The NMC Midwife Registration Pathway, Step by Step
Everything an internationally-educated midwife needs to understand about registering with the Nursing and Midwifery Council: the six stages of the Test of Competence, what each one involves, what it costs, and how the pieces fit together with your visa.
To register as a midwife in the UK you complete the NMC Test of Competence. You open an NMC account and check eligibility for the Midwife part of the register, evidence your English (usually IELTS Academic or OET), pass the midwifery computer-based test (CBT), submit and verify your qualifications, then pass the practical midwifery OSCE at a UK test centre β after which you pay the registration fee and receive your NMC PIN. Source: NMC (nmc.org.uk). Fees and rules current as of 2026-07; confirm on the NMC website.
The six stages
The pathway is the same for every internationally-educated midwife. Some stages overlap in practice, but the sequence below is how the NMC structures them.
- 1
Create an NMC account and check midwife eligibility
You begin by opening an account on the NMC online portal and completing an eligibility self-assessment. The NMC checks that your midwifery qualification and clinical experience map to the Midwife part of the UK register. You will need your qualification certificates, transcripts, and proof of registration as a midwife (or nurse-midwife) with the professional regulator in your country of training.
- 2
Provide evidence of English language competence
You must show the NMC that your English meets the required standard β normally an IELTS Academic or OET result, unless you qualify for an exemption (for example, a midwifery qualification that was taught and examined in English, or recent registration/practice in a majority English-speaking country). The exact accepted routes and scores are published by the NMC and are summarised on our English requirements page. The English requirement is the same for midwives as for nurses.
- 3
Pass the Computer Based Test (CBT) β Test of Competence Part 1
The CBT is the first part of the NMC Test of Competence. For midwives it is a midwifery-specific multiple-choice exam delivered at Pearson VUE test centres in many countries. It has a numeracy section and a clinical section based on the standards expected of a UK-registered midwife across the maternity continuum. You can sit the CBT from your home country before travelling to the UK.
- 4
Submit your registration application and supporting documents
You complete the full NMC application, upload your midwifery qualifications, and arrange for your training institution and regulator to verify your records and provide references. The NMC assesses your documents, identity, health and character declarations. This is the stage where most timelines vary, so keep your paperwork complete and responsive.
- 5
Pass the OSCE β Test of Competence Part 2
The Objective Structured Clinical Examination (OSCE) is taken in person at an approved test centre in the UK. For midwives it is set in maternity scenarios β antenatal, labour and birth, postnatal and newborn care β and assesses whether you can apply midwifery knowledge safely across assessment, planning, implementation and evaluation, plus practical clinical skills. Many internationally-educated midwives arrive in the UK on a role that supports OSCE preparation and sit the OSCE within their first weeks.
- 6
Pay the registration fee and receive your NMC PIN
Once every requirement is met, you pay the NMC annual registration fee and are entered on the Midwife part of the register. You receive an NMC PIN, which confirms you are a registered midwife in the UK and can practise. Registration is then renewed each year, with revalidation every three years.
Indicative costs
Budget for four main costs. These amounts are set by the NMC and its test providers and are revised over time β treat them as indicative and confirm the current figures before you pay.
| Cost | Indicative amount | Note |
|---|---|---|
| Eligibility / application | Β£140 | Paid when you apply to join the register from outside the UK. |
| CBT (Test of Competence Part 1) | Β£83 | Per attempt, paid to the test provider. |
| OSCE (Test of Competence Part 2) | Β£794 | Full OSCE fee; a lower fee applies if you only need to resit specific stations. |
| NMC registration fee | Β£153 | Annual fee to stay on the register once admitted. |
Source: NMC published fees (nmc.org.uk). Indicative as of 2026-07. Some employers offer to reimburse or cover certain costs as part of an international recruitment package β that is a matter between you and the employer, not Gera.
How long does it take?
There is no single answer β the pathway moves at the speed of your documents and test availability.
- English evidence and CBT can often be arranged within a few weeks to a couple of months, since both can be done from your home country.
- Document verification and the NMC application is the most variable stage; it depends on how quickly your training institution and regulator respond.
- The midwifery OSCE is taken after you arrive in the UK, commonly within the first several weeks of starting a role that supports your preparation.
Many midwives complete the whole pathway within a few months of starting, but timelines vary. The NMC does not guarantee a processing time.
How the visa fits in
NMC registration and immigration are separate but related.
NMC registration proves you meet UK professional standards; a visa gives you the right to work. Most overseas midwives come on the Health and Care Worker visa, a route within the Skilled Worker system. It requires a job offer from a UK employer that holds a sponsor licence, who issues you a Certificate of Sponsorship. The route has reduced visa fees and an exemption from the Immigration Health Surcharge. The rules β including salary thresholds and English requirements β are set by the Home Office and published on gov.uk. Gera does not sponsor visas or provide immigration advice.
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Frequently asked questions
What is the NMC Test of Competence for midwives?+
It is the two-part assessment the Nursing and Midwifery Council uses to check that an internationally-educated midwife meets UK standards. Part 1 is the midwifery computer-based test (CBT), which you can take in your home country. Part 2 is the midwifery OSCE, a practical exam taken in person at a UK test centre. You need to pass both, alongside evidencing your English and having your midwifery qualifications verified.
Can I take the CBT before I come to the UK?+
Yes. The CBT is delivered at Pearson VUE test centres in many countries, so most midwives sit it before travelling. The OSCE, by contrast, can only be taken in the UK, which is why it usually happens after you arrive and start a role that supports your preparation.
How much does NMC midwife registration cost?+
Costs include the application fee, the CBT, the OSCE, and the annual registration fee once you are admitted. The Test of Competence fees are the same for nurses and midwives. All amounts are set by the NMC and change over time; this page lists indicative figures, but you should always check the current fees on the NMC website before you budget.
What happens if I fail the CBT or OSCE?+
You can resit. There are limits on the number of attempts within a set period and a resit fee applies (the OSCE resit fee is lower if you only need to repeat specific stations). If you exhaust your attempts, the NMC sets out when and how you can reapply. The current rules on attempts and timeframes are published by the NMC.
Do I need a job offer before I start the NMC process?+
No β you can begin the NMC pathway (account, English evidence, CBT) independently. However, to work in the UK you will also need the right to work, which for most overseas midwives means a Health and Care Worker visa sponsored by a UK employer. Many midwives line up a sponsored role that supports their OSCE, but you apply for any job directly and on your own account.
Is Gera involved in the NMC process?+
No. The NMC assesses and registers midwives; Gera is not part of that process, is not a recruitment agency, and does not charge midwives anything. This page is free information to help you understand and plan the pathway. Always rely on the NMC as the authoritative source.
Next steps
Work through the parts of the pathway in whatever order suits you.
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Important β please read
This is general information to help internationally-educated midwives understand the UK registration pathway. It is not recruitment, immigration or legal advice. Gera is not a recruitment agency: we do not place midwives into NHS jobs, do not match candidates to specific vacancies, and never charge a midwife a placement fee. You apply on your own account, directly to NHS trusts and other licensed employers. Requirements, fees and pay scales change β always confirm the current position with the NMC (nmc.org.uk), UK Visas and Immigration (gov.uk) and NHS Employers (nhsemployers.org).