Your Step-by-Step Guide to Becoming a Registered Nurse in the UK
To work as a Registered Nurse (RN) in the United Kingdom, all internationally educated nurses (IENs) must successfully register with the Nursing and Midwifery Council (NMC). The NMC regulates the profession and ensures that all nurses meet the necessary standards of knowledge, competence, and fitness to practice through the Test of Competence (ToC).
Phase 1: Eligibility and Application Setup
This stage determines your eligibility and involves submitting initial documentation to the NMC.
Complete the NMC Eligibility Assessment
You begin by creating an account on the NMC’s official online platform. You must complete a self-assessment tool to verify:
- Nursing Qualification: You must have a diploma or degree in nursing, typically a minimum of three years in duration, with at least 500 hours of clinical practice.
- Professional Registration: You must be a registered nurse in the country where you trained.
- Good Health and Character: You must declare your health status and provide character evidence (e.g., police clearance).
Demonstrate English Language Proficiency
You must prove you can communicate effectively in English by achieving the required minimum scores in one of the approved language tests:
- IELTS Academic: A minimum overall score of 7.0, with a minimum of 7.0 in Listening, Reading, and Speaking, and 6.5 in Writing. (Scores can be combined across two test sittings within six months, provided no score is below 6.5 in either sitting).
- OET: Minimum score of Grade B in Listening, Reading, and Speaking, and Grade C+ in Writing. (Scores can also be combined across two test sittings within six months).
Complete Initial Application and Verification
Once eligibility is confirmed, you submit documents for verification, including identity proof and qualification certificates, and pay the initial evaluation fee (£140). The NMC will contact your nursing school and licensing authority to verify your credentials.
Phase 2: The Test of Competence (ToC)
The ToC is a mandatory, two-part examination that assesses your professional nursing competence against UK standards. You must pass both parts.
Pass the Computer-Based Test (CBT)
The CBT is a multiple-choice theory exam that tests your professional knowledge and understanding.
- Format: The CBT is split into two parts: Part A (Numeracy – 15 questions, 30 minutes) and Part B (Clinical Theory – 100 questions, 2 hours 30 minutes).
- Location: You can sit the CBT at a Pearson VUE test centre in your home country or country of residence.
- Passing: You must pass both Part A and Part B. Results are typically available within 48 hours. The CBT is valid for two years.
- Cost: The fee for the CBT is £83.
Secure an Employment Offer
After passing the CBT and meeting the English language requirements, you can actively apply for nursing positions in the UK, such as with the NHS (National Health Service). Most employers will offer a Certificate of Sponsorship (CoS) for a Skilled Worker visa (Health and Care Worker visa).
Pass the Objective Structured Clinical Examination (OSCE)
The OSCE is a practical exam taken in person in the UK that assesses your clinical skills and decision-making.
- Timing: You must sit the OSCE within three months (12 weeks) of your employment start date in the UK. During this period, you are typically employed as a pre-registration candidate.
- Structure: The OSCE consists of 10 stations: four stations testing Assessment, Planning, Implementation, and Evaluation (APIE), four stations testing clinical skills (two pairs of two skills), and two stations assessing professional behaviours and values.
- Attempts: You have a maximum of three attempts to pass the OSCE within eight months of your visa start date. You only need to resit the stations you failed.
- Cost: The fee for the OSCE is £794.
Phase 3: Final Registration and Practice
Apply for Final NMC Registration
Once you have passed both the CBT and the OSCE, you complete the final registration application via your NMC Online account. You must provide final evidence, including health and character declarations, and confirm your Professional Indemnity Insurance (PII) arrangement.
Receive Your NMC PIN
Upon final review and payment of the initial registration fee £153, the NMC will grant you full registration and issue your NMC Personal Identification Number (PIN). This PIN legally authorizes you to work as a Registered Nurse (RN) in the UK.
Maintain CPD
To maintain your registration, you must renew it annually and complete a minimum of 35 hours of Continuing Professional Development (CPD) every three years.