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NMC Registration for International Nurses: 2026 Guide
NMC Registration for International Nurses: 2026 Guide
NMC registration is the permission you need before you can work as a nurse, midwife or nursing associate in the UK, and the Nursing and Midwifery Council is the body that grants it. If you trained outside the UK, four things stand between you and the register: your qualification, your English, a two part Test of Competence, and about 1,170 pounds in fees. Last year 26.4% of everyone who joined was educated abroad, so this route is very much open. It is narrower than it was two years ago, and it rewards people who take the steps in the right order.
Written by the travel4med Editorial Team, who help medical and nursing students plan clinical placements abroad.
Key Takeaways
- One regulator, one register. The NMC register held 867,935 nurses, midwives and nursing associates on 31 March 2026, a record, and 24.4% of them were educated outside the UK.
- The Test of Competence has two parts. A computer based test you can sit in your own country, then a practical OSCE you sit in the UK. You have to pass both within two years of each other.
- English is a hard gate. Academic IELTS needs 7 in reading, listening and speaking plus 6.5 in writing. OET needs grade B in those three skills and grade C+ in writing.
- Budget 1,170 pounds if you need the Test of Competence. That covers the qualification evaluation, the CBT, the OSCE and the registration fee, and it rises if you resit.
- International joining has slowed sharply. Internationally educated professionals made up 26.4% of new joiners in 2025/26, down from 49.4% in 2023/24.
What is NMC registration, and who needs it?
NMC registration is entry on the UK register of nurses, midwives and nursing associates. Nobody may practise under those titles in the UK without it. If your qualification was awarded outside the UK, you apply through the overseas route, whatever your nationality and whichever part of the UK you plan to work in.
That applies to nurses trained in the European Union too. Since December 2020 an EU, EEA or EFTA qualification goes through the same process as any other. The exception is an adult nurse or midwife whose qualification meets the old automatic recognition rules, who skips the Test of Competence.
The register itself has never been bigger. It reached 867,935 registered professionals on 31 March 2026, up 14,228 on the year before, which is roughly 2.5% of the whole UK working population. Of those, 212,109 were educated outside the UK.
What does the NMC Test of Competence involve?
Two separate exams. Part one is a multiple choice computer based test, the CBT, which you sit at a Pearson test centre, usually in your own country. Part two is the OSCE, a practical exam you take in person in the UK. You can sit them in either order, but you need both to finish your application.
| Part | What it is | Structure | Fee |
|---|---|---|---|
| CBT Part A | Numeracy | 15 questions, 30 minutes | 83 pounds for both parts, 50 to resit Part A alone |
| CBT Part B | Clinical knowledge | 100 questions, 2 hours 30 minutes | 70 pounds to resit Part B alone |
| OSCE | Practical, taken in the UK | 10 stations | 794 pounds, or 397 to resit 7 stations or fewer |
The two CBT parts are passed or failed independently, so a fail in one does not drag the other down. You get three attempts inside one application, at least 10 days apart, all within a year.
The OSCE is the part people underestimate. Its 10 stations break down into four linked stations built around one patient scenario (assessment, planning, implementation, evaluation), four skills stations in two pairs, and two on your values and behaviours and on evidence based practice. Three providers run it: the University of Northampton, Ulster University and Leeds Teaching Hospitals NHS Trust. Results arrive by email within five working days.
You also get three OSCE attempts, again 10 days apart. Fail the third and your application closes, so you start again and wait at least six months. Pass both parts and the Test of Competence stays valid for five years.
What English language evidence does the NMC accept?
Three kinds. A recent test score, a pre registration nursing programme that was taught and examined in English, or one year of recent practice in a country where English is the majority spoken language. Most applicants use the test route, and only academic IELTS or the Occupational English Test are accepted.
The scores are specific. For IELTS you need at least 7 in reading, listening and speaking and at least 6.5 in writing. For OET you need at least grade B, which is 350 to 440, in reading, listening and speaking, and at least grade C+, which is 300 to 340, in writing. Whichever test you take, the scores must be less than two years old when the NMC considers your completed application.
Missed one skill by a fraction? You can combine two sittings of the same test, as long as the sittings are within twelve months of each other, you were tested in all four sections both times, and you never dropped below the floor the NMC sets. You cannot mix an IELTS result with an OET result. If OET is new to you, our OET exam guide explains how the four sub tests are built and marked.
How much does NMC registration cost?
The NMC publishes a full breakdown for an applicant who has to sit the Test of Competence. It comes to 1,170 pounds, and that figure assumes you pass everything first time. Four separate payments make it up, and they are spread across several months rather than taken in one go.
| Stage | Fee |
|---|---|
| Qualification evaluation (non refundable) | 140 pounds |
| Test of Competence part one, CBT | 83 pounds |
| Test of Competence part two, OSCE | 794 pounds |
| Registration fee for entry onto the register | 153 pounds |
| Total | 1,170 pounds |
An adult nurse or midwife whose EU qualification carries automatic recognition pays 293 pounds instead, because there is no Test of Competence to buy. Neither figure includes flights, a visa, accommodation while you sit the OSCE, or a resit. Budget that trip properly: our placement budgeting guide has a method you can reuse.
