English Language (IELTS, OET) Requirements Exceptions for UK Nursing Registration 

A recent pre-registration nursing or midwifery qualification which was taught and examined in English.

Trained in English

If you completed an NMC-approved pre-registration nurse, midwife or nursing associate programme within the last five years, we will accept this as evidence that you have the necessary knowledge of English.

If you did not complete an NMC-approved pre-registration nurse, midwife or nursing associate programme we need to be satisfied that your programme demonstrates that you have the necessary knowledge of English.

• If you completed your programme in a majority English-speaking country within the last five years you will need to demonstrate that your programme meets the requirements set out in our guidance by providing evidence which meets our criteria.

• If you completed your programme in a non-majority English-speaking country within the last five years you will need to demonstrate that your programme meets the requirements set out in our guidance by providing evidence which meets our criteria. We will consider your evidence but please be aware that it is likely that you will need to provide an alternative type of evidence such as a language test.

Your evidence must confirm that the programme was composed of at least 50 percent clinical interaction. Your evidence must also clearly demonstrate at least 75 percent of that was with patients, service users, their families and other healthcare professionals and must have taken place in English.

If your evidence does not clearly demonstrate the above requirements you will need to provide an alternative type of evidence such as a language test.

UK NMC Accepted English language tests

Register as a nurse or midwife if you trained outside the EU/EEA

If you have trained outside the EU/EEA and are applying to register as a nurse or midwife in the UK, please read our booklet for information about all stages of the process.

Registering as a nurse or midwife in the UK for applicants trained outside the EU and EEA

Begin or continue an overseas application

Applications

To check that the applicant is capable of practising safely and effectively in the UK, we will assess their qualification, training and experience against our standards. 

New applicants

Applicants must complete an online self-assessment of their eligibility to apply before beginning the application process.

Begin an application

There are different fees for different stages of the application process:

Application for nursing/midwifery £140
Part 1 test of competence (CBT) £130
Part 2 test of competence (OSCE) £992
Admission onto our register £153

Total £1415

Each professional field of nursing, including adult (general), children’s, learning disabilities, mental health and the midwifery profession, is examined by our test of competence. Part one is a multiple choice examination and part two is a practical examination called an OSCE (objective structured clinical examination).

Test of competence

In the UK, each field of nursing and midwifery is separate and distinct. Each requires three years of specialist pre-registration education and practice. The test of competence requires extensive preparation and study to make sure you can demonstrate knowledge, understanding and application of professional skills at the right level. See below for information on nursing and midwifery pathways, including specific

competencies and the exam blueprints:

• Adult (general) nursing
• Children's nursing
• Learning disabilities nursing
• Mental health nursing
• Midwifery

The test of competence is in line with our pre-registration standards and competencies for all nurses and midwives. There are standards for adult (general) nursing, children's nursing, learning disabilities nursing, mental health nursing and midwifery. They cover professional values, communication, nursing decision-making and leadership.

Nurses and midwives work in a variety of clinical settings and they are exposed to a variety of settings during their education. All nurses and midwives at the point of entry to the register are competent to work in all professional areas of nursing or midwifery practice.

These areas of practice include acute care, long-term care, caring for healthy people, caring for patients with complex needs and morbidities, and caring for patients in the community setting including in their own homes. All nurses are expected to be able to care competently for people across the life span and respond to a range of needs. For example, a children’s nurse should also be able to respond to the needs of pregnant and postnatal women and people with mental health needs, physical disabilities or dementia.

Once applicants have passed the eligibility assessment, they will be asked to sit the first part of the test of competence. This will be a computer-based test of theoretical practice-based knowledge. The test format will be multiple choice and can be taken in test centres around the world. Applicants will need to contact Pearson VUE, our test provider, to book and pay for their test. For more information, please read the Candidate information guide for Part 1. 

You must complete the entire application process within two years of passing the CBT. If you are unable to do this, you will need to re-sit your CBT and begin a new application with us.

The objective structured clinical examination (OSCE)

The second part of the test is the objective structured clinical examination (OSCE). This will act out scenarios which nurses and midwives are likely to encounter when they assess, plan, carry out and evaluate care. Each separate clinical examination is known as a ‘station’ and candidates will visit all the stations within a set time.

