You sat OET, and your Listening, Reading and Speaking are exactly where the NMC wants them. Writing came in just under. So you book IELTS next, thinking you can add that one strong score to your OET results and submit both. It feels logical. It also isn’t how NMC score combining works.
Quick answer: No, the NMC does not allow you to combine an OET result with an IELTS result. You can only combine scores across two sittings of the same test: two IELTS sittings, or two OET sittings. If your Listening, Reading, Writing and Speaking scores are split across OET and IELTS, only the scores from whichever test you sit twice can count toward your application.
That single rule trips up more candidates than almost any other part of NMC’s English language requirements and it’s exactly what this guide unpacks: how genuine score combining works, what the required scores actually are, and what to do if your scores are currently split across two different tests.
Can You Combine OET and IELTS Scores for NMC Registration?
The short version: not with each other. The NMC’s own guidance is explicit that you can combine tests of the same type for example, two IELTS tests or two OET tests but you cannot combine an IELTS test with an OET test.
It’s an understandable mix-up. Both tests assess the same four domains (listening, reading, writing, speaking), both are accepted by the NMC, and plenty of forum threads and outdated blog posts talk about “combining scores” without specifying which test they mean. But from the NMC’s perspective, OET and IELTS are two separate, non-interchangeable forms of evidence. If your first sitting was OET, your second sitting — the one you’re hoping to combine with it also needs to be OET. The same applies in reverse for IELTS.
Understanding the NMC English Language Requirements
Before you can register as a nurse or midwife with the NMC, you need to prove you can communicate safely and accurately in English with patients, colleagues, and in clinical documentation. This isn’t a formality; miscommunication in a clinical setting has real consequences, which is why the requirement is strict and specific.
The NMC currently accepts exactly two tests as evidence:
- IELTS Academic (not IELTS General, IELTS Indicator, IELTS Online, or the One Skill Retake option none of these are accepted)
- OET (on Paper, on Computer, or OET@Home, all Nursing profession-stream)
If you’re deciding between the two for the first time, our OET training programme page breaks down what each test actually involves. If you’ve already sat one test and are wondering about your next step, keep reading the combining rules below apply regardless of which test you started with.
How Does Combining OET and IELTS Scores Work?
Combining only works within one test type, and it isn’t as simple as “get one good score in each domain from anywhere.” To combine two sittings of IELTS, or two sittings of OET, you must:
- Sit both tests within 12 months of each other, and both must be dated no more than two years before the NMC assesses your complete application.
- Be tested in all four domains at each sitting. You cannot retake a single domain on its own — every sitting covers listening, reading, writing, and speaking together.
- Reach the full required score in each domain at least once across the two sittings — it doesn’t need to be the same sitting for every domain.
- Keep every other score, in both sittings, above a set minimum floor. This is the part people most often miss: even the domains you’re not relying on can’t fall too far below the pass mark, or the combination is rejected outright.
That fourth condition is why a nurse can’t simply average a strong sitting against a weak one. A very low score in one domain, even if another domain compensates elsewhere, can invalidate the whole combination.
Required IELTS and OET Scores for NMC Registration
| Domain | IELTS Academic (single sitting) | OET (single sitting) |
|---|---|---|
| Listening | 7.0 | Grade B (350–440) |
| Reading | 7.0 | Grade B (350–440) |
| Writing | 6.5 | Grade C+ (300–340) |
| Speaking | 7.0 | Grade B (350–440) |
Minimum floor when combining two sittings of the same test (every score, in both sittings, must sit at or above this line):
| Domain | IELTS floor | OET floor |
|---|---|---|
| Listening | 6.5 | Grade C+ (300–340) |
| Reading | 6.5 | Grade C+ (300–340) |
| Speaking | 6.5 | Grade C+ (300–340) |
| Writing | 6.0 | Grade C (250–290) |
Test scores are valid for two years from the date of the test, not the date the certificate was issued.
Important Rules When Combining OET and IELTS Results
- No cross-test combining, ever. Two IELTS sittings or two OET sittings only.
- 12-month window between sittings. Sit them further apart than that and neither can be used in combination.
- All four domains, every sitting. Booking a single-skill retest (where the format allows it) doesn’t count toward combining.
- The floor applies to every score, not just the ones you’re relying on. A high Reading score doesn’t rescue a Listening score that falls beneath the minimum.
- Two years’ validity at the point of a complete application, not at the point you submit initial paperwork. If your NMC application review is delayed, older scores can expire mid-process.
- You need one qualifying score per domain across the two sittings but you cannot mix which domain came from where if that means using different test types.
None of this is arbitrary; it’s designed to stop combining being used to paper over a genuine, consistent weakness in one skill area, while still giving a fair second chance for an off day.
Example Scenarios
Scenario 1: Passed OET in three sub-tests, missed Writing A nurse scores B in Listening, Reading, and Speaking on their first OET sitting, but only a C (below C+) in Writing. If they resit OET and score at least C+ in Writing the second time — with every other domain in both sittings still at or above C+ (or C for writing) — the combination is valid. Resitting IELTS instead would not help, however strong the IELTS Writing score is.
Scenario 2: Strong IELTS overall, one lower component A nurse scores 7.5 in Reading, Listening, and Speaking on IELTS but 6.0 in Writing just under the 6.5 required. Sitting OET to “cover” the Writing gap will not work for combining purposes, because the two tests can’t be paired. Their only route through combining is a second IELTS sitting.
