You may be feeling overwhelmed by the sheer volume of paperwork and exams required when you decide you want to take your nursing career abroad. Three exams that you will hear mentioned frequently are NCLEX and OET, and IELTS. Some nurses erroneously believe that these three exams compete with each other or that there is one of the three which is “better” or “easier” than the others; however, they actually serve completely different purposes and your decision regarding which exam to take will be based on where you wish to live, your financial situation, and how comfortable you feel speaking and writing in English.
This guide will break down NCLEX vs OET vs IELTS for nurses in an as-simple-as-possible manner so that you can have total confidence in choosing your own course.
What exactly is an NCLEX?
NCLEX (National Council Licensure Examination) is an exam to obtain a nursing license. Compared to other exams NCLEX will not evaluate your English vocabulary and grammar. Instead, this exam will measure your ability to provide care and treat patients without causing any harm. For many professionals starting their journey, finding a reliable NCLEX RN training centre in Kerala or enrolling in high-quality NCLEX RN coaching online is the most effective way to master these clinical safety concepts.
What is the OET?
OET (Occupational English Test) is an English Language test for individuals working in the healthcare profession. You will be graded on your ability to communicate (speak, read, and write). You will be asked to read patient health care records, listen and record physician and patient conversations, and engage in a fake conversation with a person portraying a stressed-out patient.
What about the IELTS?
IELTS (International English Language Testing System) is a general English language examination and is not directed toward the medical profession. It will measure your ability to comprehend university-level academic articles from the areas of history and science, explain the information contained in charts and graphs, and compose an academic essay on the general topic of environmental pollution, education, etc.
Exam Format Breakdown
Let’s take a look at each test and what they actually entail on the day of the exam.
1. NCLEX
- Computerized Exam: The NCLEX is an evaluation that uses Computerized Adaptive Testing (CAT). The length of your exam will differ from person to person based on how you complete it.
- How it works: The computer will determine your score. If you answered the last question correctly, the next question you get will be more difficult than the previous question. Meanwhile, if you answered the last question incorrectly, then the next question will be easier than the previous question.
- Length: Depending on how well you perform on each question, you could complete a total of 85-150 questions in a maximum time of five hours. The computer will determine when you are above the passing standard (95%) and stop administering the exam.
- Types of questions: There are multiple advanced formats for this assessment including but limited to; case studies, drag and drop, and “select all that apply” questions (where one answer is correct). The questions are designed to simulate actual hospital employee software and patient charts.
2. OET
The OET comprises several components that are all geared specifically towards the professional environment within the field of Nursing.
The four sections of the OET are as follows:
- Listening (45 minutes): You listen to healthcare professionals in conversation with patients as well as healthcare professional presentations. You will then record basic medical information from notes on a worksheet.
- Reading (60 minutes): You will locate factual information from hospital manuals, prescription dosage tables as well as from journal articles that you can reference after reading the passage.
- Writing (45 minutes): You will have a sheet of jumbled notes relating to a patient’s case. Your task is to organize these notes into a formal referral or discharge note for another nurse or physician.
- Speaking (20 minutes): You will complete an interactive role play simulation. During this module you and your examiner will play the role of nurse and patient, explaining the side effects of a prescribed medication or you should comfort a patient who is nervous about undergoing surgery.
3. IELTS
The IELTS Academic Test, like its predecessor, also consists of four sections that mimic traditional school exams:
- Listening (from 30 to 40 minutes): Two different types of audio will be played to the candidate. The first audio will be an everyday communication, and the second one will be an academic monologue of a lecturer speaking on wildlife.
- Reading (60 minutes): Three readings will be presented to the candidate. All three readings will be of general interest (i.e., they will be written for a general audience), but will contain dense amounts of information on a historical, scientific, or psychological subject.
- Writing (60 minutes):
Task 1: Candidates should analyse the given graph, map, or pie chart, and write a report of 150 words on your own.
