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Lower fees, more phases: Australia’s new registration system for internationally qualified nurses explained

SA government is boosting and upskilling the frontline workforce to prepare South Australia for the pandemic. Source: Getty Images/Tom Merton

Starting next month Australia will move to a new assessment model for internationally qualified nurses and midwives, which will see lowered fees but a more complex system of assessment.

In 2018 the Nursing and Midwifery Board of Australia (NMBA) had announced the introduction of a new assessment model for internationally qualified nurses and midwives (IQNMs) seeking registration in the country.

After reducing the number of assessment criteria from eight to three early last year, the NMBA is now moving to an Outcomes-Based Assessment (OBA) for overseas nurses not having “substantially equivalent” qualifications. The new system will replace the existing bridging program. 

“IQNMs will be able to start the new model of assessment in March 2020,” the NMBA said in a statement announcing the fees structure and other details of the process. 


    • Outcomes-based assessment will start in March 2020
    • Fees will be less than half of the current ‘bridging program’ system
    • Most of the assessment phases could be completed from overseas
    • Objectively structured clinical exam (OSCE) will be conducted at Adelaide

The Outcomes-Based Assessment is applicable for nurses and midwives "who hold a qualification that is relevant but not substantially equivalent or based on similar competencies to an Australian approved qualification."

“IQNMs will need to successfully complete the steps in the OBA before they can apply for registration (in Australia),” an NMBA spokesperson told SBS Malayalam.

The nurses and midwives must also meet the mandatory registration standards.

Melbourne-based education consultant Jaison Thomas from SanJose Consultancy pointed out that it was still not clear whether the new assessment system would be easier or difficult for the applicants.

“We are yet to know the exact structure of OBA. We will have to wait till someone has gone through it,” Mr. Thomas told SBS Malayalam.

More steps

The new assessment model consists of three major phases with many sub-phases, most of which could be completed from overseas.

New assessment model for internationally qualified nurses in Australia
Getty Images/Jetta Productions

The process starts with a self-check, in which the qualifications of the applicant will be assessed. Every IQNM is required to go through this self-check process and a two-part Orientation program.

Those nurses and midwives who hold a qualification ‘substantially equivalent’ to an Australian approved qualification can apply for registration after this.

If the qualification is ‘relevant but not substantially equivalent’, then the applicant has to complete an outcomes-based assessment (OBA).

OBA will have two phases, says the NMBA statement. The first stage is a multiple-choice question exam (MCQ) and the second an objective structured clinical exam (OSCE).

“The MCQ exam will be available in all countries,” an NMBA spokesperson told SBS Malayalam. It will be a cognitive test.  

Only after successfully completing the MCQ, applicants will be able to move to the second part of OBA.

OSCE, or the second part, will be managed by the Australian Health Practitioner Regulation Agency (AHPRA) and will be delivered at South Australia based Adelaide Health Simulation facility.

It is a behavioral assessment “developed to assess that an IQNM demonstrates the knowledge, skills and competence of a graduate level Australian nurse or midwife,” the NMBA says.

Fees go down

In the current system internationally qualified nurses and midwives were able to qualify for registration only after completing a short-term bridging program.

Melbourne-based education consultant Jaison Thomas said that the fees for such bridging programs ranged from $15,000 to $18,000.

However, the new system brings down the fees dramatically, and more nurses will be able to apply 

As per the NMBA statement, the fee for OSCE will be AUD $4,000.

For the MCQ exams, fee structure will be different for nurses and midwives. For registered nurses, the National Council of Licensure Examination for Registered Nurses (NCLX-RN) delivered by Pearson VUE test centres will cost USD $200 registration fees and USD $150 as international scheduling fee.

For midwives, the MCQ will be delivered through Aspeq test centres costing NZD$165 plus overseas venue fee.

Details of the MCQ for enrolled nurses are not announced yet.

nursing assessment change
GettyImages/Jetta Productions Inc.

Even though the first step – self-check – is free, any applicant moving forward will have to pay an assessment fee of AUD $640.

“The NMBA will not have any programs for preparing for the MCQ exam and OSCE. Candidates will be required to prepare as they would for any examination,” a spokesperson told SBS Malayalam.