The Test of Competence has two parts. Part 1 is the CBT, a computer-based test delivered by Pearson VUE in most countries. Part 2 is the OSCE, a practical examination held only in the UK. Both must be passed, in either order. The CBT costs £83 and the OSCE £794 for a first sitting (£397 for a partial resit), per NMC pages checked on 25 October 2026. Most candidates sit the CBT first because it can be taken at home and because passing it lets them plan the UK trip with confidence. Registration must be completed within two years of eligibility being confirmed.
One test of competence, two parts
The NMC uses the Test of Competence to confirm that nurses and midwives trained outside the UK can practise safely to UK standards. The two parts test different things in different ways. The CBT checks knowledge and judgement on a screen: numeracy, UK law and professional standards, and clinical decision-making across the seven platforms of the Standards of proficiency. The OSCE checks whether you can perform and communicate in simulated practice.
Passing one does not replace the other. The NMC CBT page says the two can be taken in either order but both must be passed. The CBT can be taken in your home country at a Pearson VUE centre. The OSCE can only be taken in the UK.
Side-by-side comparison
| Feature | Part 1: CBT | Part 2: OSCE |
|---|---|---|
| Type | Computer-based test | Practical examination |
| Where | Pearson VUE test centres in most countries | The UK only |
| Content | Numeracy (15 questions) and clinical (100 four-option questions) | Practical skills and communication (see NMC for the current station format) |
| Time | 3 hours | Check the NMC OSCE page |
| Fee (checked 25 Oct 2026) | £83 for both parts | £794 first sitting, £397 partial resit |
| Attempts | Three per application, 10 days apart, within one year | Check the NMC OSCE page |
| Result | Report at the centre, breakdown within 48 hours | Check the NMC OSCE page |
We have verified the CBT rows against NMC pages. For the OSCE we confirm only what appears on the NMC costs page and the CBT page: that it is held in the UK, that it is the second part and the fees quoted. Rows marked "check the NMC OSCE page" are deliberately left to the regulator, because OSCE formats and booking rules can change and we have not verified them.
Which should you sit first?
The NMC allows either order. Most candidates choose the CBT first for practical reasons.
- Location. The CBT is available at a Pearson VUE centre near you, with no need to travel to the UK. The OSCE requires travel.
- Cost and risk. The CBT is cheaper. Passing it first reduces the chance of paying UK travel and accommodation only to find you still have a CBT to pass.
- Knowledge base. CBT preparation covers the Code, capacity, medicines and escalation. That material also supports OSCE performance, since OSCE scenarios apply the same standards.
- Time window. The registration clock is two years from eligibility being confirmed. A quick pass of the CBT leaves more room for the OSCE and its possible resit.
There are reasons to reverse the order, such as being in the UK already or having a job-related deadline that favours the practical test. Ask the NMC or your employer if you are unsure. The NMC pages we read do not state a validity period for a CBT pass, so check how long a pass remains usable before you leave a long gap.
What the CBT tests that the OSCE does not
The CBT samples a very wide range of knowledge in 115 questions. Part B maps to the seven platforms and two annexes in the blueprint, with Platform 1 (accountable professional) at 17 of 100 questions. It tests numeracy as a separate part with its own standard. It also tests recognition of correct practice in situations that would be hard to simulate in a practical exam, such as raising concerns, reporting incidents or escalating unsafe staffing.
The cognitive level matters. The NMC specification states that about 38% of Part B questions test remember and understand, 32% apply and analyse, and 30% evaluate and create. The CBT therefore rewards judgement on scenarios, not only recall of facts.
What the OSCE tests that the CBT does not
A practical examination can show whether you carry out a procedure safely and communicate clearly with a person. The CBT can ask what the next step should be; it cannot show that you can do it. That is why the OSCE exists and why a high CBT score does not remove the need to practise skills in a hands-on setting.
Annexe A (communication and relationship management skills) and Annexe B (nursing procedures) are each 7 of 100 questions in the CBT. The CBT tests whether you recognise the right approach. The OSCE tests whether you can do it. Treat the two annexes as shared ground: revise the same content, then practise it physically for the OSCE. See Annexe A and Annexe B.
Money and timing across both parts
The NMC costs page for overseas applicants lists these items: qualification evaluation £167, CBT £83, OSCE £794, and registration £182, with a page total of £1,226. It does not include travel, accommodation, visas or English language tests.
