NMC OSCE exam guide 2026: stations, test centres, resits and how to pass

The NMC OSCE is part 2 of the UK Test of Competence. It is a practical exam of 10 stations, about 3 hours long, held only at NMC-approved centres in the UK. In November 2026 there are three: the University of Northampton, Ulster University and Leeds Teaching Hospitals NHS Trust. It costs £794, and most international nurses sit it within about 12 weeks of starting work in the UK, often with the employer paying and booking.

How the OSCE fits into NMC registration

The Test of Competence has two parts: the CBT (a computer test you can take in your own country) and the OSCE. You can sit them in either order, but you must pass both within two years of each other. The OSCE tests whether you can safely apply your knowledge at the level of a newly registered UK nurse. It does not test advanced skills. For the whole process, see our NMC registration guide.

The 10 stations and official timings

The OSCE has three groups of stations. Timings below are from the NMC's nursing station timings document (updated September 2026).

APIE scenarios currently listed

The four APIE stations follow one patient. The September 2026 timings document lists these scenarios:

• Adult (RN1): Alzheimer's disease, chronic heart failure, community assessment, ectopic pregnancy, end of life, hernia, homelessness, pneumonia, subdural haematoma, suspected deep vein thrombosis.
• Mental health (RN3): anxiety, depression and suicidal ideation, bipolar disorder, psychosis, PTSD.
• Learning disabilities (RN5): behaviours that challenge, Down's syndrome.
• Children's (RN8): allergic reaction, asthma, child fever, post-tonsillectomy bleed.

Skills stations currently listed (adult nursing)

Administration of inhaled medication (12 min), suppository (10), anti-embolism stockings (10), blood glucose monitoring (8), bowel assessment (8), catheter specimen of urine (8), fine-bore NG tube (12), fluid balance (14), IM injection (12), IV flush and VIP score (12), MSU and urinalysis (12), nutritional assessment (8), oral care plan (8), oxygen therapy (10), pain assessment (6), peak expiratory flow rate (8), pre-operative check (12), pressure area assessment (8), removal of urinary catheter (8), subcutaneous injection (12), and wound assessment with ANTT (21). Other fields have their own lists in the same document.

OSCE test centres (November 2026)

The centre is set up like a hospital ward, community setting or home. You stay in one bay for all your stations. The centre uses actors and manikins, and every bay is filmed for marking and moderation. You may be at the centre for up to 4 hours and cannot leave once registered, so eat beforehand. Water is provided.

Fees and who pays

From the NMC costs page. Rupee amounts use about ₹127 to £1 (late October 2026) and are approximate.

Sponsoring NHS trusts and care providers often pay the first OSCE fee and run OSCE training. This is common practice, not a legal duty. Policies on paying for resits differ. Under the UK Code of Practice, an employer can ask you to repay evidenced costs such as exam fees through a repayment clause, but the clause must be written in your contract, reduce over time and end after 36 months. More in our recruitment fees guide.

How booking works

1. NMC authorisation first. Once the NMC confirms you need the Test of Competence, you can book with a test centre.
2. Who books. If you are self-funding, you book and pay the centre directly. If an employer is sponsoring you, the employer usually books through a trust booking account (Northampton, for example, has a separate trust bookings route).
3. Leave time to prepare. The NMC recommends at least 14 days to study the support materials, and says many candidates need more.
4. ID check. Your face-to-face NMC ID check is done at the centre, by appointment (ID.Checks@nmc-uk.org). Bring the same valid passport that is on your NMC account. If you have a new passport, tell the NMC; updates take up to seven working days.

Timing: the OSCE, your visa and the 8-month rule

Most international nurses arrive on a Health and Care Worker visa and work as a pre-registration nurse until they pass. Two time limits matter:

• About 12 weeks to the first OSCE. NHS Employers says sponsored nurses normally have up to 12 weeks from the employment start date on their Certificate of Sponsorship to sit their first OSCE.
• 8 months to full registration. Home Office sponsor guidance (section SK9) says pre-registration nurses must achieve NMC registration within 8 months of the start date on the Certificate of Sponsorship. If not, the employer must stop sponsoring you as a nurse. The guidance also says that if you fail the OSCE three times, it is unlikely you can register in time, and sponsorship must stop.

In practice, this means you can afford a resit or two, but not a long delay. Plan your first sitting early, and prepare seriously before it.

Results, resits and limits

• Results are emailed by the centre within 5 working days, or up to 10 working days when new content is introduced.
• Pass: you passed every station. The NMC then completes your application and issues your PIN.
• Fail: you get standard feedback on the stations and elements you failed. You resit only those stations. For APIE resits you get your original paperwork from the APIE stations you passed.
• Maximum three sittings per application, with at least 10 days between sittings. (Home Office guidance says 10 working days. Check with your centre.)
• Same centre: all resits must be at the centre where you first sat, unless it has closed.
• After a third failure, your application closes. You must wait at least six months, apply again and retake all 10 stations.
• Appeals are possible only if the process was compromised or there was an irregularity. You cannot see the video of your exam.

The NMC publishes pass rates every quarter. Its January to March 2026 figures show that 3,009 candidates sat the OSCE, and the centre-level tables show that fewer than 6 in 10 candidates passed every station at their first attempt at each centre. Second-attempt pass rates were much higher. Needing a resit is common. It is not the end of your plan.

What examiners look for

Each station has its own mark scheme, and assessors score each criterion. Across all stations, the NMC says assessors look for:

• Safety first: hand hygiene before touching the patient, checking identity, allergies and consent, and safe medicine checks.
• Communication: introducing yourself, explaining care, involving the patient, active listening, and calming an anxious patient or relative. Talk to the actor or manikin, not the assessor.
• The 6 Cs: care, compassion, competence, communication, courage and commitment.
• Verbalising: say what you are doing and why. Anything done after time runs out is not marked.
• Clear documentation that meets NMC standards, with only universally recognised abbreviations.
• Evidence-based practice, not local habits from your home hospital.

Common mistakes (from the NMC's own list)

• Not reading the station instructions properly, or running out of time.
• Touching the patient before hand hygiene; not checking ID or allergies; not gaining consent.
• Inaccurate vital signs or an incomplete observation chart in the assessment station.
• Planning: an evaluation date outside the set time frame, missing self-care, illegible writing or unrecognised abbreviations.
• Implementation: not checking medicine expiry dates, not reading the whole drug chart, wrong dose, or signing before giving the medicine.
• Evaluation: leaving out the reason for or date of admission.
• Skills: contaminating a sterile field, poor chest compression depth or rate, or throwing away an ampoule before giving the injection.

If you make a mistake, tell the assessor within the time and say how you would correct it. This can be taken into account, but it will not overturn a critical fail such as an unsafe medicine error.

A 4-week preparation plan

A suggested plan for after your arrival, alongside your employer's OSCE training. Start earlier from home if you can.

Illustrative example

This is an illustrative example based on the official rules. It is not a real person.

An adult nurse from the Philippines starts at an NHS trust on 1 December. The trust books her OSCE at Northampton for late February, inside the 12-week window, and runs a two-week OSCE course. She passes nine stations but fails the IV flush and VIP score skill because she forgot to check the patient's allergies. Her feedback names the station and element. She resits that one station 12 days later (£397 fee, paid by the trust under its policy) and passes. With the CBT already passed and her paperwork complete, the NMC decides her application and she receives her PIN in April, well inside the 8-month limit.

Next steps

If you have passed the CBT and want a UK employer that books and supports the OSCE, use the free "Check your route" form on our home page. We never charge nurses. We cannot promise a job, a visa or an exam result. For costs and timelines across the whole process, read our NMC registration guide.