How many internationally educated nurses actually joined last year?
10,961 professionals educated outside the UK joined the NMC register for the first time in 2025/26. That is 9,708 fewer than the year before, a fall of 47%, and it is the sharpest movement in the whole annual data report. Internationally educated people still made up 26.4% of all new joiners.
Read that as market information, not as a verdict on you. Fewer applicants means shorter queues at OSCE centres. It also means advice from a colleague who registered in 2023 may already be out of date.
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Where do most international joiners come from?
India, by a wide margin, with 4,215 joiners in 2025/26, which is 19.8% of all new joiners to the register. Nigeria comes second with 1,614 and Ghana third with 1,391. For the first time since 2015/16, the Philippines was not among the top three sources.
India's own figure fell 54.4% in a single year, from 9,249. Nigeria dropped 31.7% and Ghana 22.0%. None of that is a change in the registration rules, which are the same for everyone.
What is the red list, and can you still apply?
A shortlist of countries whose health systems are under the most pressure. The NMC notes that Nigeria and Ghana, two of its three biggest international sources, are on it, and that active recruitment from those countries is prohibited under the relevant codes of practice. Individual nurses remain free to decide where they practise.
The idea comes from the WHO Global Code of Practice on the International Recruitment of Health Personnel, adopted by the World Health Assembly on 21 May 2010, and from the WHO health workforce support and safeguards list that sits under it. The restriction binds recruiters and employers, not you.
In practice it changes how you find work, not whether you can register. If your country is on the list, a UK employer or agency should not be running an active recruitment campaign there, so you apply to individual vacancies yourself instead.
The background is stark. WHO counts 29.8 million nurses worldwide, yet around 78% of them work in countries holding just 49% of the world's population.
Does a clinical placement abroad help with the OSCE?
Not formally. The NMC gives no credit for any placement, wherever you do it. What ward time does give you is fluent clinical English, repetition of the everyday skills the OSCE examines, and practice at the structured handover style that the scenario stations reward.
That matters most in the four linked stations, where you assess a patient, plan care, carry it out and evaluate it under time pressure while talking an examiner through your reasoning. Doing that in your second language is a skill of its own, and the only way to build it is to keep doing it with real patients. Our guide to language barriers on a clinical placement covers the habits that speed it up.
If you are still in training, a structured placement abroad is a sensible way to get that exposure early. Our nursing placement planning guide sets out how to organise one, and the nursing placement in Sri Lanka write up shows what a few weeks on a ward abroad actually looks like.
Thinking about the United States instead? The exam, the regulator and the paperwork are completely different there. Our NCLEX guide for international nurses walks through that route, so you can compare the two honestly before you spend anything.
The application, step by step
- Check your qualification against the NMC pre application checklist before you pay anything.
- Sort your English evidence first, because a test booking is often the longest lead time in the whole process.
- Submit your eligibility and qualification application and pay the 140 pound evaluation fee.
- Book and sit the CBT at a Pearson test centre, most likely in your own country.
- Arrange your travel and your OSCE booking at one of the three UK test centres.
- Sit the OSCE, and expect your result by email within five working days.
- Complete the face to face ID check with the NMC verification team.
- Pay the 153 pound registration fee, make your health and character declarations, and confirm your indemnity arrangement.
Planning a nursing placement abroad before you register? travel4med arranges supervised clinical and nursing placements at partner hospitals in Sri Lanka, Nepal, Bali and Zanzibar, including the paperwork, supervision and accommodation. Book a free consultation and we will talk it through with you.
Editorially reviewed by Nils-Andre Stritt of travel4med, who coordinates placement organisation and application paperwork for medical and nursing students.
Frequently Asked Questions
Sources
All sources accessed 15 September 2026.
- Nursing and Midwifery Council, "Register as a nurse or midwife if you trained outside the UK" (route, ID check, indemnity): nmc.org.uk overseas registration
- Nursing and Midwifery Council, "Test of Competence 2021" (two parts, two year window, five year validity): nmc.org.uk Test of Competence
- Nursing and Midwifery Council, "CBT (Computer Based Test)" (question counts, timings, attempts, resit fees): nmc.org.uk CBT
- Nursing and Midwifery Council, "OSCE" (10 stations, test centres, results, attempts, resit fee): nmc.org.uk OSCE
- Nursing and Midwifery Council, "Guidance on the English language requirements" (IELTS and OET scores, recency, combining sittings): nmc.org.uk language guidance
- Nursing and Midwifery Council, "Information for internationally trained applicants", page last updated 14 August 2026 (fee breakdown and totals): nmc.org.uk fees
- Nursing and Midwifery Council, "The NMC Register 1 April 2025 to 31 March 2026" (register size, joiner numbers, country figures, red list note): nmc.org.uk annual data report
- World Health Organization, "Nursing and midwifery" fact sheet, last updated 11 August 2026 (global workforce figures): who.int nursing fact sheet
- World Health Organization, "WHO Global Code of Practice on the International Recruitment of Health Personnel" (adopted 21 May 2010, safeguards list): who.int global code of practice