Nursing Abroad: Registration Routes for the UK, US, Canada, Australia, Ireland, New Zealand and the Gulf

One in seven nurses worldwide now works outside the country where they were born, according to the World Health Organization. For many, moving abroad brings better pay, career development and the chance to support their families. But the path is full of acronyms, exams, documents and fees, and a mistake can cost months and thousands in local currency. Every destination has its own regulator, its own tests and its own rules.

This guide sets out the main registration routes for internationally educated nurses (IENs) in the most popular destinations, the English language requirements, typical timelines, common pitfalls and how to protect yourself from exploitation. Requirements change often, so always confirm details on the regulator’s official website before you pay for anything.

Before you choose a country

Start by asking yourself some practical questions:

• Which countries recognise nursing education like mine, and how long will registration take?
• Can I meet the English language requirements, and how many attempts might I need?
• How much will the whole process cost, including exams, travel, visas and relocation?
• Do I want to move alone or with family, and what visas allow dependants?
• What is the cost of living, and how much will I really save?
• What are the working conditions, culture and climate like?
• Is there a pathway to permanent residence or citizenship if I want it?

Documents almost every country will ask for

• Nursing degree or diploma certificate
• Academic transcripts showing theory and clinical hours, often sent directly from your school
• Current nursing licence or registration, and verification of good standing from your regulator
• Passport and identity documents
• Evidence of work experience
• English language test results
• Police clearance or criminal record checks
• Health declarations and immunisation records

Keep certified copies of everything, and request transcripts and verification letters early, as some schools and regulators take months to respond.

English language requirements

Most English-speaking destinations accept either IELTS (Academic) or OET (Occupational English Test for nursing), and some accept other tests. Typical requirements:

• United Kingdom: IELTS Academic 7.0 overall, with at least 6.5 in writing and 7.0 in the other sections; or OET grade B in reading, listening and speaking and C+ in writing. Evidence of training or practice in English may be accepted in some cases.
• Ireland: IELTS Academic or OET, with scores set by the Nursing and Midwifery Board of Ireland (NMBI), similar to UK levels.
• Australia: IELTS Academic 7.0 in each section, OET B in each section, or other accepted tests, unless you qualify for an exemption.
• New Zealand: similar to Australia.
• Canada: IELTS Academic, CELBAN (Canadian English Language Benchmark Assessment for Nurses) or other approved tests, depending on the province.
• United States: requirements vary by state; for immigration, the VisaScreen certificate usually requires an English test such as IELTS, TOEFL or OET.

Some regulators allow you to combine results from two sittings within a set period. Check the exact rules, as they change.

United Kingdom

Regulator: Nursing and Midwifery Council (NMC)

Steps

1. Online eligibility and qualification application with the NMC, providing details of your training, registration and English test results.
2. Test of Competence Part 1 (CBT): a computer-based multiple-choice test of nursing knowledge, taken at test centres in many countries.
3. Submit full documents for assessment.
4. Test of Competence Part 2 (OSCE): a practical exam in a UK test centre, assessing clinical skills through simulated scenarios.
5. Registration and receipt of your NMC PIN.

Things to know

• Many NHS trusts and private employers sponsor internationally educated nurses, paying for the OSCE, visa and flights, and offering OSCE preparation, sometimes with repayment clauses if you leave early.
• Nurses usually come on a Health and Care Worker visa. Visa rules and salary thresholds have changed in recent years, so check current Home Office guidance.
• Before passing the OSCE, you may work in a lower-paid role while you prepare.
• The NMC has tightened checks on CBT test centres after investigating fraud at a centre in Nigeria in 2023 and 2024, and nurses found to have obtained results fraudulently have faced removal from the register. Never use shortcuts.

United States

Regulators: state boards of nursing (each state licenses its own nurses); national exam by the National Council of State Boards of Nursing (NCSBN).

