Where the OSCE fits in the NMC process
To register with the NMC as an internationally educated nurse or midwife, you complete a two-part Test of Competence. Part 1 is a computer-based test (CBT) of theory, which you can sit online or at a test centre before travelling. Part 2 is the OSCE – the Objective Structured Clinical Examination – which must be taken in person in the UK. Passing both, alongside your English evidence and qualification checks, is what unlocks registration.
- English language evidence (IELTS Academic, OET, or an accepted alternative) is required as part of your application, not the exam itself.
- You must also hold a recognised qualification and meet the NMC good health and good character requirements.
- Most nurses arrive on a Health and Care Worker visa with an employer who books and often funds the OSCE.
Because the OSCE is UK-based, your prospective employer usually gives you a supervised preceptorship period to settle in, learn local systems and prepare before you sit it. Treating that time as structured revision, rather than assuming ward experience alone is enough, is the single biggest factor in passing first time.
The 10 OSCE stations explained
The current Test of Competence 2021 OSCE has 10 stations and is mapped to the NMC standards for your specific field of practice (adult, mental health, children's, learning disabilities, or midwifery). The stations fall into two groups: a linked patient scenario and standalone skills.
- APIE scenario (four stations): Assessment, Planning, Implementation and Evaluation, all based on a single patient scenario, testing how you deliver and document care across a pathway.
- Evidence-based practice (one station): answering questions that show your care is grounded in current evidence and guidance.
- Professional values (one station): demonstrating the standards and accountability set out in the NMC Code.
- Four practical skills stations: drawn from a published list, for example medicines administration, aseptic non-touch technique, in-hospital resuscitation, or measuring and interpreting vital signs.
Each station is marked against clear, objective criteria, and certain safety-critical actions must be performed correctly to pass that station. Knowing exactly which steps are safety-critical, and never skipping them, protects your marks even when nerves make the rest feel rushed.
Booking, test centres and cost
The OSCE is delivered at a small number of NMC-approved universities and test centres in England and Northern Ireland. Your employer or recruitment agency usually arranges the booking once your NMC application has reached the right stage.
- Indicative fee: around £790 for a full OSCE. Individual station resits are considerably cheaper. Fees are reviewed periodically, so confirm current prices with the NMC before you plan your budget.
- Results: normally released within about five working days of sitting.
- Availability: dates are offered year-round, but popular slots fill quickly, so book as early as your application status allows.
Many Ava Medical placements include employer-funded OSCE attempts, preparation courses and access to a clinical skills lab, which removes a significant cost worry and lets you focus on passing rather than paying.
How to prepare effectively
The OSCE rewards structured, repeated practice rather than last-minute cramming. Build your revision around the published marking criteria and around UK ways of working, which may differ from your training at home.
- Learn the APIE framework until moving through assessment, planning, implementation and evaluation feels automatic, including how to document each stage.
- Memorise each skill to the exact sequence expected, including hand hygiene, gaining consent, checking patient identification, and safe disposal of sharps and waste.
- Practise out loud and to time; verbalising your clinical reasoning is part of what examiners assess.
- Use UK reference sources such as the NMC Code, NICE guidance and the British National Formulary for medicines and calculations.
- Rehearse in a mock setting, ideally with a trainer, educator or preceptor who can watch you and give specific feedback against the criteria.
Aim to be comfortable well before your booked date so that nerves on the day do not undo weeks of knowledge. Group practice with other overseas nurses is a low-cost way to build confidence.
On the day and what to expect
Arrive early with the identification documents the NMC requires, and follow the centre's instructions carefully. You rotate through the stations in a fixed order, with examiners who observe and mark you but do not coach or hint.
- Read each station brief carefully and manage your time; unfinished or omitted safety steps cost marks.
- Wash your hands, introduce yourself and confirm the patient's identity as second nature at every relevant station.
- Stay calm if one station feels difficult – each is marked independently, so a single weaker station need not sink the whole exam.
Speak clearly, keep your patient informed, and treat the simulated patients and manikins as you would real ones. Composure and clear communication are themselves part of the assessment.
Resits and what happens after you pass
If you do not pass every station first time, you can resit only the parts you failed within a set window and a limited number of attempts, rather than repeating the entire exam. This keeps both cost and delay to a minimum, and the structured feedback tells you exactly where to focus.
- Use the time between attempts for targeted, supervised practice on the specific stations you missed.
- Once you pass, the NMC completes its remaining registration checks.
On success you receive your NMC PIN, which confirms you as a registered nurse able to practise independently in the UK, usually with a step up in role and pay from any pre-registration band. From there you can build your UK career and, in time, work towards settlement.
Frequently asked questions
Can I sit the NMC OSCE in my home country?
No. The OSCE is only delivered at approved test centres in the UK, so you must travel to Britain to take it. The computer-based test (CBT) can be sat before you travel, but the practical OSCE cannot. Most overseas nurses sit the OSCE shortly after arriving to begin a sponsored role.
How many stations are there and how many must I pass?
There are 10 stations: four linked APIE care stations, an evidence-based practice station, a professional values station, and four practical skills stations. You must meet the pass standard across the exam, and safety-critical steps within stations must be performed correctly. Failed stations can usually be resat individually rather than repeating everything.
What happens if I fail part of the OSCE?
You can resit only the stations you did not pass, within the NMC's permitted window and number of attempts, rather than repeating the whole exam. Resitting individual stations costs much less than a full sitting. Use the written feedback to target your revision on the exact areas you missed before you rebook.
How much does the NMC OSCE cost in 2026?
A full OSCE is indicatively around 790 pounds, with cheaper fees for individual station resits. NMC fees are reviewed from time to time, so always check the current figure. Many employers, including roles placed through Ava Medical, fund OSCE attempts and preparation as part of the relocation package.
How long does the whole NMC process take?
Timelines vary, but once your English evidence and qualifications are approved, you can often sit the OSCE within a few weeks of arriving in the UK, with results in about five working days. Registration is completed shortly after you pass, and you then receive your NMC PIN and can practise as a registered nurse.
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