Work as a nurse in the UK: NMC CBT, OSCE and fees (2026)

• A nursing qualification gained outside the UK that has allowed you, or will allow you, to register as a nurse in the country where you trained.
• Your registration details and a certificate of good standing from your regulator (or a statement of entry to the register if certificates are not issued). The NMC contacts your regulator to confirm them.
• English at the NMC's level: IELTS Academic 7 in listening, reading and speaking and 6.5 in writing, or OET B in listening, reading and speaking and C+ in writing, or one of the NMC's other evidence routes.
• A pass in both parts of the Test of Competence, the CBT and the OSCE, in your chosen field of nursing.
• Health and character declarations, with supporting evidence where the NMC asks for it.
• A professional indemnity arrangement before you practise; if you work for the NHS this is usually through your employer.
• A face-to-face ID check at an NMC Test of Competence centre.
• For the visa: a job offer from an approved UK employer, a certificate of sponsorship and a salary that meets the national pay scales rule for your role.

Check your route with the route finder

• NMCNursing and Midwifery Council

  Nurses, midwives and nursing associates

  How to register with the NMC

1. 1

   Get your English evidence ready

   Most nurses trained in non-English-speaking countries need IELTS Academic or OET. You can combine two sittings of the same test taken within 12 months of each other. Scores are valid for two years, so time your test so it is still valid when the NMC assesses your application.
2. 2

   Gather your documents

   You need your qualification certificate, your registration certificate and a certificate of good standing, plus certified translations of anything not in English. If your name has changed, have your marriage certificate or deed poll ready. The NMC closes applications that do not progress within three months, so collect everything before you open one.
3. 3

   Make your eligibility and qualification application

   Create a MyNMC account, choose your field of nursing and submit your identity, qualification and registration details with the £167 evaluation fee. The NMC contacts your regulator and aims to assess your qualification within 14 days of hearing back. Once you are confirmed eligible, you have two years to complete registration.
4. 4

   Pass the CBT

   Book the CBT with Pearson VUE. It has a numeracy part (15 questions in 30 minutes) and a clinical part (100 questions in 2 hours 30 minutes) for your field of nursing. You have three attempts, at least 10 days apart, within one year.
5. 5

   Find a UK employer

   Apply directly to NHS trusts or other employers that recruit internationally and hold a sponsor licence. Ask what the offer includes: OSCE fees and preparation, the pay band before and after registration, accommodation, flights and any repayment clause if you leave early. These terms vary between employers.
6. 6

   Apply for the Health and Care Worker visa

   Your employer gives you a certificate of sponsorship. You apply on GOV.UK, pay the visa fee and, unless your employer certifies maintenance, show you have at least £1,270 in savings. You do not pay the immigration health surcharge on this visa.
7. 7

   Complete the registration application

   Submit your health, character and English language evidence, confirm your indemnity arrangement and pay the £182 registration fee. Check the details match your passport and qualification exactly, since mismatches slow the checks.
8. 8

   Pass the OSCE in the UK

   The OSCE is 10 stations at an NMC-approved UK test centre: an APIE scenario across four stations, four skills stations and two on values, behaviours and evidence-based practice. Results come within 5 working days. You can resit up to two more times, with a reduced fee if you failed 7 stations or fewer.
9. 9

   Get your NMC PIN and start as a registered nurse

   After the ID check and verification, the NMC aims to decide within 30 days of receiving everything. Once registered you receive your NMC PIN and can work as a registered nurse, usually starting on band 5 in the NHS. Keep up your annual fee and revalidation to stay registered.

• CBT (Test of Competence Part 1)

  A computer-based multiple-choice test delivered by Pearson VUE at centres in most countries. Part A numeracy: 15 questions in 30 minutes. Part B clinical: 100 questions in 2 hours 30 minutes, for adult, mental health, learning disabilities or children's nursing. Three attempts per application, at least 10 days apart, within one year.

  Read the guide

• OSCE (Test of Competence Part 2)

  A practical 10-station exam at an NMC-approved test centre in the UK: currently the University of Northampton, Ulster University and Leeds Teaching Hospitals NHS Trust. It tests the APIE process (assessment, planning, implementation, evaluation), clinical skills, and values and evidence-based practice. Three attempts per application, at least 10 days apart.

  Read the guide

• English language test

  IELTS Academic or OET. IELTS: 7 in listening, reading and speaking, 6.5 in writing. OET: B (350+) in listening, reading and speaking, C+ (300+) in writing. Valid for two years.

