NMC OSCE Process
Understanding the OSCE Process
Time-limited and incredibly important for many reasons. If the OSCE is not passed within a certain time period, it can lead to potential issues with employer conditions of employment/sponsorship and can have devastating effects on nurses and their families if they are unsuccessful. It is important that we support people to pass the OSCE, with confidence and competence, ideally on the first attempt.
OSCE Training & Support
OSCE training & support shouldn’t be an afterthought. Without the OSCE/Test of Competence (ToC) pass, there is no NMC registration and no UK nursing career, it’s that simple. With NMC reporting that almost half of new registrants were Internationally Educated Nurses (IENs) in 2022-2023, insight is more important now than ever.
Without proper preparation and support, most nurses will find the process extremely stressful and confusing, resulting in costly re-sits and loss of clinical confidence, both of which take their toll and time to overcome. If a nurse has to re-sit the OSCE, organisational costs increase, such as additional training support, extended agency use, and worst-case scenario, repeated recruitment costs if the nurse doesn’t pass after 3 attempts.
Significant change in pass rates since changes introduced. For perspective, between October-December 2023, 52-63% of nurses (across 5 CTC’s) had to re-sit the OSCE at least once, and 17% overall didn’t pass, with their NMC application then closed.
Ulster NMC Competence Test Centre (Ulster CTC-Derry/Londonderry) OSCE exam booking support (for any of the 5 UK NMC Competence Test Centres) is provided free of charge as part of all our packages. We adhere to standard NMC ToC preparation guidelines, which are applicable across all 5 NMC CTCs. However, as we are a Northern Ireland-based company, the majority of our learners choose to sit their exam at NMC Competence Test Centre (CTC).
Please note: the expected competence, competence and range of skills for each nurse examined during NMC OSCE/Part 2 Test of Competence is standard across all 5 UK CTC’s, regardless of location. Therefore, our OSCE preparation, guidance, support and training is all provided as per NMC and UK practice guidelines, regardless of test location.
Please see Nursing and Midwifery Council (NMC)-Test of Competence/Joining the Register for more information on the 5 test centres across the UK.
Let's Compare Old versus New Style OSCE Requirements
- OLD-Legacy OSCE (pre-2021): 6 stations-APIE & 2 skills.
- Nurses were expected to prepare for and be confident and competent with a range of 11 APIEs (Assessment, planning, implementation & evaluation) and 10 potential skills.
- NEW-Adult Pt 2 Test of Competence (ToC)/OSCE 2021-2022 onwards: 10 stations-APIE, 4 skills (2 sets of 2, paired), 1 PV & 1 EBP.
- Nurses must prepare for and be competent and confident with a range of APIEs (currently 10 – correct as of Dec 2025), 20 potential clinical skills (written and practical) and a wide range of Professional Values (PV) and Evidence-based Practice (EBP) scenarios.
- Considerable increase in terms of skill, practice, preparation, and support required. This is largely due to the updated exam now aligning fully with current clinical practice guidelines. These changes were needed but have made the exam more complex to prepare for.
As with any new assessment system, updated knowledge, time, patience, and adjustment are needed. Factors affecting pass rates include support from employers, level of support/quality of test preparation, and sector-specific challenges. The OSCE cannot be treated like a ‘checklist’; nurses must read and respond according to the patient presented, not based on what they have practiced or assume.
It’s not as simple as memorising the marking criteria, going through the motions, and saying the right words. On the day, nurses, examined at the level of a newly qualified UK trained nurse, must communicate and respond appropriately. They must make safe, independent decisions, based on the patient presented, using evidence-based rationale and in keeping with current UK practice guidelines.
The examiner, a registered nurse, is not allowed to advise or assist and can only base the final decision on what they see/hear on the day. They cannot influence the nurse and must be as unbiased as possible, to maximise patient safety. This is why the exam has been redesigned and has historically always been recorded to allow for review and to rectify any indecision, concerns, or queries if borderline results are achieved. With three attempts allowed in total for each nurse, it is important to increase the chances of getting it right the first time.
