International nurses aiming for UK registration must clear the Nursing and Midwifery Council's Test of Competence, made up of two stages: the Computer Based Test (CBT) and the OSCE.
The Two-Stage Test of Competence
The NMC Test of Competence is the assessment that internationally educated nurses and midwives must pass to join the UK nursing register. It has two distinct stages: Part 1, the Computer-Based Test (CBT), and Part 2, the Objective Structured Clinical Examination (OSCE). You must pass Part 1 before you can book Part 2.
Together, the two parts assess that you have the knowledge, clinical skills, and professional values required to practise safely and effectively as a registered nurse in the UK, meeting the standards set out in the NMC Code.
Part 1 — The Computer-Based Test (CBT)
The CBT consists of 120 multiple-choice questions to be answered in approximately four hours. Questions are single best answer format — you select the one most correct option from four. The exam is delivered at Pearson VUE test centres worldwide, including in Kathmandu, Nepal, which means you can sit Part 1 before travelling to the UK.
The 120 questions are divided into two sections: Part A, which tests numeracy and medicines calculation (15 questions), and Part B, which tests clinical nursing knowledge across professional values, communication skills, nursing practice, decision-making, and leadership (105 questions). A pass in both sections is required.
CBT: Fees, Booking, and Attempts
The CBT fee is currently £83 per attempt. There is no limit on the number of attempts, but you may only sit the CBT three times per year. Each unsuccessful attempt costs the full fee. The NMC issues a performance report after each unsuccessful attempt, detailing your areas of weakness — use this to focus your revision before retaking.
To book the CBT, you first need to receive your NMC eligibility letter (the decision letter confirming you may proceed to the Test of Competence). Once you have this letter, you book your CBT slot through Pearson VUE online. Your CBT pass is valid for three years from the date you pass — you must complete the OSCE and all other registration requirements within this window.
Part 2 — The Objective Structured Clinical Examination (OSCE)
The OSCE is a practical clinical skills assessment conducted in the UK. It consists of 10 stations, each lasting approximately 10 minutes. Stations test a range of skills including patient assessment, medicines management, vital signs monitoring, wound care, patient communication and education, infection prevention and control, and professional behaviours and values.
At each station you are given a brief scenario and must demonstrate the required skill to an assessor, interacting with a simulated patient. You are scored on both your clinical technique and your communication with the patient. The OSCE fee is £794 per attempt.
OSCE: Test Centres and Booking
The OSCE must be taken in the UK. There are five NMC-approved OSCE test centres, run by NHS trusts and universities across England and Scotland. Waiting times for slots can be several months during periods of high demand, so it is important to apply as soon as you have passed the CBT.
Many NHS trusts that recruit internationally arrange OSCE preparation as part of their induction programme. If your employer does not provide preparation, LIFE Academy offers OSCE orientation sessions covering the communication frameworks used in UK nursing, patient-centred care principles, and practice for the most commonly assessed clinical procedures.
How to Prepare for the CBT
Effective CBT preparation focuses on three areas: UK nursing knowledge (the NMC Code, medicines management protocols, UK clinical guidelines), clinical decision-making in UK-specific scenarios, and numeracy practice including medicines calculations and unit conversions.
Use official NMC preparation resources, past question banks designed for the CBT, and timed practice tests. Many international nurses underestimate the CBT because it feels like a knowledge test — but the UK-specific framing of questions can be surprising if you have not studied UK nursing standards carefully.
LIFE Academy's NMC Preparation Support
LIFE Academy provides CBT study guidance, including access to CBT-mapped question banks, UK nursing standards review, and medicines calculation practice. We also offer OSCE orientation sessions and full NMC registration support packages.
Our NMC support package starts at NPR 5,000 and covers CBT preparation, document checklist guidance, and OSCE orientation. Contact us at 9855082586 or visit our Bharatpur office to find out more.
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