Work as a midwife in the UK: NMC CBT and OSCE (2026)

• A qualification in midwifery, not nursing, that has allowed you or will allow you to register as a midwife in the country where you trained. A nursing qualification only gives access to the nursing part of the register.
• If you qualified first as a nurse and then completed a post-registration midwifery programme, the midwifery qualification is the one you apply with; ask the NMC how it will be assessed before you pay to have it evaluated.
• Proof of your midwifery registration and good standing from the regulator that registered you as a midwife; if you hold a combined nurse-midwife licence, make sure the certificate names midwifery.
• Training and experience that cover the midwifery standards across pregnancy, labour, birth, the postnatal period and the newborn, including recognising and escalating complications.
• NMC English evidence at the same level as nurses, met by a test or by one of the NMC's practice or training routes.
• Passes in the midwifery CBT and the midwifery OSCE within two years of each other.
• Health and character declarations and an indemnity arrangement; NHS maternity employers usually provide indemnity through employment.
• For a sponsored job: an offer of a midwifery post from a licensed UK employer, almost always an NHS maternity service.

Check your route with the route finder

• NMCNursing and Midwifery Council

  Nurses, midwives and nursing associates

  How to register with the NMC

1. 1

   Check that your qualification is midwifery

   Before anything else, confirm that the qualification you will apply with registered you as a midwife, not only as a nurse. Direct-entry midwives and nurses with a separate post-registration midwifery course both apply to the midwives' part of the register, but with different documents. Midwives who were licensed as nurse-midwives often need to show the midwifery element separately.
2. 2

   Map your practice to the six midwifery domains

   Read the NMC standards of proficiency for midwives and list where you gave antenatal, intrapartum, postnatal and newborn care, and where you managed complications such as postpartum haemorrhage, pre-eclampsia or neonatal resuscitation. Note gaps early. Continuity of carer and midwife-led care in the community are the areas most often missing from hospital-only careers.
3. 3

   Meet the English requirement

   Most midwives trained outside the NMC's list of majority English-speaking countries sit IELTS Academic or OET. The OET healthcare test includes letters such as referrals and handovers, which suit midwives who write clinical notes in English. Plan the test so the result is still valid when the NMC assesses you.
4. 4

   Apply to the NMC as a midwife

   Open your MyNMC application to the midwives' part of the register, not a field of nursing, and upload your midwifery qualification and registration details. The NMC contacts the regulator that registered you as a midwife. Eligibility and fees work the same way as for nurses and are set out on our NMC regulator page.
5. 5

   Sit the midwifery CBT

   Book with Pearson using exam code RM (Midwife). The NMC publishes a CBT information booklet for midwives, and Pearson offers free practice tests. The clinical part is written for midwifery, so revise UK maternity guidance as well as your own country's protocols.
6. 6

   Find a UK maternity post

   International recruitment of midwives is smaller than for nurses, so search NHS Jobs for midwife posts at trusts that sponsor, and ask whether they run an OSCE programme for midwives rather than one designed around adult nursing. Ask what the role will be before registration, what support newly registered midwives get, and how any repayment clause works.
7. 7

   Prepare for the midwifery OSCE

   The OSCE has the same 10-station structure for every candidate, but midwives sit a midwifery version. The NMC publishes an OSCE information booklet for midwives and a Preparing for your OSCE Midwifery (2021) guide; use them, because the APIE scenario and skills stations are set in maternity care. Practise documentation and handover in UK formats.
8. 8

   Register and start as a midwife

   When the NMC has your passes, ID check and declarations, it issues your PIN and you can practise as a registered midwife (RM). Your first NHS post will usually be band 5, often with a preceptorship period, before you move to band 6 roles.

• Midwifery CBT (exam code RM)

  The computer-based part of the Test of Competence, booked with Pearson using the RM exam code. Part A is numeracy, 15 questions in 30 minutes, which for midwives often means drug and infusion calculations; Part B is 100 midwifery clinical questions in 2 hours 30 minutes. The NMC's CBT information booklet for midwives describes the content, and you have three attempts within a year.

  Read the guide

• Midwifery OSCE

  The practical part, taken in the UK at the University of Northampton, Ulster University or Leeds Teaching Hospitals NHS Trust; there is no midwifery-only centre. The 10 stations follow the same pattern as for nurses, with an APIE scenario, skills and values stations set in maternity care. The NMC's OSCE information booklet for midwives and its Preparing for your OSCE Midwifery (2021) guide are the official preparation material.

  Read the guide

• IELTS Academic or OET

  Midwives need the same NMC English scores as nurses: IELTS Academic 7 in listening, reading and speaking with 6.5 in writing, or OET grade B in listening, reading and speaking with C+ in writing.

