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Trained in India

Indian nurses and doctors to UK, Ireland, Europe, US (2026)

If you trained in India, the route abroad starts with your state council, your university and your English test. This page sets out what each destination asks of an Indian-trained professional, from official sources.

United KingdomIrelandGermanyNetherlandsUnited States

Overview

If you trained as a nurse, doctor or allied health professional in India, you can register in the UK, Ireland, Germany, the Netherlands and the USA, but no destination accepts an Indian qualification automatically.

Each regulator assesses your training, asks your Indian council to confirm your registration, and sets its own English or language test. India is not on the World Health Organization's 2023 health workforce support and safeguards list, and it is not on the UK Code of Practice red or amber lists, so UK employers and agencies can recruit from India actively.

Many Indian nurses go to the UK through the NMC Test of Competence, or to Ireland through NMBI. Others go to Germany, some through Triple Win, under which the German development agency GIZ describes placing nurses from Kerala in German hospitals. Indian doctors mostly take the GMC's PLAB route to the UK, the USMLE and ECFMG route to the USA, or a supervised or PRES route in Ireland. Pharmacists, physiotherapists, radiographers and lab scientists follow the regulator for their profession in each country.

Three things are different when you trained in India. First, your licence comes from a State Nursing Registration Council, a state medical council or the National Medical Commission, not from one national nursing body: the Indian Nursing Council says it does not license nurses, and that registration and licensing are the legal role of the state councils. Foreign regulators therefore send verification requests to your state council, and slow replies are a common cause of delay. Second, India is not on any regulator's list of majority English-speaking countries, so an English-taught BSc Nursing or MBBS does not usually exempt you from IELTS or OET. Third, documents for some destinations need an apostille from the Ministry of External Affairs, which has its own sequence of state authentication and outsourced collection centres.

Departure rules are lighter for these destinations than for the Gulf. India's emigration clearance and eMigrate registration apply to employment in 18 notified countries, mostly in the Gulf and South East Asia. The UK, Ireland, Germany, the Netherlands and the USA are not among them. Visa rules in each destination still apply in full, and a UK visa application from India needs a tuberculosis test at a Home Office approved clinic.

This page is for Indian-trained professionals living in India and for those already working in the Gulf. It covers the documents to gather in India, how verification and good standing work with Indian councils, where you can sit each exam inside India, and the ethical recruitment and emigration rules that apply. Follow the links to each regulator and profession page for fees and full step-by-step detail.

Where you can go

United Kingdom

The UK is the most common destination for Indian nurses and a major one for Indian doctors. Nurses take the NMC Test of Competence (CBT in India, OSCE in the UK) and doctors usually take PLAB 1, which the GMC offers at British Council centres in six Indian cities.

  1. 1Check your qualification with the regulator first: the NMC eligibility check for nurses and midwives, the GMC's acceptable qualifications and internship rules for doctors, or the HCPC, GPhC or GDC for other professions.
  2. 2Take IELTS Academic or OET at a centre in India. The NMC asks for IELTS 7 in listening, reading and speaking and 6.5 in writing, or OET B in three skills and C+ in writing; the GMC asks for IELTS 7.0 in each area and 7.5 overall, or OET Medicine grade B in each.
  3. 3Ask your State Nursing Registration Council, state medical council or the NMC (India) to answer the UK regulator's verification request and issue a certificate of good standing, and follow up with them yourself.
  4. 4Nurses sit the NMC CBT at a Pearson VUE centre in India; doctors sit PLAB 1 in India and then PLAB 2 in Manchester.
  5. 5Accept a job with an NHS or other approved employer, get a certificate of sponsorship and apply for the Health and Care Worker visa, with a TB test from an approved clinic in India.
  6. 6Nurses sit the OSCE in the UK, usually within the first weeks or months of starting work, then join the NMC register.

Watch out: NHS Employers lists India as a country with a government-to-government agreement under the Code of Practice, and India is not on the red or amber lists. The Kerala government agency NORKA Roots has advertised recruitment of mental health nurses for Wales. GOV.UK lists India as a country where you need a TB test if you are coming to the UK for 6 months or more; the certificate is valid for 6 months from the date of your x-ray.

