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.

The ToC is made up of two parts:

  • a computer-based multiple choice test (CBT) 
  • an observed structured clinical examination (OSCE) where candidates carry out practical tests.

The information below shows the number of people who have taken each part of the test and their pass rates.

We update this information four times per year.

Test of Competence 2014

CBT

The CBT is run by our partners Pearson VUE. Candidates can attend one of a number of test centres to take the test.

Between July and September 2021, a total of 6134 applicants took the legacy CBT and 97 percent achieved a pass. 

July - September 2021: CBT pass rates

This represents the total number of CBTs delivered including resits.

  July 2021 August 2021 September 2021 Quarter total

CBT sittings

6066

84

48

6198

Pass rate

97%

93%

83%

96%

OSCE

Applicants are able to sit the OSCE in the UK at one of our approved test centres. Between July and September, a total of 5471 applicants took the legacy OSCE and 92 percent achieved a pass.

Since reopening on 20 July 2020, we have been operating at a slightly reduced capacity to adhere to the social distancing procedures. This is to ensure the safety of both candidates and test centre staff.

July - September 2021: OSCE pass rates

The below table represents the total number of OSCEs delivered including resits.

  July 2021 August 2021 September 2021 Quarter total

Oxford Brookes University

OSCE sittings

907

765

1095

2767

Pass rate

65%

66%

65%

72%

University of Northampton

OSCE sittings

765

588

728

2081

Pass rate

78%

79%

82%

80%

Ulster University

OSCE sittings

532

705

646

1883

Pass rate

83%

84%

83%

83%

Total sittings 

OSCE sittings

2204

2058

2469

6731

Pass rate

74%

76%

75%

75%

Test of Competence 2021

TOC 2021 launched on 2 August 2021 for nurses and midwives only. Volumes and pass rates for ToC 2021 will apply for August and September only for this period.

CBT

Between August and September 2021, a total of 3919 applicants took the new CBT and 94 percent achieved a pass for Numeracy and 92 percent achieved a pass for Clinical. 

July - September 2021: CBT pass rates

This represents the total number of new CBTs delivered including resits.

  August 2021 September 2021 Quarter total
Part A: Numeracy

CBT sittings

1508

2582

4090

Pass rate

92%

89%

90%

Part B: Clinical 
CBT sittings 1484 2580 4064
Pass rate 89% 88% 88%

OSCE

Between August and September, less than 20 applicants sat the new OSCE. This is due to the fact that most applicants currently taking the OSCE are still eligible to continue with the legacy OSCE 2014 during our transition period (for more information on our transition period please visit our website). We expect to see an increase in applicants taking the new OSCE in the next few months and will start reporting on pass rates then.

Factors that influence pass rates

The test of competence gives us assurance that nurses and midwives coming to the UK are capable of working safely and effectively.

There are a number of factors that influence an applicant’s success rate, in particular for the OSCE, and we've been working with OSCE test centres and employers who support applicants through the OSCE process to better understand these.

The most important factor is test preparation and having access to good quality support. The vast majority of applicants are supported by an employer or recruitment agency and the level of support and quality of test preparation can vary greatly.

Also important, in particular for candidates who are new to the UK, is the amount of time candidates have to settle in and acclimatise themselves to the UK ahead of the examination.

The impact of pastoral care that is given to applicants during the settling in, preparation period and on the day of the OSCE should not be underestimated. This period can often be emotional and, at times, stressful due to the high levels of pressure and responsibility that many candidates face.

Over the last year, to help candidates prepare for their OSCE, test centres have released various support materials, including OSCE mock exams, marking criteria and top tips. These materials and other guidance documents can be found on their websites: