How to be a UK Nurse: The Ultimate Guide for Overseas Nurses in 2025

International nurses are an integral part of the UK healthcare system, providing essential care and expertise within the NHS and other healthcare settings. Recognizing their invaluable contribution, the Nursing and Midwifery Council (NMC), the UK's regulatory body for nurses and midwives, has modernized its registration process to be more accessible for internationally trained professionals. This streamlined, fully online system aims to facilitate the entry of qualified nurses into the UK workforce, ensuring the continued delivery of high-quality patient care.

This comprehensive guide provides a detailed, step-by-step overview of the current requirements and procedures for overseas nurses seeking registration in the UK. From initial eligibility assessments and English language proficiency tests to computer-based testing and practical assessments, this resource covers all key aspects of the NMC registration journey. It offers valuable support and guidance, empowering internationally trained nurses to navigate the process with confidence.

By outlining the current procedures, requirements, and available resources, this guide aims to equip aspiring UK nurses with the knowledge they need to successfully complete the registration process. The NMC's commitment to improved guidance and support ensures that applicants have the necessary tools and information to achieve their professional goals in the UK.

STEP 1: Complete the NMC Eligibility Assessment

Before starting your application, contact your referees and verifiers to ensure their details are correct as well as gain their consent on sharing their contact details with the NMC. It is imperative to provide the name, address and email address of your education institution so that the NMC can contact them and verify your details.

If you are a registered nurse, the NMC will contact your regulator (PRC) to verify the registration details you have provided.

Make sure that you inform your regulator (PRC) and college/university (whichever is applicable), that you are applying for a NMC registration so that they will respond to your request for confirmation. You may need to submit or complete documents with your regulator to ensure that they respond to your request.

Here are the other required documents:

1. Proof of identity

• Valid Passport  (details to be entered on your online account and upload a copy of the picture page)

• Proof of name change if your current name is different from your passport

• Must clearly show your previous name and issued by an official body ie. marriage, civil partnership or divorce certificate, or a deed pool notification

• Upload scanned copy but the original version must be shown on face to face verification

2. Qualification Certificate

• Must have graduated with equivalent foundation degree level in the UK

• Showing your name, qualification title, date achieved, and name of education      institution

3. Professional Registration

• PRC registration certificate is only required if you are a board passer.

4. Pay the Evaluation Fee (non-refundable) - £140

• NMC will send you a confirmation email after payment. Take note of your CRM number which you will need for the next step.

5. Process your Stateboard Verification (SBV) from PRC for NMC verification.

• You will need to present your PRC Board Certificate, copy of your valid PRC license, and CRM number from the NMC confirmation email and pay 200 pesos. NMC might need additional information if any of the details provided are unclear.

• Whilst you are already at PRC for your SBV, you can also ask for a Certificate of Good Standing (COGS) which you will need to submit as you go along the application process.

6. Wait for the outcome of NMC's evaluation by email.

STEP 2: TAKE THE RECOGNISED EXAMINATION

You may start preparing for the required English test whilst completing the eligibility requirements. I understand how much time and effort you need to exert to achieve the minimum grades so it’s better to start as early as you can if you really wanted to apply as a UK nurse. I know you got this!

I have also gathered opinions from nurses I knew who arrive to UK recently and they recommended passing the English Exam first and take it from there as some may find the English Exam harder to pass than the CBT. Both exams are time sensitive with two years validity, so dealing with the more challenging exam first may be beneficial.

You must get the minimum required score for either IELTS or OET to prove your English Language proficiency. The two language tests accepted by the NMC are the following:

International English Language Test System (IELTS)

• You must take the Academic Module for your NMC registration or also known IELTS UKVI.

• NMC accepts both the paper based and computer based IELTS Academic test delivered at a test centre.

• To know more, click link.

Occupational English Test (OET)

• NMC is now accepting the OET@Home test as evidence of English language competency. The OET@Home test is identical to the test standards of the test venue centres but this allow the candidates to take their OET on their computer      at home. This eliminates the need to travel to test centre.

• Computer Test is also available to take in the test centre instead of the previous paper-based test.

• OET consists of the same categories with IELTS but it uses real healthcare scenarios to assess your communication skills. The highest score you can get in each category is A.

IELTS

• All scores in both sittings are not below 6.5

• You still need to achieve at least a score of 6.5 in writing & 7 in other sections.

OET

• All scores in both sittings are not below C+

• You still need to achieve at least a score of C+ in writing & B in other sections.

For more details, you can read- Blog: We’re making changes to our English language requirements - The Nursing and Midwifery Council (nmc.org.uk)

Step 3: Take the Computer based test

Once the NMC verified you to be eligible to apply, you can now complete the Test of Competence and the Registration application. 

    Under the new process, you can take the Test of Competence whilst completing the registration requirements. It is no longer a linear process where you have to finish one step to get to the next. This allows flexibility for the applicants and their sponsors to complete the process that best suit their circumstances.

