IELTS for nurses: the NMC and AHPRA scores, combining two tests, and IELTS or OET

Quick take. For both the UK's NMC and Australia's AHPRA, you need IELTS Academic (not General Training) with 7.0 in Listening, Reading and Speaking and 6.5 in Writing; AHPRA also asks for 7.0 overall. The OET equivalent is B in three skills and C+ in Writing. You can combine two sittings taken within 12 months, but every score in both sittings must clear a floor: for the NMC that is 6.5, or 6.0 in Writing. A Writing score of 5.5 in either test means that test cannot be combined at all. Writing is the skill most nurses get stuck on, so plan around it.

Most pages on this topic list the scores and stop. The questions nurses actually ask are about the rules around them: can I combine my last two tests, what if my Writing dropped, and should I switch to OET? This guide answers those, using the regulators' own pages, checked on 7 October 2026.

The scores at a glance

Two things are easy to get wrong here.

General Training does not count. Many nurses take IELTS General Training because it is the version used for migration, then find the regulator will not accept it. Both the NMC and AHPRA ask for Academic. If your visa route needs General Training, you may need both.

Writing is now 6.5, not 7.0. The NMC lowered its Writing requirement to 6.5, and AHPRA's updated scores, with Writing at 6.5, took effect on 23 April 2026. Older articles, social media posts and agents may still quote 7.0 in every skill.

Combining two test sittings

Both regulators let you combine results from two sittings. This is where most of the confusion is, so here are the NMC's rules exactly.

You can combine two IELTS Academic results if:

• the two tests were taken within 12 months of each other;
• across the two sittings you have at least one score of 7.0 in Reading, 7.0 in Listening, 7.0 in Speaking and 6.5 in Writing; and
• every score in both sittings is at least 6.5, or 6.0 in Writing.

You cannot mix IELTS with OET. AHPRA's rule is similar: a maximum of two sittings in 12 months, with no component below 6.5 in either sitting.

What the floor means in practice

Here is a worked example for the NMC:

Now change one number. If Writing in Sitting 1 had been 5.5, that sitting falls below the 6.0 Writing floor and cannot be used at all, however good the other three scores were. You would need a fresh pair of sittings or a single test that meets every score.

That is why one bad Writing paper costs more than one score. It can cost you the whole sitting.

Before you book another test, put both of your last results into the score requirement checker with the NMC or AHPRA minimums. It shows which skill falls short and by how much.

IELTS or OET?

OET (the Occupational English Test) is built for healthcare workers: its reading, listening and speaking tasks use clinical situations, and its Writing task is a referral or discharge letter rather than an essay. Both regulators accept it on equal terms.

Some nurses find OET's clinical context easier, especially for Speaking and Writing. Others prefer IELTS because test centres and dates are easier to find, or because they need IELTS for another part of their move anyway. There is no single right answer. Consider:

• Which Writing task suits you? IELTS Academic asks for a chart description and an argument essay. OET asks for one clinical letter from case notes. If you write case notes every day, OET Writing may feel more familiar.
• Do you need IELTS for anything else? A visa route or a university course may need IELTS specifically.
• Where and when can you test? Check dates and centres near you for both.
• Have you already taken one? You cannot combine IELTS and OET, so switching tests means starting again with your two-sitting window.

Why Writing is the score nurses get stuck on

Ask nurses who have taken IELTS several times and the story is often the same: Listening, Reading and Speaking come up to 7.0, and Writing stays at 6.0. There are good reasons.

• Task 2 is an argument essay, not a clinical document. It rewards a clear position, developed ideas and linking between paragraphs, which clinical writing rarely needs.
• Small errors add up. Band 7 asks for frequent error-free sentences. A handful of repeated slips in articles, plurals or tenses can hold the whole paper at 6.0 or 6.5. See the common grammar mistakes guide.
• Task 1 is a chart, which many nurses have not described in writing since school. The Academic Task 1 guide covers every chart type.
• Time. Writing two answers in 60 minutes leaves little room to plan, so the essay drifts. A five-minute plan fixes most of that.

If Writing is the only score missing, see what to do when Writing is the score holding you back, and check whether One Skill Retake is accepted for your route before you book.

Other English routes

The NMC and AHPRA also accept some nurses without a test, for example if you trained in English in certain countries, or have practised in a majority English-speaking country. These routes have detailed conditions, so read the NMC English language requirements or the AHPRA standard above before relying on one.

Requirements for Canada and the USA are set by different bodies and vary by province or state, so check the regulator where you plan to work.

Scores and combining rules checked on 7 October 2026 against nmc.org.uk and ahpra.gov.au. Regulators change these rules, so confirm with them before you book a test.