If you trained as a nurse outside the country where you plan to work, you will meet a confusing list of exam names. They are not alternatives to each other. Each has a different purpose, and the one you need depends on the country and the regulator.
This article gives a general overview. Requirements change, so always confirm with the official regulator or exam body before you register or pay.
NCLEX-RN and NCLEX-PN (United States)
The NCLEX is the licensing exam run by NCSBN. Candidates who wish to be licensed as a registered nurse take the NCLEX-RN, and those seeking practical or vocational nurse licensure take the NCLEX-PN. Each state board of nursing decides who is eligible to sit the exam, so the first step is to contact the board in the state where you want to work.
CGFNS Qualifying Exam (United States)
CGFNS is an organisation that helps evaluate the credentials of internationally educated nurses. Its Qualifying Exam tests nursing knowledge, and some routes to US immigration or licensure use it. Whether you need it depends on your visa route and the state you are applying to, so check with CGFNS and your state board.
IELTS (English language)
IELTS is an English language test, not a nursing exam. Many regulators require proof of English proficiency, and IELTS Academic is one of the accepted tests, often with minimum scores in each skill. The required scores differ by regulator, and some accept other tests such as OET. Nurse360 offers IELTS-focused preparation for nurses, using healthcare contexts.
NMC Computer Based Test (United Kingdom)
For nurses who want to register with the UK Nursing and Midwifery Council, the Test of Competence has two parts: a computer-based test (CBT) of theory and a practical Objective Structured Clinical Examination (OSCE). The CBT is the first stage. Check the NMC website for the current process, which has been updated in recent years.
OET (English language for healthcare)
The Occupational English Test assesses English in healthcare settings and is accepted by many regulators as an alternative to IELTS.
How to decide
- Choose your destination. Country first, then state or regulator.
- Read the regulator's requirements page. It lists the exams, English scores and documents needed, and in which order.
- Make a timeline. Language tests and credential evaluations can take weeks or months to arrange.
- Then plan your study. Prepare for the one exam you need next, not all of them at once.
Mistakes to avoid
- Paying an agent for a service you can arrange directly with the regulator.
- Booking an exam before confirming you are eligible.
- Relying on outdated forum posts. Rules change.
Once you know which exam is next, focus your practice on its blueprint. Nurse360 organises questions by exam type, so you can practise for the one you are preparing for and change later if your plans change.