of formal training in NASG, Pharmacology and IV therapy for Midwives 
• Receive a passing score of at least 75% on final exam
• Final exam is timed, proctored and comprised of 500+ questions
• 8 letters of recommendation; 5 from former clients and 3 from Midwives or Physicians you have worked with.

Requirements for Experienced Midwife applicant, without training under a CIM registered preceptor:

• 150 primary births post completion of your training - random audits are performed -must have charts for all 
• In Primary practice for 5+ years post completion of your training 
• 75 of the primary births must have continuity of care spanning 3 trimesters and the postpartum/postnatal  
• 10+ Primary births in a low resource setting; 7 must be out-of-hospital 
• Submit the completed initial registration and full exam fee.
• Current NRP, HBB or equivalent 
• Current BLS CPR
• 50 hours of breastfeeding support 
• Proof of didactic Midwifery training
• Proof of formal training in NASG, Pharmacology and IV therapy for Midwives 
• 8 Letters of recommendation; 5 from prior Midwifery clients and 3 from Midwives or Physicians whom have knowledge of your experience, skill level and Good character 
• Passing score of at least 75% on the IRM proctored and timed, 500+ question final exam

Continuity of Care Exceptions

In regions where continuity of care is not a cultural norm, exceptions to this requirement may be made on a case-by-case basis. We understand that midwifery practices differ across various cultural and regional contexts, and flexibility is sometimes necessary to account for these differences. If providing continuity of care is not feasible due to local practices, midwives may still fulfill the clinical requirements through alternative qualifying experiences, provided they can demonstrate consistent involvement in the maternity care process and meet the overall standards for safe and effective midwifery care.

If this applies to your situation, please reach out to discuss your specific circumstances, and we will work with you to ensure the training requirements reflect your context.

Definition of Low-Resource Settings

A low-resource setting refers to environments where access to essential maternity medical resources is limited or inconsistent. These settings may include:

• Inconsistent or no access to power or running water

• Limited availability of medical supplies, medications, or diagnostic tools

• Few trained healthcare providers, leading to higher patient loads

• Facilities lacking sterile environments, operating rooms, or emergency transport

• Disaster zones 

Additionally, low-resource settings can be defined by socioeconomic factors, discrimination, or systemic barriers that prevent women from accessing maternity care. This includes indigenous communities in both the U.S. and abroad, as well as migrant populations or other marginalized groups who struggle to receive care due to poverty, immigration status, or social exclusion.

To address the needs of U.S.-based students unable to travel for globally, we have expanded our definition to include births within Amish communities and high-risk populations, such as but not limited to migrant communities at the U.S. /Mexico border. However, we continue to encourage gaining global experience whenever possible, as each country and community presents its own unique challenges in maternal healthcare.

The CIM board examination is administered over two consecutive days and is proctored in person. Prior to your exam date, you will be responsible for securing a qualified proctor who will be in communication with IRM. The proctor must be available for both exam days.

The exam is divided into two sections, taken on separate days:

Day One – Section One

Section One is administered on the first day and consists of approximately 230 multiple choice questions. You should plan for up to five hours to complete this section, with an additional hour allotted for setup, instructions, and short breaks.

Day Two – Section Two

Section Two is administered on the second day and consists of approximately 270 multiple choice questions, plus one written essay-style question. As with Day One, you should plan for up to five hours to complete the exam, with an additional hour for setup, instructions, and short breaks.

Each section must be printed separately. Section Two will not be provided to the examinee until the second day of testing.

Exam Day Procedures and Rules

Upon arrival each day, the proctor will confirm the examinee’s identity by comparing them to a valid government-issued photo ID.

During the exam, the examinee may have only at the exam station:

• Water
• A pen or pencil

No other materials are permitted at the workstation. This includes, but is not limited to: papers, books, notes, phones, purses, backpacks, computers, smart devices, or other electronic equipment. A snack may be left with the proctor and eaten on a break.

If a restroom or snack break is needed before the completion of a test section, the incomplete exam section must be turned in to the proctor prior to leaving the room. No papers, books, phones, purses, backpacks, or electronic devices may be taken on restroom or snack breaks.

The proctor, or another designated staff member, must remain nearby and available throughout both exam days.

Retakes and Waiting Periods

If a section of the exam is not passed, only the failed section must be retaken. There is a mandatory 30-day waiting period before retesting.

Retake attempts are subject to a fee of up to $450 USD per attempt. Please inquire about the retake fee for your exam tier by country and your scholarship status. Proctors may assess their own fees in addition.