NMC test of competence

The Nursing and Midwifery Council (NMC) uses the Test of Competence to assess people applying to join its register from overseas, or to rejoin after a long period away from practice. Each Test of Competence has two parts:

• The CBT, a multiple-choice computer-based test with a numeracy part and a clinical part, delivered by Pearson VUE.
• The OSCE, a practical exam of 10 stations testing clinical and communication skills, held at NMC-approved test centres in the UK.

You take a test specific to the part of the register you want to join: adult nurse, mental health nurse, learning disabilities nurse, children's nurse, midwife or nursing associate.

The NMC says that if you hold a relevant European general nursing or midwifery qualification that meets the requirements for automatic recognition, it will recognise your qualification and you will not need the Test of Competence, even if you are not an EU national. If you do not hold such a qualification, you will need to take it, because the NMC cannot otherwise recognise your qualification.

For readmission, nurses and midwives without enough practice hours can choose either an approved return to practice programme or the Test of Competence.

1. Submit your eligibility and qualification application to the NMC and pay the £140 evaluation fee.
2. If the NMC confirms you need the Test of Competence, book the CBT through Pearson VUE.
3. Book the OSCE with one of the approved test centres. You can sit the CBT and OSCE in any order.
4. Pass both parts within two years of each other.
5. Complete your registration application, including health, character, English and indemnity evidence, and pay the £153 registration fee.

As part of registration, the NMC also requires every applicant to have a face-to-face ID check, carried out by its ID verification team at one of the Test of Competence centres, to verify that documents are original.

The NMC lists the CBT at £83 and the OSCE at £794, with a reduced OSCE resit fee of £397 if you need to resit seven or fewer stations. The NMC puts the total cost of fees and tests at £1,170 if you need the Test of Competence, before any resits, visa, flights or accommodation.

Once you have passed both the CBT and OSCE, your Test of Competence remains valid for five years.

Each part allows three attempts within one application, at least 10 days apart. If you fail either part three times, your application closes and you must wait six months before starting again.

• Taking the wrong test. A CBT that does not match your application type is not accepted.
• Letting the two-year window lapse between your CBT and OSCE passes.
• Centre changes. The Northumbria University OSCE centre closed on 19 February 2026. OSCE resits normally have to be taken at the centre where you first sat.

Read our guides to the NMC CBT and the NMC OSCE for preparation detail.