Ahpra English Language Requirements: Tests, Scores & Pathways

To register with Ahpra as a doctor, nurse or midwife trained overseas, you have to satisfy the English language skills (ELS) registration standard. This guide covers the accepted tests and their current minimum scores, how two test sittings can be combined, how long results stay valid, and the non-test education pathways that let some applicants skip the test entirely.

What the standard is

The English language skills registration standard sets the minimum English proficiency Ahpra and the National Boards require before granting registration. There are actually two current standards that work in parallel:

• The Common ELS standard covers medical practitioners (and 12 other professions). It was approved by the Ministerial Council on 14 November 2024.
• The Nursing and Midwifery ELS standard covers enrolled nurses, registered nurses and midwives. It was approved on 21 June 2024.

Both took effect on 18 March 2025. They share the same accepted tests, the same minimum scores, the same two-sitting rule, the same two-year validity window and the same recognised-country list. The only real difference is the wording of the non-test education pathways, so most of this page applies to doctors and nurses alike.

Accepted tests

There are currently five accepted English language tests, each of which must be sat at an approved test centre:

• OET (Occupational English Test)
• IELTS Academic
• PTE Academic
• TOEFL iBT
• Cambridge — C1 Advanced or C2 Proficiency

Minimum scores

This is the part that trips people up: the minimum scores changed on 23 April 2026. The score you have to meet depends on when you sat the test, not when you apply.

• Tests sat on or after 23 April 2026 are judged against Table 2 (below).
• Tests sat on or before 22 April 2026 are judged against the older Table 1 scores, which are still valid for those tests.

Ahpra states the change reflects updated concordance research and alignment with Department of Home Affairs migration scores, and does not change the level of proficiency required. Note it is not simply "easier" — for example the PTE overall requirement fell from 66 to 63, but PTE Speaking rose sharply from 66 to 76.

Table 2 — tests taken on or after 23 April 2026 (current)

OET no longer has a single overall score (shown as "N/a"); it is now expressed as numerical component scores. Note the asymmetry — Reading and Speaking need 360, but Listening and Writing need 350. The IELTS Writing minimum is 6.5, not 7.

Table 1 — tests taken on or before 22 April 2026

If you already hold a valid result from a test sat on or before 22 April 2026, it is assessed against the older scores. The key differences from Table 2:

• OET: a minimum of B in each of Listening, Reading and Speaking, and C+ in Writing (letter grades, not numerical scores).
• PTE Academic: overall 66, with 66 in Listening, Reading and Speaking and 56 in Writing.
• TOEFL iBT: total 94, with 24 in Listening, Reading and Writing and 23 in Speaking.
• IELTS Academic: unchanged — 7 overall, 7 in Listening/Reading/Speaking, 6.5 in Writing.
• Cambridge: 185 overall (with 176 in Writing).

Combining two sittings

You do not have to hit every minimum in a single sitting. Ahpra accepts results from one sitting, or a maximum of two sittings whose dates are no more than 12 months apart. The rules on combining are strict:

• Both sittings must independently meet the required overall and component minimums for that test.
• No component in either sitting may fall below the specified per-skill floor.
• You cannot combine results from different providers — you cannot bank an IELTS Listening from one test and an OET Reading from another.
• If your two sittings straddle 23 April 2026, the earlier one is judged against Table 1 and the later one against Table 2.

There is one narrow extra option: for IELTS only, Ahpra accepts the IELTS One Skill Retake — re-sitting a single component within 60 days. It is not treated as an extra sitting. This is not available for OET, PTE, TOEFL or Cambridge.

How long results stay valid

Test results are valid for two years before the date you lodge your application. Results older than two years can still be accepted, but only if since sitting you have either:

• been continuously working as a registered health practitioner (or in another relevant health, disability or aged-care role) where English was the main language of practice, in a recognised country; or
• been continuously enrolled in a Board-approved program of study,

and you lodge your application within 12 months of finishing that work or study. If you are relying on two sittings, the two-year clock runs from the earlier sitting date.

