NMC CBT and OSCE Guide 2026 for Nurses Trained Abroad

Nurses and midwives who trained outside the UK usually join the Nursing and Midwifery Council (NMC) register through a two-part Test of Competence: a computer-based test (CBT) you can take in your home country, and an objective structured clinical examination (OSCE) taken in the UK.

The Test of Competence at a glance

You can sit the CBT and OSCE in either order, but you must pass both to continue your application.

Where the Test of Competence fits in your application

The Test of Competence is one stage of a longer process. Broadly, you create an NMC Online account, complete a self-check of your eligibility, have your qualification evaluated (the £167 fee), pass the CBT, submit your full application with evidence such as English language results and character and health declarations, and then pass the OSCE before registration. The order of some steps can vary.

Two practical points save time:

• Keep names consistent across your passport, NMC Online account and test bookings.
• Plan the OSCE early because your visa, travel and any employer start date all depend on when you can sit it in the UK; if an employer is recruiting you, agree the timing with them.

The CBT: format

The CBT is taken in one sitting and has two parts, each passed or failed independently:

Part B is field-specific: adult, children's, mental health or learning disabilities nursing, and a separate version for midwifery. A test specification for each field sets what can be asked.

Numeracy tips

Numeracy questions require an exact answer. Practise drug calculations (tablets, liquids, infusion rates, unit conversions) until they are automatic, and always sense-check your answer: a dose that is ten times larger than usual is a red flag.

CBT rules (as of October 2026)

• Three attempts per application.
• At least 10 days between sittings.
• All attempts within one year, after which both parts must be retaken.
• If you fail one part, you only resit that part.
• After three failed attempts, the application closes and you must wait six months before a new application.

The OSCE: format

The nursing OSCE has 10 stations and you must pass all 10:

The nursing OSCE takes no more than 2 hours 45 minutes of assessment time. The NMC publishes mock OSCEs and a preparation booklet.

Approved OSCE providers

As of October 2026 there are three approved providers: the University of Northampton, Ulster University and Leeds Teaching Hospitals NHS Trust. Some earlier centres have closed.

OSCE resits

If you fail the OSCE, a partial resit (up to seven stations failed) costs £397 and a full resit (eight or more failed) costs £794. A candidate who fails on the third attempt must start a new application and wait at least six months.

Full cost overview

NMC fees increased on 1 October 2026. Visa, flights and accommodation are extra.

A six-week CBT preparation plan

MediFlow's NMC CBT course has field-relevant practice questions with explanations and free test questions to start; the same bank is in our app for short daily sessions.

OSCE preparation

• Learn the APIE sequence and practise the four stations as one story about one patient.
• Use the NMC mock OSCEs and marking criteria; practise with a timer.
• Rehearse skills hands-on. Watching videos is not enough for medication administration, aseptic technique or basic life support.
• Write clearly in documentation stations; examiners must be able to read your care plan.
• Speak to the patient, not to the examiner: introduce yourself, gain consent, explain what you are doing.

Common mistakes

• Treating the CBT as a knowledge-only test and ignoring the Code and professional values.
• Rushing numeracy and skipping the sense-check.
• Studying generic nursing material instead of the NMC test specification for your field.
• Forgetting that every OSCE station must be passed.
• Booking the OSCE before arranging a visa and travel window.

After you pass

Once both parts are complete and your application is approved, you can join the register and work as a registered nurse in the UK. Newly registered nurses in the NHS in England are typically employed on Agenda for Change pay, with Band 5 at £32,073 (entry), £34,592 (intermediate) and £39,043 (top) from 1 April 2026. The band for a specific job is set by the employer.