Ahpra English Language Requirements for Nurses & Midwives

To register with the Nursing and Midwifery Board of Australia (NMBA) as an internationally-qualified nurse or midwife, 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 National Boards require before granting registration. Nurses and midwives sit under the Nursing and Midwifery ELS standard, which covers enrolled nurses, registered nurses and midwives and was approved on 21 June 2024. (Doctors and 12 other professions sit under a separate Common ELS 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 nurses and midwives.

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:

• 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) pathway

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 the NMBA education pathway. The 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. There is no NZREX or PLAB alternative for nurses and midwives — those apply only to doctors.

Recognised countries

The education pathway only counts 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 pathway even if it was delivered in English. The 30 recognised countries and territories are:

FAQ

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

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. Tests taken on or before 22 April 2026 are judged against the older Table 1 scores instead. The scores are the same for nurses, midwives and doctors.

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. Each sitting must test all four components, and for IELTS, PTE and TOEFL each sitting must also meet the overall minimum. The component minimums only need to be met across the two sittings combined, but no component in either sitting may fall below the per-sitting floor (for example IELTS 6.5 in every component; OET 320 listening, 340 reading, 350 writing, 350 speaking). You cannot mix providers. 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 can I meet the standard without sitting a test?

Through the NMBA education pathway, if your education was taught and assessed solely in English in a recognised country. The routes require English as your primary language plus 6 years of primary and secondary education in English (including at least 2 years between years 7 and 12) with your pre-registration program in English; or, for registered nurses and midwives, 5 years of continuous full-time-equivalent education in English including the tertiary qualification; or, for enrolled nurses, 5 years of continuous full-time-equivalent education including the vocational qualification. Recognised countries include Australia, the UK, Ireland, the USA, Canada and New Zealand — India, the Philippines, Nigeria and South Africa are not on the list.

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 Nursing, is accepted.

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