NMBA and Ahpra Australia: Nurse Registration Pathways, NCLEX and OSCE, English, Fees and Notifications (2026 Guide)

Part of our Nursing Councils of the World series. Last checked: October 2026.

Australia has one national registration system for nurses and midwives. The Nursing and Midwifery Board of Australia (NMBA) sets the standards. The Australian Health Practitioner Regulation Agency (Ahpra) handles applications, the public register and complaints (called notifications). Once registered, you can work in any state or territory.

Which pathway are you on?

Every internationally qualified nurse or midwife (IQNM) starts with the free online Self-check on the NMBA website. It places you in a stream:

PathwayWho it is forWhat you do
Expedited (streamlined) pathwayRNs who trained in the UK, Ireland, the US, Canada (British Columbia or Ontario), Singapore or Spain, or who hold the NCLEX-RN or the UK CBT plus OSCE. You also need at least 1,800 hours of RN practice since 1 January 2017.Apply directly, without the OBA
Stream AQualifications substantially equivalent to an Australian degreePay the IQNM assessment fee, complete Orientation Part 1, then apply for registration
Stream B: outcomes-based assessment (OBA)Relevant qualifications that are not substantially equivalent. This is common for nurses from the Philippines, India, Nepal, Kenya, Nigeria and many other countries.Portfolio → NCLEX-RN (the cognitive exam) → OSCE in Australia → registration
Stream CQualifications that cannot be assessed or do not meet the criteriaComplete an approved qualification first, such as a bachelor of nursing

The outcomes-based assessment (Stream B)

  1. Self-check and Orientation Part 1, an online module on the Australian health system.
  2. Portfolio: identity, qualifications and registration history, verified by Ahpra. For TruMerit or other verification, start early.
  3. Cognitive exam: the NCLEX-RN, taken through Pearson VUE. Australia uses the same exam as the US, with 85–150 adaptive questions in up to 5 hours.
  4. OSCE: a clinical exam held only in Australia, at centres in Adelaide and Melbourne. It costs about AUD 4,000 per attempt, the largest single cost of the pathway.
  5. Orientation Part 2 and the registration application: English evidence, a criminal history check, and professional indemnity insurance.

English language standard

TestMinimum
IELTS Academic7.0 in listening, reading and speaking; 6.5 in writing
OETB in listening, reading and speaking; C+ in writing
PTE Academic66 in each skill
TOEFL iBT94 total, with minimums in each section
Cambridge C1/C2185 in listening, reading and speaking; 176 in writing
As reported in August 2026. Results from two sittings within 12 months can be combined under set conditions. Check the NMBA English language skills registration standard before booking.

What it costs (AUD, 2026)

ItemApproximate cost
IQNM assessment fee (Orientation Part 1 and document review)Check Ahpra’s fee schedule
NCLEX-RN (Stream B)About US$350 including the international scheduling fee
OSCE (Stream B)About AUD 4,000 per attempt
Registration applicationAbout AUD 200
Annual registration feeAbout AUD 193
Criminal history checkAbout AUD 42
Typical total: expedited or Stream AAbout AUD 1,500–2,500
Typical total: Stream B (OBA)About AUD 5,500–9,000, or much more with travel, accommodation and prep courses
Estimates from GdayNurse and MedExamCenter (2026), which flag that figures change. Migration skills assessment through ANMAC (about AUD 595) is separate from registration.

Keeping your registration

  • Renew by 31 May every year, online through Ahpra. A one-month late period applies, with an extra fee. After that, your registration lapses.
  • CPD: at least 20 hours a year for each registration you hold, documented.
  • Recency of practice: at least 450 hours in the previous five years, or an approved re-entry programme.
  • Professional indemnity insurance, usually provided by your employer.

Discipline: how notifications work

  1. Notification: anyone can raise a concern. Nurses, employers and education providers must make mandatory notifications about serious risks, such as practising while impaired, intoxicated at work, sexual misconduct or a significant departure from accepted standards.
  2. Assessment: Ahpra and the NMBA decide whether to close the matter, take immediate action, or investigate. (In New South Wales, the NSW Nursing and Midwifery Council and the Health Care Complaints Commission handle complaints. In Queensland, the Office of the Health Ombudsman takes all complaints first.)
  3. Immediate action: if there is a serious risk, the board can suspend or restrict registration straight away.
  4. Investigation, health or performance assessment: depending on whether the issue is conduct, health or competence.
  5. Outcomes: no further action, a caution, accepting undertakings, conditions, or referral to a panel or a state tribunal. Only a tribunal can cancel registration or disqualify a nurse.

Conditions and tribunal outcomes appear on the public register. Respond to every Ahpra letter on time, and get support from your union or indemnity insurer.

Sources: NMBA, Self-check and assessment stages; MedExamCenter, Australia OBA pathway guide (August 2026); GdayNurse, Ahpra registration fees 2026. Always confirm current fees and standards with the NMBA and Ahpra.

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