Full guide to working in the United Kingdom

Ireland

Ireland recruits Indian nurses through NMBI recognition and an aptitude test or adaptation period, and offers doctors several routes through the Medical Council. Indian internships are not on the Council's list for the Certificate of Experience route, so most Indian doctors use PRES, a recognised higher qualification or a supervised post.

  1. 1Nurses open a MyNMBI account, get the qualification form completed by your college and ask your State Nursing Registration Council to send a Certificate of Current Professional Status directly to NMBI.
  2. 2Sit IELTS Academic (7.0 overall with at least 7.0 in three components and 6.5 in one) or OET (B in three and C+ in one) in one sitting. NMBI does not accept combined results, IELTS online or OET at home.
  3. 3Complete the RCSI aptitude test in Dublin or an adaptation period with an approved hospital if NMBI asks for a compensation measure.
  4. 4Doctors verify the MBBS through EPIC, then follow the PRES route (PRES Level 2 is held in Dublin and Dubai) unless you hold an accepted higher qualification, a PLAB 2 pass or a supervised post offer.
  5. 5Get a Critical Skills Employment Permit or, for hospital doctors, the permit your employer arranges, then apply for an Irish employment visa.

Watch out: Neither NMBI nor the Medical Council exempts Indian-trained applicants from English testing: NMBI's exemptions cover training or practice in Australia, Canada, New Zealand, the USA and the UK, and the Medical Council's cover graduates of schools in Ireland, the EU/EEA, the UK, Australia, New Zealand and the USA. The Medical Council's Certificate of Experience country list (Australia, Malaysia, Malta, New Zealand, Pakistan, South Africa, Sudan and the UK) does not include India.

Full guide to working in Ireland

Germany

Germany recognises Indian nursing and medical qualifications through the authority of the federal state where you will work, and the language requirement is German, not English. Many Indian nurses enter on a recognition partnership or a residence permit for recognition measures and complete an adaptation period or knowledge test while employed.

  1. 1Find your authority with the Recognition Finder on anerkennung-in-deutschland.de for the state where you want to work.
  2. 2Learn German: nurses need B2, and doctors need a B2 certificate plus the medical Fachsprachprüfung, oriented to C1. A2 is usually enough to enter on a recognition partnership or recognition measures permit.
  3. 3Have your degree, transcripts, registration and good standing documents translated into German by a translator the authority accepts, and apostilled where the authority asks.
  4. 4Apply for recognition and receive the notice (Bescheid) listing any substantial differences.
  5. 5Complete the knowledge test or adaptation period, then receive your permission to use the title (nurses) or your Approbation (doctors).

Watch out: GIZ describes placements of nurses from Kerala under Triple Win, and NORKA Roots, a Kerala government agency, publishes Triple Win selection lists. India is not on the annex to section 38 of the German Employment Ordinance (BeschV), which reserves recruitment of health workers from listed countries to the Federal Employment Agency, so private recruiters may operate. The Bezirksregierung Münster asks for qualified German translations even of English documents.

Full guide to working in Germany

Netherlands

The Netherlands has a route for Indian-trained doctors, nurses, dentists, pharmacists and other BIG professions through a certificate of competence, but Dutch is the main hurdle. Expect a long timeline: the BIG register says learning Dutch to the right level takes an average of one and a half to two years.

  1. 1Use the BIG register's advice wizard and book a free consultation hour before you spend money.
  2. 2Reach the Dutch level for your profession (B1 for nurses, B2 for hbo professions, B2+ for doctors, dentists and pharmacists) and show English reading at the level set for your profession.
  3. 3Have your documents certified by an authorised body; the BIG register does not accept an apostille for this step. Get sworn translations of anything not in Dutch or English.
  4. 4Sit the BI-test if you are a doctor, dentist or nurse, then attend the CBGV meeting.
  5. 5Register in the BIG register with a recent Certificate of Current Professional Status from your Indian council and a certificate of good conduct, then complete three months of supervised work.

