1.1 Overview of the NMC CBT & Test Structure

Overview of the NMC CBT & Test Structure

The Nursing and Midwifery Council (NMC) regulates nurses and midwives in the United Kingdom to ensure public protection and high standards of clinical care. For internationally educated nurses (IENs) seeking registration to practice in the UK—as well as UK nurses returning to practice after a prolonged career break—the NMC requires completion of the Test of Competence (ToC). Updated under the Test of Competence 2021 framework, this assessment evaluates whether a candidate possesses the knowledge, professional judgment, and clinical skills required of a UK registered nurse (RN).

The Test of Competence consists of two distinct components:

1. The Computer-Based Test (CBT): A theoretical examination evaluating clinical knowledge and drug calculation proficiency, taken at authorized test centers worldwide.
2. The Objective Structured Clinical Examination (OSCE): A practical examination evaluating hands-on clinical skills, communication, and decision-making, undertaken at an accredited test center in the UK.

Understanding the structural architecture, administrative procedures, and scoring mechanics of the CBT is the crucial first step toward achieving NMC registration.

---

Delivery & Administration via Pearson VUE

The NMC CBT is delivered globally in partnership with Pearson VUE, a leading electronic testing administrator. Candidates can take the CBT at authorized Pearson VUE professional centers located across the UK and internationally in over 100 countries. This electronic format ensures standardized test administration, high-level security, instant data transmission, and automated scoring.

To schedule a test, candidates must first submit their initial registration application to the NMC. Once the NMC confirms preliminary qualification eligibility, it issues an Authorization to Test (ATT) notification directly to Pearson VUE, enabling the candidate to create a Pearson VUE account and book their examination slot.

---

Examination Architecture: Part A & Part B

The NMC CBT under the Test of Competence 2021 is split into two separately timed, computer-administered modules: Part A: Numeracy and Part B: Clinical Knowledge. Candidates take both modules in a single testing session unless they are re-sitting a specific failed module.

Part A: Numeracy Assessment

Part A evaluates essential mathematical competence required for safe dosage calculations and medication administration in UK clinical environments. Items focus on clinical calculations such as converting units of measurement (e.g., milligrams to micrograms), calculating tablet quantities, liquid medication dosages, intravenous (IV) infusion flow rates (mL/hr and drops/min), and fluid balance totals. Precision is essential; candidates must input numerical answers directly into text fields following specified rounding rules (e.g., rounding to the nearest whole number or decimal place as instructed in the prompt).

Part B: Clinical Knowledge Assessment

Part B assesses theoretical nursing knowledge across the lifespan, structured around the NMC Future Nurse: Standards of Proficiency for Registered Nurses (2018). Questions reflect real-world UK nursing practice and evaluate candidate knowledge across seven core domains:

1. Being an accountable professional
2. Promoting health and preventing ill health
3. Assessing needs and planning care
4. Providing and evaluating care
5. Leading and managing nursing care and working in teams
6. Improving safety and quality of care
7. Coordinating care

Part B includes general clinical questions relevant to all fields of nursing, alongside field-specific items tailored to the candidate's chosen registration pathway (Adult Nursing, Children's Nursing, Mental Health Nursing, or Learning Disabilities Nursing).

---

Scoring Mechanics & Independent Pass/Fail Rules

One of the most critical structural features of the NMC CBT is its independent modular scoring system:

• Independent Performance Evaluation: Part A and Part B are evaluated separately. Passing Part A does not depend on your score in Part B, and vice versa.
• Module Retention: If a candidate passes Part A but fails Part B, they are only required to re-sit Part B. The passing result for Part A is retained in the candidate's NMC profile.
• Published Pass Standards (ToC 2021 nursing test specification): Part A (Numeracy) requires 87% — that is, 13 of 15 items correct. Part B (Clinical) pass marks vary by nursing field (adult, mental health, children's, learning disabilities) and are generally set within 60%–70%. Standards are maintained across test forms; candidates receive a pass/fail result for each part, not a published raw score breakdown of every item.

---

Administrative Fees, ATT Validity & Attempt Limits

Navigating the administrative timeline and financial requirements ensures smooth progress through the registration journey:

• Examination Fees: The combined booking fee for both Part A and Part B taken together is £83. If a candidate needs to re-sit a single module, separate re-sit fees apply (£50 for Part A only; £70 for Part B only).
• CBT Attempt Window: All three CBT attempts must be completed within a 1-year window from the first sitting (NMC CBT page, updated 10/02/2026). After this window, candidates must re-sit both modules again.
• CBT and OSCE Cross-Validity: Separately, the CBT and OSCE must each be passed within 2 years of each other (NMC Test of Competence overview).
• Maximum Attempt Allowance: Candidates are permitted up to 3 attempts for each part under a single ATT application. If a candidate does not pass after 3 attempts, their application closes, and a mandatory 6-month wait is required before re-applying to the NMC.