Overseas NMC registration process

Nurse and scanner

22 / 9 / 2016 1.03pm

This page provides information for employers about the Nursing and Midwifery Council (NMC) registration process for nurses and midwives trained outside of the European Economic Area (EEA).

Click on the links below for further information:

The NMC registration process

All nurses and midwives trained outside of the EEA are tested for competence through a two-part process as part of the NMC registration process:

  • part one - this is a computer-based, multiple-choice examination which is accessible by applicants in their home countries
  • part two - this is a practical observed structured clinical examination (OSCE) which is always held in the UK.

As well as the test of competence, overseas applicants are required to have achieved level 7 of the international English language testing system (IELTS) before starting the NMC registration process. Further details of the full process can be found on the NMC website.

The observed structured clinical examination (OSCE)

The OSCE is based on UK pre-registration standards. Candidates are required to act out scenarios that nurses or midwives are likely to encounter when assessing, planning, delivering and evaluating care.  An individual entering the UK to take a nursing role has up to 3 months (12 weeks) from the employment start date noted on the Certificate of Sponsorship to sit the OSCE exam. During this period they can be legally employed as a pre-registration candidate. Applicants must complete the OSCE in the UK at the University of Northampton (currently the only independent provider of the OSCE).

See below for top tips to help your staff prepare for the OSCE, read the Cambridge University Hospital blog by Vickie Jones and a case study from Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust.

What is involved in the OSCE?

The OSCE is made up of six separate stations using simulated patients in a clinical setting. Four stations are designed to test the candidate’s knowledge and understanding of assessment, planning, implementation and evaluation of care, and the remaining two stations test clinical skills. The NHS constitutional values and the 6Cs of nursing are assessed throughout the OSCE at all stations.  

Find out more on the University of Northampton website.

OSCE preparation

To ensure candidates have adequate time to prepare for the OSCE, they are given up to 12 weeks from the start date on their CoS to complete the exam. In the run up to the exam, candidates should be given support and the opportunity to practice and prepare for the OSCE.

OSCE preparation top tips

The experience a candidate has in the first few weeks is vital to their success in the OSCE. The NMC registration process no longer requires applicants to complete a period of supervised practice, therefore the importance of establishing a quality and well-structured induction and socialisation period is critical. Many trusts also provide specific OSCE preparation support for their international recruits. 

The following top tips were provided by Cambridge University Hospitals NHS Foundation Trust and Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust – both trusts have support programmes in place. Vickie Jones, clinical education facilitator at Cambridge University hospitals, has also written a blog to share her experience of designing an OSCE preparation programme. 

  • Empower candidates with practice and experience, and stress the importance of being able to verbalise and demonstrate their knowledge.
  • Build up their resilience and confidence to speak up in front of others, as this can be something which overseas nurses are not always comfortable with. 
  • Set up practice rooms in the same way as the OSCE, with simulated patients in a clinical setting, so that the setting is familiar to them.
  • Create a dedicated support group - for example, a Facebook group.
  • Consider sending a representative to the train-the-trainer course run by the University of Northampton, who is in a position to cascade the information with in their trust.
  • Make sure candidates have plenty of time to practise their skills prior to taking the OSCE.
  • Plan a mock, timed practice at least three weeks before the OSCE date to help identify if the candidate is ready (any later than this may then cause a delay in getting a new test date within the 12 week limit).
  • If your candidates are not ready for their test, make sure you give them the choice to change the date.
  • Although there is always time pressure linked to a candidate sitting the OSCE and to move staff through this process quickly, low pass rates suggest speed initially may cause more difficulties in the long term.

Useful information

Nursing and Midwifery Council (NMC)
Visit the NMC website for further information about joining the UK register. 

University of Northampton

Visit the University of Northampton NMC Test of Competence web section to find:

  • the candidate journey document
  • a candidate information booklet
  • an OSCE video
  • info about costs, how to book the exam and location maps
  • train the trainer course contact details.

Overseas registration – avoiding common application errors

In June 2015, the NMC released an update on progress of the new overseas registration process. It includes the most common errors in application forms, which can cause significant delays to the overall registration timeline. Employers can play an important role in helping applicants to understand the registration process and to avoid delays in the process caused by mistakes made in applications.  

The NMC runs a dedicated employer helpline to answer questions about the overseas registration process - T: 020 7681 5954. The NMC website also has a useful list of frequently asked questions about the overseas registration process.

Applicants with individual queries about the status of their registration are advised to contact the NMC directly.

For more information about general visa requirements, please visit our Tier 2 visasimmigration points-based system and employer sponsorship web pages.

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