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NMC Registration From Overseas: Two English Gates

Registering costs £1,170 and your English is judged twice, once as evidence and again at the OSCE, where communication skills are examined alongside clinical ones.

Registering with the NMC from overseas costs £1,170 by the NMC's own reckoning, and it puts your English in front of an examiner twice.

Once as evidence, before you get near a ward. Then again at the OSCE, where the NMC says you will be tested on your clinical and communication skills together.

Most guides cover the first gate and treat the second as a clinical exam. It is not only a clinical exam, and the difference costs £794 a go.

If speaking is what worries you, SpeakShark is free with three AI conversation sessions a day and no card, each capped at five minutes and four turns.

In this guide: what registration costs · gate one, your evidence · gate two, the OSCE · what the OSCE looks like · where you can sit it · what to practise · what we could not verify · how we researched this · FAQ

Key takeaways

  • The NMC puts application and registration at £1,170, and says it can be higher if you resit.
  • The OSCE alone is £794, which makes it the expensive thing to repeat.
  • English is assessed twice: as evidence first, then inside the OSCE, where communication is examined with clinical skill.
  • The OSCE has 10 stations, and you may sit it before or after the computer-based test.
  • Two of the three accepted English evidence types are not tests at all.

What registration actually costs

The NMC publishes the breakdown, and it is worth seeing the components separately rather than as one number.

Stage Fee
Qualification evaluation £140, non-refundable
Test of Competence part one, computer-based test (CBT) £83
Test of Competence part two, OSCE £794
Registration fee for entry onto the register £153
Total £1,170

The NMC adds that this could be higher if you need to resit tests.

Look at where the money sits. The OSCE is 68 percent of the total, and it is the component sat last, in the UK, after you have already spent on everything else. A resit there is not a minor setback, it is most of the budget again.

That is the practical reason to take the communication half of the OSCE seriously rather than assuming your English evidence already covered it.

Gate one, your English evidence

Before any of that, the NMC has to be satisfied about your English. It accepts three types of evidence and will accept one of them without needing further evidence:

  • A recent pass in an accepted test, meaning IELTS Academic or OET
  • A pre-registration qualification taught and examined in English
  • One year of recent practice as a nurse, midwife or nursing associate in a country where English is the majority-spoken language

Two of those three involve no exam. We set out the conditions on each, and why checking first can save an entire test fee, in the NMC English requirements for overseas nurses.

If your route is a test, the numbers are stated domain by domain with no overall score to hide behind. See the NMC IELTS scores and the NMC OET grades. If a test comes back half a band short in one domain, read what to do when you narrowly miss before you rebook, and if you were planning on PTE, read is PTE accepted by the NMC first, because it is not.

Gate two, the OSCE

Here is the sentence that reframes the whole process, in the NMC's words:

Part two of the Test of Competence is a practical exam known as the OSCE. In this part you'll be tested on your clinical and communication skills.

Communication is not a footnote to the clinical assessment. It sits in the same sentence, as a thing being tested.

That is a different demand from a language exam. A language test asks whether you can produce English to a standard. The OSCE asks whether you can use English while doing something else that requires your attention: assessing a patient, explaining a plan, handing over. Anyone who has spoken a second language while concentrating on a task knows those are not the same skill.

There is also a sequencing point people find surprising:

You can sit your CBT or OSCE in any order, but you must successfully complete both parts to continue with your application for initial registration or readmission.

Most candidates sit the computer-based test at home and travel for the OSCE, because the OSCE is delivered at approved UK centres. But the order is not fixed by rule.

What the OSCE actually looks like

The NMC publishes the structure, and knowing the shape is worth more than any anecdote:

  • 10 stations in total
  • Four stations linked around one scenario, covering assessment, planning, implementation and evaluation, known as the APIE
  • Four stations testing skills, arranged as two pairs of two
  • Two stations assessing values and behaviours and evidence-based practice

The four linked APIE stations are the ones where language load is highest, because they follow a single patient through a sequence rather than testing an isolated procedure. You are talking your way through a case, not performing four unrelated tasks.

The NMC also publishes OSCE information booklets for nurses and for midwives, which are the right level of detail for preparing the clinical content.

Where you can sit the OSCE

At the time of writing the NMC lists three approved OSCE test providers:

  • University of Northampton
  • Ulster University
  • Leeds Teaching Hospitals NHS Trust

It also notes that the centre at Oxford Brookes University has closed.

Centre lists change, and this one demonstrably has. Check the NMC's own OSCE page before booking travel or accommodation, because a centre that has closed is an expensive thing to learn late.

What to actually practise

The two gates need different preparation, and people tend to prepare only for the first.

  1. For the evidence gate, practise the format of the test you booked. OET speaking for nurses, the OET speaking criteria and OET role play cards cover the clinical version; speaking practice for nurses covers the vocabulary either way.
  2. For the OSCE, practise talking while doing. The skill being tested is English under cognitive load, not English in a quiet room. A 30 day plan to improve speaking and free methods to raise fluency build the base.
  3. Rehearse handover and explanation out loud, because the APIE stations follow one patient through a sequence. Breaking bad news is the closest analogue we cover.
  4. Fix clarity rather than accent. In a station with a time limit, being understood first time is the whole game. Six pronunciation fixes in fourteen days and reducing mother tongue influence target exactly that.
  5. Get a baseline before you commit money. Test your English speaking level free, and read why your English speaking is not improving if study alone has not shifted it.
  6. Practise daily rather than in a block. Start a free session. Free sessions run five minutes with four turns, which suits a daily habit rather than a full mock.

