For most nurses and doctors, IELTS vs OET is not a question of which test is easier. The main regulators in the UK, Ireland and Australia accept both, and most set matching targets: OET grade B for IELTS 7, and OET C+ for IELTS 6.5. The right choice depends on where you are registering, which test's tasks suit you, and how much room for a retake you need.
In some cases the choice is made for you. Doctors applying for ECFMG certification in the US must take OET Medicine, because IELTS isn't accepted. Nurses moving to Canada are usually better off with IELTS, because Canada's immigration department doesn't accept OET. And in Australia, since 23 April 2026, Ahpra asks for a higher OET Writing score (350, which is grade B) while its IELTS scores haven't changed. This guide compares the 2026 rules side by side so you can pick the test with the best chance of getting you registered first time.
What is the difference between IELTS and OET?
IELTS Academic tests the English you need for university study, and it is also used for professional registration. Everyone takes the same test, whatever their job. Regulators accept only the Academic version, not General Training, so check that before you book. Our guide to IELTS Academic vs General Training explains the difference.
OET (Occupational English Test) is designed for healthcare workers, with versions for 12 professions, including nursing and medicine. Listening and Reading are the same for every profession. Writing and Speaking use tasks from your own profession, so a nurse takes OET Nursing and a doctor takes OET Medicine.
| IELTS Academic | OET | |
|---|---|---|
| Listening | About 30 minutes, 40 questions, everyday and academic situations | About 40 minutes, 42 questions, healthcare situations such as patient consultations |
| Reading | 60 minutes, 40 questions on three long academic passages | 60 minutes, 42 questions; Part A is a strict 15-minute task on four short healthcare texts |
| Writing | 60 minutes, two tasks: describe a chart or diagram (150+ words) and write an essay (250+ words) | 45 minutes, one letter of 180–200 words, such as a referral or discharge letter, written from case notes |
| Speaking | 11–14 minutes, an interview with an examiner on everyday topics | About 20 minutes, two 5-minute role-plays with an interlocutor playing a patient or relative |
| Scores | Bands from 0 to 9 in half bands, plus an overall band | 0 to 500 for each sub-test, shown as grades A to E; grade B is 350–440 |
| Results (on computer) | Usually within 1–2 days | As little as 48 hours; OET says 95% arrive within 6 days |
| Fee | Set by country, for example INR 19,000 in India | AUD 587 in most countries (USD 455 for computer and home tests in the US) |
| At-home version | IELTS Online | OET@Home |
The fee gap is real in many countries. OET charges the same AUD 587 almost everywhere, which comes to well over the INR 19,000 IELTS fee in India once converted. Check both prices in your own currency before you decide.
IELTS vs OET scores: what each regulator asks for in 2026
Here are the minimum scores from each regulator's own website, checked in November 2026:
| Regulator | IELTS Academic | OET |
|---|---|---|
| NMC (UK nurses and midwives) | 7 in Listening, Reading and Speaking; 6.5 in Writing | B (350) in Listening, Reading and Speaking; C+ (300) in Writing |
| GMC (UK doctors) | 7.5 overall, with at least 7 in every skill | B (350) in every sub-test of OET Medicine |
| NMBI (Irish nurses and midwives) | 7 overall, with 7 in three skills and 6.5 allowed in one | B in three sub-tests and C+ allowed in one |
| Ahpra (all Australian National Boards, tests from 23 April 2026) | 7 overall; 7 in Listening, Reading and Speaking; 6.5 in Writing | 350 Listening, 360 Reading, 350 Writing, 360 Speaking |
| ECFMG (US doctors, 2027 Pathways) | Not accepted | OET Medicine: 350 in Listening, Reading and Speaking; 300 in Writing |
You can check the details on the NMC's accepted tests page, the GMC's English language guidance, the NMBI's English requirements and ECFMG's OET page. Two of these rules change the IELTS vs OET decision more than most guides admit.