Each of the six stations has standardised marking criteria against which all candidates are assessed. Candidates are assessed by a panel of examiners and will be filmed for quality assurance purposes.

Candidates are expected to demonstrate safe and effective practice. The test of competence is based on current UK pre-registration standards.

You can take the OSCE in the UK at one of our approved university test centres. When we authorise candidates to take the OSCE, they should contact the university directly.

Full details about the OSCE processes and links to relevant resources can be found on the approved universities' website, please follow the links below for more information.

Approved OSCE Test Centres

The following universities are currently approved as test centres:

• University of Northampton
• Oxford Brookes University
• Ulster University

Taking the test of competence

For applications started before 6 April 2017:

• Applicants can sit both parts of the test of competence (CBT and OSCE) twice as part of one application.
• If the applicant is unsuccessful after their permitted attempts, their application will close. They will be required to submit a new application but will not be able to sit the OSCE again for a minimum of six months.
• This period should provide any applicant with adequate time to address any shortfalls identified and carry out the appropriate revision or training.

For applications started after 6 April 2017:

CBT

• Applicants can sit the first part of the test of competence (the CBT) twice as part of one application.
• If an applicant is unsuccessful at their first CBT they must wait a minimum of 28 working days before they can sit the CBT again.
• If an applicant is unsuccessful after their second CBT, their application will close. They will be required to wait six months before submitting a new eligibility application to take the test again.

OSCE

• Applicants may sit the second part of the test of competence, the OSCE, up to three times as part of one application.
• If an applicant is unsuccessful at their first OSCE, they must wait a minimum of 10 working days before they can take the examination again.
• If an applicant is unsuccessful at their second OSCE, they must wait a minimum of three months from the date of their second attempt before they can take the OSCE for the third time.
• If the applicant is unsuccessful after their permitted attempts, their application will close. They will be required to submit a new application but will not be able to sit the OSCE again for a minimum of six months.

Pass rates for the test of competence and OSCE

Identification check

Applicants are required to attend a face-to-face identification check at the test centre on the day of the OSCE exam. At the ID interview you must produce the original versions of the documents you sent photocopies of. We will make final checks on your previous registration, and take a photograph for our records. Applicants applying for entry to the register through the old overseas process will be contacted separately through email, therefore please ensure your contact details with us are kept up to date.

We cannot issue you with a Pin, or place you on our register, until you have met the requirements of this check. Please do not attempt to make an identity check appointment until we have contacted you.

Practice Requirements

Previously overseas nurses and midwives wishing to apply to join our register must have worked for 12 months after achieving their qualification. We have now removed this requirement meaning applicants can apply to join our register immediately after qualifying.

English language requirements

All applicants must supply evidence that they have the necessary knowledge of English.

There are a number of pieces of evidence that we will accept:

competencies and the exam blueprints:

• Adult (general) nursing
• Children's nursing
• Learning disabilities nursing
• Mental health nursing
• Midwifery

The test of competence is in line with our pre-registration standards and competencies for all nurses and midwives. There are standards for adult (general) nursing, children's nursing, learning disabilities nursing, mental health nursing and midwifery. They cover professional values, communication, nursing decision-making and leadership.

Nurses and midwives work in a variety of clinical settings and they are exposed to a variety of settings during their education. All nurses and midwives at the point of entry to the register are competent to work in all professional areas of nursing or midwifery practice.

These areas of practice include acute care, long-term care, caring for healthy people, caring for patients with complex needs and morbidities, and caring for patients in the community setting including in their own homes. All nurses are expected to be able to care competently for people across the life span and respond to a range of needs. For example, a children’s nurse should also be able to respond to the needs of pregnant and postnatal women and people with mental health needs, physical disabilities or dementia.

Once applicants have passed the eligibility assessment, they will be asked to sit the first part of the test of competence. This will be a computer-based test of theoretical practice-based knowledge. The test format will be multiple choice and can be taken in test centres around the world. Applicants will need to contact Pearson VUE, our test provider, to book and pay for their test. For more information, please read the Candidate information guide for Part 1. 

