The steps American nurses must take to get a license in the UK

As nurses we know that wherever you practice, you have to have a license.  

Taking that ridiculously high paying travel contract in California?  

Gotta get a California Nursing License.  

Moving to New York?  

Gotta get a New York Nursing License. 

The same concept applies when moving to the UK. You must register with the relevant body and in this case it’s the Nursing and Midwifery Council, often just referred to as the NMC. 

This post is intended to give you a concise overview of the process without getting bogged down with too much detail – because believe me, I could talk about this for hours. Don’t fret, though, I run an online course called Nurse Your Way to the UK which is specially designed to help internationally educucated nurses navigate the process of getting licensed and finding a job in the UK.

Without further ado, here are the 6 steps that American nurses (and many other international nurses) need to take to get a UK License. 

Choose your field of nursing 

You have to choose your field of nursing?! For some of you this may be a shocker. In the UK, there are 4 separate registers – 4 seperate degrees of nursing. Before you begin your nursing license application with the NMC you must choose which field of nursing you want to register for: adult, children, mental health, learning disability. If you are a midwife, don’t fret, this post still applies to you. At this point, however, you’ll want to choose to apply to the midwifery register.  

Once you know which register you’d like to join, you can begin your application. Congratulations! This will be the longest, most frustrating, and most worthwhile processes you’ve ever gone through. On average it takes about a year from start to finish. 

You may also be interested in:
The 4 fields of nursing in the UK: what you need to know as an overseas nurse

Start your application 

The application you have to submit to the NMC is called the Eligibility and Qualification Application and the fee is £140.

In this step they are just checking your identity and eligibility based on your ID documents, degree/diploma, and information about your registration/license from your Board of Nursing.

Once you receive confirmation of your eligibility you have 2 years complete your registration with the NMC. If you miss this deadline, you have to start the application process all over again. So mark it in your calendar, and give yourself a little buffer.

This link will take you to the page on the NMC website which is dedicated to international nurses who wish to register in the UK: Joining the register for those trained outside the UK.

NMC email invitation

Once you have been through the eligibility phase of the application, the NMC will send you an email invitation to take the CBT and OSCE. The next section of your application will open and they will also ask you to start gathering supporting documents as well. You can schedule, study for or take your CBT & OSCE while you gather the necessary evidence.

Taking the CBT 

As mentioned earlier, as long as you’ve received the email from the NMC inviting you to take the CBT, you can take it whilst you are gathering evidence. The CBT is a computer-based test which you can take at your local testing centre.  I took mine at the local Ivy Tech. Just to make a difficult process even harder, it sometimes goes by another name: the NMC Test of Competence Part 1.

It is divided into 2 parts. The first is drug calculations and the second is multiple choice questions about nursing practice. It was stressful at the time, but in spite of taking it just days after major knee surgery, I passed. And I found out almost immediately after the test which was a huge relief. 

-> Interested in knowing more about the CBT? Read ‘the complete guide to the CBT‘

Further evidence an verifications

After you have passed the CBT, you can focus gathering all the evidence and planning for the verifications that you’ll need to get from other people. It will take a while and it will test your patience.

At this stage you must be aware of the length of validity of each of your verifications. If you get them too soon, they will expire before your application is assessed which will cause you a massive headache.

The emails from the NMC to your verifiers will be sent automatically once you pay the £153 registration fee.

Once you do that, you will be at the center of a whirlwind of communication that you hope is happening around you, and you will get very little feedback. The trouble is, wires get crossed and sometimes things you think are being completed simply aren’t.  

Be sure you speak to everyone who needs to fill out documents for you and be sure that you contact the NMC as soon as you think something is being forgotten. Sometimes emails don’t get sent… or read.

The evidence & verifications will support your health and ability to work, your character (including an exciting FBI background check), and that you speak English (a language test may be required). It sounds simple, but it takes a lot of cross-cultural communication over thousands of miles and a few time zones.  

This process of getting registered from start to finish often takes an entire year. The fastest I’ve ever heard it going is 3 months and I reckon one reason is because they were a new graduate and didn’t need to get anything from any boards of nursing. 

Take the OSCE 

The objective structured clinical examination is a simulation-based exam which can only be taken at a handful of locations in the UK. It, too, has another name: NMC Test of Competence Part 2. For me, it was the most stressful step of them all! Have I said that at each along the way?

For 2 weeks before I took the OSCE I had to stop drinking coffee because my anxiety was getting out of control. If you know me, you know I love coffee. I still don’t know exactly how I managed without it. Perhaps that is when my relationship with British tea truly began. 

There’s so much to say about the OSCE – too much for this little post. The OSCE experience is not one to take lightly. It is the most stressful exam I’ve ever taken and it has so much riding on it. Nothing within the exam is technically difficult, but the pressure is immense. All I can say is have a strategy and practice until you’re reciting the marking criteria in your sleep.

As a clinical educator, I’ve taught many a session on the OSCE and though I don’t run an OSCE prep programme, it is one of the topics we cover in Nurse Your Way to the UK. As a student, you even receive a self study checklist to help organize and track your studying.

Application Assessment

Once you have passed your OSCE, the last step is assessing your application. The NMC’s decision should come within 35 days after you get your OSCE results. If there are any issues with your documents and verifications at this point it can cause MASSIVE delays because the NMC will take 35 days to assess any new documentation and they will take 35 days to respond to any queries. You can see how the months just roll right on by if multiple things need to be addressed.

Once your application has been approved you will soon receive your registration number, also known as your NMC PIN! 

Congratulations! 

Now that the process is no longer a mystery, you can tackle it.

One step at a time… 

… and perhaps with the help of a few bottles of wine.

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If you would like to tap into the tips, tricks and guidance that Nurse Your Way to the UK offers, join the waitlist to be the first to know when enrollment opens!

A helpful link for looking a bit deeper into the process and the reference for this post: 
Joining the register for those trained outside the UK

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