Steps

1. Choose a state to apply to, as requirements differ.
2. Credentials evaluation: many states require evaluation of your education by an organisation such as CGFNS International or another approved evaluator, to confirm it is comparable to US education.
3. Apply to the state board for licensure by examination.
4. Register for and pass the NCLEX-RN, the US nursing licensure exam, which uses the Next Generation NCLEX format focused on clinical judgement. The exam is offered at Pearson VUE centres in the US and several other countries.
5. Receive your licence in that state. Nurse Licensure Compact states allow a multistate licence for residents of compact states.
6. Immigration: most nurses move through employer-sponsored permanent residence (often the EB-3 category), which requires a VisaScreen certificate from CGFNS. Waiting times depend on visa availability for your country of birth and can be long.

Things to know

• The process can take one to several years, mainly due to immigration backlogs.
• Many recruitment agencies sponsor nurses but may require multi-year contracts with penalties for leaving early. Read contracts carefully and get advice.
• Pay and conditions vary greatly between states and employers.

Canada

Regulators: provincial and territorial nursing regulators, such as the College of Nurses of Ontario, the BC College of Nurses and Midwives, and others.

Typical steps

1. National Nursing Assessment Service (NNAS): historically the first step for most provinces, collecting and verifying documents and producing an advisory report.
2. Apply to a provincial regulator, which assesses your education and experience.
3. Competency assessment or bridging education may be required to fill gaps.
4. Pass the NCLEX-RN (registered nurses) or the relevant exam for licensed or registered practical nurses.
5. Meet language and good character requirements.
6. Register and apply for a work permit or permanent residence.

Things to know

• Since 2023, several provinces, including Ontario, British Columbia and Nova Scotia, have introduced faster or simplified routes for internationally educated nurses, and some no longer require NNAS for all applicants. Check your chosen province’s current process.
• Canada has immigration streams that prioritise healthcare workers, including Express Entry category-based draws and provincial nominee programmes.
• Consider registering as a licensed or registered practical nurse first if your education is assessed as not fully equivalent, then upgrading later.

Australia

Regulator: Nursing and Midwifery Board of Australia (NMBA), through the Australian Health Practitioner Regulation Agency (Ahpra).

Outcome-based assessment (OBA)

1. Self-check: an online check of your qualifications to see which pathway applies.
2. Portfolio and identity verification.
3. NCLEX-RN: Australia uses the NCLEX-RN as the multiple-choice cognitive exam for many internationally qualified nurses.
4. OSCE: a practical exam held at the Adelaide Health Simulation centre.
5. Apply for registration.

Things to know

• Since late 2024, nurses registered in certain comparable countries, such as the UK, Ireland, the US, Canada and New Zealand, can access an expedited pathway without the full OBA, subject to conditions. The list may expand.
• Australia has skilled visa routes, including employer-sponsored and points-based options; registered nurses appear on skilled occupation lists.
• Pay and conditions vary by state, with some states enforcing nurse-to-patient ratios.

Ireland

Regulator: Nursing and Midwifery Board of Ireland (NMBI).

1. Apply for recognition of your qualification to NMBI, with documents and English test results.
2. Decision: NMBI may grant registration directly, or require you to complete compensation measures.
3. Compensation measures: typically either a period of adaptation and assessment in an Irish hospital or an aptitude test (an OSCE-style exam).
4. Registration and employment, usually through a Critical Skills Employment Permit for non-EU nurses, which can lead to permission to bring family and later long-term residence.

Ireland recruits many nurses from India, the Philippines, Zimbabwe, Nigeria and other countries. Housing shortages and high rents in Dublin are important considerations.

New Zealand

Regulator: Nursing Council of New Zealand (Te Kaunihera Tapuhi o Aotearoa).

• Internationally qualified nurses apply to the Council, which assesses their qualifications and experience
• In recent years, the Council has moved to a pathway that includes passing the NCLEX-RN and an OSCE in New Zealand, replacing the older competence assessment programme for most applicants
• Nurses registered in Australia can usually register in New Zealand under the Trans-Tasman Mutual Recognition arrangement
• Registered nurses are on New Zealand’s Green List for faster residence pathways

The Gulf States

Saudi Arabia, the United Arab Emirates, Qatar, Kuwait, Oman and Bahrain recruit large numbers of nurses, offering tax-free salaries, housing or housing allowances and flights. Each country, and in the UAE each emirate, has its own regulator.