Watch out: The BIG register has said BI-test places for doctors and dentists are full. Check the current position before you plan around a date, and get an IND-recognised sponsor for the highly skilled migrant permit.

Full guide to working in the Netherlands

United States

Indian nurses can take the NCLEX-RN in India, at Pearson Professional Centers in 15 cities on the October 2026 list, and Indian doctors can sit USMLE Step 1 and Step 2 CK in India before applying for residency through ECFMG certification. Immigration for nurses is usually an EB-3 green card, and the Visa Bulletin lists India separately.

  1. 1Nurses choose a state board, order a credentials evaluation (TruMerit's CES is accepted by all 50 boards), and have your college and State Nursing Registration Council send documents directly.
  2. 2Take an English test the board and VisaScreen accept, such as IELTS 6.5 overall with 7 in speaking. An English-taught Indian programme does not exempt you from VisaScreen.
  3. 3Register for the NCLEX-RN with Pearson VUE and book an Indian centre, which adds a $150 international scheduling fee.
  4. 4Doctors open a MyIntealth account, have ECFMG verify your MBBS diploma and transcript with your college, pass Step 1 and Step 2 CK and OET Medicine, and apply to a Pathway.
  5. 5Apply for residency through ERAS and the Match, or for a nursing job with an employer that files your immigrant petition.

Watch out: USMLE says an 18% goods and services tax is collected on exams taken in India, from December 4, 2024. The State Department's Visa Bulletin publishes separate dates for people born in India in the employment-based categories, so EB-3 waits for Indian-born nurses can differ from the rest of the world. Check the current bulletin and ask an immigration attorney about your case.

Full guide to working in the United States

Documents to gather

  1. Passport and name consistency

    Get or renew your passport early and make sure your name matches your degree, registration and test certificates exactly. Indian documents often differ by an initial, a surname order or a married name, and regulators such as the NMC ask for a marriage certificate or other legal evidence for any change. Fix differences before you book IELTS or OET, because the name on your test must match your passport.

  2. Degree certificate, mark sheets and transcript

    Collect your final degree or diploma certificate (BSc Nursing, GNM, MBBS, BDS, BPharm, BPT and so on) and the semester mark sheets from your university or examining board. Many regulators and agencies (NMBI, TruMerit, ECFMG and the BIG register) want the transcript or verification sent directly by the institution, so find out how your university's registrar or examination branch handles requests from abroad. Ask for the syllabus with theory and clinical hours as well, because NMBI, German authorities and the BIG register compare hours and content.

  3. Council registration certificate

    Keep a copy of your registration with your State Nursing Registration Council (and your NUID if you are enrolled on the Indian Nursing Council's NRTS), your state medical council or National Medical Commission registration, or your state pharmacy, dental or physiotherapy council registration. Keep the registration current while you apply: lapsed registration makes good standing harder to obtain.

  4. Certificate of good standing

    Nurses request good standing from the State Nursing Registration Council where you are registered; the Indian Nursing Council says licensing is the job of the state councils. Doctors use the National Medical Commission's doctor portal, which lists Good Standing Certificates as a service, or the state medical council where you are registered. Each destination sets a validity window (three months for the GMC and the Irish Medical Council, six months for NMBI), so time the request for when the regulator needs it.

  5. Experience certificates

    Ask every hospital you have worked in for an experience certificate on letterhead with your dates, ward or department and post, signed by the nursing superintendent, medical superintendent or HR. NMBI has its own employment forms, which your employers must complete, and German authorities count experience against gaps in training. Get these before you leave a job, because hospitals can be slow to respond once you have left.

  6. Police clearance certificate

    Germany and the Netherlands ask for a certificate of good conduct, and employers and visa offices in other destinations may ask for a police record. In India the Police Clearance Certificate is issued through Passport Seva. Many authorities want it to be no more than three months old, so apply close to the time it is needed.