  Read the guide

• The NMC sets one English standard for nurses and midwives: IELTS Academic 7 in listening, reading and speaking and 6.5 in writing, or OET B (350 or above) in listening, reading and speaking and C+ (300 or above) in writing.
• Results count if the test was taken no more than two years before the NMC assesses you, and two sittings of the same test within 12 months can be combined; IELTS and OET results cannot be mixed.
• A midwifery programme taught and examined in English can be used instead of a test if it was in a country on the NMC's majority English-speaking list; elsewhere the transcript must show at least half your time with women and families and at least 75% of those interactions in English.
• A year of registered midwifery practice in the last two years in a listed country, where you passed an English assessment to register, can also count.
• If you are already working in the UK in a maternity support role for at least 12 months with one employer, the NMC's SIFE route lets an employer reference support a near-miss score.
• The CBT, the OSCE and your daily work are all in English, including documentation of labour and birth and conversations about consent and birth choices; many midwives find OET's healthcare scenarios closer to that work than IELTS.
• The visa has its own English rule, but GOV.UK exempts nurses and midwives who passed an English assessment accepted by the NMC; see our UK country guide.

Estimate your total cost

• Allow extra time if you trained as a nurse-midwife: getting a certificate or transcript that shows the midwifery element separately is often the slowest step.
• The NMC aims to assess your qualification within 14 days of hearing from your midwifery regulator.
• Revising for the midwifery CBT typically takes a few weeks; you have three attempts within a year of the first.
• Midwifery OSCE places depend on your employer's training programme; results arrive within 5 working days.
• NHS Employers says a midwife sponsored for a UK role must sit a first OSCE within 12 weeks of the start date on the certificate of sponsorship and pass within eight months of the visa start.
• Once everything is in, the NMC aims to decide within 30 days, and you must finish within two years of being confirmed eligible.

NHS midwives are paid on Agenda for Change, 2026/27 rates from NHS Employers effective 1 April 2026, before any high cost area supplement. NHS Health Careers says midwives start at band 5, band 6 includes team manager roles, and consultant midwives are at bands 8b to 8c. Each employer sets the band for the post and the pay before you pass the OSCE.

• Band 5, entry

  £32,073

  Usual first post for a newly registered midwife.

• Band 5, intermediate (after 2 years)

  £34,592

• Band 5, top (after a further 2 years)

  £39,043

• Band 6, entry

  £39,959

  Experienced midwives and team roles.

• Band 6, intermediate (after 2 years)

  £42,170

• Band 6, top (after a further 3 years)

  £48,117

See your NHS band and annual pay

• NHS trust maternity services are the main employers of midwives in the UK, and some run international recruitment for midwives as well as nurses.
• International midwife recruitment is smaller than nurse recruitment, so apply widely and check each employer holds a sponsor licence.
• Ask whether the employer helps with OSCE preparation and fees for midwives specifically, since some OSCE programmes are designed around nursing.
• Before you pass the OSCE you will work in a non-registered role; your job title and pay in that period are set by the employer and should be in your contract.
• Read any repayment clause for recruitment costs, and ask what support you will get as a newly registered midwife in the UK.

• Midwives are SOC 2020 code 2231, midwifery nurses, which GOV.UK lists as eligible for the Health and Care Worker visa.
• The visa fee, salary rules, savings and surcharge exemption are shared with every health profession and set out on our UK country guide; the NMC application mechanics are on our NMC regulator page.
• Sponsors for midwives are almost always NHS trusts and health boards with maternity services; independent midwifery practices are rarely licensed sponsors.
• Before you pass the OSCE you are sponsored for a pre-registration role, so check the job title and pay in your contract match the code and pay band your employer uses.
• If you do not pass the OSCE within the permitted attempts, NHS Employers says the employer must stop sponsoring you and your permission to stay is shortened.
• Your partner and children may be able to join you as dependants.

1. 1

   A DHA, DOH, MOHAP, SCFHS, QCHP or other Gulf midwifery licence does not transfer: you still need NMC registration, the midwifery CBT and the midwifery OSCE.

2. 2

   The NMC checks the registration your qualification gave you in the country where you trained and asks for a certificate of good standing. If you are also licensed in the Gulf, request good standing from your Gulf regulator as well and declare all your registrations; check the NMC's current guidance on which certificates it needs.

3. 3

   If your Gulf licence is as a nurse rather than a midwife, the NMC assesses the qualification you apply with, not your job title; make sure your midwifery qualification allowed you to register as a midwife.

4. 4

   Gulf practice does not count for the NMC's recent-practice English route unless the country is on the NMC's list of majority English-speaking countries, so most Gulf-based midwives need IELTS Academic or OET.

5. 5

   Ask Gulf employers for experience letters showing dates, the unit (labour ward, antenatal, postnatal) and hours; UK employers use these when deciding your band and role. You can sit the CBT in the Gulf, but the OSCE only in the UK.

• Application plan with every step, fee and deadline

• Document checklist tailored to you, and a review of each document before upload

• Timeline built around the regulator's closure windows and document validity periods

• Help completing the application forms accurately and consistently

• Support with profession-specific evidence, such as the HCPC standards of proficiency mapping

• Guidance on certificates of good standing, references and certified translations

• Preparation for identity checks and declarations on health and character

• Tracking your application and help responding to regulator requests

• Next steps after the decision: exams, adaptation, PIN or licence and your first job

Regulators make all registration decisions and set all fees. Our fee is separate from the regulator's fees, exam fees and translation costs.

What our registration and licensing support includesPackages and fees