• Saudi Arabia: Saudi Commission for Health Specialties (SCFHS), with a Prometric licensing exam and primary source verification through DataFlow
• United Arab Emirates: Dubai Health Authority (DHA), Department of Health Abu Dhabi (DOH), or the Ministry of Health and Prevention (MOHAP) for other emirates; each requires an exam (often Prometric) and DataFlow verification
• Qatar: Department of Healthcare Professions (DHP) under the Ministry of Public Health
• Oman, Kuwait and Bahrain: national health authorities with similar processes

Things to know

• Most require at least two years of post-registration experience
• Primary source verification (DataFlow) checks your documents directly with issuing institutions
• Contracts may be fixed-term, and residence is usually tied to employment
• Read contracts carefully regarding working hours, annual leave, end-of-service benefits and the employer’s obligations

Protecting yourself from exploitation

• Never pay recruitment fees. Under the WHO Global Code of Practice and many national rules, ethical recruiters do not charge nurses fees for placement.
• Never hand over your passport or original certificates to an agent or employer to keep.
• Verify agencies with official lists where available, such as approved ethical recruiters in the UK.
• Get your contract in writing before you travel, and read it in full. Watch for excessive repayment clauses, unpaid “training periods” and vague job descriptions.
• Check job offers directly with the employer.
• Beware of shortcuts: fake certificates, leaked exams or proxy test-takers can end your career permanently.
• Know where to get help: your embassy, the regulator, nursing unions and migrant worker organisations in the destination country.

Thinking about your home country

Many nurses feel conflicted about leaving countries with severe shortages. WHO’s Health Workforce Support and Safeguards List identifies countries where active international recruitment should be avoided unless government-to-government agreements are in place. This rule applies to recruiters and governments, not to your individual right to migrate. Many nurses support their home countries through remittances, returning with new skills, mentoring, teaching online or contributing to health projects.

Comparing the main destinations at a glance

• United Kingdom: clear, well-established route (CBT then OSCE); many sponsored jobs; NHS pay bands are public; cost of living high in London and the south-east; dependants generally allowed on the Health and Care Worker visa, subject to current rules.
• United States: high earning potential; licensing through NCLEX is straightforward for many, but immigration waits can be long; contracts through agencies need careful review; costs such as health insurance and housing vary by state.
• Canada: strong demand and immigration routes for nurses; processes have become faster in several provinces; winters are long and housing costs high in major cities.
• Australia: attractive pay and lifestyle; OBA requires NCLEX and an OSCE in Adelaide unless you qualify for an expedited pathway; English requirements are strict.
• Ireland: English-speaking, EU member, with permits that allow families to join; housing shortages are a major challenge.
• New Zealand: smaller market, Green List residence pathway, strong work-life balance; pay is generally lower than in Australia.
• Gulf states: tax-free salaries and benefits, large expatriate nursing communities; residence tied to employment and limited routes to permanent residence or citizenship.

Budgeting for your move

Costs vary hugely, but most nurses need to budget for some or all of the following before their first salary arrives:

• English language tests, sometimes more than once
• Regulator application and assessment fees
• Licensing exams (CBT, NCLEX, Prometric) and OSCEs
• Credential evaluation and document verification
• Certified translations, transcripts and courier fees
• Police checks and medical examinations
• Visa application fees and, in some countries, health surcharges
• Flights, temporary accommodation and deposits for rented housing
• Warm clothing, household items and transport in the first months

Sponsored employers may cover some of these costs, often in exchange for a commitment to stay for a period. Calculate what you would owe if you left early.

Your first months abroad

Registration is only the start. Most internationally educated nurses describe the first six to twelve months as the hardest: new equipment, documentation systems, medicines with different names, unfamiliar accents and abbreviations, different expectations of nurses’ roles, and homesickness. Good employers offer orientation, preceptorship and pastoral support. Seek out other nurses from your country, join professional networks and unions, and give yourself time to adjust. Within a year, many nurses say they feel confident and settled.

