Where to study

Tests

Driving testsCitizenship testsSchool and university admissionsNursing, medicine and healthEnglish and French testsTeachingMoney, law and insuranceTrades and work certification and licensesPilots, drones, boats and radio

Countries

United StatesCanadaUnited KingdomAustraliaNew Zealand

United Kingdom · Registration test

The NMC Test of Competence: how the CBT and OSCE fit together

The Nursing and Midwifery Council (NMC) uses its Test of Competence (ToC) to check the knowledge and skills of people joining its register from overseas, or rejoining after a long time away from practice. It has two parts: the computer-based test (CBT) and the objective structured clinical examination (OSCE), a practical exam in the UK. You can sit them in either order.

  • 2 yearsTo pass both the CBT and the OSCE
  • 5 yearsHow long a full pass stays valid
  • 10 stationsIn the OSCE, for every field
Read the NMC’s guide to the test

Updated November 2026 · Written from official sources, listed at the bottom of this page

What is the NMC Test of Competence?

Each Test of Competence has the same two parts, but there’s a separate test for each part of the register. You take the one for the part you’re applying to join or rejoin. You can choose the field of nursing you apply to, even if your qualification isn’t specific to it, but you can’t use one qualification for more than one field.

  • Adult nurse (RNA)
  • Mental health nurse (RNMH)
  • Learning disabilities nurse (RNLD)
  • Children’s nurse (RNC)
  • Midwife (RM)
  • Nursing associate (NAR)

Who has to take it depends on where and how you trained. The UK nursing exams page sets out each route, including the European qualifications that don’t need it.

Who takes which test in the UK →The CBT, part one →

The OSCE, part two

The OSCE tests your clinical and communication skills at a UK test centre. For nurses it has 10 stations: four linked stations around one scenario, called the APIE (assessment, planning, implementation and evaluation), four skills stations in two pairs, and two stations on professional values and evidence-based practice. The nursing associate OSCE also has 10 stations, built around a three-station scenario.

Three providers are approved for the OSCE: the University of Northampton, Ulster University and Leeds Teaching Hospitals NHS Trust. The centre at Northumbria University closed on 19 February 2026 and the one at Oxford Brookes University closed on 31 July 2026. Candidates who started at either can resit at another approved centre by emailing it; the centre confirms if it has space.

NMC: OSCE for nurses and midwives ↗University of Northampton: Competence test centre ↗Ulster University: NMC competence test centre ↗Leeds Teaching Hospitals: OSCE test centre ↗

OSCE fees, results and resits

ItemFee
OSCE, first sitting£794
Resit of 8 or more stations£794
Resit of 7 or fewer stations£397

Your centre emails the result within 5 working days. If you fail, you get feedback on the stations and elements you didn’t pass, and you resit only those. You have three attempts, at least 10 days apart, all at the centre where you first sat. After a third fail your application closes, and you wait at least six months before sitting all 10 stations again.

From January to March 2026, the NMC reports, 3,009 candidates sat the OSCE across five centres (two of them closed during 2026), resits included, and 78% passed.

NMC: Test of Competence pass rates, 2026 ↗NMC: How much is it going to cost? ↗

OSCE stations updated in 2026

The NMC refreshes OSCE content regularly, without changing the number of stations. In 2026 it added new adult nursing stations for first attempts from 23 February 2026, midwifery, children’s and mental health stations from 13 April 2026, and new adult, mental health and children’s nursing stations from 26 October 2026, covering topics such as donor human milk, unsafe staffing levels and mental state examination. If your first OSCE falls on or after a change date, the NMC says you may meet the new stations and should use the updated marking criteria.

NMC: CBT and OSCE preparation materials ↗

How long is the Test of Competence valid?

You must pass the CBT and the OSCE within two years of each other. Once you’ve passed both, the result stays valid for five years, so you can use it to join or rejoin the register within that time.

If you’re returning to practice, the Test of Competence is one way to make up missing practice hours. The other is an approved return to practice course. Your whole application has its own time limit too, set out on the registration page.

NMC: Take a Test of Competence to return to practice ↗From the Test of Competence to the register →
Sources: NMC and 9 more. Checked November 2026.

Rules and fees can change, so check the official site before your test.

Explore

Everything else, in one place

OverviewStudy optionsPractice testsNumeracyBookingRegistrationUK nursing exams