The Test of Competence measures the knowledge, understanding and application of professional nursing skills of the applicants. It consists of Computer-Based Test (CBT) and the Objective Structured Clinical Examination (OSCE). 

CBT is split into 2 parts: Part A which covers numeracy and Part B covers clinical questions for nursing or midwifery. CBT Part A Numeracy takes about 30 minutes to complete 15 questions while Part B Clinical takes about 2 hours and 30 mins about 100 questions.

The fee for CBT for taking both parts is £83. If you need to resit the CBT, these fees applies:

• Resit Part A and Part B: £83

• Resit Part A only: £50

• Resit Part B: £70

The practical side exam of the test which is the OSCE is structured with 10 stations.

• 3 stations are linked together around a nursing associate care process scenario: the AIE(one station for assessment, implementation and evaluation)

• 5 stations to test skills

• 2 new stations to assess the candidates values and behaviours and evidenced-based practise.

The fee for OSCE is £794. The reduced resit fee is £397, if you need to resit 7 or fewer stations.

    You can take any of these tests in any order but have to pass both to be fully qualified. Once you pass one of the 2, you have 2 years to pass the 2nd one to retain its validity. Once you pass both, both will be valid for 5 years.

The type of tests you need to take would depend on the part of register you want to join. These can be:

• Adult nurse (RNA)

• Mental health nurse (RNMH)

• Learning disabilities nurse (RNLD)

• Children’s nurse (RNC)

Typically, the first route to take is passing the Computer Based Test.  The NMC will send you an Authorisation to Test after verifying your eligibility to register. Employers hiring nurses require both CBT and English exam in order to process your application and UK working visa. The OSCE takes place as you arrive in the UK and employers normally provide a lot of support in preparation for your examination.

If you took one of your ToC before August 2021, please check guidance to know which route to take.

To check OSCE, the other Test of Competence, go to Step 6.

Step 4: Complete your Registration Application

    As mentioned earlier, you can start providing the supporting evidence for your registration whilst completing your Test of Competence. You have two years from passing the CBT or OSCE (whichever comes first)  to complete your registration application.  So can I just stress, please ensure you keep the momentum of passing all the exams and meeting the necessary requirements within the said time frame.

1.   Health evidence

• Self-declaration on your health condition. You must declare any condition that may affect your practise.

• If you have a condition that is managed appropriately, there is NO need to let NMC know about it.

• If you have any condition or disability that is NOT managed, you have to provide further information so NMC can decide if you are fit to practise (further information on NMC website) 

• You must provide details of a qualified medical practitioner that NMC will contact to verify your health condition. The health assessment must have been carried out in the last six months. 

2.   Character evidence

• Self-declaration about your character. You must declare any police charge, caution, conviction or conditional discharges you’ve received as well as determination from regulatory bodies in the UK or overseas. 

• If you declare any offences, NMC will ask you to provide more details about the incident to gain more insight if you are fit to practise safely in the UK.

• Upload police clearance or DBS. 

Police clearance

       - required for those who lived overseas for 12 months or more in total (not necessarily consecutive) within the last ten years; must be issued no more than 12 months before uploading. Check the Gov.UK website for more information.  For applicants based in the Philippines, NBI Clearance is required. Click link to know how to apply for NBI Clearance.

Disclosure and Barring Service  (DBS)

• If you lived in the UK for 3 months or more.- Contact details of your nominated person for supporting declaration

Your nominated person must confirm whether you are capable to practise safely and effectively or not. Nominated person must not be related to you or previously employed by you. I have categorised below the referees you can nominate based on your registration status.

Registered Nurse or have been in the last 3 years

Your regulator and current employer will provide supporting declaration. 

Previously Registered (but not registered in the last 3 years) 

Details of your last regulator AND supporting character declaration from a nominated person.

No Registration

Supporting character declaration from nominated person

Who can be the NOMINATED PERSON for supporting character declaration? 

• your recent employer

• education institution where you graduated and gained qualification

• NMC registrant OR other UK regulated healthcare professional whom you have known for a year and been in contact in the last 6 months from submitting your application

• If you cannot provide any of the above, NMC will ask you to give details of two people from their list of approved signatories to provide character reference. 

3.    Language evidence

• Confirm the evidence of your English Proficiency.

It can be any of the following:

IELTS

      -  Provide your TRF number and original certificate 

OET

      -  Provide your candidate number and original certificate

      -  Make sure you updated your myOET account to allow NMC to verify your results

Transcript of Records

     - This evidence is only allowed if your record of training shows 50% clinical interaction and 75% of that interaction with patients, relatives or healthcare professionals must have occured in English. 

Registered Practice in Majority English speaking country

       -  this is acceptable for those who practiced in these countries for a year. You need to provide your registration details and certificate, how your English proficiency was assessed by that regulator and your employer details. 

4.    Confirm indemnity arrangement

• This is a legal requirement for every UK registered nurse as it will ensure you are covered in case a claim is made against you while you’re in practise.

