If you trained as a nurse or midwife outside the UK and want to register with the NMC, you may need to complete an English language test (such as IELTS or OET) and/or be required to take the NMC Test of Competence.

On this page you'll find advice and resources to help you prepare.

If you want to apply for registration with the NMC as an overseas qualified nurse, you will first need to meet various eligibility criteria and provide specific information or evidence around your:

• identity
• qualifications
• health
• character
• English language

For more information and a step-by-step checklist of what you will need to submit/evidence, see the NMC’s advice page: Register as a nurse or midwife if you trained outside the UK.

NMC English Language requirements

One of the eligibility criteria is that your English language ability meets certain English language requirements specified by the NMC.

If you can’t meet these requirements, you will need to take steps to do so before you can apply. Most applicants do this by taking an NMC approved English language test such as the IELTS or OET.

In order to meet the NMC’s English language requirements, you will need to satisfy one of the following criteria:

• You have recently achieved the required score in one of the NMC Accepted English language tests
• You have a recent pre-registration nursing or midwifery qualification which was taught and examined in English.
• You can demonstrate 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.

English Language Tests accepted by the NMC

If you need to do an English language test, the NMC accepts two types:

• International English Language Test System (IELTS)
• Occupational English Test (OET)

For more information about the NMC's accepted English language tests, and what marks are required to pass, please see the NMC's guidance on Accepted English language tests.

OET resources

• The OET preparation portal has preparation materials, sample answers, sample tests, online masterclasses and more.

• Prepare and practice by downloading free OET nursing sample tests here.

• You can search here for classroom, online or private classes. You can also filter by country.

• Some universities may also run OET language preparation courses

IELTS resources

• The British Council's website offers a wide range of IELTS resources. See Prepare for your test for more details.

• There are resources and sample tests available on the ielts.org website. See Preparing for your IELTS test.

• In order to obtain an adequate score, you will need to understand how the scoring system works, and what the examiners are looking for when they mark your test. The assessment criteria or 'band descriptors' are public and available to view here.

• NOTE: As from 5th December 2018, the NMC lowered its required IELTS score for writing from 7 to 6.5. See the NMC's information here for more details.

RCN library resources and reading lists

The RCN library has put together an IELTS, OET and OSCE exams reading list.

RCN members can borrow books in person and via post, and access eBooks online. 

Reading through nursing journals, books and newspapers will help develop your English and understanding of nursing issues. RCN members can also access a range of journals for free through the RCN library.

Other resources

• Your local university may offer IELTS or OET preparation courses. These can differ in cost and length depending on your specific needs. 

• You can also improve your English through English language courses that are available at local colleges and training providers. 

• If you are employed, ask your employer if they can offer any support or assistance. You should also check if your employer has any study policies, development policies or can offer funding. 

Hiring a private language tutor

Private tutors range in price per hour and can coach you either one on one, or in a group. Some tutors offer tuition via skype or facetime.

If you are going to hire a private tutor, consider the following:

• What qualifications and experience do they have?
• Do they have specific knowledge and experience of the OET / IELTS process and OET / IELTS scoring system?
• Do they have a good track record of helping students pass?
• Can you get recommendations, testimonials or feedback from past students?

NMC Test of Competence

If you do not have a European qualification that meets NMC requirements for automatic recognition you will need to complete a Test of Competence as part of your NMC application.

The NMC Test of Competence (ToC) is used to assess the skills and knowledge of individuals applying to join the NMC register from overseas.

Who needs to take the NMC Test of Competence?

New regulations passed by the UK Government following the UK's departure from the EU allow for certain EU general nursing and midwifery qualifications to be recognised up until the end of 2022.

If you have a relevant European qualification that meets the requirements for automatic recognition you may not need to take the Test of Competence. This applies even if you are not an EU national, but you have a relevant European qualification.

See the NMC website for more details and to check whether you need to take the Test of Competence or not. If in doubt, contact them directly for more information. 

The New NMC Test of Competence

The NMC launched a new version of the Test of Competence for nurses and midwives on 2 August 2021. (The legacy version of the test will be available for some eligible candidates to take up to August 2022.)

The Test of Competence consists of two parts:

• A multiple-choice computer-based test (known as the CBT)
• A practical test called an "Objective Structured Clinical Examination," (known as OSCE)

You can sit your CBT or OSCE in any order and must successfully complete both within two years of each other. The test you take will need to be specific to the part/branch of the register you're applying to join, e.g. adult, child, mental health, etc.

Test of Competence part 1: Computer based test (CBT)

Part 1 is a computer-based test (known as the CBT). It’s split into two parts:

• Numeracy
• Clinical

You will need to take this test under formal exam conditions in a Pearson VUE test centre. See Pearson Vue website for more details on how to book.

See the NMC website's section on CBT and the Test of Competence for more information and help, including the Test of Competence information booklet (which explains what you can expect throughout the entire CBT process) as well as webinars, resources, and preparation materials.

You can also find CBT practice tests on Pearson VUE's website. They are accessible to all and do not need to be booked.

Test of Competence part 2: OSCE exam

Part 2 of the test is called the OSCE (Objective Structured Clinical Examination) which will act out scenarios which nurses and midwives would be likely to come across when they assess, plan, carry out and evaluate care.

You must sit the OSCE exam at one of three test centres in the UK. These are:

• Northampton University
• Oxford Brookes University (On campuses in Swindon and Oxford)
• Ulster University 

For more details, see the NMC's information on OSCE, including the OSCE information booklet for nurses and midwives. 

NMC resources and materials

The NMC's Test of Competence preparation materials include:

• information booklets
• preparation materials
• Webinars covering different aspects of the new test
• Test specifications

University resources 

• University of Northampton's website: NMC Test of Competence information and resources
• Oxford Brookes University's website: NMC test of competence information and resources
• University of Ulster's website: NMC Competence Test Centre (CTC) and Preparing for the OSCE

Employer resources

Some employers provide support and training in preparation for your OSCE. Speak with employers/managers/ HR and recruitment departments for more information.

Some employers offer overseas nurses preparation programmes and training, and may have appointed a specific contact (such as an Overseas Nurse Preceptor  or a specific team (such as an Overseas Nurse recruitment team) to support overseas applicants.

If you have an RCN Learning rep in your organisation you could also approach them for support/signposting.

Other resources 

The RCN library has put together an IELTS, OET and OSCE exams reading list. RCN members can borrow books and access eBooks and journals online. 

The NHS Employers website also has information about the CBT and OSCE. See Recruitment of Overseas Nurses.