Non-test (education) pathways

You may not need to sit a test at all. If your education was taught and assessed solely in English in a recognised country, you can meet the standard through an education pathway. This is where the two standards differ.

For doctors (Common ELS standard)

The medical standard sets out four pathways, three of which are non-test:

• Combined-education pathway: at least 2 years of secondary education taught and assessed solely in English in a recognised country, plus your profession qualification(s) taught and assessed solely in English in a recognised country.
• School-education pathway: English is your main language, plus at least 10 years of primary and secondary schooling taught and assessed solely in English in a recognised country, plus a qualification taught and assessed solely in English (any country).
• Advanced-education pathway: at least 6 years total of full-time-equivalent education, all taught and assessed solely in English in a recognised country (including a degree at AQF level 7 or above), with the last period completed no more than 2 years before you apply.

Doctors also have two medicine-only alternatives to the test pathway: successful completion of the New Zealand Registration Examination (NZREX) or the Professional and Linguistic Assessments Board test (PLAB) satisfies the English requirement. These do not apply to nurses or midwives.

For nurses and midwives (NMBA ELS standard)

The nursing and midwifery standard is worded differently. The non-test routes are:

• English is your primary language and you completed at least 6 years of primary and secondary education taught and assessed solely in English in a recognised country (including at least 2 years between years 7 and 12), and your pre-registration program was taught and assessed solely in English in a recognised country (registered nurse or midwife at least 2 years full-time-equivalent; enrolled nurse at least 1 year); or
• for registered nurses and midwives, at least 5 years of full-time-equivalent continuous education taught and assessed solely in English in a recognised country, including the relevant tertiary qualification; or
• for enrolled nurses, at least 5 years of full-time-equivalent continuous education, including the relevant vocational qualification.

For the five-year routes, the last period of education must be within 5 years of applying.

Recognised countries

The education pathways only count if the education was delivered in a recognised country, and the list is exhaustive and specific. It is not "any English-speaking country" — India, Nigeria, the Philippines, South Africa, Singapore and Pakistan are not on it, so education there does not satisfy the education pathways even if it was delivered in English. The 30 recognised countries and territories are:

Antigua and Barbuda, Anguilla, Australia, The Bahamas, Barbados, Belize, Bermuda, British Indian Ocean Territory, Canada, Cayman Islands, Dominica, Falkland Islands, Gibraltar, Grenada, Guernsey, Guyana, Isle of Man, Jamaica, Jersey, Malta, New Zealand, Republic of Ireland, Saint Helena/Ascension/Tristan da Cunha, St Kitts and Nevis, St Lucia, St Vincent and the Grenadines, Trinidad and Tobago, the United Kingdom, the United States of America, and the US Virgin Islands.

FAQ

What are the minimum Ahpra English test scores for doctors and nurses?

For tests taken on or after 23 April 2026: IELTS Academic 7 overall, with 7 in Listening, Reading and Speaking and 6.5 in Writing; OET (numerical) Listening 350, Reading 360, Writing 350, Speaking 360; PTE Academic 63 overall, with Listening 58, Reading 59, Writing 60 and Speaking 76; TOEFL iBT 91 overall, with Listening 22, Reading 22, Writing 23 and Speaking 24; Cambridge C1 Advanced 178 overall or C2 Proficiency 185. The same scores apply to medicine and to nursing and midwifery. Tests taken on or before 22 April 2026 are judged against the older Table 1 scores instead.

The scores changed in April 2026 — do my old test results still count?

Yes, if you sat them by the deadline. The score you must meet depends on when you sat the test. Tests taken on or before 22 April 2026 are judged against the old scores (Table 1); tests taken on or after 23 April 2026 are judged against the new scores (Table 2). If you combine two sittings that straddle the date, the first must meet the old scores and the second the new scores. Ahpra states the change reflects updated concordance research and alignment with migration scoring, and does not change the level of proficiency required.