Australia raised the OET bar on 23 April 2026
Until 22 April 2026, Ahpra asked for grade B in OET Listening, Reading and Speaking and C+ in Writing. For tests taken on or after 23 April 2026, Ahpra's accepted tests page now asks for numeric scores: 350 in Listening and Writing, and 360 in Reading and Speaking. The same scores apply to every profession, including nursing, midwifery and medicine.
Ahpra says the update follows new score research and the scores set by the Department of Home Affairs, and that the level of English required hasn't changed. In practice, though, OET Writing now needs 350, which is grade B, not C+. Reading and Speaking need 360, one step above the lowest B. The IELTS requirement stayed the same: 7 overall, 7 in Listening, Reading and Speaking, and 6.5 in Writing.
So if you chose OET because "nurses only need C+ in Writing", that is no longer true for Australia. Many guides still list the old letter grades, so always check which table applies to your test date.
UK doctors: IELTS 7.5 overall vs grade B in every OET sub-test
The GMC asks for more than 7 in each IELTS skill. You also need 7.5 overall, in the same test and in your most recent sitting. Because the overall band is the average of your four scores, rounded, you need an average of at least 7.25. With 7 in every skill, that means two skills at 7.5 or one at 8:
| Listening | Reading | Writing | Speaking | Average | Overall | |
|---|---|---|---|---|---|---|
| Not enough | 7.0 | 7.0 | 7.0 | 7.0 | 7.0 | 7.0 |
| Enough | 7.5 | 7.5 | 7.0 | 7.0 | 7.25 | 7.5 |
You can try your own scores in our IELTS band score calculator. OET Medicine has no extra overall target: grade B in each sub-test is enough. That is the main reason many doctors choose OET for the GMC. IELTS has one advantage, though: the GMC accepts IELTS One Skill Retake, so one weak skill doesn't mean resitting the whole test.
Retakes, combined scores and home tests
These rules matter as much as the scores, because they decide what happens if you miss your target by half a band in one skill.
| Regulator | IELTS One Skill Retake | Combine two sittings | IELTS Online | OET@Home |
|---|---|---|---|---|
| NMC (UK) | No | Yes, within 12 months | No | Yes |
| GMC (UK) | Yes | No, one sitting only | Yes | Yes |
| NMBI (Ireland) | No | No, one sitting only | No | No |
| Ahpra (Australia) | Yes | Yes, within 12 months | No | No |
| ECFMG (US) | Not applicable | No, one sitting only | Not applicable | Only if your country has no test centre |
A few details sit behind this table:
- Combining has minimums. The NMC lets you combine two sittings of the same test, but no score in either sitting can be below 6.5 (6 in Writing) for IELTS, or below C+ (C in Writing) for OET. Ahpra's minimums are 6.5 in every IELTS skill, with 7 overall in each sitting. For OET tests from 23 April 2026, they are 320 in Listening, 340 in Reading and 350 in Writing and Speaking.
- You can't mix tests. Two IELTS sittings or two OET sittings can be combined, but never one of each.
- OET has no single-skill retake. If you miss grade B in one OET sub-test, you sit all four again. With IELTS, you can retake one skill within 60 days, where your regulator accepts it. Our guide to IELTS One Skill Retake explains the rules and fees.
- Australian visas follow the same home-test rule. Australia's Department of Home Affairs accepts both IELTS and OET for visas, but not IELTS Online or OET@Home.
Is OET easier than IELTS for nurses and doctors?
No official study shows that one test is easier, and most regulators set matching targets for the two. What differs is the type of English each test rewards, so one will usually feel easier to you.
OET may suit you if:
- You write referral or discharge letters at work and can pick out the important case notes quickly.
- You are confident talking to patients in English. OET Speaking marks clinical communication, such as building a relationship with the patient, understanding their concerns, gathering information and explaining clearly.
- Medical topics feel easier to you than general academic topics, such as an essay on city planning.
IELTS may suit you if:
- You can write a clear 250-word argument essay and describe a chart in 20 minutes.
