Who qualifies for NMC registration
This route applies to registered nurses (adult, mental health, learning disability, children's) and midwives who trained and are currently registered outside the UK, Ireland or the EU/EEA (recognition rules differ slightly for EU-trained applicants). You will typically need:
- A nursing or midwifery qualification the NMC recognises as equivalent in content and level to a UK pre-registration programme.
- Current, unrestricted registration or licence to practise in your home country.
- Recent practice hours, usually within the last few years, or evidence you meet the NMC's return-to-practice requirements if you have had a break.
- Proof of good health and good character, including police/conduct checks.
The NMC application route, step by step
- Create an online account (NMC Online) and complete the application, declaring your qualifications, work history and any health or character issues.
- Submit your English language evidence — IELTS Academic or OET, unless exempted.
- Qualification and identity checks — the NMC verifies your nursing qualification and registration status directly with your training institution and regulator, and checks your identity documents.
- Decision on your application — the NMC confirms whether you can proceed straight to the Test of Competence or need further information.
- Sit the CBT (Computer-Based Test), usually at a Pearson VUE centre in your home country or the UK.
- Sit the OSCE (Objective Structured Clinical Examination) at an approved UK test centre.
- Receive your NMC PIN once both parts are passed and all checks are complete — this is your registration number and confirms you are a registered nurse or midwife in the UK.
The Test of Competence: CBT and OSCE explained
The CBT (Part 1) is a multiple-choice computer-based test covering two papers: numeracy and clinical knowledge, testing safe medicines calculations and evidence-based practice across the four fields of nursing or midwifery. It can be sat in many countries worldwide, so most candidates complete it before travelling to the UK.
The OSCE (Part 2) is a practical, simulated clinical exam held at NMC-approved UK test centres (for example, at university test sites run by providers such as Northumbria, Oxford Brookes or Ulster). It assesses a series of stations covering skills such as medicines management, clinical skills, communication, and person-centred, evidence-based care. You must pass the CBT before booking the OSCE, and the OSCE must usually be taken within a set validity window afterwards.
Preparation matters: many nurses find dedicated OSCE preparation courses, practice stations and mock scenarios significantly improve first-attempt pass rates, since the format and pace can feel unfamiliar even to experienced clinicians who have not sat a structured objective exam before.
Documents and verification you'll need
Be ready to provide, and have translated where necessary:
- Your nursing/midwifery degree or diploma certificate and full transcript.
- A certificate of current professional status or good standing from your home regulator.
- Evidence of recent practice hours.
- Passport and identity documents, checked in line with NMC requirements.
- Police clearance/character reference where requested.
The NMC verifies your qualification and registration history directly with the awarding body and your home regulator, which is often the step that takes longest — start this as early as possible in your planning.
English language requirements
Most applicants must evidence English proficiency through:
- IELTS Academic — overall 7.0, with no component below 6.5 (7.0 in each is the safest target and required for some routes); or
- OET — Grade B in all four skills.
Nurses who trained and worked recently in a majority English-speaking country, or who meet other NMC exemption criteria, may not need to sit a separate test — check your eligibility on the NMC's website before booking an exam you may not need.
Realistic timelines and indicative costs
Allow around 4 to 9 months from starting your NMC application to receiving your PIN, depending on how quickly your documents verify and how soon a CBT/OSCE slot is available. OSCE test centres can have waiting lists, so book as early as your CBT pass allows.
Indicative 2026 costs (always confirm current figures on the NMC website) commonly include:
- NMC application and registration fees.
- CBT test fee.
- OSCE test fee — this is the largest single cost and varies by test centre.
- English test fee (IELTS/OET).
- Travel and accommodation for the OSCE in the UK.
Many candidates budget in the region of £1,200–£2,500 in total, though costs vary by test centre and home country — some UK employers and NHS trusts contribute to or reimburse OSCE costs as part of sponsored recruitment programmes.
Visa pathway and route to settlement
Once you have an NMC PIN (or, in some cases, a conditional offer pending your OSCE), UK employers can sponsor you on the Health and Care Worker visa, which offers reduced fees and an Immigration Health Surcharge exemption compared with the standard Skilled Worker visa. Many NHS Trusts and independent providers run structured international recruitment pipelines that support your OSCE preparation, travel and initial accommodation.
After five years of continuous residence on this visa, you can usually apply for Indefinite Leave to Remain, followed by British citizenship if you choose. Dependants such as a spouse or civil partner and children can typically be included on your visa application, an important factor when planning a family relocation.
Salaries, pitfalls and how Ava Medical helps
Overseas nurses typically join the NHS on Band 5 of the Agenda for Change pay scale, with progression to Band 6 and beyond as you gain UK experience and take on specialist or senior roles; independent sector pay varies by employer. Check current NHS pay bands before making financial decisions, as figures are reviewed annually.
Common pitfalls include sitting the CBT before checking English test validity, arriving in the UK for the OSCE without confirmed accommodation or a booked test date, and underestimating how long qualification verification can take from some countries.
Ava Medical supports nurses through every stage of NMC registration — from document preparation and English test guidance to OSCE readiness and matching you with sponsoring NHS and private employers. Our service is completely free for candidates and fully WHO-code compliant. Upload your CV today for a free eligibility check and a personalised registration timeline.
Frequently asked questions
Do I need to pass the CBT before I can travel to the UK?
You don't have to, but most nurses pass the CBT in their home country first, since it can be sat at Pearson VUE centres worldwide, and only the OSCE requires travel to an approved UK test centre.
How many times can I resit the OSCE?
The NMC allows a limited number of attempts at each part of the Test of Competence within a set timeframe; check the current NMC guidance, as repeated failures may require additional evidence or a fresh application.
Is the NMC OSCE the same as the medical PLAB 2 exam?
No, they are separate exams run by different regulators (NMC for nurses and midwives, GMC for doctors), though both are practical, station-based clinical assessments.
Can my employer sponsor my OSCE costs?
Many NHS Trusts and some independent healthcare providers sponsor or reimburse OSCE fees, travel and accommodation as part of ethical international recruitment programmes — Ava Medical only works with employers who follow WHO Code principles.
What is an NMC PIN?
It's your unique Personal Identification Number confirming you are registered with the NMC and legally entitled to practise as a nurse or midwife in the UK.
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