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The Nursing and Midwifery Board of Australia (NMBA) undertakes functions as set by the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law). The NMBA regulates the practice of nursing and midwifery in Australia, and one of its key roles is to protect the public. The NMBA does this by developing registration standards, professional codes, guidelines and standards for practice which together establish the requirements for the professional and safe practice of nurses and midwives in Australia.
Registration as an enrolled nurse, registered nurse or midwife requires you to meet the NMBA’s mandatory registration standards and to practise within the relevant NMBA approved standards, codes, guidelines and frameworks.
The following questions answer common queries about the NMBA English language skills registration standard (2019), which came into effect on 1 March 2019 and replaced the NMBA English language skills standard (2015).
The NMBA English language skills registration standard (2019) amends the Extended Education Pathway of the standard to clarify the existing requirement to complete at least five (5) years (full-time equivalent) education as continuous education.
This reflects the position of the NMBA that the five years of education should be over a set period of time in order to meet all elements of the English language skills registration standard (2019) (including speaking, listening, reading and writing) and be equivalent to the other pathways.
The Extended Education Pathway is intended as an exceptional pathway for applicants.
A definition of ‘five years (full-time equivalent) continuous education’ is now provided and the requirements to demonstrate English language competency using the Extended Education Pathway have been reworded to improve clarity.
A definition for the term ‘vocational education’ has also been added.
The standard has been revised to provide clarity for applicants that the Extended Education Pathway requires them to complete at least five (5) years (full-time equivalent) education as continuous education.
This reflects the position of the NMBA that the five years of education should be over a set period of time in order to meet all elements of the English language skills registration standard (including speaking, listening, reading and writing) and be equivalent to the other pathways.
This intent was reflected in the NMBA English language skills registration standard policy (2016). The NMBA decided to add this further clarity in the English language skills registration standard (2019) to make this requirement clear.
This aligns with the approach of other National Boards who have required the education to be continuous which is more clearly defined and able to be demonstrated.
In order to be registered as a health practitioner in Australia, you must be able to demonstrate that your English language skills will enable you to safely practise your profession. The English language skills registration standard is one of the five core standards that practitioners are required to meet, under the National Law.
The revised NMBA English language skills registration standard (2019) outlines the pathways that you can use to demonstrate your English language competence. The pathways include the:
The Extended Education Pathway is intended as an exceptional pathway.
A flow diagram to help you find the most appropriate pathway for you is published on the English language skills page on the AHPRA website.
If you grew up and completed all of your education in Australia, the most appropriate pathway for you is the Primary Language Pathway.
You can either:
in a full-time equivalent pre-registration program of study approved by the recognised nursing and/or midwifery regulatory body in any of the recognised countries.
If your qualification as a nurse or midwife was not taught and assessed in English in one of the recognised countries, you will need to demonstrate that you meet the standard through the English Language Test Pathway.
The information you provide in your application for registration about your English language skills may be checked by AHPRA.
It is up to you to ensure that you maintain your level of English language proficiency once you are registered, even if you frequently communicate with patients in a language other than English.
The NMBA and AHPRA may reassess your English language skills if specific concerns arise, for example if a complaint is made about you.
The recognised countries are: Australia, United States, United Kingdom, Canada, New Zealand, the Republic of Ireland and South Africa. With the exception of South Africa and Australia, these countries are the same as the countries recognised by the Department of Immigration and Border Protection (DIBP) for the purpose of exempting visa applicants from having to sit a test to demonstrate English language competency.
This approach reflects similar approaches taken by state and territory health practitioner boards in Australia before the National Scheme commenced, as well as National Boards' experience since the National Scheme started. The recognised countries have healthcare delivery systems with significant similarities to Australia. In most of these countries, healthcare is almost always delivered in English.
South Africa is included in the list of recognised countries in the standard, consistent with the approach taken by a number of Australian health practitioner regulators before the National Scheme started. In developing the current standard, National Boards consulted on whether South Africa should be removed from the list, bringing it into line with DIBP. After considering the available evidence, National Boards decided that South Africa should remain on the list of recognised countries for the time being.
The NMBA and other National Boards do not currently plan on adding any new countries to the list of recognised countries.
This issue was considered as part of the most recent review of English language skills registration standards but there was no strong evidence to support the addition of new countries. National Boards may reconsider this issue in future reviews of the standard.
The NMBA English language skills registration standard applies to all applicants for initial registration as enrolled nurses, registered nurses or midwives in Australia. This means that all new applicants for registration must meet the standard, regardless of their language background or visa status.
The standard aligns closely with the DIBP English language requirements for skilled migration visas. The four tests listed in the NMBA standard – IELTS Academic, OET[1], TOEFL iBT and PTE Academic – are also used by DIBP to assess English language competence. If you sat one of these tests as part of your application for a skilled migration visa in the past two years and you achieved the results specified in the standard, you can use those results and do not need to sit another test.
Note: the Cambridge English: Advanced (CAE) test is accepted by DIBP but is not currently accepted by National Boards.
While the NMBA English language skills registration standard is similar to the common standard of most National Boards, key differences ensure that registered nurses, enrolled nurses and midwives are not disadvantaged compared with other registered health professions in the assessment of their English language skills.
The issues specific to nursing and midwifery which need to be addressed in the NMBA standard include:
The NMBA has taken these issues into consideration in developing a professions-specific standard.
All registered nurses and midwives, including enrolled nurses, must be able to demonstrate the same level of English language proficiency in order to become registered and safely practice the profession. However, the NMBA has taken differences in the education of enrolled nurses into consideration when developing the standard. Although enrolled nurses are required to demonstrate the same number of total years of education in English as registered nurses and midwives in order to meet the requirements of the Primary Language Pathway and the Extended Education Pathway, they are only required to have successfully completed a minimum of one year of a full-time equivalent pre-registration program of study in English, as part of their total education in English in a recognised country.
If English is your primary language, it is likely that you meet the standard through the Primary Language Pathway.
In this pathway, you do not need to demonstrate continuous education in English over a specified number of years, however you must be able to show that you have you have attended and satisfactorily completed at least six years of primary and secondary education taught and assessed in English. This education must have been attended and completed in one of the recognised countries, including at least two years of education between years seven and twelve.
In addition, you must have successfully completed your relevant qualification as an enrolled nurse, registered nurse or midwife in English in one of the recognised countries. It does not matter if you have had a break from study or if you did not complete all six years of high school, as long as you meet the other criteria specified in the standard.
If you sat one of the English language tests listed in the standard within the past two years and you achieved the results specified in the standard, you do not need to sit another test.
If your results were lower than the results listed in the standard, or you sat the test more than two years ago, you may have to sit another test.
The Extended Education Pathway in the NMBA English language skills registration standard specifies that you must be able to demonstrate five years of continuous education (as defined) taught and assessed in English in a recognised country, including a minimum of two years (registered nurses and midwives) or one year (enrolled nurses) of a nursing or midwifery program of study. The five years of continuous education may be a combination of tertiary and/or vocational and/or secondary education. If you are able to demonstrate that you meet the standard through this pathway, then you do not need to sit another English language test.
The tests used by the National Boards to determine English language competence are also used by the DIBP to determine visa eligibility. The scores required to demonstrate English language competence for each test are specified in the standard. Each test is slightly different, however the scores required to meet the standard have been benchmarked so they are set at equivalent levels across all the tests. It is not easier to achieve the required scores on one test, compared with any of the others.
The IELTS, PTE Academic and TOEFL iBT test can be taken by applicants from any profession. Currently, the OET[2] test is not applicable for chiropractic, osteopathy and psychology applicants for registration, as OET has not yet developed a specific test for these professions. For Chinese medicine, any of the existing OET tests will be accepted as evidence.
In choosing which test to sit, you will need to do your own research and decide on which test is the most suitable or convenient for you. Links to the tests are published on the English language skills page on the AHPRA website.
2Note there is not a specific OET for midwifery, however, midwives may choose to sit the OET for nursing.
Ideally, you will be able to demonstrate that you meet the standard in one test sitting. However, National Boards will accept results from a maximum of two test sittings in a six-month period so long as certain minimum scores are achieved in each sitting. These vary from test to test and are outlined in the standard. Note that this does not mean that you can only sit the test twice in the six-month period; you may sit the test more than twice if you wish (although this is not recommended by the testing authorities). However, only the results from two sittings will be considered by National Boards.