Can I combine results from two test sittings?

Yes, within limits. Ahpra accepts results from one sitting, or a maximum of two sittings whose dates are no more than 12 months apart. Both sittings must independently meet the required overall and component minimums, and no component in either sitting may drop below the specified floor. You cannot mix providers — you cannot pair an IELTS Listening with an OET Reading. For IELTS only, a One Skill Retake (re-sitting a single component within 60 days) is also accepted and is not counted as an extra sitting.

How recent must my English test results be?

Results are valid for two years before the date you lodge your application. They can be older than two years only if, since sitting, you have been continuously working as a registered health practitioner or in another relevant health, disability or aged-care role where English was the main language of practice in a recognised country, or continuously enrolled in a Board-approved program of study — and you lodge within 12 months of finishing. If you rely on two sittings, the two-year clock runs from the earlier sitting date.

How can I meet the standard without sitting a test?

Through an education pathway, if your education was taught and assessed solely in English in a recognised country. For doctors the options are the combined-education pathway (at least 2 years of secondary schooling in English plus your professional qualification in English), the school-education pathway (at least 10 years of primary and secondary schooling in English, with English your main language), or the advanced-education pathway (at least 6 years of full-time-equivalent education in English including a degree at AQF level 7 or above, last completed within 2 years of applying). For nurses and midwives the routes require English as your primary language plus 6 years of primary and secondary education in English, or 5 years of continuous full-time-equivalent education in English. Recognised countries include Australia, the UK, Ireland, the USA, Canada, New Zealand and about two dozen others.

Does OET still use letter grades like B and C+?

Not for tests taken on or after 23 April 2026. Ahpra now expresses OET requirements as numerical scores: Listening 350, Reading 360, Writing 350, Speaking 360. Tests taken on or before 22 April 2026 are still assessed against the old letter grades — a minimum of B in Listening, Reading and Speaking and C+ in Writing. Any profession-specific OET, such as OET Medicine or OET Nursing, is accepted for any profession.

Are the English requirements different for doctors versus nurses?

The accepted tests, minimum scores, two-sitting rule and validity window are identical. What differs is the wording of the non-test education pathways, because there are two separate standards: the Common English language skills standard (covering medicine and 12 other professions, approved 14 November 2024) and the Nursing and Midwifery standard (approved 21 June 2024). Both took effect on 18 March 2025. Doctors also have two medicine-only alternatives — passing the NZREX or the PLAB test satisfies the English requirement.

Sources & methodology

Every figure on this page — the accepted tests, the Table 1 and Table 2 minimum scores, the two-sitting rule, the validity window, the education pathways and the recognised-country list — is drawn from Ahpra's own primary pages and the two registration-standard PDFs, verified on 3 July 2026. Because the minimum scores changed on 23 April 2026, both score tables are shown; the authoritative current numbers live on Ahpra's "Accepted English language tests" page (Table 2), not in the older standard PDFs' appendices. This is general information about the standard, not immigration or legal advice — always confirm the current requirements against Ahpra before you book a test or lodge an application.

• Ahpra — Accepted English language tests (primary; holds Table 1 and Table 2 scores, the two-sitting rule, validity window and One Skill Retake)
• Ahpra — English language skills registration standard (hub page; links both standard PDFs; effective 18 March 2025)
• Common English language skills registration standard PDF (medical + 12 other professions; the four doctor pathways and recognised-country list)
• Nursing and Midwifery English language skills registration standard PDF (the nurse/midwife education pathways and recognised-country list)
• Ahpra — English language skills FAQ (confirms the two-standard split: Common standard vs NMBA standard)
• Medical Board of Australia — English language skills (doctor landing page)
• Nursing and Midwifery Board — Fact sheet: English language skills registration standard