NMC English requirements: IELTS 7 with 6.5 Writing, or OET B with C+ Writing
Published 6 min read
Before the Nursing and Midwifery Council will look at the rest of your application, your English test has to clear an exact bar, skill by skill. Miss one skill by half a point and the whole result can be rejected, which can cost you weeks you did not plan to lose. Here is exactly what the NMC asks for, and which test formats it will not accept at all.
What the NMC asks for, in plain numbers
The NMC accepts two main routes for English: IELTS Academic (including IELTS Academic UKVI) and OET. Each has its own minimum score in every skill, and both tests are marked against every skill separately: an average is not enough, and a weak skill is not covered by a strong one elsewhere. That single rule catches more applicants than any other part of the English requirement, because it is easy to assume a strong overall result is enough when one skill quietly falls short.
IELTS Academic route: the exact scores
For IELTS Academic, the NMC accepts at least 7 for reading, listening and speaking, and at least 6.5 for writing. IELTS Academic UKVI tests are accepted on the same basis. There is no rounding between skills: a 6.5 in listening does not average out against a 7.5 in reading, so you need every one of the four numbers to individually clear its own line.
OET route: the exact grades
For OET (Nursing), the NMC accepts at least grade B, which is 350 or above, for reading, listening and speaking, and at least grade C+, which is 300 or above, for writing. OET@Home results are accepted on the same basis as the test centre version, so where you sit the test does not change which grade you need.
| Skill | IELTS Academic (minimum) | OET (minimum) |
|---|---|---|
| Listening | 7 | Grade B (350+) |
| Reading | 7 | Grade B (350+) |
| Speaking | 7 | Grade B (350+) |
| Writing | 6.5 | Grade C+ (300+) |
What the NMC will not accept
Three IELTS formats are specifically ruled out for NMC registration: the IELTS One Skill Retake, IELTS Online and the IELTS Indicator test. If you are close to meeting the score in only one skill, a One Skill Retake might look like the quick fix, but it will not be accepted here even though other organisations allow it. Book a full test instead if you need to retake anything, and build in enough time for a full result rather than assuming a partial retest will save you a step.
Choosing between IELTS Academic and OET
OET is written around healthcare scenarios: the listening recordings are consultations and workplace talk, the writing task is a clinical letter, and the speaking test is a role-play with a patient. Nurses who are more confident discussing clinical situations than writing a general essay often find OET's format closer to the work itself. IELTS Academic uses general academic topics throughout, which can suit nurses who prefer a wider range of subjects and more practice material to draw on. Neither test is easier on paper; the right one depends on which format matches how you work and think in English, and some nurses find it worth trying a full practice attempt of each before committing to one.
How to practise each skill before you book
- Start with the skill furthest from its minimum score, since that is the one that can block the whole application.
- For OET, practise the clinical letter and role-play formats specifically; general essay practice will not prepare you for either.
- For IELTS Academic, work through full-length Listening and Reading sections under timed conditions, since both are marked strictly against a fixed answer key.
- Get feedback on full Speaking and Writing attempts, not isolated sentences, so you can see how a complete answer is judged.
- Leave time to sit the test again if your first result falls short in even one skill, rather than booking registration steps that assume a pass.
What to do if one skill falls short
A result that clears three skills and misses the fourth by a small margin is a common outcome, not a rare one, given how strictly each skill is marked on its own. For IELTS Academic, the NMC does not accept the One Skill Retake, so a full retest of all four skills is the way forward even when only one number needs to move. For OET, focus your next round of practice specifically on the sub-test that fell short rather than spreading study evenly across all four, since the other three have already cleared the bar.
PractiseNow has practice for both routes: OET Listening, Reading, the clinical letter and role-plays built for nursing, and IELTS Academic's four skills with AI feedback on Speaking and Writing. Every AI-marked answer gets an estimated score and specific feedback on what to fix, as a practice estimate rather than an official result; only the official test provider can issue the score the NMC will accept.
Fitting the test into your registration timeline
English test results sit alongside the rest of an NMC application, not ahead of it or after it, so it helps to treat booking the test as one of the first steps rather than something to fit in once everything else is ready. A test slot, a result, and in some cases a retake all take real time, and the NMC cannot process the wider application without a result that already clears every skill. Nurses moving from a role where English was used daily, but mostly for speaking rather than formal writing, often underestimate how much separate practice the writing task needs compared with the other three skills. Building a short weekly plan around whichever skill is weakest, rather than revising everything equally, tends to close that gap faster.
Why the numbers feel strict compared with other routes
Some nurses have already sat an English test for a different purpose, such as a student visa or an earlier job application, and assume that result will carry over. The NMC sets its own minimums independently of visa or study requirements, and a score that was enough for one purpose is not automatically enough for registration. Checking the NMC's own page before you rely on an older result, rather than assuming equivalence between purposes, avoids finding out too late that a test needs to be retaken.
Frequently asked questions
Can I combine an IELTS score with an OET score?
No. The NMC assesses each test on its own; a strong OET result does not combine with a weaker IELTS attempt, or the other way round.
Does the NMC accept IELTS General Training?
The scores above are for IELTS Academic, including the UKVI version. Check the NMC's own page before assuming a General Training result will be accepted.
Why does writing have a lower minimum than the other skills?
The NMC sets the minimum for each skill separately, and writing's threshold (6.5 for IELTS, grade C+ for OET) is lower than the other three. It is still a real minimum: falling under it fails that skill regardless of your other scores.
Is OET@Home treated differently from the test centre version?
No, the NMC accepts OET@Home results on the same basis as OET taken at a test centre.
Last checked: 16 October 2026. Test rules and score requirements change: confirm on the official pages linked in this article before you book or apply.
Check the NMC's IELTS Academic page or the NMC's OET page for the current rules, then pick your test and see passes and credits before you start free to practise the skill that needs the most work first.