What we could not verify

We have not reproduced the OSCE marking criteria. The NMC publishes information booklets for nurses and midwives, and the detail belongs there.

We have not checked whether the three test provider list is current beyond the date we read it. The NMC's own note that a centre has closed is evidence that this list moves.

We did not verify visa or employer sponsorship requirements, which are set by the Home Office and by employers, not by the NMC, and are a separate process with separate rules.

We are not publishing OSCE pass rates. We did not find a figure we could attribute on the pages we read, and an unattributed pass rate is worse than no pass rate.

How we researched this guide

The fee breakdown and the £1,170 total come from the NMC's information for internationally trained applicants page, which carried a last updated date of 21 October 2025 when we read it.

The OSCE description, the clinical and communication skills wording, the either order rule, the 10 station structure and the three approved providers come from the NMC's OSCE page, which carried 4 August 2026, three days before we published this. That page is actively maintained, which is another reason to open it yourself rather than trust any summary, including this one.

The three English evidence types come from the NMC's English language requirements page, which carried 31 May 2024.

We quoted the communication wording rather than paraphrasing it because the whole argument of this post rests on one conjunction. Clinical and communication skills is a different claim from clinical skills alone, and a paraphrase would have flattened it.

Practise speaking, from SpeakShark

SpeakShark is an AI English speaking practice app, and it is our pick for NMC preparation because of the second gate. Your English evidence proves you can produce the language. The OSCE asks you to use it while your attention is on a patient, and that only gets easier by speaking under mild pressure, repeatedly. You talk, the AI answers what you actually said, and you get speaking feedback while the conversation is still going. The free tier gives basic feedback; the detailed pronunciation and grammar breakdown is on Premium.

Start free with three sessions a day and no card, each free session capped at five minutes and four turns. Paid sessions run ten minutes with unlimited turns. Limits are on the pricing page, and how it works walks through a full session.

We are a speaking improvement tool. We are not an exam preparation provider, not a regulator, and we are not affiliated with the NMC, OET, the IELTS partners, Pearson or any exam board. For test format, booking and official practice material, go to the exam body directly, and for what registration requires, read nmc.org.uk. Use SpeakShark to make your spoken English stronger, and use official material to learn the test.

Sources

FAQ

How do I register with the NMC from overseas?
In outline: your qualification is evaluated, you provide English language evidence, and you pass a two part Test of Competence made up of a computer-based test and a practical exam called the OSCE. The NMC puts the total cost of application and registration at £1,170, and says this could be higher if you need to resit tests. Each stage has its own requirements, so read the NMC pages for your own profession rather than a general summary.
How much does NMC registration cost for an overseas nurse?
The NMC publishes a total of £1,170 and breaks it down as a qualification evaluation fee of £140, which is non-refundable, £83 for the computer-based test, £794 for the OSCE, and a £153 registration fee for entry onto the register. It also states that the cost could be higher if you need to resit tests, and the OSCE is by far the most expensive single component to repeat.
Is English tested twice in NMC registration?
In effect, yes, though the NMC does not frame it that way. First you provide English language evidence, which for most applicants means an accepted test result or one of the two non-test evidence routes. Then, separately, the OSCE examines clinical and communication skills together. Passing the English evidence stage does not exempt anyone from the communication side of the OSCE, because they assess different things.
What is the OSCE and what does it test?
The OSCE is part two of the NMC Test of Competence, a practical exam sat in the UK. The NMC's wording is that you will be tested on your clinical and communication skills. It has 10 stations: four linked around one scenario covering assessment, planning, implementation and evaluation, four testing skills in two pairs, and two assessing values and behaviours and evidence-based practice.
Can I take the OSCE before the computer-based test?
Yes. The NMC states that you can sit your CBT or OSCE in any order, but that you must successfully complete both parts to continue with your application for initial registration or readmission. In practice most candidates sit the computer-based test in their home country and travel to the UK for the OSCE, because the OSCE is delivered at approved centres in the UK.
Where can I sit the NMC OSCE?
At the time of writing the NMC lists three approved OSCE test providers: the University of Northampton, Ulster University, and Leeds Teaching Hospitals NHS Trust. It also notes that the centre at Oxford Brookes University has closed. Centre lists change, so check the NMC's OSCE page before you plan travel, because a closed centre is not a detail you want to discover after booking flights.

Curious how it works? Explore SpeakShark's features or see plans and pricing.

Keep reading

NMC English Requirements for Overseas Nurses in 2026

Two of the NMC's three accepted evidence types need no English test at all. Check those before you book, because most guides only explain the one that costs money.

English Tests for Nurse Registration: UK, Australia, Canada

The same nurse needs a different test, a different score and sometimes no test at all, depending on which country reads the file. Four regulators compared.

Is PTE Accepted by the NMC? The Short Answer Is No

The NMC accepts two English tests for nurse registration in the UK: IELTS Academic and OET. PTE is not one of them, and the NMC says so in its own words.