- Plan for the cheapest failure. A Part A resit is £50 and a Part B resit £70. An OSCE partial resit is £397. Failing early and cheaply is better than failing late and expensively.
- Count the registration window. Two years from eligibility being confirmed. Leave time for at least one resit of each part in your plan.
- Re-check prices each autumn. The NMC states its fees increase on 1 October.
- Keep your ATT and records. You need the Authorisation to Test to book the CBT.
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How to prepare for both without duplicating effort
The two parts overlap on standards and differ on format. A sensible plan separates what you read from what you rehearse.
- Shared knowledge. The Code, consent and capacity, safeguarding, infection prevention, medicines safety and NEWS2 matter in both.
- CBT-only work. Numeracy sets, typed-answer practice, reading speed and timed blocks.
- OSCE-only work. Hands-on practice, spoken communication and structured procedure steps.
- Order of effort. Finish the CBT plan, then switch to the OSCE with the knowledge already secured. See the study plan.
This site prepares you for the CBT question bank. It is not a replacement for OSCE practice, and it does not claim to be. Follow the NMC OSCE guidance for stations, marking and booking.
A sample sequence
This sequence is an illustration of how a candidate might order the steps, not NMC advice.
- Month 0. Apply to the NMC, receive the decision that a Test of Competence is required, and receive the ATT.
- Months 1 to 3. Prepare for and book the CBT in your home country. Start thinking about an OSCE preparation course or centre.
- Month 3 or 4. Sit the CBT. Receive the report at the centre and the breakdown within 48 hours.
- Months 4 to 8. Resit any failed CBT part, or move on to the OSCE booking and travel arrangements.
- Before the two-year point. Pass the OSCE, complete registration and pay the registration fee.
The timing of every step depends on your own dates, so check them with the NMC. The only fixed outer limit we verified is the two years from eligibility being confirmed.
Questions to settle with the NMC
- How long a CBT pass stays usable before you sit the OSCE.
- Where and how to book the OSCE, and what the current format is.
- How many OSCE attempts you have, and the rules on resits.
- Whether your own timeline fits inside the two-year registration window.
We list these as questions because the pages we read did not answer them for the OSCE. The NMC is the authority on every one.
Whichever order you choose, keep your evidence in one place: the ATT, your CBT report, the Pearson VUE breakdown and your NMC Online screenshots. You will need them if a date, fee or result is ever queried, and they make planning the second part far less stressful.
Frequently confused points
Is the CBT the same as the NCLEX? No. The NCLEX is a US licensing exam. The NMC CBT is UK-specific, is not adaptive, and tests UK law, the Code and UK clinical guidance. US habits such as different early warning scores or terminology can cost marks.
Does a CBT pass count as registration? No. After the CBT and the OSCE are passed, registration must still be completed, including the registration fee, within two years of eligibility being confirmed.
Do midwives take the same CBT? No. Midwifery has its own exam code (RM), and each nursing field has its own code. This hub covers adult nursing, code RNA.
For the CBT format and blueprint, return to the NMC CBT hub. For doctors, the equivalent regulator route is described in our PLAB 1 guide. MedPass Exams is independent of the NMC and Pearson VUE.
Frequently asked questions
Can I take the OSCE before the CBT?
Yes. The NMC CBT page says the two parts can be taken in either order, but both must be passed. Most candidates sit the CBT first because it is available at Pearson VUE centres in most countries and the OSCE is held only in the UK.
Where can I take the CBT and the OSCE?
The CBT is delivered by Pearson VUE at test centres in most countries, so you can sit it in your home country. The OSCE takes place in the UK.
How much do the two parts cost?
On 25 October 2026 the NMC pages listed £83 for the CBT (paid to Pearson VUE) and £794 for a first OSCE sitting, with £397 for a partial OSCE resit. The NMC says its fees rise each October, so check current amounts.
Does passing the CBT mean I am registered?
No. You must also pass the OSCE and complete registration, including the registration fee, within two years of eligibility being confirmed.
Is preparation for the CBT useful for the OSCE?
Yes for knowledge: the Code, consent, capacity, safeguarding, infection control and medicines safety. The OSCE also needs hands-on practice and spoken communication that a computer test cannot give.