How to register as a nurse in the UK (NMC) from abroad: full 2026 guide

To work as a registered nurse in the UK, you must join the Nursing and Midwifery Council (NMC) register. If you trained outside the UK, the usual route is: prove your English, have your qualification checked, pass the two-part Test of Competence (a computer test called the CBT, and a practical exam in the UK called the OSCE), pass health, character and ID checks, then receive your PIN. The NMC's own fees and tests cost £1,226 in total for first attempts (fees rose on 1 October 2026), and most nurses take the OSCE after arriving in the UK with a sponsoring employer.

Who can use this route

This guide is for nurses who trained outside the UK, for example in India, the Philippines, Nigeria, Kenya, Ghana or Nepal. The NMC checks two basic things first:

• Your qualification. It must be a nursing qualification that allowed you (or would allow you) to register in the country where you trained. The easiest proof is your registration with your home regulator, such as a State Nursing Council in India. If you never registered, the regulator must confirm your qualification would let you register. If you still need to pass a local registration exam, the NMC may not accept your application.
• Your field of nursing. The UK has separate registers for adult, children's, mental health and learning disabilities nursing. You apply, and take the Test of Competence, in one field. Most nurses from India and the Philippines apply as adult nurses (RNA).

The NMC's eligibility pages do not set a minimum amount of work experience. Employers often do, so read each job advert carefully. Nurses with certain European qualifications may get automatic recognition instead of the Test of Competence; this guide does not cover that route.

The full process at a glance

1. Prepare. Use the NMC pre-application checklist tool. Gather your degree certificate, registration certificate, transcripts and passport.
2. Meet the English requirement (usually IELTS Academic or OET).
3. Eligibility and qualification application on the NMC online portal, and pay the £167 evaluation fee.
4. CBT (Test of Competence part 1), at a Pearson VUE centre in your own country, once the NMC tells you that you need it.
5. Find a UK employer who will sponsor your Health and Care Worker visa. Many nurses start this step earlier, after passing English.
6. Registration application: health and character declarations, English evidence, professional indemnity, and the £182 registration fee.
7. Visa and travel to the UK.
8. OSCE (Test of Competence part 2) at a UK test centre, plus your face-to-face ID check.
9. NMC decision and PIN.

The CBT and OSCE can be taken in either order, but you must pass both within two years of each other. Once you pass both, your Test of Competence stays valid for five years.

Step 1: The English language requirement

Everyone must show they can communicate clearly in English. You need only one accepted type of evidence. Most nurses from India, Nepal and the Philippines use a test.

Scores you need

There is no overall score requirement. You must reach the score in each of the four skills. Source: NMC accepted English language tests.

Combining two sittings

If you narrowly miss one skill, you can combine results from two sittings of the same test. The rules are strict:

• The two sittings must be within 12 months of each other.
• Both must be no more than two years old when the NMC assesses your complete application. The test date counts, not the certificate date.
• You must sit all four skills each time.
• No score in either sitting can fall below the minimum. For IELTS that is 6.5 in reading, listening and speaking, and 6.0 in writing. For OET it is C+ in reading, listening and speaking, and C (250+) in writing.
• You cannot mix IELTS with OET.

Which versions are accepted

• IELTS: paper or computer IELTS Academic at a test centre, including IELTS Academic UKVI. Not accepted: IELTS Online, IELTS One Skill Retake, IELTS Indicator, IELTS General Training. (NMC IELTS page)
• OET: choose the Nursing test. OET on Paper, OET on Computer and OET@Home are all accepted. (NMC OET page)

IELTS or OET: which suits you?

This is general guidance, not a rule. See our IELTS vs OET guide for a deeper comparison.

Other ways to prove English

• Recent practice in English: at least one year of registered practice, within the last two years, in a country on the NMC's list of majority English-speaking countries. The NMC says its list is based mainly on the UK visa list of majority English-speaking countries, which does not include India, Nepal, the Philippines, Nigeria, Kenya or Ghana. Check the current list via the NMC recent practice page.
• Qualified in English: your nursing course was taught and examined in English. If you trained in a country where English is not the majority language, a transcript alone is usually not enough.
• SIFE (supporting information from your employer): extra evidence only for people already working in the UK. You must have worked at least 12 months full-time in a non-registered health or care role with the same UK employer, and either trained in English or narrowly missed one test skill by no more than 0.5 (IELTS) or half a grade (OET) in two attempts. Details on the NMC SIFE page.

Step 2: Eligibility and qualification application

You create an NMC online account and submit details of your qualification and registration. You will need:

• A copy of your nursing qualification certificate (name, qualification and award date clearly visible).
• Your registration certificate from your home regulator, or a statement of entry to its register.
• Contact details for your college or university and your regulator. Tell them in advance that the NMC will contact them.
• Proof of any name change, such as a marriage certificate. You must show the original at your ID check.
• For documents not in English: the original, a stamped and signed copy, and a full certified English translation with the translator's contact details.

You pay the £167 non-refundable evaluation fee. The NMC aims to assess your qualification within 14 days, but that clock only starts once your regulator and college have replied. In practice, slow replies from home institutions are one of the most common causes of delay, so chase them politely.

Once the NMC confirms you are eligible, you have two years to complete your registration, including the CBT and OSCE.

Step 3: The CBT (Test of Competence part 1)

The CBT is a computer test taken at a Pearson VUE centre, available in most countries, including India. It has two parts:

• Part A, numeracy: 15 questions in 30 minutes. An on-screen calculator is provided.
• Part B, clinical: 100 multiple-choice questions in 2 hours 30 minutes.