Task 2: Candidates will write a standard 250-word essay for school, arguing for or against a public issue.
- Speaking (11 to 14 minutes): A live interview with the examiner. During this interview, the candidate will be asked to discuss their hobbies, speak for 2 minutes based on a topic they are given from a card, and participate in an abstract discussion regarding their society.
A visual representation of these differences is shown below:
| Feature | NCLEX | OET (Nursing) | IELTS Academic |
| What does it test? | Nursing knowledge & clinical safety | Medical-based English | General academic English |
| Who takes it? | Nurses wanting to practice in the US/Canada/Australia | Healthcare workers only | Anyone moving abroad for study or work |
| Speaking Topic | None | Role-playing as a nurse with a patient | General conversation on abstract topics |
| Writing Topic | None | Writing a patient transfer or referral letter | Analyzing a chart and writing a standard essay |
| Approx. Cost | ~$200 USD (plus regional test center fees) | ~$590 AUD (highly expensive) | ~$220 – $250 USD (more affordable) |
| Results Ready | 2 to 4 business days | 10 to 16 business days | 3 to 5 days (computer) / 13 days (paper) |
Global Nursing Boards Require Score Levels
You don’t need to get 100% on everything in order to move abroad, but you will need to achieve different scores based on the requirements of foreign health systems.
1. NCLEX Scores Did Not Have Any Input
No grades, numbers or percentages. You just receive either a Pass or Fail rate.
2. OET Grades Standard
OET provides an evaluation based on individual modules with a letter grade of A (highest) to E (lowest) based on the numerical score of 0 to 500 provided.
- Goal: To achieve the required OET score for UK nursing registration or registration with Australia’s AHPRA, you will typically be required to have a B (350+) in Listening, Reading & Speaking modules.
- Exception for Writing: Because it is more difficult to write a letter, many nursing boards will allow you to receive a C+ (300+) in the Writing module if you qualify with the B in the previous 3 modules.
- Clubbing: Some countries allow you to combine scores of two separate attempts within 6 months if you have failed in 1 of 4 modules, thereby allowing you to avoid having to start all over again.
3. IELTS Band Scale
The IELTS Band Scale is applied as a score range of 1.0–9.0.
- Target: The historical approach of regulatory nursing boards was to only accept a minimum band score of 7.0 in each of the four sub-components (listening, reading, writing and speaking). If a candidate received at least three sub-components band scores of 8.0 but received a 6.5 in writing, he/she would receive no credit for that test.
- Current Position: The nursing regulatory bodies in some countries have relaxed their requirements for pass rates for candidates in recent years. Some examples include the 6.5 pass mark for the Writing sub-component in the UK and meeting the 7.0 score for listening, reading and speaking sub-components and an overall average of 7.0 if the candidate receives a 6.5 in writing.
- Partial Retake Option: For some regulatory bodies, if you don’t achieve the passing score for one module (i.e. writing), you may retake that module within 60 days of your test administration without having to re-take the entire test.
Destination Maps
Your Destination Map is the most significant factor in determining which exam you may be eligible to sit for, therefore, you should determine your destination first before selecting your test.
Destination: United States
- The Rule: The NCLEX-RN is a mandatory requirement. There are no over-rides for the NCLEX-RN.
- The Language Step: After passing the NCLEX, you need to apply for a “VisaScreen” as part of the US immigration process in order to prove English language competency. You can use either an OET or an IELTS exam to demonstrate English competency for the VisaScreen application. The NCLEX is always the first step.
Destination: United Kingdom or Ireland
- The Rule: You will not take the NCLEX to practice in either the UK or Ireland.
- The Language Step: You need to pass an English Language Test (either OET or IELTS Academic) before you register with the nursing council in the UK or Ireland.
- The Clinical Step: Once you demonstrate your English language competency, you need to complete the UK or Ireland’s local process for obtaining a nursing license, e.g., sitting for the CBT internet-based test and then taking the OSCE practical examination, in the UK, within one month of arrival.
