Speaking Is the Highest Bar in Four Countries

We have read more than twenty published English requirements for this series: healthcare regulators in three countries, teaching in two, aviation, immigration in one, and a federal list covering nine professions at once.

One pattern survives every change of country, test and profession. Speaking carries the highest number.

SpeakShark is free for exactly that skill, three AI conversation sessions a day with no card.

In this guide: the United States · Canada · the United Kingdom · aviation · OET · the exceptions · the negative version · what to do · limits · method · FAQ

Key takeaways

• The US federal list sets speaking highest on all six accepted tests.
• It holds speaking constant across three professional levels while everything else falls.
• Two Canadian provinces set it above reading and writing on every test.
• One UK regulator sets it a full band above the other three sections.
• The exception is CELBAN, where listening is higher.

The United States

The list HRSA published as of 12 May 2026 covers nine health professions under federal law, with six accepted tests.

Six tests, six scales, one number standing out in every row.

Then the structural half. HRSA publishes three columns by professional level, and every overall and every reading, writing and listening figure falls for lower-qualified roles. The speaking requirement does not move in any of the six. We work through that in every US healthcare English test now ranks speaking highest.

And the direction of travel is explicit. The previous revision lowered overall scores and raised speaking ones, with PTE's speaking floor going from 50 to 76, covered in the US lowered every score except speaking.

Canada, twice over

Ontario nursing. On all five tests with published component scores, speaking is above reading and writing. On the French TEF the gap is 500 against 400, covered in Ontario ranks speaking above reading on every test.

Nova Scotia nursing. Identical benchmarks, covered in two provinces, same nursing scores, different doors.

Ontario teaching. Speaking is the highest component in four of seven accepted tests and the lowest in none, covered in one province accepts the two tests another refuses.

Two professions, two regulators, one province, and a second province agreeing.

The United Kingdom

The UK is the least uniform of the four, which makes the two clear cases more interesting.

The General Optical Council requires an overall 7.0 with sections not below 6.0, except speaking, where 7.0 is required. It is the only body in the series that names speaking and holds it higher, covered in the regulator that wants 7.0 in speaking.

The Nursing and Midwifery Council requires 7 in listening, reading and speaking, and 6.5 in writing. It also publishes a criterion that the speaking element must be tested by a person and not via a computer test, covered in the NMC wants speaking marked by a person.

Most other UK requirements are flat across the four skills, so they neither support nor contradict the pattern. We compared nine of them in eight UK regulators, eight different English rules.

Aviation is built on it

Aviation is the strongest case and the least comparable, because its language standard is not four skills at all.

The whole ICAO framework is about spoken interaction over a radio. Its top level is examined by a separate test, and what that test assesses is the ability to adapt to a less proficient speaker, deal with misunderstandings and resolve ambiguity, covered in aviation splits Level 6 into its own separate test and ICAO Level 6 rewards adapting to a weaker speaker.

A whole international regime built on one skill is not evidence that speaking outranks writing. It is evidence that when the consequences of misunderstanding are immediate, the language requirement collapses onto the spoken half.

One test, nine readers

The cleanest control in the series, because the instrument is held constant.

Nine bodies accept OET, and speaking is set at grade B or its numeric equivalent at every one of them that distinguishes between the sub-tests. Writing is the sub-test most often permitted lower.

That comparison is in one OET grade, nine different passing scores.

Nine readers, one test, no disagreement on which sub-test carries the load.

The honest exceptions

A pattern reported without its exceptions is not a finding, it is advertising.

CELBAN sets listening highest, at 9 against speaking 8, reading 8 and writing 7. It is the only nursing-specific test in the comparison, and its two highest components are the two that happen in real time and cannot be reread, covered in CELBAN speaking for Canadian nurses.

Several requirements are flat. The GMC, the GPhC, the GOsC and most of the HCPC set the same figure in every skill. They neither confirm nor contradict.

Two designs let the candidate choose. The RCVS and Ireland's nursing board allow one component to sit lower and let the applicant decide which, so speaking can be the one dropped, covered in the RCVS worked examples and Irish nursing English.

PTE Core, on Ontario's teaching list, is flat at 69 across all four.

So the claim is not that speaking is always highest. It is narrower than that, and the narrower version is stronger.

The version that holds everywhere

Here is the form of the pattern we have not found a single counterexample to across the whole series:

No body sets speaking as the skill you are permitted to drop.

Writing is dropped at the NMC, at Ontario, at Nova Scotia and on OET at four bodies. Reading is dropped at Ontario and at the GOC. Listening is dropped at the GOC.

