<p>The United Kingdom (UK) currently has <a rel="noreferrer noopener" href="https://www.bbc.com/news/health-54844786" target="_blank">90</a><a href="https://www.walesonline.co.uk/news/uk-news/nhs-90000-vacant-posts-need-20431363" target="_blank" rel="noreferrer noopener">,000 registered nursing vacancies</a>, and they’re looking towards hiring overseas workers to help fill the gap. If you are interested in <a rel="noreferrer noopener" href="https://www.trueprofile.io/member/resources/how-to-work-in-the-uk-as-an-overseas-nurse" target="_blank">working in the UK as an overseas nurse or midwife</a>, one of the processes you may need to undertake is an evaluation of your professional nursing or midwifery skills, knowledge and attitude. The <a rel="noreferrer noopener" href="https://www.nmc.org.uk/registration/joining-the-register/toc/toc-2014/" target="_blank">Nursing and Midwifery Council</a> (NMC), the nursing and midwifery regulator for the United Kingdom, refers to this as the NMC Test of Competence (ToC). </p>
<h2>Who needs to take the NMC Test of Competence (ToC)?</h2>
<p>For nurses, nursing associates, and midwives who trained outside the UK, you will need to take the Test of Competence. Once you submit your application, the NMC will first evaluate your qualifications and then confirm if you need to take the exams. Healthcare professionals who hold a <a href="https://www.nmc.org.uk/globalassets/sitedocuments/registration/eu-directive-annex-5---list-of-qualifications.pdf" target="_blank" rel="noreferrer noopener">relevant qualification</a> from an EU Member state are exempt from the ToC exam. Healthcare workers who are already in the UK but do not have the relevant qualifications, including those already practicing on the <a href="https://www.nmc.org.uk/news/coronavirus/temporary-registration/#overseas" target="_blank" rel="noreferrer noopener">COVID-19 temporary register</a>, still need to sit the second element of the ToC, the OSCE.</p>
<h2>The NMC Test of Competence</h2>
<figure class="wp-block-image size-large"><img decoding="async" loading="lazy" width="1000" height="469" src="https://production-prod-trueprofile-blogassets-origin.s3.ap-southeast-1.amazonaws.com/uploads/2021/06/shutterstock_1687367284-1.jpg" alt="NMC Test of Competence UK Nurse" class="wp-image-11661" title="NMC Test of Competence UK Nurse" srcset="https://production-prod-trueprofile-blogassets-origin.s3.ap-southeast-1.amazonaws.com/uploads/2021/06/shutterstock_1687367284-1.jpg 1000w, https://production-prod-trueprofile-blogassets-origin.s3.ap-southeast-1.amazonaws.com/uploads/2021/06/shutterstock_1687367284-1-300x141.jpg 300w, https://production-prod-trueprofile-blogassets-origin.s3.ap-southeast-1.amazonaws.com/uploads/2021/06/shutterstock_1687367284-1-768x360.jpg 768w" sizes="(max-width: 1000px) 100vw, 1000px" /></figure>
<h4>*Beginning August 2021, there will be changes to the Test of Competence. Please refer to <a href="https://www.nmc.org.uk/registration/joining-the-register/toc/toc-review/" target="_blank" rel="noreferrer noopener">this page from the NMC</a> for more details.</h4>
<p>The NMC Test of Competence is divided into two parts. The first part of the ToC is the Computer Based Test (<a href="https://www.nmc.org.uk/registration/joining-the-register/toc/toc-2014/cbt/" target="_blank" rel="noreferrer noopener">CBT</a>) which can be undertaken under formal standardized examination conditions at various Pearson Vue test centers. The second part of the ToC is the Objective Structured Clinical Examination (<a href="https://www.nmc.org.uk/registration/joining-the-register/toc/toc-2014/osce/" target="_blank" rel="noreferrer noopener">OSCE</a>) which is a practical test that can be taken at three test centers across the UK. While the NMC states that you can take the CBT or OSCE in any order, the <a href="https://www.brookes.ac.uk/nmc-test-of-competence/" target="_blank" rel="noreferrer noopener">Oxford Brookes University</a> test centers require you to complete Part 1 (CBT) of the ToC first. If you’re an overseas nurse, it makes sense to take and pass the CBT in your home country before paying for a flight to the UK to take the OSCE. Once you pass both parts of the ToC, you can continue with your application for initial registration or readmission.</p>