Scenario 3: Results taken too far apart A nurse sits IELTS in January, doesn’t reach the required score, and resits IELTS 14 months later with a strong result. Because the two sittings are outside the 12-month window, they can’t be combined — the nurse would need a further sitting within 12 months of one of the two to create a valid pair.
Scenario 4: Assuming any combination is automatically accepted A nurse has scores from one OET and one IELTS sitting, both individually close to the pass mark, and assumes the “best of both” will be accepted. It won’t. This is the most common misunderstanding covered in this guide the NMC will only assess the two sittings of the same test as a combined pair.
Common Mistakes Nurses Make When Using OET and IELTS for NMC Registration
- Assuming OET and IELTS scores can be mixed together. They can’t — this is the single most common and most costly misunderstanding.
- Relying on outdated blog posts or forum advice. NMC rules around combining have changed more than once in recent years; always check the current guidance before booking a resit.
- Ignoring the two-year validity window, especially when an NMC application review takes longer than expected.
- Booking a resit before checking which domain actually needs improving, and in which test.
- Confusing NMC registration requirements with visa or immigration language requirements — these are assessed separately and don’t always accept the same evidence.
- Trusting informal social media groups over the NMC’s own published guidance for anything score- or rule-specific.
Should You Take OET or IELTS for NMC Registration?
Neither test is universally “easier” the better fit depends on you, not on the exam.
OET uses healthcare-specific material: referral letters, clinical case notes, and patient role-plays. Nurses who find it easier to engage with workplace-relevant content, rather than general-interest academic topics, often prefer this format.
IELTS Academic covers general academic and everyday topics rather than clinical scenarios. Nurses with strong general English from academic study, or who’ve prepared for IELTS before for another purpose, sometimes find it more familiar territory.
Worth weighing before you commit to (or recommit to) either test:
- Which format matches how you already read and write day to day
- Whether you’ve sat either test before and know your natural strengths
- Cost OET is generally the pricier of the two
- Test centre and date availability in your location
If you’re still deciding, our OET training programme is built specifically around the clinical communication skills the test assesses, which can be a useful data point when you’re weighing which exam plays to your strengths.
How Medax Group Can Support Your NMC Journey
Sorting out English language evidence is one stage of a longer process. Medax Group works with internationally trained nurses through the full NMC registration journey:
- OET training structured preparation across all four OET domains, with mock exams and feedback aimed at reaching a first-attempt Grade B.
- CBT preparation for the Computer-Based Test stage that follows your English language evidence.
- OSCE preparation across nursing specialties Adult, Mental Health, Midwifery, Nursing Associate, and Paediatric pathways.
- Guidance through the wider NMC registration process a full walkthrough of the stages after your English test is sorted.
If you’ve already sat OET and are working out your Writing score specifically, our guide on scoring Grade B in OET goes into the preparation side in more depth.
Key Takeaways
- OET and IELTS scores cannot be combined with each other under NMC rules.
- You can only combine two sittings of the same test two IELTS or two OET.
- Combining requires both sittings within 12 months, all four domains tested each time, and every score above a set minimum floor.
- If you narrowly miss the required score in just one domain after exhausting combining options, Supporting Information from Employers (SIFE) may be an option, depending on your circumstances.
- Requirements can and do change always confirm your specific situation against current NMC guidance before booking a resit.
Frequently Asked Questions
Can I combine OET and IELTS for NMC registration?
No. The NMC only allows combining across two sittings of the same test — two IELTS sittings or two OET sittings, never one of each.
What is the minimum OET score for NMC?
At least Grade B (350–440) in Listening, Reading, and Speaking, and at least Grade C+ (300–340) in Writing, in a single sitting.
What IELTS score does the NMC require?
At least 7.0 in Listening, Reading, and Speaking, and at least 6.5 in Writing, in a single sitting.
Can I use different test results for different skills for example, OET Writing and IELTS Speaking?
No. Each domain must come from a valid sitting of the same test type used across your combination; you cannot mix domains from OET and IELTS.
How long are IELTS and OET results valid for NMC purposes?
Two years from your test date, calculated at the point the NMC assesses your complete application — not the date you first submit documents.
Can I combine scores from more than two attempts?
NMC’s published combining rules are based on two sittings of the same test. If you’ve sat a test more than twice, check your specific situation directly with the NMC or via the official test combining calculator.
Is OET easier than IELTS for nurses?
Not universally OET’s healthcare-specific content suits some candidates better, while others do better with IELTS Academic’s general format. It comes down to your own strengths, not a fixed difficulty ranking.
What should I do if I miss the required score in just one component?
First, check whether a same-test resit within 12 months would let you combine scores. If you’ve already exhausted that route and are still short in exactly one domain, you may be able to explore the SIFE pathway with your current UK employer, depending on eligibility.
A Final Note on Accuracy
NMC requirements are reviewed and updated periodically. The figures and rules in this guide reflect current published NMC guidance at the time of writing, but you should always verify your specific circumstances against the NMC’s official English language requirements pages before booking a test or submitting your application.
If you’d like structured support getting your OET score where it needs to be, you can get in touch with Medax Group’s team for a free consultation on your next steps.
