Trained outside Europe

Information for nurses and midwives who trained outside of the EU or EEA countries

From October 2014, we have a new process in place for overseas registration

If you have trained outside the EU/EEA and are applying to register as a nurse or midwife in the UK, please read 'Registering as a nurse or midwife in the UK' [PDF]. This document provides detailed information about all stages of the process.

If you applied before October 2014, please see the information further down the page.


To satisfy ourselves that the applicant is capable of practising safely and effectively in the UK as a nurse or midwife we will assess their qualification, training and experience against our standards. We will consider whether the applicant has undertaken the necessary post-qualifying practice and experience in each area of nursing or midwifery deemed appropriate for the part of the Register for which they are applying.

See our FAQs for further information.

New applicants

Applicants must complete a self-assessment of their eligibility to apply prior to beginning the application process. This is completed online.

Before deciding to apply, applicants should consider if they meet the general and specific requirements. Please read 'Registering as a nurse or midwife in the UK' [PDF].

Begin an application.

There are different fees for different stages of the application process:

Application Stage Fee
Application for nursing/midwifery £140
Part 1 test of competence (CBT) £130
Part 2 test of competence (OSCE) £992
Admission onto our register £153
Total £1395

Each distinct professional field of nursing – adult, children’s, learning disabilities and mental health – and the midwifery profession is examined by our test of competence. Part 1 is a multiple choice examination and part 2 is a practical examination called an OSCE.

Test of competence

The test of competence represents a new way of assuring nurses and midwives seeking to register and work in the UK. In the UK, each field of nursing and midwifery are separate and distinct, each requiring three years of specialist pre-registration education and practice. The test of competence requires adequate and extensive preparation and study to ensure the clear demonstration of knowledge, understanding and application of professional skills are at the level required by us. Information and specific competencies on nursing and midwifery pathways are available below:

Adult (general) nursing

Children's nursing

Learning disabilities nursing

Mental health nursing


The pre-registration standards and competencies for all nurses and midwives are the benchmarks to which the test of competence is aligned.

These exist for Adult Nursing, Children's Nursing, Learning Disabilities Nursing, Mental Health Nursing and Midwifery. They cover domains of professional values, communication, nursing decision making and leadership.

Nurses and midwives work in a variety of clinical settings and they are exposed to a variety of settings during their education. All nurses and midwives at the point of entry to the register are competent to work in all professional areas of nursing or midwifery practice.

These areas of practice include acute care, long term care setting, caring for the healthy people, caring for patients with complex needs and morbidities, caring for patients in the community setting including their own homes. All nurses are expected to be able to care competently for people across the life span and respond to the needs of, for example, pregnant and postnatal women, people with mental health needs, physical disability and dementia, even if they are (for example) a children's nurse.

Once applicants have passed the eligibility assessment, they will be asked to sit the first part of the test of competence. This will be a computer based test of theoretical practice-based knowledge. The test format will be multiple choice and can be taken in test centres around the world. Applicants will need to contact Pearson Vue, our test provider, directly to book and pay for their test.

Candidate guide for Pearson Vue [PDF]

The objective-structured clinical examination (OSCE)

The OSCE will simulate a clinical environment and patient scenarios which registered nurses and midwives are likely to encounter when they assess, plan, implement and evaluate care. The OSCE contains nursing or midwifery scenarios along with separate skill stations. Each separate clinical examination is known a ‘station’ and candidates will circulate through all the stations within a set timeframe.

Each of the six stations has standardised marking criteria against which all candidates are assessed. Candidates are assessed by a panel of examiners and will be filmed for quality assurance purposes.  Nurses and Midwives must demonstrate competence.

Candidates are expected to demonstrate safe and effective practice The test of competence is based on current UK pre-registration standards.

The OSCE will be taken in the UK at the University of Northampton. When we authorise candidates to take the OSCE, they should contact the university. Information about processes and links to relevant resources are available from the University of Northampton.

Identification check

Applicants are required to attend a face to face identification check at our office in London. At the ID interview you must produce the original versions of the documents you sent photocopies of. We will undertake final checks on your previous registration, and take a photograph for our records.

We cannot issue you with a Pin or place you on the our register until you have satisfied the requirements of this check. Please do not attempt to make an identity check appointment until you have been contacted by us, asking you to book one.

English language requirements

All applicants also meet our English language requirements, with an international English language test (IELTS) score of 7.0.

UK's immigration processes

Applicants should be aware that they will, separately, be required to meet the full requirements of the UK’s immigration processes.

Applicants who applied under the old system (before October 2014)

If you have submitted an application under the previous process, you can continue with this application. However, the overseas nursing programme (ONP) and the adaption to midwifery programme will only be available for a limited period of time.

If you have not yet submitted all the required documents and assessment fee as part of the first stage (mandatory) application, we must receive these requirements by 14 November 2014 for your application to be considered under this process.

If you are at the second stage (assessment) of the application process, we must receive all the required documents by 28 February 2015.

We strongly recommend that you return the complete applications to us before these deadlines so that we have time to assess and request further information if necessary. If we do not receive all the requirements prior to the deadlines, you will not be allowed to continue under this process and you will be required to make a new application.


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