International nurses applying for NMC registration need to demonstrate English language proficiency through an approved test. Two tests are accepted: OET (Occupational English Test) and IELTS Academic. This page explains what each test requires, what scores the NMC needs, and how to choose the right route for your situation. If you are looking for preparation support for the OET Writing component, visit the OET Writing Course for Nurses page.
What English Test Does the NMC Accept?
The NMC accepts two English language tests for registration purposes: OET (Occupational English Test) and IELTS Academic. OET is a healthcare-specific test developed by Cambridge Boxhill Language Assessment, designed for medical and healthcare professionals. Every text, task, and scenario in OET is set in a clinical or healthcare context, making it directly relevant to nursing practice. IELTS Academic is a general academic English test used across a wide range of professions and academic programmes. Both tests are internationally recognised and both are accepted by the NMC for the purpose of demonstrating English language proficiency.
What OET Scores Do You Need for NMC Registration?
The NMC requires a minimum score of 350 (Band B) in each of the four OET sub-tests: Reading, Writing, Listening, and Speaking. This applies to each sub-test individually – you cannot average a strong result in one component against a weaker result in another. Each component must reach Band B (350 or above on a scale of 200 to 500). As of 2026, the NMC accepts scores from the same sitting or from combined sittings within a 24-month validity window, meaning you do not need to pass all four sub-tests on the same day. Please verify the current NMC policy at the time of your application, as requirements can be updated.
OET vs IELTS for NMC Registration – Which Should You Choose?
Both tests are accepted by the NMC, and neither is objectively easier than the other – it depends on your strengths and background. OET uses healthcare scenarios throughout, so if you are already working in a clinical environment, the vocabulary and contexts will feel familiar. The Writing component requires you to write a clinical letter (typically a referral or discharge letter), which is a task that mirrors real nursing documentation. The Speaking component is a roleplay between a healthcare professional and a patient or carer.
IELTS Academic uses general academic topics across all four skills. The Writing component includes a data interpretation task (Task 1) and an essay (Task 2). Many nurses find the general academic content less relevant to their daily work, while others find the essay format more manageable than clinical letter writing. The Reading component tests a range of text types from academic journals and general publications.
If your English is strong in clinical contexts but you are less confident in general academic writing, OET may suit you better. If you are equally comfortable in both settings, it is worth researching both test formats before deciding. For OET Writing support, see our OET Writing Course for Nurses.
How to Book OET in the UK
OET is delivered by Cambridge Boxhill Language Assessment. Test centres are available across the UK, and an online (computer-based) option is available for those who prefer to sit from home. To find available test dates, locations, and fees, visit the official OET website at occupationalenglishtest.org. Registration and booking are completed through the OET website directly. You will need to create a candidate account, select your preferred test date and format, and pay the registration fee at the time of booking.
What Happens if You Fail One OET Component?
If you do not achieve Band B in one or more sub-tests, you can retake those components individually – you do not need to resit all four sub-tests. The NMC accepts resit results alongside passed component results from previous sittings, subject to the 24-month validity window. This means if you passed Reading and Listening in one sitting but need to retake Writing and Speaking, your earlier passes remain valid while you resit. Please verify the current NMC policy at the time of your application. Of the four components, Writing has the highest failure rate among international nurses seeking NMC registration.
How to Prepare for OET Writing
OET Writing is the component where most nurses fall short – and the most common reason is not a lack of English ability but a lack of familiarity with the specific clinical letter format that Highfield assessors expect. Generic English preparation is not enough. You need targeted practice with feedback from someone who understands OET assessment criteria.
Functify Learning’s OET Writing Course for Nurses is taught by Joycellyn Akuffo, a Cambridge Boxhill OET-trained teacher, qualified teacher, and former journalist. The course includes Practice Educator Reviews on your practice letters – detailed written feedback identifying exactly where marks are being lost and how to correct each issue. Visit the course page for full details on modules and pricing.
Take the free OET readiness quiz at FunctifyLearning.co.uk/oet-readiness-quiz to see where you currently stand before you start preparing.