From Kerala to the NHS: The Nursing Route, Step by Step
OET or IELTS, the CBT in India, the OSCE in the UK, and the Health and Care Worker visa — the sequence Kerala nurses actually follow, and where it usually goes wrong.
Updated 16 August 2026 · AimBritz
Why the order matters more than the exams
Most nurses we meet know the components — English test, CBT, NMC application, job, OSCE. What derails people is sequencing. Your CBT pass is valid for a limited window, and if your job offer and visa take longer than expected, you can find yourself needing to sit it again.
Plan the whole route backwards from when you want to be working, not forwards from whichever exam you can book first.
English: OET or IELTS
The NMC accepts both. Most Indian nurses choose OET because it is healthcare-specific — the reading and writing tasks are clinical rather than academic, which many find more natural.
The required grades are set by the NMC and have been revised before, so confirm the current threshold rather than working from an older guide.
The Test of Competence: CBT then OSCE
The CBT is a multiple-choice knowledge test you can sit in India at a Pearson VUE centre. It is the first half of the Test of Competence and the part you complete before leaving.
The OSCE is the practical half — a clinical examination taken at an approved centre in the UK, normally after you arrive. Many employers support new international nurses through OSCE preparation as part of onboarding, so it is not something you face alone.
The job and the visa
You need an offer from a UK employer holding a sponsor licence, and a Certificate of Sponsorship, to apply for the Health and Care Worker visa. That visa generally allows eligible dependants and counts towards settlement, which is why it is the route most Kerala nurses take.
Dependant rules have changed in recent years. Confirm the current position before making family plans around it.
Where applications actually fail
In our experience it is almost never the clinical knowledge. It is documentation — registration evidence, employment references, and proof of practice hours that do not match what the NMC expects.
- ·Registration and good-standing evidence from your home regulator
- ·Employment references covering the required practice hours
- ·Consistent names and dates across every document
- ·Timing the CBT so its validity does not expire while you wait on a job offer
Common questions
Can I take the OSCE in India?
No. The OSCE is taken at an approved centre in the UK, normally after you arrive and usually with support from your employer. Only the CBT can be sat in India.
How long does NMC registration take?
It varies widely depending on how quickly your documents are in order and how soon you secure a sponsored job. Documentation delays are the most common reason the process stretches out, which is the part we manage most closely.
Free consultation
Every case is different. Get this checked against your own profile — free, with a British Council–certified counsellor.
