We use the Test of Competence (ToC) to assess the skills and knowledge of people applying to join our register from overseas or rejoin our register after a long period away from practice.

Who needs to take the Test of Competence?

Applying for initial registration

New regulations passed by the UK Government following the UK's departure from the EU allow for certain EU general nursing and midwifery qualifications to be recognised up until the end of 2022.

If you have a relevant European qualification that meets the requirements for automatic recognition, we’ll recognise your qualification and you won’t need to take the Test of Competence.

This applies even if you are not an EU national, but you have a relevant European qualification.

Check if your qualification is on the list of European qualifications that meet the requirements for automatic recognition.

If you do not hold a relevant European qualification, you will need to take a Test of Competence as we cannot recognise your qualification.

Applying for readmission

If you don’t have enough practice hours for readmission to the register, you can either complete an approved return to practice programme or take a Test of Competence to meet the practice hours requirement.

What does it involve?

Each Test of Competence is split into two parts:

  • A multiple-choice computer based test known as the CBT.
  • A practical test known as the OSCE.

You will need to take a test that's specific to the part of the register you're applying to join or rejoin. These are:

  • adult nurse (RNA)
  • mental health nurse (RNMH)
  • learning disabilities nurse (RNLD)
  • children’s nurse (RNC)
  • midwife (RM)
  • nursing associate (NAR)

How long is it valid for?

You must pass the CBT and OSCE within two years of each other. 

You can sit your CBT or OSCE in any order, but you need to complete both parts to continue with your application for initial registration or readmission.

Once you have successfully passed both the CBT and OSCE, your ToC will remain valid for five years.

Test of Competence review

Since 2019, we've been working in partnership with AlphaPlus to develop a new test that reflects our new standards for nurses and midwives.

We launched the new version of the test for nurses and midwives on 2 August 2021. This is known as the Test of Competence 2021. 

Learn more about the review and read our transition information to check which version of the test you need to take.