Top 5 Exams Nurses Must Clear to Work Abroad: UK, USA, Canada, Australia & NZ

Nursing as a profession is widely accepted and respected, offering a range of opportunities for those seeking to build a career abroad.

However, the transition to working abroad for Indian graduates is not easy; they must prove their competence and qualifications by passing exams relevant to the country.

These exams, though complicated, ensure that international candidates meet the healthcare standards to practice ethically and safely. It is therefore essential to know that nurses should have the right qualifications and certifications if they want to work abroad.

This article provides an in-depth guide on the exams nurses must take to work in Australia, Canada, New Zealand, and the US.

Australia – NCLEX-RN

Australia’s healthcare system is one of the best in the world. It is excellent for education, work, and living. It boasts a high quality of education, a low cost of living, and is an overall great place to live.

There are two types of NCLEX exams;

• NCLEX-RN

• NCLEX-PN

The NCLEX-RN Exam is for candidates who wish to become Registered Nurses. The NCLEX-PN is for those who want to have a practical nurse licensure.

However, the requirements to become a registered nurse are also stringent. The Nursing and Midwifery Board of Australia (NMBA) and the Australian Health Practitioner Regulation Agency (AHPRA) oversee the registration of internationally qualified nurses and midwives in the country. Here are some things you will need to do if you want to become a registered nurse and emigrate to Australia. The NMBA checks:

• How is your English language proficiency

• Your recent nursing practice

• Your professional insurance arrangements

• If you have a criminal record

You will have to apply to the National Council of State Boards of Nursing (NCSBN). Follow the procedures given by the individual State Boards of Nursing. In some states, there is combined registration for the NCLEX-RN exam for licensure.

In others, you must apply for licensure with the State Board of Nursing in the state in which you wish to become licensed. Once used, you will get a Candidate Bulletin to register for the NCLEX-RN® exam.

Registration Process

• Meet the registration requirements

• Meet the immigration requirements

• Complete Self-check

• If Stream A: Complete Orientation Part 1

• If Stream B: Complete Orientation Part 1 and the outcomes-based assessment (OBA)

• Fill the application form and provide all documentation to AHPRA

• NMBA will assess whether you meet the requirements for registration

• Receive registration

• Apply for immigration to Australia

• Obtain employment

• Emigrate to Australia

• Begin working as an RN

Format of the Exam

• The NCLEX uses a computerized Adaptive Testing system that adjusts difficulty level according to the responses.

• Every test is unique, and the test ends when it is certain that your performance is above or below the passing standard.

• Test duration is up to 5 hours for NCLEX-RN

• 85-150 questions

• Multiple Choice, Fill-in-the-blank calculations, Image-based, and Case studies (Next Gen NCLEX)

Candidates must demonstrate clinical judgment, critical thinking, and the ability to make sound nursing decisions under pressure.

The subject areas are divided into five components:

United Kingdom – CBT & OSCE (NMC Registration)

If you want to work as a registered nurse in the UK, you must register with the Nursing and Midwifery Council (NMC). The process involves two key stages of assessment:

1. Computer-Based Test (CBT):

• The CBT evaluates theoretical knowledge, clinical skills, and critical thinking.

• It is taken online and covers topics including patient safety, fundamentals of nursing, pharmacology, and ethical principles.

• You cannot proceed to the OSCE test without clearing the CBT.

2. Objective Structured Clinical Examination (OSCE):

• The OSCE is a practical skills assessment conducted in the UK.

• Candidates demonstrate competence in simulated clinical scenarios, showcasing communication, patient care, and emergency handling.

CBT Exam Eligibility Criteria

Here is the eligibility criteria set by the NMC:

• Education: You must have a nursing degree or a diploma from a recognized institution.

• Registration in Home Country: Candidates must hold a nursing license in their home country, where they received their education.

• English Language Proficiency: Provide proof of language proficiency by taking tests such as IELTS, OET, or PTE Academic.

• Document Verification: Submit nursing documents and proof of professional registration, as they are required for the application.

NMC CBT Syllabus for Nurses

The syllabus is divided into two parts:

Part A: Numeracy

• Drug calculations

• Units of measurement conversions

• Dosage calculation

Part B: Clinical Questions

• Ethical practices, respect for patients, and professional conduct.

• Communication skills with patients and healthcare teams.

• Knowledge of clinical procedures, patient assessments, and evidence-based care practices.

• Team coordination, conflict management, and decision-making

These nurse registration exams abroad ensure that nurses are adequately prepared for the high standards of the NHS and UK healthcare system. You must pass the CBT test before appearing for the OSCE.

Passing both the CBT and OSCE successfully grants you NMC registration and the ability to practice as a registered nurse in the United Kingdom.

United States – NCLEX-RN

The United States follows the same pattern and exam, the NCLEX-RN, as Australia. This test is conducted by the National Council of State Boards of Nursing (NCSBN).

