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.

This guide is for candidates taking the current Test of Competence. We have separate information about the new Test of Competence launching in 2021.

Find out more about the Test of Competence 2021.

Who needs to take the ToC?

Applying for initial registration

If you trained outside the UK, or outside England for nursing associate applications, we may ask you to complete the Test of Competence.

You won't be required to take the Test of Competence if you hold a relevant European qualification, as new regulations passed by the UK Government following the UK's departure from the EU allow for certain general nursing and midwifery qualifications to be recognised.

We'll confirm if you need to take a Test of Competence after we evaluate 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 requirements.

What will I need to do?

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 nursing
  • children's nursing
  • learning disabilities nursing
  • mental health nursing
  • midwifery
  • nursing associate.

Each Test of Competence is split into two parts:

  • Part one is a multiple-choice computer based test known as the CBT.
  • Part two is a practical test known as the OSCE.

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