- You might need IELTS for something else later, such as study or Canadian permanent residence.
- You want fast results (usually 1–2 days on computer), a lower fee where you live, or the One Skill Retake safety net.
One common trap: OET is not a test of medical knowledge. Its Writing is marked on six criteria, including purpose, conciseness and language, and spelling mistakes cost marks in Reading. Strong clinicians still miss grade B because of language accuracy, so prepare for OET as seriously as you would for IELTS.
Which test should you take? A quick decision guide
Start with where you are registering, then look at your strengths:
- US doctors (ECFMG): OET Medicine. IELTS is not accepted, and for the 2027 Pathways you need the scores in one sitting on or after 1 January 2025.
- Canada: IELTS. Canada's Express Entry accepts IELTS General Training but not OET, and provincial nursing regulators mostly name IELTS Academic or CELBAN. You may need IELTS Academic for registration and General Training for permanent residence.
- UK doctors (GMC): OET if you expect grade B in all four sub-tests but not 7.5 overall in IELTS. IELTS if you are strong in Listening and Reading and want the One Skill Retake option.
- UK nurses and midwives (NMC): either. The targets are equal, and both tests can be combined across two sittings. OET@Home is accepted, but IELTS must be taken at a test centre.
- Ireland (NMBI): either, but you need all your scores in one sitting with no home tests or retakes. Choose the test where you have the biggest margin.
- Australia (Ahpra): look closely at Writing. Since April 2026, IELTS Writing still needs 6.5 while OET Writing needs 350 (grade B). IELTS also allows One Skill Retake for Ahpra.
For the UK, you don't need a separate IELTS for UKVI after OET. The Health and Care Worker visa guidance says doctors, dentists, nurses and midwives don't need to prove their English again if they passed an assessment accepted by their regulator.
If your regulator accepts both tests, test yourself in both formats before you book. OET publishes free sample tests on its website, and you can take timed IELTS tests on PrepAsk. Compare how far you are from each target, and book the test with the bigger margin.
How to prepare for IELTS as a nurse or doctor
For the NMC, NMBI and Ahpra, your targets are 7 in Listening, Reading and Speaking and 6.5 in Writing. For the GMC, you need 7 in every skill and 7.5 overall. Here is how to work on each skill.
- Writing (6.5 or 7): IELTS Writing is marked on four criteria: Task Achievement (Task 1) or Task Response (Task 2), Coherence and Cohesion, Lexical Resource, and Grammatical Range and Accuracy. In Task 1, always write an overview of the main trends. In Task 2, answer every part of the question. Health topics do come up, but don't rely on clinical vocabulary or abbreviations, because the examiner is checking your general academic English. Practise IELTS Writing on PrepAsk to get a band score for each criterion and feedback on what to fix.
- Speaking (7): IELTS Speaking is not a role-play. You talk about yourself, then a topic card, then broader questions. Extend your answers with reasons and examples, and don't recite memorised scripts. Practise IELTS Speaking by recording your answers and checking your fluency, vocabulary, grammar and pronunciation scores.
- Reading and Listening (7): a Band 7 needs roughly 30 correct answers out of 40, similar to OET's 30 out of 42 for grade B. Speed is the usual problem in Reading, and spelling costs marks in Listening. Take full IELTS Reading tests and IELTS Listening tests on PrepAsk, then use the review to see where each answer was in the passage or transcript.
The bottom line
The NMC, GMC, NMBI and Ahpra all accept IELTS and OET at similar levels, so the "easier" test is the one whose tasks match your strengths. The rules around the scores often decide it: US doctors need OET Medicine, Canada favours IELTS, the GMC's 7.5 overall pushes many doctors to OET, and Australia's April 2026 change makes OET Writing harder than before.
If your regulator accepts IELTS, find out where you stand before you pay for any test. Take a full set of IELTS practice tests, compare your scores with your regulator's targets, and focus your preparation on the skill that is furthest away.
