To join the UK nursing register, most internationally educated nurses pass the NMC’s two-part Test of Competence: the CBT (computer-based test), usually taken in your home country, and the OSCE (a practical exam) in the UK.
Part 1: the CBT
- A multiple-choice exam that tests numeracy (drug calculations) and clinical knowledge against UK standards and the NMC Code.
- Taken at a test centre. Check the NMC website for the current format, fees and booking.
- How to prepare: learn the NMC Code and UK practice, including consent, capacity, safeguarding, escalation with NEWS2 and SBAR, and duty of candour. Practise calculations until they are automatic.
Part 2: the OSCE
- A practical exam with timed stations at an approved UK test centre.
- It includes a scenario based on the nursing process: assessment, planning, implementation and evaluation.
- It also includes skills stations, such as medicines administration, basic life support, infection prevention, wound care or catheter care, and professional values.
- How to prepare: use the official marking criteria, practise out loud with a partner and time yourself. Many NHS trusts run OSCE training for nurses they recruit, so ask before paying for private courses.
Common reasons nurses fail the OSCE
- Forgetting basics: hand hygiene, identifying the patient, checking allergies, gaining consent.
- Not speaking to the “patient”. Communication is assessed throughout.
- Medicines errors, such as missing a check, or signing before the drug is given.
- Documentation that doesn’t match UK standards.
Before you start
You’ll also need an accepted English test result (IELTS or OET at the NMC’s required scores) and an eligibility decision from the NMC. Full details, including fees, are in our NMC registration guide. Once you’re in the UK, see NHS pay scales and interview questions.
Educational guide. Confirm the current CBT and OSCE format, fees and booking rules with the NMC before you apply.