  7. State authentication and MEA apostille

    Where a destination asks for an apostille (German authorities may; the UK, Ireland and the USA verify directly with your institution and council), the Ministry of External Affairs apostilles personal and educational documents once they are authenticated. Documents covered by e-Sanad can be verified online; for others you first get authentication from the state's Regional Authentication Centre, then submit through an MEA outsourced agency. MEA charges ₹50 per apostille and the agency adds its own fee. The Netherlands' BIG register does not accept an apostille in place of its own certification.

  8. Translations

    Indian degrees and registrations are usually issued in English, which the UK, Ireland, the Netherlands and the USA accept. Germany is different: the Bezirksregierung Münster, for example, asks for qualified German translations of all foreign-language documents, including English ones, by a translator publicly appointed in Germany or confirmed by the German mission. Documents in Hindi or a regional language need a certified English translation for every destination.

Verification and good standing

  • UK, nurses: the NMC contacts your regulator directly to confirm your qualification and registration, and says most delays come from the overseas regulator. For Indian nurses that is your State Nursing Registration Council, so ask it how it handles NMC requests before you apply.
  • UK, doctors: the GMC requires your primary medical qualification to be verified by ECFMG through EPIC, which checks it with your college or university. It also asks for a certificate of good standing from every medical regulator you were registered with in the last five years, valid for three months from signature.
  • Ireland: NMBI asks for a Certificate of Current Professional Status from every jurisdiction where you registered or practised, issued in the last six months, and your council can send it directly. The Medical Council wants a certificate of good standing dated within three months, emailed by each regulator to [email protected].
  • USA: state boards and TruMerit want your licence verified directly by the State Nursing Registration Council, and TruMerit says license validations must have signatures dated within three years (some states require nine months). ECFMG verifies your diploma and transcript with your medical school through MyIntealth.
  • Germany and the Netherlands: both ask for a recent certificate of good standing or CCPS, no more than three months old for German authorities and the BIG register, and a certificate of good conduct.
  • If you are registered in more than one Indian state, or also hold a Gulf licence (DHA, DOH, MOHAP, SCFHS, QCHP and others), every regulator you have been registered with may need to confirm your standing. List every registration, including lapsed ones.

English tests

  • India is not on the NMC's, GMC's, NMBI's or the Irish Medical Council's lists of exempt or majority English-speaking countries. An English-taught Indian degree does not on its own exempt you, so most Indian-trained applicants take IELTS Academic or OET.
  • The NMC has a qualification route for training taught and examined in English outside majority English-speaking countries, but the transcript must show at least half your time interacting with patients and others, with at least 75% of those interactions in English. Most Indian nurses take a test instead.
  • IELTS is jointly owned by the British Council, IDP and Cambridge University Press & Assessment, and is offered across India; find a centre and date on ielts.org.
  • OET is offered in India on paper and on computer. OET says results for the paper test come in as little as 5 days after the test date for candidates tested in India. Check which formats your regulator accepts: NMBI does not accept OET at home, the Irish Medical Council does not accept online tests, and ECFMG allows OET@Home only where there is no test venue in your country.
  • US state boards and VisaScreen do not exempt Indian programmes. TruMerit lists IELTS 6.5 overall with 7 in speaking, or OET 360 speaking, 340 reading, 350 writing and 320 listening, for registered nurses.
  • ECFMG accepts only OET Medicine for doctors, with no exemptions: 350 in listening, reading and speaking and 300 in writing, in one sitting.
  • Germany and the Netherlands require the local language: German B2 for nurses and B2 plus a C1-oriented Fachsprachprüfung for doctors in Germany, and B1 to B2+ Dutch depending on your profession in the Netherlands.

