So you’re an Aussie or Kiwi nurse thinking about making the move to the UK, and somewhere between browsing NHS job listings and daydreaming about Sunday roasts, you’ve hit the big question: do I need to sit IELTS or OET to register with the NMC? I nearly booked an OET exam slot three days after landing in London before a colleague at Whipps Cross stopped me and said, “Sheila, you trained in Sydney – why on earth would you pay for that?” Turns out she had a point. The answer for most of us is surprisingly simple, but it’s buried under generic advice written for nurses coming from non-English-speaking countries. This article is specifically for Australian and New Zealand nurses, because our situation is genuinely different – and nobody seems to be spelling it out clearly.
The Three Ways to Prove Your English to the NMC
Here’s the thing most people get wrong: the Nursing and Midwifery Council doesn’t only accept test scores. There are three distinct evidence pathways to satisfy the English language requirement, and two of them don’t involve sitting an exam at all. Before you spend a cent on exam fees, you need to understand all three.
Evidence Type 1 – Passing IELTS Academic or OET
This is the route that dominates every forum thread and recruitment agency flyer, which is why so many of us assume it’s the only option. The NMC accepts two tests: the IELTS Academic exam and the Occupational English Test. For IELTS, you need a minimum of 7.0 in reading, listening and speaking, and 6.5 in writing. For OET, the requirement is a grade B in reading, listening and speaking, and a C+ in writing. Results must be less than two years old when the NMC considers your application.
These are serious benchmarks. Plenty of native English speakers have been caught off guard by the reading passages or the timed writing tasks. It’s achievable, but it takes preparation and money. So before you go down this road, check whether you actually need to.
Evidence Type 2 – A Nursing Qualification Taught and Examined in English
If your pre-registration nursing degree was delivered and assessed entirely in English, and during that programme at least half of your time involved interacting with patients, service users and other healthcare professionals – with at least three-quarters of those interactions in English – you can use your qualification itself as evidence. No test required.
Think about your Bachelor of Nursing back home. Lectures in English? Yes. Exams in English? Yes. Clinical placements in English-speaking hospitals? Absolutely. The overwhelming majority of Australian and New Zealand nursing programmes meet these criteria without question. What you’ll need is documentation – typically a transcript and a confirmation letter from your university stating that the programme was taught and examined in English. Most unis are familiar with these requests. It usually takes a couple of weeks, and it could save you hundreds of dollars and months of exam stress.
Evidence Type 3 – One Year of Recent Practice in a Majority English-Speaking Country
The NMC maintains an official list of countries it recognises as majority English-speaking. Both Australia and New Zealand are on it – alongside the UK, Canada, Ireland, the United States and a handful of others. If you’ve been practising as a registered nurse for at least one year within the last two years in either country, that practice alone satisfies the English language requirement.
The key detail is the two-year recency window. The end of your period of practice needs to fall within the last two years when the NMC assesses your application. If you’ve been working on the wards in Melbourne right up until you applied, you’re golden. If you took a three-year career break before deciding to move to London, this pathway might not cover you – and that’s when the tests come into play.
If You DO Need to Sit a Test – IELTS vs OET, Honestly Compared
For the minority of Australian and Kiwi nurses who fall outside both exemptions – perhaps you trained overseas before migrating to Australia, or you’ve had a career gap beyond the recency window – you will need to sit one of the two accepted tests. Here’s how they compare.
IELTS Academic – Broad, Rigorous, and Not About Nursing
The IELTS Academic exam tests your English across four modules: listening, reading, writing and speaking. It’s a general academic test, which means the content has nothing to do with healthcare. Your reading passages might cover urban planning, marine biology or the history of paper manufacturing. The writing tasks ask you to describe a graph and write a discursive essay. The speaking component is a face-to-face interview covering everyday and abstract topics.
The NMC requires at least 7.0 in reading, listening and speaking, and 6.5 in writing. Test centres are plentiful – you can sit IELTS in virtually every major city in Australia, New Zealand and the UK, at roughly AUD 400 per sitting. The main advantage is global recognition: if your plans change and you want to register in Canada or apply for a skilled visa elsewhere, your IELTS score travels with you. The main disadvantage is that none of the content reflects what you actually do as a nurse.
OET – Built for Healthcare, and It Shows
The OET was designed specifically for healthcare professionals, and it shows. The listening section uses recordings of clinical consultations and health-related lectures. The reading passages deal with medical topics. The writing task asks you to compose a referral or discharge letter based on clinical case notes – something you’ve probably done hundreds of times. The speaking sub-test is a simulated clinical role-play with an interlocutor acting as a patient or carer.
The NMC requires a grade B in reading, listening and speaking, and C+ in writing. It costs around AUD 590 per sitting, with test centres in major Australian, New Zealand and UK cities, though slightly fewer locations than IELTS. For a practising nurse, OET feels significantly more natural. You’re not writing essays about whether governments should fund space exploration; you’re writing a referral letter for a patient with poorly controlled diabetes. That familiarity can make a real difference to your score.
The 2023 Score-Combining Rules – Your Safety Net
Since February 2023, the NMC has allowed candidates to combine scores from two test sittings taken within 12 months of each other – provided no sub-score drops more than half a grade below the threshold. For OET, this means you could score a C in writing on one attempt (250 or above) and a C+ on the other, and still combine them. For IELTS, you could score 6.0 in writing on one sitting and 6.5 on the next. The same logic applies across all four skills.
This is a genuine safety net if you narrowly miss in one area. There’s also a supplementary employer-evidence route for candidates already working in a UK healthcare setting for at least 12 months who fall short by half a grade in a single domain – but that requires you to already be in the UK and employed.
Sheila’s Cheat Sheet – What I’d Tell a Mate Over a Flat White
Get Your Evidence Sorted Before You Spend a Cent on Tests
Honestly, this is the single most important piece of advice I can give. Before you even look at IELTS or OET booking pages, do two things. First, contact your university and request a letter confirming your nursing programme was taught and examined in English. Second, download your registration history from AHPRA (or the Nursing Council of New Zealand) as proof of recent practice. Between these two documents, most of us have the English language requirement completely sorted.
I was days away from dropping nearly 600 dollars on an OET booking when my confirmation letter arrived from UTS. That one piece of paper made the whole test question disappear overnight. The NMC’s online self-assessment tool is also worth running through early – it helps you figure out which pathway applies to your situation.
Don’t Let Anyone Rush You Into a Test You Don’t Need
I’ve lost count of the Aussie and Kiwi nurses I’ve spoken to in London who sat IELTS or OET unnecessarily because a recruitment agency told them they had to. Some agencies default to requesting test scores from every overseas applicant, regardless of where they trained. They mean well, but it can cost you real money and real time.
The NMC is the authority on what you need, not a Facebook group, not a forum post from 2019, and not an agency consultant who processes applications from dozens of countries. Go directly to the NMC website, read the registration language requirements guidance, and check the approved list of majority English-speaking countries. If you trained and practised in Australia or New Zealand, the evidence pathway is almost certainly simpler than you think.
Moving to the UK to nurse is one of the best decisions I’ve made – even on days when London weather makes me miss Bondi. The NMC registration process can feel daunting from a distance, but once you understand which pathway applies to you, it shrinks down considerably. Check your exemptions first, test second. And if you’ve got questions, drop them in the comments or get in touch through the blog – I’m always happy to help a fellow Antipodean navigate the system.