<p>Traveling to take the OSCE test is considered essential travel, and all three of these UK test centers continue to operate with <a href="https://www.nmc.org.uk/news/coronavirus/test-of-competence/osce/" target="_blank" rel="noreferrer noopener">COVID-19</a> security measures in place.</p>
<h2>Part 1: Computer Based Test (CBT)</h2>
<p><a href="https://home.pearsonvue.com/nmc" target="_blank" rel="noreferrer noopener">Pearson Vue</a> is the agency responsible for conducting the subject-oriented CBT on behalf of the NMC. If this is your first registration with the NMC, you can book your CBT and pay directly with Pearson Vue. If you are taking the test for readmission, you can book the ToC via your <a href="https://www.nmc.org.uk/registration/nmc-online/" target="_blank" rel="noreferrer noopener">NMC online account</a>.</p>
<h2>The Structure of the Nursing CBT</h2>
<p>You need to take the CBT for the professional field of practice for which you seek UK registration. For example, if you want to register for Adult Nursing, you need to take the Adult Nursing CBT. </p>
<p>The nursing CBT is made up of 120 multiple choice questions:</p>
<ul><li>50 questions relate to generic nursing competencies</li><li>50 questions relate to the application of generic nursing competencies</li><li>20 questions focus on specific competencies required for the field of nursing you’re applying for </li></ul>
<p></p>
<p>The midwifery CBT consists of 120 questions; </p>
<ul><li>60 questions focus on general theoretical and technical instruction</li><li>60 questions assess subjects specific to midwife activity </li></ul>
<p></p>
<p>A short video tutorial about the CBT exam rules will be shown to you before the start of the examinations. Make sure you arrive at the test center with plenty of time to orient yourself.</p>
<figure class="wp-block-image size-large"><img decoding="async" loading="lazy" width="1000" height="667" src="https://production-prod-trueprofile-blogassets-origin.s3.ap-southeast-1.amazonaws.com/uploads/2021/06/shutterstock_1664631550-1.jpg" alt="NMC Test of Competence UK Nurse" class="wp-image-11663" title="NMC Test of Competence UK Nurse" srcset="https://production-prod-trueprofile-blogassets-origin.s3.ap-southeast-1.amazonaws.com/uploads/2021/06/shutterstock_1664631550-1.jpg 1000w, https://production-prod-trueprofile-blogassets-origin.s3.ap-southeast-1.amazonaws.com/uploads/2021/06/shutterstock_1664631550-1-300x200.jpg 300w, https://production-prod-trueprofile-blogassets-origin.s3.ap-southeast-1.amazonaws.com/uploads/2021/06/shutterstock_1664631550-1-768x512.jpg 768w" sizes="(max-width: 1000px) 100vw, 1000px" /></figure>
<h2>Pearson Vue Test Centers</h2>
<p>There are several Pearson Vue test centers worldwide, and there are country-specific requirements for those who want to take the exam. You can look up your own country’s health and safety requirements directly from the Pearson Vue <a href="https://home.pearsonvue.com/coronavirus-update#country-specific" target="_blank" rel="noreferrer noopener">website</a>. </p>
<p>Once you arrive at the test site, you will need to present the same passport used when registering with the NMC. If you were issued a new passport, you need to <a href="https://www.nmc.org.uk/contact-us/phone-numbers-and-email-addresses/overseas-registration/" target="_blank" rel="noreferrer noopener">contact NMC</a> to update your information. However, if your examination date is near (within 7 days), you need to call NMC at this number: (UK country code +44) 020 7333 6600.</p>
<h2>CBT Results</h2>