Sitting exams from here

  • NMC CBT (Part 1 of the Test of Competence): delivered by Pearson VUE, which the NMC says has test centres in most countries. Book through Pearson VUE once the NMC confirms you need the test. The OSCE (Part 2) is only in the UK.
  • PLAB 1: the GMC lists British Council venues in India in Bangalore, Chennai, Hyderabad, Kolkata, Mumbai and New Delhi, according to the GMC venue page as archived in September 2025. Bookings for overseas venues close about six weeks before the exam. PLAB 2 is only in Manchester.
  • NCLEX-RN: NCLEX's October 2026 international test centre list includes Pearson Professional Centers in Ahmedabad, Amritsar, Bangalore, Chandigarh, Chennai, Gurugram, Hyderabad, Jalandhar, Ludhiana, Mohali, Mumbai, New Delhi, Noida, Pune and Surat. International centres add a $150 scheduling fee.
  • USMLE Step 1 and Step 2 CK: can be taken outside the US and Canada with a region fee ($210 for Step 1, $235 for Step 2 CK), and USMLE collects 18% GST on exams taken in India. Step 3 is only in the United States.
  • Irish Medical Council PRES Level 2: held in Dublin and Dubai in 2026, not in India. PRES Level 3 and the RCSI nursing aptitude test are in Ireland.
  • German and Dutch exams (Kenntnisprüfung, Fachsprachprüfung, BI-test) are all held in Germany or the Netherlands.

Ethical recruitment rules

  • WHO: India is not on the WHO health workforce support and safeguards list 2023, the list of 55 countries where WHO discourages active international recruitment. WHO said the next update is scheduled for 2026; its health workforce migration page still showed the 2023 list when this page was reviewed.
  • UK Code of Practice: India is not on the red list (no active recruitment) or the amber list (recruitment only under a government-to-government agreement). NHS Employers lists India among countries with a government-to-government agreement under the Code, and UK employers and agencies may recruit from India actively.
  • Recruitment fees: the Code says it is illegal under the Employment Agencies Act 1973 for a recruitment organisation based in Great Britain to charge a job seeker for finding work, and that recruiters' costs belong in the fee charged to employers. NHS Employers maintains the ethical recruiters list of organisations that follow the Code; check that any agency approaching you in India is on it.
  • Germany: India is not on the annex to section 38 of the Employment Ordinance (BeschV), so recruitment of health workers from India is not reserved to the Federal Employment Agency.
  • India's emigration rules: holders of Emigration Check Required (ECR) passports must get emigration clearance from the Protector of Emigrants, and the MEA has told Non-ECR passport holders going for overseas employment to register on eMigrate, but both apply to the 18 notified countries (Afghanistan, Bahrain, Indonesia, Iraq, Jordan, Kuwait, Lebanon, Libya, Malaysia, Oman, Qatar, Saudi Arabia, Sudan, South Sudan, Syria, Thailand, the UAE and Yemen). The UK, Ireland, Germany, the Netherlands and the USA are not on that list.
  • Kerala's NORKA Roots, a state government agency, runs recruitment drives for overseas employers, including nurses for the UK and Triple Win for Germany. Using a government agency is optional; you can also apply directly to employers.

Questions

Yes. The CBT is delivered by Pearson VUE, which the NMC says has test centres in most countries, including India. You book it after the NMC confirms you need the Test of Competence. The OSCE is taken only in the UK.

No. India is not on the red or amber list of the UK Code of Practice, and NHS Employers lists India among countries with a government-to-government agreement. UK employers and agencies can recruit from India actively.

Usually not. India is not on the NMC's, GMC's, NMBI's or the Irish Medical Council's lists of exempt countries. The NMC has a narrow qualification route for programmes taught in English elsewhere, but most Indian applicants take IELTS Academic or OET.

Nurses get it from the State Nursing Registration Council where they are registered; the Indian Nursing Council does not license nurses. Doctors use the National Medical Commission's doctor portal or their state medical council, depending on where they are registered. Allied professionals use their state council.

Not for these destinations. India's emigration clearance and eMigrate registration apply to employment in 18 notified countries, mostly in the Gulf, and the UK, Ireland, Germany, the Netherlands and the USA are not among them. You still need the destination's work visa.