Common mistakes to avoid

• Paying agents before checking whether the regulator process can be done directly
• Booking exams before confirming eligibility with the regulator
• Underestimating the time needed for document verification from your school or regulator
• Letting your home registration lapse, which can complicate applications
• Signing contracts without reading repayment and termination clauses
• Relying on social media rumours rather than official guidance
• Moving without enough savings for the first two to three months

Other destinations to consider

Beyond the main English-speaking countries and the Gulf, several other destinations recruit internationally educated nurses:

• Germany: a large and growing recruiter of nurses from the Philippines, India, Mexico, Tunisia and other countries. Nurses usually need German language skills (often at B1 to B2 level), recognition of their qualification (Anerkennung), and may complete an adaptation course or knowledge exam. Some employers offer language training before and after arrival.
• Netherlands, Belgium, Norway, Finland and Denmark: recruit nurses but generally require learning the local language to a professional level.
• Singapore: recruits nurses through the Singapore Nursing Board, which assesses qualifications and may require a licensure exam.
• Japan: has accepted nurses from Indonesia, the Philippines and Vietnam through economic partnership agreements, but candidates must pass the Japanese national nursing exam in Japanese.

Non-English-speaking countries can offer good opportunities, but language learning takes time and commitment. Factor this into your plans.

Keeping your career moving

Moving abroad should be a step forward in your career, not just a move to a new place. Ask potential employers about preceptorship for international nurses, opportunities to specialise, funding for further study, and promotion pathways. Keep a portfolio of your continuing professional development, as most regulators require evidence of ongoing learning to renew registration. Many internationally educated nurses go on to become ward managers, specialist nurses, educators and leaders in their new countries.

A simple timeline to plan around

• Months 1 to 3: research destinations, check regulator requirements, request transcripts and verification letters, and start English test preparation.
• Months 3 to 6: sit your English test, open your application with the regulator, and complete any required credential evaluation.
• Months 6 to 9: take the computer-based licensing exam (such as CBT or NCLEX), and start applying to employers or sponsors.
• Months 9 to 15: secure a job offer, apply for your visa, prepare for any practical exam (OSCE), and plan your move.
• After arrival: complete remaining exams or adaptation, receive full registration, and begin your new role.

Some nurses move faster; others take longer because of exam retakes, document delays or immigration queues. Build in extra time and money.

Above all, treat official regulator websites as your source of truth. Agencies, social media groups and friends can help with advice and encouragement, but only the regulator can tell you exactly what you need to register. Save the official links, check them before every step, and keep records of every payment and submission.

Frequently asked questions

Which country has the quickest registration process?

It depends on your qualifications, English scores and the current process. Countries with streamlined pathways for nurses from comparable jurisdictions can be fast for those nurses; for others, processes often take six months to two years.

Do I need experience before moving?

Some regulators and most employers require post-registration experience, often one to two years; Gulf countries commonly require two years.

Can I take the NCLEX outside the US?

Yes. The NCLEX is offered at Pearson VUE centres in several countries, though availability changes.

Is OET or IELTS better?

Many nurses find OET more relevant because it uses healthcare scenarios, but the best test is the one you can score highest in and that your regulator accepts.

Can I register in more than one country?

Yes, many nurses hold registration in more than one country, but each has its own fees and continuing practice requirements.

But is moving abroad really worth it?

For many nurses, it transforms their careers and family finances. For others, high living costs, isolation, discrimination or difficult contracts make it harder than expected. The nurses who do best are those who research carefully, plan their finances, connect with communities of other migrant nurses, and protect themselves from exploitation. Make the decision with your eyes open.

Related: Holding registration in two countries · Relocating abroad with family: checklist · Culture shock in your first year abroad

Sources: Nursing and Midwifery Council (UK), National Council of State Boards of Nursing, CGFNS International, National Nursing Assessment Service (Canada), Nursing and Midwifery Board of Australia and Ahpra, Nursing and Midwifery Board of Ireland, Nursing Council of New Zealand, Saudi Commission for Health Specialties, Dubai Health Authority, World Health Organization Global Code of Practice and State of the World’s Nursing 2025. Requirements change frequently; always check official regulator websites.