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Pathway guide

Nurse vs Midwife: How the NMC Routes Differ

Nurses and midwives both register with the NMC, and the process looks similar on the surface β€” but they are separate professions on separate parts of the register. If you trained as a midwife, here is exactly what differs from the nurse route, so you follow the right pathway from the start.

Nurses and midwives both register with the NMC via the Test of Competence, but they are distinct parts of the register. The English requirement and the two-part CBT-plus-OSCE structure are the same. The differences are that midwives join the Midwife part of the register, the NMC assesses a midwifery qualification, and the CBT and OSCE are midwifery-specific β€” the OSCE is set in maternity scenarios rather than general nursing situations. Source: NMC (nmc.org.uk). Information as of 2026-07.

Side-by-side comparison

The core structure is shared; the profession-specific detail is where the two routes diverge.

AspectNurse routeMidwife route
Part of the registerYou join the Nurse part of the NMC register (for example, Registered Nurse β€” Adult).You join the Midwife part of the NMC register. Your NMC PIN confirms you are a registered midwife.
Qualification assessedThe NMC assesses your nursing qualification and nursing registration.The NMC assesses your midwifery qualification specifically. In some countries midwifery is a direct-entry degree; in others you qualify as a nurse-midwife. Either can register as a midwife if the midwifery content meets NMC standards.
CBT content (Part 1)The computer-based test is set to the standards expected of a UK-registered nurse.The computer-based test is midwifery-specific, set to the standards expected of a UK-registered midwife across the maternity continuum.
OSCE content (Part 2)Scenarios use general nursing situations built around the nursing process (APIE) plus nursing skills stations.Scenarios are set in maternity care β€” antenatal, labour and birth, postnatal and newborn β€” with midwifery skills stations such as immediate care of the newborn.
Scope of practiceCare of patients across a chosen field (adult, child, mental health, learning disability).Care of women and birthing people and their newborns across pregnancy, labour, birth and the postnatal period.
English requirementIELTS Academic or OET, or an exemption route β€” set by the NMC.Identical requirement: IELTS Academic or OET, or an exemption route β€” set by the NMC.
Typical NHS entry payNewly registered nurses normally start on Agenda for Change Band 5.Newly registered midwives typically start on Band 5 during preceptorship and progress to Band 6; many midwifery posts are Band 6.

Source: NMC (nmc.org.uk) and NHS Employers (nhsemployers.org). The NMC is the authoritative source on which part of the register your qualifications map to β€” confirm your specific position with them.

What the two routes share

Plenty is common to both β€” which is why the nurse guidance is a useful companion.

  • The same regulator β€” the Nursing and Midwifery Council registers both professions.
  • The same two-part Test of Competence β€” a computer-based test you can sit abroad, then a practical OSCE taken in the UK.
  • The same English requirement β€” IELTS Academic or OET, or an exemption route.
  • The same visa framework β€” most overseas practitioners come on a Health and Care Worker visa sponsored by a UK employer.
  • The same Agenda for Change pay framework β€” though typical entry bands differ in practice.

Because so much overlaps, the parallel nurse-registration guides can be a helpful companion for the shared stages β€” just remember to follow the midwifery-specific detail for the CBT, OSCE and register part.

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We are not a recruitment agency and never charge midwives a placement fee. The checklist is general information, not immigration advice.

Frequently asked questions

Is registering as a midwife the same as registering as a nurse?+

They share the same regulator and the same overall structure β€” both go through the NMC Test of Competence with a CBT and an OSCE, and the English requirement is identical. But they are distinct parts of the register with profession-specific assessments. Midwives join the Midwife part, the NMC assesses a midwifery qualification, and the CBT and OSCE are set in a maternity context.

I am a nurse-midwife. Can I register as both a nurse and a midwife?+

The part of the register you can join depends on the qualifications you hold and how the NMC assesses them. Some internationally-educated practitioners hold both a nursing and a midwifery qualification (for example, a Registered Nurse and Registered Midwife). Whether you can register on one or both parts, and whether that means separate Tests of Competence, is determined by the NMC β€” confirm your specific position with them.

Is the midwife OSCE different from the nurse OSCE?+

Yes. Both use the same station-based format and the assessment-planning-implementation-evaluation (APIE) framework, but the midwifery OSCE is set in maternity scenarios β€” antenatal, labour and birth, postnatal and newborn care β€” with midwifery skills stations such as immediate care of the newborn. The nurse OSCE uses general nursing situations. Both are taken in person at UK test centres.

Do midwives and nurses earn the same in the NHS?+

Both are paid under the same Agenda for Change framework, so the band structure is identical. Where they differ in practice is the typical entry point: newly registered nurses normally start on Band 5, while newly registered midwives typically start on Band 5 during preceptorship and progress to Band 6, with many midwifery posts sitting at Band 6.

If I trained as a nurse, can I switch to the midwife route?+

The NMC assesses the qualification you actually hold. To register as a midwife you need a midwifery qualification that meets NMC standards; a nursing qualification alone registers you as a nurse. If you want to become a midwife and only hold a nursing qualification, that is a question of further midwifery education, which is outside this pathway β€” the NMC and UK universities are the authoritative sources.

Follow the right pathway from the start

Get a free personalised NMC midwife pathway checklist β€” built for the midwife route, not the nurse route β€” covering English, CBT, the midwifery OSCE and registration.

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).