You must complete the entire application process within two years of passing the CBT. If you are unable to do this, you will need to re-sit your CBT and begin a new application with us.

The objective structured clinical examination (OSCE)

The second part of the test is the objective structured clinical examination (OSCE). This will act out scenarios which nurses and midwives are likely to encounter when they assess, plan, carry out and evaluate care. Each separate clinical examination is known as a ‘station’ and candidates will visit all the stations within a set time.

Each of the six stations has standardised marking criteria against which all candidates are assessed. Candidates are assessed by a panel of examiners and will be filmed for quality assurance purposes.

Candidates are expected to demonstrate safe and effective practice. The test of competence is based on current UK pre-registration standards.

You can take the OSCE in the UK at one of our approved university test centres. When we authorise candidates to take the OSCE, they should contact the university directly.

Full details about the OSCE processes and links to relevant resources can be found on the approved universities' website, please follow the links below for more information.

Approved OSCE Test Centres

The following universities are currently approved as test centres:

• University of Northampton
• Oxford Brookes University
• Ulster University

Taking the test of competence

For applications started before 6 April 2017:

• Applicants can sit both parts of the test of competence (CBT and OSCE) twice as part of one application.
• If the applicant is unsuccessful after their permitted attempts, their application will close. They will be required to submit a new application but will not be able to sit the OSCE again for a minimum of six months.
• This period should provide any applicant with adequate time to address any shortfalls identified and carry out the appropriate revision or training.

For applications started after 6 April 2017:

CBT

• Applicants can sit the first part of the test of competence (the CBT) twice as part of one application.
• If an applicant is unsuccessful at their first CBT they must wait a minimum of 28 working days before they can sit the CBT again.
• If an applicant is unsuccessful after their second CBT, their application will close. They will be required to wait six months before submitting a new eligibility application to take the test again.

OSCE

• Applicants may sit the second part of the test of competence, the OSCE, up to three times as part of one application.
• If an applicant is unsuccessful at their first OSCE, they must wait a minimum of 10 working days before they can take the examination again.
• If an applicant is unsuccessful at their second OSCE, they must wait a minimum of three months from the date of their second attempt before they can take the OSCE for the third time.
• If the applicant is unsuccessful after their permitted attempts, their application will close. They will be required to submit a new application but will not be able to sit the OSCE again for a minimum of six months.

Pass rates for the test of competence and OSCE

Identification check

Applicants are required to attend a face-to-face identification check at the test centre on the day of the OSCE exam. At the ID interview you must produce the original versions of the documents you sent photocopies of. We will make final checks on your previous registration, and take a photograph for our records. Applicants applying for entry to the register through the old overseas process will be contacted separately through email, therefore please ensure your contact details with us are kept up to date.

We cannot issue you with a Pin, or place you on our register, until you have met the requirements of this check. Please do not attempt to make an identity check appointment until we have contacted you.

Practice Requirements

Previously overseas nurses and midwives wishing to apply to join our register must have worked for 12 months after achieving their qualification. We have now removed this requirement meaning applicants can apply to join our register immediately after qualifying.

English language requirements

All applicants must supply evidence that they have the necessary knowledge of English.

There are a number of pieces of evidence that we will accept:

• You have recently achieved the required score in one of the English language tests accepted by the NMC. You must achieve the required score in each of the four skills of reading, writing, listening and speaking.
• A recent pre-registration nursing or midwifery qualification which was taught and examined in English.
• Registration and practice of at least one year in a country where English is the first and native language and an English language assessment was required for registration.

Find out more about our English language requirements.

UK immigration processes

Applicants should be aware that they will be required to meet the full requirements of the UK’s immigration processes separately. Read more about the UK immigration process.

Reviewing our registration process

We're reviewing our entire registration process for nurses and midwives trained outside the EEA. We’re aiming to improve our process so that it is quicker and simpler, and puts applicants at its heart. 

While we develop our plans the current process will still be in place for existing and future applicants. We’ll make sure that we let all applicants and their representatives know well before any changes take place and what those changes will mean. 

UK nursing registration begin here