If you’re a nurse planning to register in the UK or Australia, you’ll usually choose between two tests: OET and IELTS Academic. Both are accepted by the Nursing and Midwifery Council (NMC) and by Ahpra. They test the same four skills, but in very different ways. This page compares them so you can pick the one that suits you.

The short version

• OET uses healthcare situations throughout: case notes, a referral letter, role-plays with a patient. If you work in English with patients every day, it can feel more familiar.
• IELTS Academic uses general academic topics: a graph or diagram to describe, an essay on a social issue, an interview about everyday subjects. It’s also accepted for immigration and university study, so one result can do more than one job.

Neither test is “easier” for everyone. Choose the one whose tasks match your strengths, and check that your regulator accepts it.

Side by side

What regulators ask for

NMC (UK):

• OET: grade B (350) in Listening, Reading and Speaking, and C+ (300) in Writing.
• IELTS Academic: 7.0 overall, 7.0 in Listening, Reading and Speaking, and 6.5 in Writing.
• Both: you can combine two sittings of the same test within 12 months (with minimum floors in each sitting), but you can’t combine an OET result with an IELTS result. Scores are valid for two years.

Ahpra and the Nursing and Midwifery Board of Australia:

• OET, tests on or after 23 April 2026: Listening 350, Reading 360, Writing 350, Speaking 360.
• IELTS Academic: 7 overall and at least 7 in each component, except Writing at 6.5.
• Ahpra accepts the IELTS One Skill Retake under its conditions. It doesn’t accept at-home or remotely proctored versions of either test.

Requirements change, so check the details on OET score requirements by country and the regulator’s own website.

How the tasks differ

Writing

This is often the deciding factor.

• OET: one letter of about 180 to 200 words to a health professional, using case notes. The skill is choosing relevant information and presenting it clearly. If you write handovers and referrals at work, this is close to your daily job.
• IELTS: a 150-word report describing data, then a 250-word essay giving and supporting an opinion on a general topic, such as education or technology. It rewards general academic vocabulary and argument.

Speaking

• OET: you play yourself, a nurse, talking to a patient or relative. Empathy, structure and explaining clearly are marked alongside language.
• IELTS: an examiner asks about familiar topics, then you give a two-minute talk from a cue card, then discuss more abstract questions. Nothing is clinical.

Reading and Listening

OET texts use healthcare vocabulary and settings, and Part A of each sub-test rewards fast, accurate note-taking. IELTS texts cover a wide range of academic subjects, from archaeology to economics, where vocabulary may be less familiar to a nurse.

Which should you choose?

OET may suit you if:

• you work in English with patients and are comfortable with clinical vocabulary,
• you find the IELTS essay or graph description hard,
• you only need the result for professional registration.

IELTS Academic may suit you if:

• you also need a test result for a visa or study application that doesn’t accept OET,
• you’re comfortable with academic essays and general topics,
• you aren’t yet working in a clinical setting in English.

Many nurses try a sample of each before deciding. If your Writing score is the obstacle, compare the OET letter with the IELTS essay: whichever you can do more consistently is often the better choice.

Keep reading

Read the OET test guide for the full format, and see a full sample letter in the OET referral letter guide.