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OET vs IELTS for migrating nurses

OET and IELTS are both accepted by most nursing regulators. Which fits which candidate, plus a four-question test to find yours.

May 7, 20264 min readBy OET Live

Almost every migrating nurse we've talked to has hit the same fork in the road: take OET or take IELTS Academic. Both are accepted by every major nursing regulator (UK NMC, AHPRA, NCNZ, NMBI, etc.). The score thresholds map roughly to each other. The cost is in the same ballpark. So which one should you take?

The right answer is not "the easier one". The right answer is the one that fits your professional context.

Here is the decision framework we walk most candidates through. (For a deeper format comparison, see our OET vs IELTS help article.)

The four-question test

1. Do you currently work in healthcare in an environment where you regularly speak English?

If yes, lean OET. The vocabulary lift is real. You already say "hypertension", "compliance", "post-op", and "contraindication" daily. OET will reward that. IELTS Academic asks you to write about urban planning, museums, and tourism, which is exactly the vocabulary you have not spent the last decade developing.

If no — say you're a nurse from Vietnam who studied in Vietnamese and works in a primarily-Vietnamese-speaking ward — both tests are roughly equally foreign on the vocabulary axis. Choose on questions 2–4.

2. Can you write a referral letter in English without significant effort?

If yes, lean OET. The Writing sub-test is a referral or discharge letter in your profession. You do this for a living. IELTS Academic Task 1 asks you to describe a chart or process. Task 2 asks you to write a 250-word essay on a debate topic.

If no, IELTS Academic Writing might actually be the easier ride. Chart descriptions follow a predictable structure once you've drilled them.

3. Is your regulator indifferent between the two?

Most are. UK NMC, AHPRA, NCNZ, NMBI, PSI — all accept both with broadly equivalent score thresholds.

Some have stated preferences or specific score-aggregation rules that work better with one test than the other. The UK GMC's two-sitting aggregation policy, for example, applies to both tests but has slightly different mechanics for each. If your regulator has a preference, take their preferred test even if you'd score marginally better on the other one — administrative friction is real.

4. Have you taken either test before?

If you've already attempted IELTS and got 6.0 or 6.5 overall but need 7.0, and you work in healthcare in English daily, strongly consider switching to OET. The half-band that's been blocking you may be a vocabulary-context issue rather than an English-proficiency issue. People regularly score B in OET after stalling at 6.5 IELTS for that exact reason.

If you've already attempted OET and scored C+ in Speaking specifically, switching to IELTS isn't usually the fix — your problem is more likely a Speaking-skill issue than a test-fit issue. See our post on what makes OET Speaking hard for diagnostic questions.

Three real candidate profiles

To make this concrete:

Candidate A: Filipino ICU nurse, UK-bound

8 years clinical English, fluent at bedside
Already passed Writing in OET (referral letters are second nature)
Stuck at C+ in Speaking

Recommendation: Stay in OET. The problem isn't the test — it's the Speaking sub-test specifically. Drill the 9 criteria, focus on understanding the patient perspective and providing structure, and re-take Speaking only.

Candidate B: Indian doctor, Australia-bound, never worked clinically in English

Strong written English from medical school texts
Limited spoken English in clinical contexts
Hasn't taken either test yet

Recommendation: Take both free practice tests of OET and IELTS Speaking. Honestly, this candidate might find IELTS Speaking less stressful because the conversation format is general, not patient-facing. But OET's higher correlation with the actual work they'll do in Australia could make the prep more meaningful. If they're indifferent, OET wins on alignment.

Candidate C: Filipino nurse who studied in Tagalog, working in a Tagalog-speaking ward, NZ-bound

Limited English work context
Strong general English from school
Confident on essay-style writing

Recommendation: Take IELTS Academic. The general-English context maps better to their preparation strengths. They can always re-pivot to OET if they stall.

Cost / practical considerations

OET is more expensive per sitting (~$587 USD) but offered fewer times per year (~16). OET@Home is widely accepted.
IELTS is cheaper per sitting (~$215–$280 USD) and offered multiple times per week. Computer-delivered IELTS Academic results are usually returned in 3–5 days.

If you're on a tight visa timeline, IELTS gives you more re-take flexibility. If you're aiming for one or two clean sittings, OET is competitive on total cost.

The wrong reason to choose

Don't choose IELTS just because "it has fewer criteria". OET Speaking has 9 criteria; IELTS Speaking has 4. But IELTS Writing has 4 criteria that are also notoriously hard to score 7.0 on without practice, and IELTS Listening / Reading are exactly as hard as OET equivalents. The aggregate effort is roughly the same; the difference is where the difficulty lives.

How OET Live fits

OET Live is for candidates who picked OET. If you picked IELTS, we're not for you yet — though we may build an IELTS Speaking variant in the future.

If you picked OET (or you're leaning that way), join the waitlist and you'll get TestFlight access when your wave opens. The fastest way to know whether OET fits you is to do one full role-play with full per-criterion feedback. That's what the app is for.