• Format: The NCLEX-RN uses computer adaptive testing (CAT), meaning the exam automatically adjusts question difficulty based on your responses.

• Content Areas: Safe and effective care, health promotion, pharmacological therapies, and physiological integrity.

• Eligibility: Internationally educated nurses must apply through their chosen state board of nursing and often need to complete credential evaluations.

The NCLEX-RN is considered one of the most important exams for overseas nurses, as it opens doors not only in the US but also in some Canadian provinces, since Canada also accepts NCLEX-RN results.

Canada – NCLEX-RN (via NNAS & Regulatory Bodies)

Canada has an excellent healthcare system and offers diverse opportunities across hospitals, with competitive pay and retirement benefits.

Successfully passing the NCLEX-RN ensures you can practice across Canadian provinces, apart from Quebec, which follows its own exam process.

The journey involves both credentialing and examination.

Registration Process

• Apply to NNAS: To be eligible for the NCLEX-RN exam and become registered in Canada, candidates must go through an evaluation by the National Nursing Assessment Service (NNAS).

• Verify Documents: Get transcripts, nursing registration documents, and work experience.

• Language proficiency: You can take the IELTS, OET, or PTE Academic as proof of language.

• NNAS Advisory Report: Receive a report that compares your qualifications to Canadian standards.

• Submit to Provincial Nursing Body: Decide which province you want to practice in and forward the NNAS report to them.

• Confirm Eligibility: Once the provincial body approves of your application, you can register for the exam.

• Register with Pearson VUE: Schedule your NCLEX exam through the Pearson VUE portal.

NCLEX-RN Exam Canada

Once eligibility is confirmed, you can appear for the NCLEX-RN exam, similar to the US, which tests essential nursing competencies.

New Zealand – CAP (Competency Assessment Program)

New Zealand’s healthcare sector is experiencing significant growth, and the demand for qualified nurses has never been higher. Nurses play a critical role in the healthcare system, making nursing an advantageous career path in the country and one that is highly sought after.

For Indian nurses, New Zealand is the perfect destination to begin an enriching and sustainable career. Indian nurses are highly valued, and New Zealand offers benefits, such as the possibility of work visas or direct residence visas. This allows them to live and work in New Zealand and have access to permanent residence.

Registration Process:

1. Verifying documents with TruMerit (CGFNS)

All candidates must provide:

• Identity proof

• Current registration held in the last 10 years

• Nursing qualification equivalent to New Zealand qualifications

• Proof of English proficiency

• 1,800 hours post-registration nursing experience

2. Submitting an Application to the NCNZ

Once the CGFNS verification is done, apply through the NCNZ’s online portal with the required documents and fees. NCNZ then reviews eligibility for registration.

3. Criminal Record and Background Checks

Candidates must go through a criminal history check. Local police certificates are not accepted.

4. Cultural training

Candidates must take the free “Welcome to Aotearoa New Zealand” program. This training offers cultural safety, Maori history and knowledge, and Treaty of Waitangi understanding.

5. Competency Assessment Program (CAP)

Some may have to take a theory test (medication safety & general nursing) and an OSCE. The OSCE tests practical, clinical, and communication skills after orientation training.

6. APC application

Apply for an Annual Practicing Certificate through NCNZ. This is mandatory to work as a registered nurse in New Zealand.

Examination Format

The exam is divided into two parts:

• Part A: Medication Safety, consisting of 12 questions.

• Part B: Nursing knowledge is composed of 108 questions.

• The time allotted to complete the exam is 180 minutes. No extensions.

• You are allowed three attempts to pass the exam.

Unlike the NCLEX-RN exam, New Zealand emphasizes hands-on competency through CAP. This ensures nurses adapt well to the local health environment and patient care standards. After which, they can be fully registered as a nurse in New Zealand.

Conclusion:

Nurse registration exams confirm your ability to work in different medical systems. Moreover, these exams open doors to new opportunities, higher salaries, professional growth, and familiarity with the most recent trends in the medical field.

These routes show that international nurse licensing exams are vital in the process of global healthcare quality standardization.

It is a primary uphill task to get prepared for international licensing exams, and hence, there is a need for proper guidance, organized preparation, and dependable resources. This is precisely the role that Elite Expertise fills.

• We support students in licensure exams who want to become pharmacists abroad, such as the OPRA Exam Preparation, the PEBC exam in Canada, the PSI exam for Ireland, and the PTE English test.

• Our programs provide a practical and theoretical foundation, along with the skills necessary for safe practice.

• We offer the full scope of mentoring, training, and support for the exams.

• Our mentors are licensed practitioners and have a total of 10+ years of industry experience.

At Elite Expertise, we help you be on the right track and turn your dream job into a reality.

About the Author

Radhika

Content Writer | Elite Expertise

Radhika loves all things content! With a Master's in English Literature and over 4 years of experience in digital strategies. She specializes in creating engaging content across diverse industries - including healthcare, technology, and e-commerce - always writing content that connects to its readers.

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