Speaking is dropped nowhere, except in the two designs that let the candidate choose which component falls, and even there it is a choice rather than a policy.

That is a smaller claim than the headline and it is the one worth carrying, because it is the one that survives every exception above.

What to do with it

• Prepare speaking first, whatever your target body.
• Aim above the line, not at it. It is the number least likely to be relaxed.
• Do not plan to spend a permitted drop on speaking, even where you may.
• Check whether a person marks it. At least one regulator insists.
• Expect it to be the section you cannot resit alone, at several bodies.

Speaking is also the skill with the least opportunity to practise alone, which is a poor combination with being the highest requirement. Role play scenarios and a daily speaking partner are the practical routes, speaking practice for nurses covers the clinical register, and testing your speaking level free shows where you stand. CEFR levels for speaking explains the scale, IELTS for UKVI by CEFR level maps bands to levels, and English certificates that expire covers validity. For how examiners mark spoken English, Cambridge speaking criteria by level works from real scored candidates.

What we could not verify

Almost no body publishes its reasoning. Ontario's nursing regulator comes closest with a purpose-based statement about nursing practice.

We did not check every regulator in the world. This is more than twenty requirements across four countries and several professions.

We did not verify concordance between the tests. Speaking being highest within each scale says nothing about the scales being comparable.

We have an interest in this conclusion. We sell speaking practice, which is exactly why the exceptions section exists and why the claim we stand behind is the narrow one.

Requirements change. One of the sets here changed in May 2026 and another in January 2026.

This is not registration or immigration advice. It is a synthesis of published requirements, all linked in the guides above.

How we researched this guide

We did not set out to find this. The first twenty guides in this series were written one body at a time, each from its own published pages, and this pattern only became visible once there were enough of them to lay side by side.

That order matters, and it is why we trust the result more than we would if we had gone looking. A body reading each requirement on its own terms notices what that requirement is doing. A body looking for a pattern finds one.

The strongest single piece of evidence is the American three column table, because it is a controlled comparison the regulator built itself. Same tests, same page, three professional levels, and one number that refuses to move while all the others fall.

The OET comparison is the second, because it holds the instrument constant and varies the reader. Nine bodies, one test, and none of them treats speaking as the concession.

Writing the exceptions section took longer than writing the pattern, and that is the right ratio. We sell speaking practice, so a guide claiming that everybody agrees speaking matters most would be exactly the kind of thing a reader should distrust. The claim we will defend is the narrow one: nobody makes speaking the skill you may drop.

Practise speaking, from SpeakShark

SpeakShark is an AI English speaking practice app, so treat the framing here with the scepticism it deserves and check the underlying pages, which are all linked.

What we would say is that the evidence was gathered one regulator at a time, over weeks, without this conclusion in mind, and that the exceptions are set out above rather than buried.

If the pattern holds for your target body, the practical answer is unglamorous. Speaking is the number to clear first and the one to clear by a margin, and it is built by talking rather than by studying.

You talk, the AI answers what you actually said, and you get speaking feedback while the conversation is still running. The free tier gives basic feedback; the detailed pronunciation and grammar breakdown is on Premium.

Being straight about the limits: a free session runs five minutes with four turns, we issue no certificates, and we appear on no regulator's accepted list anywhere in this guide.

Start free with three sessions a day and no card. Paid sessions run ten minutes with unlimited turns. Limits are on the pricing page, and how it works walks through a session. Sign up here if speaking is the number you need to clear.

We are a speaking improvement tool. We are not an exam preparation provider, and we are not affiliated with Cambridge English, the IELTS partners, Pearson or any exam board. For test format, booking and official practice material, go to the exam body directly. Use SpeakShark to make your spoken English stronger, and use official material to learn the test.

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Sources

• HRSA, updated list of tests and scores for foreign health care workers as of 12 May 2026: the six test table across three professional levels, and the previous list used to establish the direction of the last revision
• College of Nurses of Ontario, language proficiency: the five benchmark tables including the French TEF, and the statement that the benchmarks align with the language demands of safe, ethical and effective nursing practice
• General Optical Council, international optometrists: the requirement of 7.0 in speaking with other sections permitted at 6.0
• NMC, accepted English language tests: the requirement of 7 in listening, reading and speaking with 6.5 in writing, and the criterion that speaking must be tested by a person
• ELPAC, English Language Proficiency for Aeronautical Communication: the aviation suite built on spoken interaction with a separate test for its top level

FAQ