Refresher Process for Re-entry to Clinical Practice


  • College of Health Professions

Degree Earned

  • Certificate

Program Type

  • Online
Name: Midwifery & Women’s Health Programs
Organization: Jefferson – Center City Campus

130 S. Ninth Street, Suite 960
Philadelphia, PA 19107

Contact Number(s):

Contact Admissions

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Once accepted to complete a refresher process, refresher midwives enroll at the Midwifery Institute at Jefferson (Philadelphia University + Thomas Jefferson University) as non-matriculated students. Course of study is determined after review of admission documents and an advisory meeting with the Program Director.  When students begin their studies, they are assigned a faculty contact available to them throughout their refresher process.


Credit-by-exam is a process where a student pays for one academic credit and is then given access to learner objectives, learner resources in the course module. The student studies the materials for the course independently and takes all course exams. Upon successful completion of course exams, the student is awarded credit-by-exam for the course.

For example, if a student takes credit-by-exam for MIDW-610 Antepartum Care, the student pays for one credit, studies independently for a thorough review of the course content, successfully takes the exams showing mastery of didactic content and is awarded 4 credits for MIDW-610. Courses are taken as credit/no credit. Students taking credit-by-exam do not participate in seminar room discussion, case studies, problem based learning tutorials, and do not write papers or complete projects related to the course. 

Successful completion of each credit-by-exam is recorded on the student’s transcript. Upon successful completion of theory courses, students are eligible to begin a supervised clinical experience under the direction of a qualified CNM/CM preceptor.

Students must demonstrate competency in all aspects of midwifery care either through current work in that area, or refresher content in the area they are refreshing. Upon successful completion of the clinical practicum, the student is issued a letter confirming successful completion of the refresher process and is able to obtain a transcript of all course work completed as credit-by-exam from the university registrar.

While the course of study is individualized, a typical plan of study for a midwife who has not practiced for more than 5 years includes credit-by-exam for the following courses:

  • Semester 1: MIDW-643 Advanced Physiology/Pathophysiology for Primary Care; MIDW-645 Healthcare of Woman; MIDW-610 Antepartum;
  • Semester 2: MIDW-611 Intrapartum; MIDW-612 Postpartum/Newborn; MIDW-619 Advanced Perinatal Pathophysiology
  • Semester 3: MIDW-634 Clinical Full-scope Midwifery II

Additionally, each applicant is responsible to check with their state regulatory board for any board required courses such as: MIDW-699 Advanced Physical Assessment and/or MIDW-638 & 644 Advanced Pharmacology I and II, and to see if there are other board specific requirements.  

Students are responsible for identifying a clinical site during the application process (Clinical Site Form). Once a student is accepted into the refresher process, the Midwifery Institute processes a formal affiliation agreement with the proposed clinical site.

Accepted students are responsible for purchasing and maintaining liability insurance for clinical refresher practice. An ACNM partner company has developed refresher student rates for CNM/CMs. Additionally, accepted students must maintain CPR, NRP and EFM certification while in clinical and have a background check, drug screen and health clearance. A notarized passport photo is required for identification.  Clinical sites may have additional requirements prior to starting the clinical refresher.

If you have questions about your unique circumstances, please contact an admissions counselor at 215-951-2943 or by email at