TPG International

Candidate Information

IELTS – International English Language Testing System

What is the difference between IELTS and OET?

Both IELTS (International English Language Testing System) and OET (Occupational English Test) are used to test the English language of healthcare professionals in different parts of the world.

They are chosen by regulatory bodies to ensure doctors, nurses and other professions have sufficient language skills to communicate at a high level with patients and colleagues, and so ensure safe and effective care.


There are a number of similarities between the two tests.

Each one consists of four sub-tests, one for each skill: reading, listening, writing and speaking. A test takes place on one day. There is no pass/fail, but a graded score – different institutions need test takers to achieve different scores.

In practice, the required scores in the two tests for professions such as nurses are for similar levels of language skill when measured on the Common European Framework of Reference.

Both tests were developed in the late 1980s and are part-owned by Cambridge Assessment English. IELTS ownership is shared with IDP and the British Council. OET ownership is shared with Boxhill Assessment.

However, that’s where the similarities end. As you can see from the below, they are quite different tests in many ways.



IELTS tests academic English – at least the version of IELTS used by Higher Education institutions and healthcare regulatory bodies around the world. This includes the ability to write essays, follow lectures, understand academic articles and discuss a wide range of topics, from the environment to education to social trends to cultural values.

OET tests healthcare English, including the ability to communicate effectively in medical scenarios, write a referral letter, understand a patient consultation, or follow a text taken from a medical journal.


IELTS offers 2 versions of the test – Academic as described, and General Training, used by organisations to test the more general language considered more appropriate for immigration or vocational purposes. The Listening and Speaking sections are the same for both. The Academic Reading and Writing is more geared to Higher Education than the General Training.

OET offers 12 versions of the test for different healthcare professions; nurses, doctors, dentists, pharmacists, optometrists, podiatrists, occupational therapists, vets, speech pathologists, dieticians, physiotherapists, and radiographers. The Reading and Listening sections are the same for both. The Speaking and Writing sections are tailored to the specific scenarios in which each profession uses English.

Preparation requirements

Preparing for IELTS involves learning huge amounts of vocabulary on a wide range of academic subjects so test takers are prepared to read academic texts quickly and effectively, understand lectures and discussions, talk about abstract questions and give opinions in detail. Test takers need to learn how to write reports on a variety of data and a range of essay types. Written texts need to be at an advanced level and so include complex structures and grammar. Learning a set of key exam techniques is also crucial.

Preparing for OET involves learning a wide range of healthcare-related and profession-specific language, so test takers are able to follow, engage with and participate in a variety of clinical scenarios, as well as understand medical texts and talks. They need to be able to write a healthcare-related letter, such as a referral letter, at an advanced level. They need to acquire a range of exam techniques so they can work quickly and effectively in the test.

As a result, preparation courses for the two tests follow very different pathways and use very different materials.


IELTS is marked out of 9, with a separate score for each paper. Half marks are awarded as part of this. OET is graded from A (best) to E.

Healthcare regulatory bodies which use both exams to test English for healthcare professions tend to specify an advanced C1 level of language, i.e. around 7 in IELTS and a B in OET.

The score equivalencies between the two tests are as follows:

8 – 9 A
7 – 7.5 B
5.5 – 6.5 C
4.5 – 5.5 D
4 E


IELTS is recognised by universities, regulatory bodies, immigration authorities and companies in many countries around the world. This includes universities in non-English speaking countries where a course may be delivered in English. There are over 1,100 test centres in over 140 countries. OET is recognised by healthcare regulatory bodies and Higher Education healthcare educators in Australia, New Zealand, Singapore, Dubai, and Namibia. There are over 80 test venues in 35 countries.

Numbers of test takers

Over 3 million people took IELTS in the past year, compared to around 25,000 for the OET. This reflects the size and reach of the global Higher Education market on the one hand and the specialist nature of the OET on the other. Until now, the main market for OET has been those professionals wishing to work in Australia.

Preparation infrastructure

IELTS has a global infrastructure developed around preparing learners to take the test, including universities, private language schools, published materials, online content, and thousands of teachers and writers.

