What is the NMC CBT?

If you trained as a nurse outside the UK and want to join the NMC register, you will usually have to pass the Test of Competence. It comes in two parts. Midwives sit their own version of the test, written to the midwifery standards, and this site does not cover it. The CBT is the first: a multiple-choice exam you sit at a Pearson VUE test centre, available in most countries. The second part is the OSCE, a practical exam taken in the UK.

You can sit them in either order, though most people take the CBT first. This page is about the CBT. There is a separate set of pages on the OSCE , including a simulator for its assessment station, and an overview of the Test of Competence as a whole if you are not yet sure which half you have been asked to book.

CBT here is short for computer-based test. That is the full form, and in the context of NMC registration it always means this exam: the written half of the Test of Competence, sat on a computer at a test centre.

It is not cognitive behavioural therapy, which shares the initials and is the thing most people find first when they search for CBT in a health setting. The two have nothing to do with each other. If you have been told to book a CBT as part of registering with the NMC, this page is the right one.

You may also see it written as the ToC CBT, the NMC CBT or the Test of Competence Part 1. They are the same exam.

The CBT is 115 questions and you get 3 hours overall. It is easy to think of that as one long paper, but it is really two, and they are timed and passed separately. Fail one and you only resit that one.

Every question is worth one mark. There is no partial credit and nothing is taken off for a wrong answer, so there is no reason to leave anything blank. Guess rather than skip.

The NMC sets the pass mark statistically and keeps it steady across versions of the test, so it is not published as a fixed percentage. You are told pass or fail for each part and nothing more: no score, no breakdown of where you went wrong. Results come by email within 48 hours, and appear in your Pearson VUE account.

The test is written for a specific field, and there is a separate blueprint for each. About nine tenths of the content is shared whichever field you are joining, and roughly a tenth of Part B is specific to yours. There is a fuller answer on how much your field actually changes , including which questions differ and what it means for revision.

• Adult nursingRN1
• Mental health nursingRN3
• Learning disabilities nursingRN5
• Children's nursingRN8

You can sit the CBT up to three times on one application, with at least ten days between attempts, and you get a new version of the paper each time. Only the part you failed needs resitting: 30 minutes for Part A, or 2 hours 30 minutes for Part B.

If you use all three attempts without passing, the application closes and there is a six-month wait before you can sit it again on a new one. That gap is the reason it is worth going in prepared rather than treating the first attempt as a practice run.

You cannot book directly. The NMC has to invite you first, which happens once your application has reached the stage where the Test of Competence is the next step, and the invitation is what unlocks booking with Pearson VUE. Candidates lose weeks assuming the booking site is open to anyone.

The CBT is sat at a Pearson VUE test centre, and it is available in most countries, so it is normally taken before you travel. The OSCE is the part you have to be in the UK for. You may sit them in either order, and most people take the CBT first for that reason.

The result is not given to you in the room. It goes to the NMC and reaches you through your NMC account rather than from the test centre, and it reports each part separately, because each part is passed separately.

Arrive half an hour early with the passport you registered on your NMC account. Personal belongings go in a locker, including your phone and watch, and you cannot get to them during a break. There is no scheduled break: the three hours are yours to pace, and any break you take comes out of them.

You get an erasable note board and a marker, and you must not write on either until the tutorial has finished. Writing beforehand counts as brain dumping and will put your result on hold.

There is an on-screen calculator for the numeracy part, so you are not doing the arithmetic by hand, and you cannot bring your own. Practising on paper and then meeting an on-screen calculator under a clock is a small shock that is easy to avoid.

These are not knowledge gaps. They are the things a capable nurse gets wrong because the UK does something differently from where they trained.

• Revising both parts together. They are passed separately and reward different work. Numeracy improves with short daily practice; clinical questions do not. Mixed revision usually means the numeracy gets whatever time is left.
• Pacing to the wrong clock. Part A is 15 questions in 30 minutes, which is two minutes each. Part B is 100 in 2 hours 30 minutes, which is ninety seconds each. The clinical part is the tighter one, and most people expect the opposite.
• Reading the unit rather than the number. Milligrams against micrograms, grams against milligrams. Converting after dividing rather than before is the single commonest arithmetic error, and it produces an answer a thousand times out that still looks plausible.
• Answering with what is safest everywhere. Several options are usually defensible. The paper asks for the best next action in UK practice, which often means escalating, documenting or gaining consent before doing the clinically obvious thing.
• Leaving numeracy answers blank. There is no negative marking, so an unanswered question and a wrong one score the same. A guess costs nothing.

The NMC publishes how many questions come from each part of the blueprint, so it is possible to know in advance where the marks are. There is a page for each of the 15 sections, with what it covers, what it is worth, where candidates lose marks, and sample questions.

Browse the CBT section by section