Destination: Australia or New Zealand
- The Rule: The OBA (Outcome-Based Assessment) process used by the National Boards in Australia requires that you pass the NCLEX-RN to demonstrate that you possess the necessary clinical skills, and one of the two English language proficiency testing exams (OET or IELTS) to determine that you possess the requisite English language skills.
Language Site Assessments – OET compared to IELTS
If you are interested in immigration to either the UK, Ireland or Australia, at some point you will need to select between two different types of English test. Most nurses struggle with the decision of which one to take, so let us examine the important factors to consider when choosing your English proficiency test.
1. Why Do Nursing Professionals Prefer the OET?
- Pro (Familiarity): The OET is a huge advantage in that it gives you the opportunity to use your current skills in a familiar way with your patients.
- Con (Price): The OET is one of the more expensive English tests. Failing two or more times could become a financial burden. In addition, the OET test has significantly fewer test centres throughout the world. Resulting in additional expenses to take the exam.
2. Why Nurses Select the IELTS Exam
- Advantage (Cost/Affordable): The IELTS test costs about half the price of the OET exam, which ranges from approximately $220-250 dollars. There are many testing centres located throughout major cities around the world, and they are extremely easy to schedule a time to take the test.
- Advantage (Versatile): The IELTS test has a universal acceptability. For example, if your plan is to apply for a university degree instead of practice as a nurse, the IELTS test will meet the requirements needed for admission at that university regardless of what visa you hold. Additionally, if your spouse should apply for a visa based on being a dependent of you who has a valid visa under the IELTS test requirements, they will not need a separate exam/separate qualifications to be accepted.
- Disadvantage (Academic Wall): However, the IELTS exam has one disadvantage, a candidate must demonstrate their writing ability in an essay format and interpret non-healthcare based graphs to complete the exam. This can be a very difficult transition for candidates who haven’t completed an essay in academic format in years as a nursing professional as well as to complete the skill of interpreting non-healthcare graphs.
A Beginner’s Guide to Choosing Your Path
Look at the scenarios below that describe your life, and select the appropriate Strategy.
Scenario A: “I only want to live and work in the USA”
Select the NCLEX-RN if you don’t want to spend any more money or time on English language tests right now. Focus on getting through the NCLEX-RN. When you have passed your NCLEX-RN exam, you can use your previous experience to study for a few weeks before taking the IELTS or OET to get your visa.
Scenario B: “I am trying to get to “the UK” in the shortest time possible; my general English grammar and essay-writing skills really do not exist.”
Select the OET as your testing option. The OET costs more upfront than other types of English tests, but your background in working in a hospital will greatly help you get ready for the OET much faster than if you took a general English test. You will pass the OET on your first try because of your experience with patient care. This will save you from having to pay to take the general English exam multiple times.
Scenario C: “I have limited financial resources, but I can speak and write in English fluently. Therefore, I want to have continued options for getting work in multiple countries.”
Your Plan of Attack: Take the IELTS Academic. You will save yourself money by using the lower test fee. Focus your efforts on practicing only what you need to pass both Task 1 (graphs) and Task 2 (essays). If you score below the minimum required on one of the two sections, use the one-skill-retake in order to succeed as quickly as possible.
Choose the exam you feel based on your desired country, budget, and play to your natural way of communicating.
We are Tiju’s Academy, one of the best institute for OET in Kerala available to help nurses and other professional workers reach their global career goals. We have the highest-quality and highest-rated training courses for the most popular international exams, including the OET (Occupational English Test) and other GREs (Graduate Record Examinations), as well as some computer-based exams (professional exams) like CBTs (Computer-Based Testing) and other exams that require testing your English language proficiency.
Our modern offline classrooms or flexible online learning system (LMS) can provide you with one-on-one, individualised attention and the most current books and materials for your examinations, and our trainers are all highly trained professionals.
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