OET has a small, specialist preparation infrastructure, with a small number of providers and a minimal materials base.

What is IELTS?

IELTS: International English Language Testing System, regulated and owned by three companies:

The British Council (
Cambridge English Language Assessment (
IDP – Educational Organisation (

IELTS is a global test for a global language. Many people undertake IELTS for further study, work and travel. The IELTS test is standardised across the world.

For your NMC registration, Nurses must undertake the ACADEMIC module.

IELTS Examines 4 areas of language competence:

• Listening
• Speaking
• Writing
• Reading

IELTS test summary (ACADEMIC module)


The Listening section lasts 40 minutes. Includes 4 recorded monologues and conversations. Includes candidates having to answer multiple choice questions and note completing. The recordings will only be played once each time.


Takes between 11-14 minutes in 3 parts and is assessed by a face to face interview. Is marked in terms of fluency and coherence, lexical resource (vocabulary), grammatical range and accuracy and pronunciation.


Takes 60 minutes with 2 parts. 1st part requires the candidate to write 150 words summarising and describing a table/ graph or other illustration. 2nd part requires the candidate to write 250 words as a short essay to replicate what might be required in academic studies.


The reading section is different for academic and general modules. The candidate will complete 40 questions in 1 hour. Includes 3 long reading passages, ranging from descriptive to factual. Candidates will then be asked questions about the texts. Includes non-verbal material and authentic texts from books.

How IELTS is marked?

You will be given a score from 1 to 9 for each part of the test – Listening, Reading, Writing and Speaking. The average produces your overall band score. You can score whole (e.g., 5.0, 6.0, 7.0) or half (e.g., 5.5., 6.5, 7.5) bands in each part of the test. The following rounding conversion applies: if the average across the four skills ends in .25, it is rounded up to the next half band, and if it ends in .75, it is rounded up to the next whole band. For registration with the NMC you need a score of 7.0 in each area, and an overall score of 7.0 or more. Your IELTS results will be available 13 days after your test and recorded on a Test Report Form.

Here you can find some examples how the overall band is calculated:

  Listening Reading Writing Speaking Average score* Band score
Test taker A 6.5 6.5 5 7 6.25 6.5
Test taker B 4.0 3.5 4.0 4.0 3.875 4.0
Test taker C 6.5 6.5 5.5 6.0 6.125 6.0

* Average score = total of the four individual component scores divided by four.

Getting candidates to IELTS 7.0

How difficult is 7.0?

A score of 7.0 is high. It is rated as a C1 level on the European Framework of Language, which is an advanced level, equivalent to that expected of a second year Modern Languages undergraduate in the UK. It is also the level of English required by overseas students who wish to study at Oxford or Harvard Universities.

How long does it take to improve an IELTS score?

To go up 1 band in IELTS takes most students approximately 200 to 300 hours of study, consisting of face-to-face tuition and guided self-study, and the higher the level, the more is required.

The CEO of International House London, the UK’s largest IELTS test centre suggests the following: “Assuming candidates have experience of test format, progress up the bands is much quicker from a low base from e.g. 4.0 to 5.0 around 150 -200 hours; 5.0 to 6.0 needs 200 hours +; 6.0 to 7.0 needs 300 hours +”

When tested, most EU nurses that we work with benchmark at around 5.0 or 5.5 in IELTS. This means they really need 500 hours or more of study in order to achieve the level set by the NMC.

The IELTS Test is certainly ‘teachable’, but it is necessary to be realistic on the timelines concerned.

IELTS preparation and assessment

Specialist Language Courses (SLC) in partnership with Primary Care Recruitment works with clients to prepare candidates to achieve 7.0 in the four papers. It looks at the full training cycle, from initial assessment to training to post-test options for those who don’t succeed. For more information check the GUIDE FOR TRAINING AND RECRUITMENT PROFESSIONALS IN UK HEALTHCARE

Useful links

IELTS – International English Language Testing System -
IELTS Articles -
British Council -