The GMC lists British Council venues in Bangalore, Chennai, Hyderabad, Kolkata, Mumbai and New Delhi. PLAB 1 runs four times a year, and bookings for overseas venues close about six weeks before the exam. PLAB 2 is only in Manchester.

Yes. India is one of the international NCLEX locations, with Pearson Professional Centers in cities including New Delhi, Mumbai, Bangalore, Chennai, Hyderabad, Pune and several Punjab cities on the October 2026 list. An international centre adds a $150 scheduling fee.

It depends on the destination. The UK, Ireland and the USA verify your degree directly with your university and council, while German authorities may ask for an apostille or legalisation. The Dutch BIG register does not accept an apostille and asks for its own certification instead.

No. The Medical Council's list of countries whose internships count for the Certificate of Experience route is Australia, Malaysia, Malta, New Zealand, Pakistan, South Africa, Sudan and the UK. Indian graduates usually use PRES, a recognised higher qualification, a PLAB 2 pass or a supervised post.

Yes, if you are coming to the UK for 6 months or more. GOV.UK lists India as a country where you need a TB test at a Home Office approved clinic. The certificate is valid for 6 months from the date of your x-ray.

It depends on the Visa Bulletin, which publishes separate dates for people born in India in employment-based categories. Waits can differ from the rest of the world and change month to month, so check the current bulletin and your employer's attorney rather than past estimates.

Only if you are ready to learn it. You need German at B2 for recognition, though A2 is usually enough to enter on a recognition partnership and keep learning while you work.

Sources

  1. 1WHO: Health workforce support and safeguards list 2023
  2. 2WHO: Health workforce migration
  3. 3NHS Employers: Code of Practice red and amber list of countries
  4. 4NHS Employers: Code of Practice for international recruitment
  5. 5GOV.UK: Code of Practice for the international recruitment of health and social care personnel in England
  6. 6GOV.UK: Tuberculosis tests for visa applicants
Show all 45 sources
  1. 7GOV.UK: Countries where you need a TB test to enter the UK
  2. 8GOV.UK: Health and Care Worker visa
  3. 9MEA: Advisory for registration of Non-ECR passport holders travelling for employment in 18 ECR countries
  4. 10MEA: Advisory for ECR passport holders
  5. 11MEA: Attestation and apostille
  6. 12MEA e-Sanad
  7. 13eMigrate
  8. 14Passport Seva: Police Clearance Certificate
  9. 15Indian Nursing Council
  10. 16Indian Nursing Council: NRTS FAQs
  11. 17National Medical Commission
  12. 18NMC (UK): Registering as a nurse or midwife trained outside the UK
  13. 19NMC (UK): CBT
  14. 20NMC (UK): English language requirements
  15. 21NMC (UK): Qualified in English
  16. 22GMC: When and where can I take PLAB 1 (archived September 2025)
  17. 23GMC: Using your IELTS certificate
  18. 24GMC: Primary source verification for international medical graduates
  19. 25NMBI: English language requirements
  20. 26NMBI: Qualified outside the EU
  21. 27Medical Council: Overseas internships recognised as equivalent
  22. 28Medical Council: English language requirements
  23. 29Medical Council: PRES Level 2 exam
  24. 30NCLEX: Testing locations
  25. 31NCLEX: October 2026 international test centres
  26. 32USMLE: Apply for exams
  27. 33ECFMG: OET Medicine
  28. 34TruMerit: VisaScreen
  29. 35TruMerit: Tests and scores for foreign health care workers (May 12, 2026)
  30. 36U.S. Department of State: Visa Bulletin
  31. 37OET: Book a test
  32. 38IELTS
  33. 39Beschäftigungsverordnung (BeschV), section 38 and annex
  34. 40Recognition Finder (anerkennung-in-deutschland.de)
  35. 41Bezirksregierung Münster: Approbation for third-country qualifications
  36. 42GIZ: Expertise (Triple Win placements from Kerala)
  37. 43NORKA Roots
  38. 44BIG register: Certifying and translating documents
  39. 45BIG register: Dutch language proficiency

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