<p>The results of your test will be updated on your Pearson Vue account 48 hours after your examination. You can retake the test (if it does not pass the NMC standards) a maximum of three times, after which you need to file a new application for registration with the NMC. Times in between takes should have a buffer period of ten days between examination dates. If you are unsuccessful after three permitted attempts, your application will close. You’ll be required to submit a new application and will not be able to sit the CBT again for a minimum of six months.</p>
<h2>Passing Rates</h2>
<p>The current overall pass rates for the nursing domains are:</p>
<ul><li>Adult Nursing – 68%</li><li>Mental Health Nursing – 72%</li><li>Learning and Disability Nursing – 71%</li><li>Children’s Nursing – 71%</li><li>Midwifery – 63%</li></ul>
<p></p>
<h2>Part 2: Objective Structured Clinical Examination (OSCE)</h2>
<p>The OSCE is an exam that tests clinical skill performance and competence in health sciences such as midwifery, nursing and physician assistants. The exam assesses understanding of the medical decision-making process. Aside from that, it also tests for improved decision-making based on evidence-based practice for real-world responsibilities. </p>
<h2>Test Centers</h2>
<p>As with the CBT, you can book your OSCE directly with the test centers, or if you are applying for readmission, you can book it via your online NMC account. NMC has three official test centers in the United Kingdom. They are the <a href="https://www.brookes.ac.uk/nmc-test-of-competence/" target="_blank" rel="noreferrer noopener">Oxford Brookes University</a>, the <a href="https://www.northampton.ac.uk/about-us/services-and-facilities/nmc-test-of-competence/" target="_blank" rel="noreferrer noopener">University of Northampton</a>, and <a href="https://www.ulster.ac.uk/nmc-competence-test-centre" target="_blank" rel="noreferrer noopener">Ulster University</a>. </p>
<p>Those applying for nurse associate registration need to take their OSCE with the University of Northampton. For information on what to expect during the OSCE, you can get a candidate information booklet from the test center where you will be taking the practical exam. You can also download mock scenarios and other resources. Please refer to the additional resources link at the end of this article.</p>
<h2>The Day of the Test</h2>
<p>You will be asked to provide your passport as proof of identity. This should be the same passport used to register with NMC. Your picture will also be taken by a test center representative and used as your onsite ID. The new OSCE has 10 stations. The first four stations will be for the assessment, planning, implementation and evaluation based around a scenario. Four OSCE stations will test your practical clinical skills (two pairs of two skills). The last two stations will assess the candidate’s values and behaviours and evidence-based practice.</p>
<h2>OSCE Results</h2>
<p>The results for the OSCE will be sent to you by email within 5 working days of your examination date. As with the CBT, you can retake the OSCE a maximum of three times, with 10 days in between retakes. You only need to retake the stations that you did not pass.</p>
<h3>Additional Resources:</h3>
<p><a href="https://www.nmc.org.uk/standards/code/" target="_blank" rel="noreferrer noopener">The NMC Code</a></p>
<p><a href="https://www.nmc.org.uk/registration/joining-the-register/toc/toc-2014/test-blueprints/" target="_blank" rel="noreferrer noopener">NMC Test blueprints</a></p>
<p><a href="https://www.nmc.org.uk/globalassets/sitedocuments/registration/candidate-information-guide-toc-part-1-pearson-vue.pdf" target="_blank" rel="noreferrer noopener">CBT Information Booklet</a></p>
<p><a href="https://www.ulster.ac.uk/__data/assets/pdf_file/0007/416563/Reading-Lists-V1.4.pdf" target="_blank" rel="noreferrer noopener">Reading Lists for taking the ToC</a></p>
<p><a href="https://www.nmc.org.uk/registration/joining-the-register/toc/toc-review/resources/" target="_blank" rel="noreferrer noopener">2021 Test Resources</a></p>
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