The four ways to meet the NMC English language requirement
The NMC accepts any one of these four routes as sufficient evidence on its own, so you do not need to combine them.
Route 1: pass an approved English language test (IELTS Academic or OET)
Route 2: complete a pre-registration nursing qualification that was taught and examined in English
Route 3: one year of recent practice in a country where English is the majority-spoken language
Route 4: supporting information from a UK employer (SIFE), available in specific circumstances
If you trained in the Philippines, Route 2 or Route 3 likely applies to you. If you trained in India, you will almost certainly need Route 1 or Route 4. If you are already working in the UK as a healthcare assistant, Route 3 or Route 4 may apply.
Route 1: pass an approved English language test
This is the route most nurses use. The NMC accepts exactly two tests for it, not four.
IELTS Academic
The NMC accepts IELTS Academic, paper-based or computer-based, delivered at a test centre. You need at least 7.0 in listening, reading, and speaking, and at least 6.5 in writing, with an overall band score of at least 7.0.
Two points that catch nurses out most often:
It has to be IELTS Academic, not IELTS General Training. The NMC will not accept General Training, regardless of the score you get.
IELTS for UKVI Academic is fine. It's the same content and scoring as standard Academic, just administered for visa purposes. What the NMC won't accept is the IELTS Indicator, IELTS Online, or the IELTS One Skill Retake, all reduced-security or remote formats. Only a standard face-to-face Academic test at a registered centre counts.
OET
OET uses healthcare scenarios throughout, including patient referral letters and clinical consultations, which many nurses find more relevant than IELTS's general academic essay format.
You need to score a grade B (350 or above) in reading, listening, and speaking, and a grade C+ (300 or above) in writing. OET on Paper, OET on Computer, and OET@Home are all accepted.
With OET, you give the NMC permission to verify your scores through your myOET account.
Combining scores across two sittings
If you do not hit the required scores in one sitting, you can combine scores from two sittings of the same test, taken within 12 months of each other, and both within two years of your application assessment. You must be tested in all four domains each time, and reach the required pass score in each domain across the two sittings combined.
There's a floor either way: for IELTS, no score below 6.0 in writing or 6.5 elsewhere; for OET, nothing below grade C (250) in writing or C+ (300) elsewhere. You cannot combine IELTS with OET.
The NMC runs an official test using a calculator. Use it before deciding whether your scores are combinable.
Score validity
Test scores are valid for two years, counted from your test date to the date the NMC assesses your complete application, not the date you submit it. If other parts of your application take longer than expected, check that your scores have not expired before submitting. If they have, you will need to resit.
Route 2: trained and examined in English
If your pre-registration nursing qualification was taught and examined in English, you may not need to sit a test at all, though the criteria are specific.
To use this route, your programme needs to have been an NMC-approved pre-registration course where at least 75% of clinical interaction with patients, service users, families, and other healthcare professionals took place in English. You can read the exact criteria on the NMC's qualified in English page.
If you trained in a country where English is the majority-spoken language, this route is straightforward. The NMC holds an official list of these countries. The Philippines is on it. India is not.
If you trained in English in a country where English is not the majority language, for example, India or parts of West Africa, you will need two pieces of evidence instead: a transcript or official letter confirming the course was taught and examined in English, plus supporting information from a current UK employer confirming your clinical English interaction. That is the SIFE route, covered below.
Route 3: recent practice in a majority English-speaking country
If you have worked as a registered nurse, midwife, or nursing associate for at least one year in a country where English is the majority-spoken language, you may be able to use this as evidence instead of sitting a test.
That year of practice needs to have ended within the last two years of your NMC application date, and the NMC will ask for specific evidence to verify it.
The UK counts as a majority English-speaking country for this route. A nurse who has worked in the UK for at least a year, even as a healthcare assistant in a role comparable to nursing, may be able to use this route instead of sitting a language test. Check the exact requirements on the NMC website before applying, since the NMC assesses each case individually.
Route 4: employer supporting information (SIFE)
The NMC can accept supporting information from a current UK employer as supplementary evidence, but only in two specific circumstances:
You narrowly missed the required score in one IELTS or OET sub-test: 6.0 (IELTS) or grade C (OET) in writing, or 6.5 (IELTS) or grade C+ (OET) in one of the other three, in the sitting where you fell short.
You were trained and examined in English, but in a country where English is not the majority-spoken language, and you need to provide evidence of clinical English interaction.
To use SIFE, you need to have worked for your UK employer for at least 12 months within the last two years, in a health and social care setting. Your direct manager must be an NMC-registered professional and complete the standard NMC employer form, which is countersigned by a more senior NMC-registered professional from the same employer.
The NMC considers SIFE carefully, but it does not guarantee registration. It is supplementary evidence.
Translating your documents for the NMC
If you trained in a non-English-speaking country, you will need to submit supporting documents to the NMC in English. If they were originally issued in another language, you will need a certified translation.
At a minimum, most applicants need two certified translations: their nursing qualification certificate and their good standing or registration letter from their home country's nursing council. Depending on your application route and country of training, you may also need certified translations of:
Nursing qualification certificates, degree transcripts, and course syllabi (most commonly for Route 2 applicants from countries where English is not the majority language)
Good standing letters or registration certificates from your home country's nursing council
Police certificates and criminal record checks issued in a non-English language
Training transcripts and course syllabi used as evidence for Route 2
Identity documents, where relevant to your application
The number of documents varies by country of origin. A nurse from Romania, Italy, Portugal, Greece, or Poland will typically need 2-4 certified translations covering their qualification, registration, and criminal record documentation. A nurse from the Philippines whose programme was taught and examined in English may need no translation at all under Route 2.
The NMC follows UKVI standards here. The certified translation must include a signed statement of accuracy, the translator's name and contact details, and evidence of accreditation such as CIOL, ITI, or ATC membership. Translayte provides certified translations accepted by the NMC, delivered within 12 hours from anywhere in the world.
Note: the NMC does not require notarised translations. A certified translation with the elements mentioned above is sufficient.
Recommended Reading
What Does a Certified Translation Look Like
Common mistakes to avoid
Sitting the wrong test entirely. General Training, the IELTS Indicator, and TOEFL or PTE are all rejected. Only face-to-face IELTS Academic, including IELTS for UKVI Academic, and OET count.
Letting test scores expire. Scores are valid for two years. If CBT scheduling, qualification verification, or OSCE booking delays your registration, check your score expiry date before submitting.
Assuming the Philippines and India are equivalent for Route 2. The Philippines is on the NMC's majority English-speaking country list. India is not.
Trying to combine IELTS and OET scores. You can only combine two sittings of the same test.
Using SIFE without checking eligibility. It's supplementary, not a standalone route, and the NMC does not guarantee it will accept SIFE evidence in place of a test.
Meeting the NMC English language requirements: what to do next
Whichever route applies to you, the goal is the same: clear, verifiable evidence that you can communicate safely in English at the standard the NMC sets. Work out which route fits first, then put your time and money into that one.
If your nursing qualifications, good standing letter, or registration certificate were issued in a language other than English, you will need a certified translation before the NMC will accept them. Translayte provides certified translations accepted by the NMC, delivered within 12 hours. Request a certified translation today.
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