  Read the guide

• IELTS Academic: 7 in listening, 7 in reading, 6.5 in writing, 7 in speaking.
• OET: B (350 or above) in listening, reading and speaking; C+ (300 or above) in writing.
• Scores must be from a test taken no more than two years before the NMC assesses your application.
• Two sittings of the same test, taken within 12 months of each other, can be combined if all four skills were tested each time and you reach the required score in each skill across the two. IELTS and OET cannot be combined.
• A nursing qualification taught and examined in English can count: a transcript is enough if you trained in a majority English-speaking country on the NMC's list; otherwise the transcript must show at least half your time with patients and others, with at least 75% of those interactions in English.
• At least one year of registered practice in the last two years in a majority English-speaking country on the NMC's list, where you passed an English assessment to register there, can count instead of a test.
• SIFE: if you have worked in a non-registered role with one UK health or care employer for at least 12 months full time, an employer reference can support a near-miss test result (no more than 0.5 below in one IELTS domain or half a grade in OET, across two attempts) or an English-taught qualification from a non-majority English-speaking country.

Estimate your total cost

• English test and documents: the stage that varies most, from weeks to several months depending on your scores and how quickly your regulator issues good standing.
• Qualification assessment: the NMC says it aims to assess your qualification within 14 days once it has your application and your regulator's response.
• CBT: book once the NMC confirms you need the Test of Competence; three attempts within one year.
• Visa: GOV.UK says you will usually get a decision within 3 weeks.
• OSCE: results within 5 working days; resits need at least 10 days between sittings.
• Registration decision: the NMC says it aims to decide within 30 days of having all your evidence, results and fee. You have two years from eligibility to finish.

NHS nurses are paid on Agenda for Change. These are the 2026/27 annual rates published by NHS Employers, effective from 1 April 2026, before any high cost area supplement. Newly registered nurses usually start at band 5. Pay before you pass the OSCE is set by your employer; NHS Employers' pay scales do not set a specific band for that period.

• Band 5, entry

  £32,073

  Usual starting point for a newly registered nurse.

• Band 5, intermediate (after 2 years)

  £34,592

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

  £39,043

• Band 6, entry

  £39,959

  Experienced or specialist nurse 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 trusts and health boards are the largest employers of internationally educated nurses, and many run their own international recruitment programmes with a set intake of nurses.
• Private hospitals, care homes and community providers also sponsor nurses; check the employer holds a sponsor licence for the Health and Care Worker visa.
• Employers that recruit internationally often help with OSCE preparation and fees, but what is included varies, so ask for it in writing.
• Before your OSCE you will usually work in a non-registered role while you prepare; your job title and pay in that period are set by the employer and should be in your contract.
• Read any repayment clause carefully: some employers ask you to repay recruitment costs if you leave within a set period.
• Ask about preceptorship: a structured support period for newly registered nurses that many NHS employers offer after you gain your PIN.

• Most international nurses come on the Health and Care Worker visa, for qualified nurses and other health professionals with a job offer from an approved UK employer and a certificate of sponsorship.
• Eligible occupation codes include 2231 (midwifery nurses) to 2237 (other registered nursing professionals), covering community, specialist, mental health and children's nurses and nurse practitioners.
• Your salary must meet the rules for your role; for nurses GOV.UK points to its table of national pay scales for eligible healthcare jobs, listed by NHS pay band and area of the UK.
• Visa fees are £324 per person for up to 3 years and £628 for more than 3 years, the same inside or outside the UK. You do not pay the immigration health surcharge.
• You usually get a decision within 3 weeks. The visa can last up to 5 years before you need to extend it, and after 5 years you may be able to apply for indefinite leave to remain.
• Your partner and children may be able to apply as your dependants.

1. 1

   Your DHA, DOH, MOHAP, SCFHS, QCHP or other Gulf licence does not replace NMC registration, and Gulf experience does not exempt you from the CBT or OSCE. You follow the same route as any internationally educated nurse.

2. 2

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

3. 3

   Gulf practice does not count towards 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 nurses need IELTS Academic or OET.

4. 4

   Your Gulf experience matters to employers: it supports applications for band 5 posts and, with relevant specialist experience, band 6 roles. Ask former employers for detailed experience letters on letterhead showing dates, unit and hours.

5. 5

   Plan your timing around your Gulf contract: you can sit the CBT at a Pearson VUE centre in the Gulf, but the OSCE is only held in the UK, and your English scores and Test of Competence each have time limits.

• 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