No, you will need to re-sit the entire test and achieve the required result in the relevant component, and any other minimum scores as outlined in the NMBA English language skills registration standard.
If you do not achieve the required results, you will have to re-sit the entire test again. You may only count the results of two tests within a six-month period.
Usually, yes.
However, there are certain circumstances in which you may not have to sit another test.
You may not have to sit another test if:
Each application will be assessed to ensure that the employment or study undertaken satisfies the requirements specified in the standard.
For further information on the evidence you will need to verify your test result and your period of employment or study, please see the NMBA English language skills registration standard evidence guide published on the English language skills page on the NMBA website.
No. If you have demonstrated that you meet the standard through the Language Test Pathway, you do not need to sit another test as long as you remain registered.
If the two tests were taken within a six-month period, and the first test was taken less than two years ago, then it is possible that you now meet the standard. Your results will need to be assessed to ensure that they meet all the criteria for multiple test sittings specified in the standard. You should contact AHPRA to check the status of your application.
The evidence required to demonstrate secondary education taught and assessed in English in one of the seven recognised countries listed in the standard may vary, depending on where it occurred.
For detailed information about the evidence you need to provide, please see the NMBA English language skills registration standard evidence guide published on the English language skills page on the NMBA website.
The evidence required to demonstrate tertiary and/or vocational education taught and assessed in English in one of the seven recognised countries listed in the standard may vary, depending on where it occurred.
You will need to provide certified copies of your transcripts for all education you are relying on to meet the NMBA English language skills registration standard.
For further information about the evidence you need to provide, please see the NMBA English language skills registration standard evidence guide published on the English language skills page on the NMBA website.
You should provide as much information as possible in the application form. AHPRA will consider whether the information you have provided is sufficient evidence of meeting the standard. If not, you may need to sit an English language test.
‘Full-time equivalent’ means:
One year of full-time equivalent study is the maximum that you can claim in a single year, even if your subject load would normally be considered to be more than full-time.
If your course load is greater than full-time, you cannot count the additional study towards the total number of years you are claiming. For example, if you are undertaking full-time study for a particular course, but are also studying another course part-time, you cannot claim the equivalent of 1.5 times the duration of study in English.
You can count part-time studies if your overall course load is full-time equivalent. For example, you may be studying one part-time course with a 40% course load and another part-time course with a 60% course load. Together, this would be considered a full-time equivalent course load.
If your part-time education does not add up to a full-time equivalent course load, it cannot be counted in the Extended Education Pathway. You can only count your part-time course if you were studying another part-time course at the same time, and together the courses made up a full-time equivalent course load.
How the length of time of a program/course is counted may depend on the type of program/course it is. For tertiary education, a three-year undergraduate degree would be counted as three years if successfully completed full-time. For shorter vocational education programs/courses these may be counted in months or days dependent on the program/course successfully completed.
For a program/course to be counted it needs to be successfully completed at full-time or part-time, for example it you are counting a program as full-time and fail one subject then you have not successfully completed the program full-time.
Yes, you may be able to include this course if it meets the requirements in the definition for vocational education in the standard and you provide the required evidence. English language courses that do not meet the definition of tertiary or vocational education in the standard cannot be counted towards the Extended Education Pathway.
The length of time you may count towards the required number of years of study in English will depend on whether you studied full-time or part-time. If you studied part-time, you can only count this course if you were studying another course part-time (that also meets the requirements in the definition), so that your total hours of study in English would be considered ‘full-time equivalent’.
You can only count online study if the course meets the requirements in the definition for vocational education in the standard:
Vocational education for the purpose of this standard is education that is taught and assessed solely in English in a recognised country where:
Some online courses will not meet the requirement for you to use English language speaking, writing, reading and listening skills. Courses that are delivered entirely online and do not require students to use all these English language skills to communicate are not acceptable. You may be required to provide further evidence about the program and delivery method.
It is unlikely. Traineeships and apprenticeships generally involve full-time work and workplace-based training by an employer, which is added to by some formal education with a Registered Training Organisation, whereas the Extended Education Pathway considers a full-time course of study that is formally assessed.