Ahpra English Language Requirements for IMG Doctors

To register with the Medical Board of Australia as an internationally-qualified doctor, you have to satisfy Ahpra's 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 Medical Board require before granting registration. Doctors sit under the Common ELS standard, which covers medical practitioners and 12 other professions and was approved by the Ministerial Council on 14 November 2024. (Nurses and midwives sit under a separate Nursing and Midwifery standard.)

Both standards took effect on 18 March 2025 and 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, covered below for doctors.

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

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:

• Each sitting must test all four components, and for IELTS, PTE and TOEFL each sitting must also meet the overall minimum (OET has no overall score; Cambridge's combining rule imposes no per-sitting overall).
• The component minimums only need to be met across the two sittings combined — your best result in each component counts. This is the point of combining: one sitting can carry a weaker component if the other covers it.
• No component in either sitting may fall below the per-sitting floor: IELTS 6.5 in every component; OET 320 listening / 340 reading / 350 writing / 350 speaking; PTE 53 / 54 / 60 / 66; TOEFL 19 / 19 / 23 / 22; Cambridge C1 168 / 168 / 180 / 187 and C2 176 in all components.
• 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. The medical (Common ELS) 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.

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:

FAQ

Sources & methodology