• Most of the employers such as NHS and some private sectors provide indemnity cover. Make sure you check it is in place, otherwise, you can arrange this with unions such RCN and UNISON. 

5.    Pay for your registration fee - £153.

NMC will verify your application.

• Wait for the decision.

Step 5: Search and apply for the job.

You can already start searching and applying for jobs during the onset or have this as Step 1. But based from feedback, it is easier to find roles and get offers if you have Steps 1-4 completed.

Where can you find these Nursing vacancies:

• POEA Accredited Recruitment Agencies- Most UK big employers particularly NHS use recruitment agencies to source for suitable nurses and help them process their documents and application. You can the POEA accredited jobs in this link.

• NHS jobs or employer. There are still employers who are hiring direct. If you plan to apply direct, make sure to check that the employers have the license to sponsor. You can search and find the employer in this link.

Related Article- Is my job offer real or am I being scammed?

Related Video- How to be a UK Nurse without an agency/ direct hiring

Step 6: Take the Objective Structured Clinical Examination

After completion of IELTS, CBT and initial requirements, employers grant an applicant a Certificate of Sponsorship (COS) necessary to obtain a Tier 2 Working Visa so you can move to the UK to complete the OSCE. You only have three months from your employment start date indicated in you COS to sit in the OSCE exam. Currently, there are 5 approved OSCE Test Centres.

The new OSCE still has 10 stations.

• 4 stations is linked with APIE (Assessment, Planning, Implementation &  Evaluation)

• 4 stations is linked to test skills (two pairs of two skills)

• 2 stations is linked to assess the candidate's values and behaviours and evidence-based practice

Aside from technical skills, communication skills will be assessed in OSCE - This includes verbal, non verbal and written communication skills. Assessors would observe how candidate interacts with the patient, including the nursing  documentation in each station.

At this point, you are legally employed as a pre-registered nurse.  You will also need to show your valid passport for a face to face identity check on the day of the test. 

Fee will be £794 and resit fee is £397.

To prepare for the exam, we recommend you read:

• The Code

• Test of Competence 2021: OSCE information booklet for nurses

• Test of Competence 2021: preparation materials

Step 7: Obtain a Certificate of Sponsorship

As an International Educated Nurse (IEN) seeking to work in the UK, you’ll need to obtain a Certificate of Sponsorship from a UK employer. This document is essential for applying for a Tier 2 visa, which allows you to work in the UK. Here’s what you need to do:

• Find an Employer: Actively search for nursing job vacancies in the UK. Websites like NHS Jobs and Indeed can be helpful resources. Consider working with recruitment agencies that specialize in placing international healthcare professionals.

• Apply for a Certificate of Sponsorship: Once you have a job offer, your employer will need to apply for a Certificate of Sponsorship on your behalf. Your employer must have a valid Sponsor License from the Home Office to be able to sponsor you.

Then, you will receive a certificate in a few weeks, after which you can apply for the visa.

Step 8:Apply for a Tier 2 Visa

Once you have a Certificate of Sponsorship from a UK employer, you can proceed to apply for a Tier 2 visa (now the Skilled Worker visa). This visa allows you to work in the UK for a specific employer for a set period.

Here’s how the route to becoming a nurse in the UK goes:

Step 1: Fill out the online visa application form accurately and comprehensively.

Step 2: Collect all the necessary documents, including:

• Your passport

• Certificate of Sponsorship

• Proof of financial support (e.g., bank statements)

• English language test results

• Medical examination certificate

• Biometric enrollment fee

• Visa application form

  
  

Step 3: Upload copies of the required documents online.

Step 4: Pay the visa application fees using a credit or debit card.

Step 5: Visit a visa application center to have your biometrics (fingerprints and photograph) taken.

Step 6: Once you have completed the application, uploaded documents, and paid the fee, submit your application.

The UK Visas and Immigration (UKVI) will review your application and make a decision. If your application is approved, you will be issued a visa. The processing time can vary, but it typically takes several weeks. You may be able to apply for a fast-track service if you need to travel to the UK urgently.

Step 9: NMC assessment

         Once you have passed the Test of Competence and completed the Registration Application, NMC will contact your referees to verify your information. If NMC needs further information about your supporting details, they will contact you through email. 

        All you have to do at this stage is to wait for the registration outcome decision from the NMC.

Step 10: Registration

       Congratulations! You are now a qualified UK RN.

         After receiving your confirmation of registration from the NMC, you will automatically be in the register so you can practice as a Band 5 in the hospital/trust that have employed you. 

Sources:

• NHS employers. https://www.nhsemployers.org/your-workforce/recruit/employer-led-recruitment/international-recruitment/immigration-rules-and-the-points-based-system/overseas-nurses-and-midwives

• NMC (2018) ‘The Code’

• NMC blueprints and test specifications

• NMC OSCE Handbook

• https://www.nmc.org.uk/registration/joining-the-register/register-nurse-midwife/trained-outside-uk/how-to-guide/check-ready/costs/