The NMC Test of Competence: CBT and OSCE Overview

The NMC Test of Competence is the assessment international nurses take to demonstrate they meet UK nursing standards before joining the register. It’s two separate examinations: a computer-based test (CBT) and an objective structured clinical examination (OSCE).

This chapter is the overview. The chapters that follow break down each part in detail.

Who has to take the test

The test is for nurses who trained outside the UK and (in most cases) outside the EU/EEA. The full list of exemptions changes periodically and you should always check the NMC’s current guidance, but the main categories are:

• Nurses trained in the UK at NMC-approved institutions.
• Nurses trained in some specific countries with mutual recognition agreements.
• Nurses returning to the register after lapse (Return to Practice route instead).

For everyone else applying to join the UK register from overseas, the test is part of the registration process.

The CBT (Computer-Based Test)

Taken first, usually from your home country.

• Format: 120 multiple-choice questions.
• Duration: 4 hours total.
• Sections: Part A (Numeracy, 15 questions) and Part B (Clinical, 105+ questions).
• Delivery: Pearson VUE test centres worldwide.
• Pass mark: roughly 60-70%, standard-set per question difficulty.
• Retakes: allowed; specific limits apply.

The CBT covers core nursing knowledge mapped to the UK Standards of Proficiency for Registered Nurses. It tests theoretical knowledge. The practical application is the OSCE.

The OSCE (Objective Structured Clinical Examination)

Taken second, in the UK at an approved university test centre.

• Format: 10 stations.
• Duration: approximately 3 hours total.
• Stations: 4 APIE stations (Assessment, Planning, Implementation, Evaluation) plus 4 skills stations plus 2 silent written stations.
• Delivery: NMC-approved test centres (currently Northampton, Oxford Brookes, Ulster, others).
• Pass mark: passes per station; minimum acceptable passes required overall.
• Retakes: limited; typically 3 attempts maximum.

The OSCE tests applied clinical skill. You demonstrate care for a simulated patient or task, observed by examiners.

The fees

As of 2026:

• CBT: £83 (set by Pearson VUE; subject to revision).
• OSCE: £794 for the full OSCE.
• OSCE resit: £397 for resitting fewer than 7 stations; full fee for resitting 7 or more.
• NMC application fees: separate, including ID checks and assessment of training.

The total cost from application to registration typically runs £1,500–£3,000 in fees alone, before considering travel, accommodation for the OSCE, and any preparation courses.

The typical timeline

A realistic timeline from starting the process to UK registration:

• Months 1-3: NMC application, document submission, English language test (IELTS or OET).
• Months 4-6: CBT booking and preparation.
• Months 7-9: CBT taken; results returned typically within 2 weeks.
• Months 10-15: OSCE booking (often limited availability), travel to UK.
• Months 16-18: OSCE taken; results returned.
• Months 19-24: NMC final review and registration.

Most international nurses budget 18-24 months from start to registration. Some complete faster; many take longer due to OSCE booking constraints.

What the test actually measures

The CBT measures whether you have the theoretical knowledge expected of a UK-registered nurse. Drug calculations, anatomy and physiology, infection control, professional standards, NHS structure, UK clinical guidelines.

The OSCE measures whether you can apply that knowledge in clinical scenarios. Assessing a deteriorating patient, planning care, performing specific clinical skills under observation, communicating professionally.

A nurse who passes both has demonstrated the level of competence the NMC expects for safe practice on the UK register. Failure rates vary. Historically the OSCE has had higher failure rates than the CBT, often due to communication and documentation issues rather than clinical knowledge.

What this guide covers in Part 6

The remaining chapters of Part 6 walk through:

• CBT structure and content (Chapter 71).
• CBT numeracy methods (Chapter 72) and worked examples (Chapter 73).
• CBT clinical content and the 7 Future Nurse Platforms (Chapter 74).
• CBT registration and fees in detail (Chapter 75).
• OSCE structure (Chapter 76) and each station type (Chapters 77-82).
• OSCE fees and retake rules (Chapter 83).
• The 12 known OSCE APIE scenarios (Chapter 84).

The next chapter is the detailed CBT structure walkthrough.