IELTS or OET for nurses? Scores needed for the UK (NMC), USA and other countries

Quick answer: For the UK, the Nursing and Midwifery Council (NMC) accepts either IELTS Academic (7.0 in listening, reading and speaking, 6.5 in writing) or OET Nursing (grade B in listening, reading and speaking, C+ in writing). Both are equally valid for UK registration, so choose the one where your practice scores are higher. For the USA, Ireland and Australia the rules are different, and some tests that the UK accepts (such as OET@Home) are not accepted elsewhere.

This guide gives the exact scores for each regulator, the rules on combining results, costs in rupees and pounds, and the mistakes that make nurses lose money and months. All figures were checked against official pages on 3 November 2026.

Scores needed by each regulator

Each country's nursing regulator sets its own English rules. The table shows the minimum scores for a single test sitting.

UK (NMC) in detail

The NMC accepts only two tests: IELTS Academic and OET. It says it is not planning to accept other tests at the moment.

• IELTS: IELTS Academic on paper or on computer at a test centre is accepted. IELTS Academic for UKVI is also accepted. IELTS General Training, IELTS Online, the IELTS Indicator and IELTS One Skill Retake are not accepted.
• OET: You must choose the Nursing version. OET on paper, OET on computer and OET@Home are all accepted.
• Speaking must be tested by a person, not by a computer.
• Validity: the test must be taken within two years before the NMC assesses your complete application.
• The NMC gives you a TRF number (IELTS) or candidate details (OET) to verify your result. If you combine two tests, you must give details of both.

Some nurses do not need a test at all. For example, if you trained in English in a majority English-speaking country, or have worked as a registered nurse in one, other evidence may be accepted. Check the NMC's English language requirements before you book a test.

USA (VisaScreen and state boards)

The USA has two separate English checks, and nurses often confuse them.

1. VisaScreen (for the visa or green card). Most foreign-educated nurses need a VisaScreen certificate from TruMerit (formerly CGFNS). The English scores are set by the US Health Resources and Services Administration (HRSA). HRSA updated its list of tests and scores on 12 May 2026. For registered nurses, IELTS Academic stays at 6.5 overall with at least 7.0 in speaking. The accepted tests are Cambridge English (B2 First, C1 Advanced, C2 Proficiency), TOEFL iBT, IELTS Academic, MET, OET and PTE Academic. TOEIC is no longer on the list for nurses. At-home versions of tests are not accepted.
2. Your state board of nursing (for your licence). The NCLEX-RN itself is not an English test, but some state boards ask for English proof as part of licensing. Rules differ by state. See our NCLEX-RN guide.

The VisaScreen rules also say that you may not need a test if your nursing education was in English in the UK, Ireland, Australia, New Zealand, Canada (not Quebec) or the USA. Nursing education in India, the Philippines or Nigeria does not qualify for this exemption, even if it was taught in English.

Ireland (NMBI) and Australia (Ahpra)

Ireland: the NMBI asks for IELTS Academic 7.0 overall, with 7.0 in three skills and at least 6.5 in the fourth, or OET with B in three skills and C+ in one. The NMBI accepts only one result from a single sitting. It does not accept IELTS Online, IELTS One Skill Retake or OET@Home. Results must be less than two years old.

Australia: the Nursing and Midwifery Board of Australia lowered the IELTS writing minimum to 6.5 from 18 March 2025 (listening, reading and speaking stay at 7.0). Ahpra changed its minimum scores for some tests, including OET and PTE, for tests taken from 23 April 2026. OET results there are now shown as numbers rather than letters. Check the current table on the NMBA website before booking.

Combining two test results (UK)

If you miss one score, the NMC lets you combine two sittings. This is useful, but the rules are strict.

• Both sittings must be the same test: two IELTS or two OET. You cannot combine IELTS with OET.
• The two test dates must be within 12 months of each other.
• You must take all four skills at each sitting. Single-skill retakes do not count.
• Across the two sittings you need one pass score in each skill.
• No score in either sitting may fall below the minimum.
• Both tests must still be within the two-year validity when the NMC assesses your application.

Illustrative example (not a real person): a nurse scores IELTS listening 7.0, reading 6.5, writing 6.0, speaking 7.0 in March. In August she scores listening 6.5, reading 7.0, writing 7.5, speaking 8.0. She now has a 7.0 in listening, reading and speaking and at least 6.5 in writing across the two tests, and nothing is below the minimums. The NMC would accept this combination. If her March writing had been 5.5, it would not work, because 5.5 is below the 6.0 minimum.

How the two tests are different

Both tests check listening, reading, writing and speaking. The big difference is the content.

Fees change, and rupee amounts depend on the exchange rate on the day you pay. Check the current fee with OET and your IELTS test provider before booking.

Which test should you choose?

There is no "easy" test. The right test is the one where you reach the required score with fewer attempts. Use this table as a starting point, then take one full practice test of each.

How long to prepare

There is no official figure. It depends on your starting level. A practical plan:

1. Week 1: take a timed, full practice test of IELTS and of OET. Score them honestly, or ask a tutor to score your writing and speaking.
2. If you are within half a band (or about 30 OET points) of every target: many nurses need around 4–8 weeks of focused practice before booking.
3. If you are a full band or more below in any skill: plan for several months. Booking too early is the most common way nurses waste money.
4. Book the real test when you hit the target in at least two timed practice tests in a row.
5. Plan your timeline backwards. Remember the two-year validity. If your NMC application will take a long time (for example, you still need to pass the CBT or collect documents), do not take the test too early.

Common mistakes and traps

• Booking IELTS General Training. The NMC, NMBI and VisaScreen want IELTS Academic. General Training will be refused.
• Taking IELTS Online. The NMC and NMBI do not accept it.
• Using a single-skill retake. IELTS One Skill Retake and OET single sub-test retakes do not meet the NMC rule that all four skills are tested at the same sitting.
• Assuming OET@Home works everywhere. It works for the NMC, but not for Ireland or VisaScreen.
• Forgetting the two-year clock. For the NMC, the test must be under two years old when the NMC assesses your complete application. Delays in your application can make a valid score expire.
• Trying to combine IELTS with OET. Not allowed.
• Choosing the wrong OET profession. NMC applicants must take OET Nursing.
• Trusting old score tables. The USA (May 2026) and Australia (April 2026) both changed their rules this year. Many websites still show old figures.
• Paying an agent to "guarantee" a score or sell a certificate. Regulators verify results directly with the test provider. A fake certificate can end your registration application and your career. See our guide to recruitment fees and scams.

Costs: what to budget

Some UK employers refund English test fees after you join. This is up to each employer, so ask before you accept an offer and get it in writing.

What this means for you

• If you are aiming for the UK, IELTS Academic and OET Nursing are equally good. Pick the one you score higher in.
• If the USA or Ireland is a real option for you later, take a test centre version (not at home), and aim to pass in one sitting.
• Your English result is only one step. For the UK you also need the CBT, the NMC application and the OSCE. See our NMC registration guide.
• For the UK visa, nurses who passed an English test accepted by the NMC usually do not need a separate English test for the Health and Care Worker visa, according to GOV.UK.

Not sure which country or test fits your plans? Use our free "Check your route" form on the home page. We never charge nurses, and we cannot promise jobs or visas.