The fee is £83. You get three attempts per application, with at least 10 days between sittings, all within one year. If you fail one part, you resit only that part (£50 for numeracy, £70 for clinical). Full details, preparation advice and common reasons people fail are in our NMC CBT exam guide.

Step 4: Find a sponsoring UK employer

To take the OSCE you must be in the UK. Most international nurses travel on a Health and Care Worker visa, sponsored by an NHS trust or a care provider with a sponsor licence. The employer gives you a Certificate of Sponsorship and a job as a "pre-registration nurse" until you get your PIN.

Under Home Office rules, a sponsored pre-registration nurse must achieve NMC registration within 8 months of the start date on the Certificate of Sponsorship. If you do not, the employer must stop sponsoring you as a nurse. While you wait, you can be paid less than the usual £25,000 threshold, but not less than the NHS Agenda for Change Band 3 rate. See our Health and Care Worker visa guide.

Step 5: Registration application

Alongside the Test of Competence you complete the registration part of your application:

• Health declaration: that you are able to practise safely.
• Character declaration: including any cautions, convictions or fitness-to-practise issues. Be honest. Hiding something is treated far more seriously than declaring it.
• English language evidence: your test results or other evidence.
• Professional indemnity: you must have cover before you practise. If you are employed by the NHS or another employer, their indemnity arrangement usually covers you, but confirm it in writing.
• Registration fee: £182, paid on submission. It may be refunded in some circumstances.

The NMC will contact referees to verify your information. Once everything is in (including CBT and OSCE results), it aims to decide within 30 days.

Separately, for the visa itself you will usually need a criminal record certificate from each country you have lived in (rules depend on your age), and a TB test if you are from a listed country such as India. See the GOV.UK documents list and our documents checklist.

Step 6: The OSCE (Test of Competence part 2)

The OSCE is a practical exam with 10 stations: four linked stations following one patient (Assessment, Planning, Implementation, Evaluation, known as APIE), four clinical skills stations, and two silent stations on professional values and evidence-based practice. It takes about 3 hours of testing.

As of 3 November 2026, the NMC lists three approved centres: the University of Northampton, Ulster University (Northern Ireland) and Leeds Teaching Hospitals NHS Trust. The fee is £794. NHS Employers says sponsored nurses normally have up to 12 weeks from their employment start date to sit their first OSCE. Your ID check also happens at the centre. Our NMC OSCE exam guide covers every station, retakes and a prep plan.

Step 7: Decision and your PIN

When you have passed both tests and the NMC has everything, it makes a decision. If approved, you receive your PIN (personal identification number). Only then can you work as a registered nurse. Employers check your PIN on the NMC register. After joining, you pay an annual fee, which is £143 for notices sent on or after 1 October 2026, and you revalidate every three years.

Costs: what you pay and who usually pays

NMC figures from the NMC costs page (after the 1 October 2026 increase). Rupee amounts use about ₹127 to £1 (late October 2026) and are approximate only.

Realistic timeline

These are typical ranges from the steps above, not guarantees. Your own timeline depends on your English level, how fast your regulator and college reply, and how quickly you find a sponsor.

Added up, many nurses take roughly 6 to 18 months from starting English preparation to receiving a PIN. Some are faster. Resits add time.

Illustrative example: a typical journey

This is an illustrative example built from the official rules above. It is not a real person.

A BSc-qualified adult nurse in Kerala with two years of hospital experience decides to aim for the UK in January. She chooses OET because she finds clinical letters easier than essays. On her first attempt she gets B in reading, listening and speaking but only C in writing. On her second attempt in April she gets B in those three skills and C+ in writing, which meets the NMC requirement. In May she opens her NMC application, pays £167, and asks her college and State Nursing Council to expect the NMC's request. Their replies take about six weeks. In July the NMC confirms she needs the Test of Competence. She studies the NMC blueprint and Pearson practice test for a month and passes the CBT in August. An NHS trust interviews her in September and offers a job. The trust pays for her visa and flight and books her OSCE. She arrives in December, does the trust's OSCE course and sits the OSCE in February. She fails one skills station, resits it 14 days later at the same centre (£397, paid by the trust under its policy) and passes. The NMC issues her PIN in March, about 14 months after she started.

Common mistakes that cost time or money

• Taking IELTS General Training or IELTS Online. Neither is accepted. Book IELTS Academic at a test centre.
• Letting English results expire. They must be under two years old when the NMC assesses your complete application, not when you first apply.
• Booking the wrong CBT. Pearson has separate exams for adult (NMC_RNA), children's (NMC_RNC), mental health (NMC_RNMH) and learning disabilities (NMC_RNLD). A wrong booking is not accepted and not refunded.
• Passport mismatch. The passport you show at the CBT, OSCE and ID check must match your NMC account. Update the NMC at least seven working days before a test if you renew it.
• Not warning your college and council. If they ignore the NMC's email, your application stalls.
• Paying an agent for a "guaranteed" job or PIN. No one can guarantee NMC registration or a visa. Charging nurses for finding work breaks the UK Code of Practice.
• Signing a contract without reading the repayment clause. Check what you would owe if you leave early, and that it reduces over time.
• Relying on old blog posts. Fees changed on 1 October 2026 and two OSCE centres closed in 2026.

What this service does and does not do

Nurse Pathways Abroad is free for nurses. Licensed recruiters and employers pay us. We cannot promise a job, an NMC decision or a visa. Those decisions belong to employers, the NMC and the Home Office. If you want to check whether the UK route fits your qualification and English level, use the "Check your route" form on our home page. For a wider comparison of countries, see working as a nurse abroad.