The Occupational English Test (or OET) is an alternative exam to IELTS for healthcare students and medical professionals who need to demonstrate their English language proficiency. This exam is becoming more popular because it focuses more on the practical language you will need in the workplace. In this guide, we will answer the most frequently asked questions about the test. Let’s take a look!
The OET can be expensive, so it is right that potential candidates ask questions before committing to take the test. Here are answers to some of the most frequently asked questions about the OET exam.
The OET (Occupational English Test) is an English language exam for non-native English speakers who need to demonstrate adequate English language skills for study or work in the healthcare profession.
The OET has four parts (or sub-tests):
These sub-tests happen on the same day. Be prepared for the whole exam to take around three hours to complete. For more information about the format, follow this link.
The OET is for non-native English speakers who need to prove their English level in order to work in the medical field. There are 12 different versions of the OET for the following medical professions: nurses, doctors, dentists, pharmacists, optometrists, podiatrists, occupational therapists, veterinarians, speech pathologists, dieticians, physiotherapists and radiographers. Each exam follows the same format and content for the reading and writing sub-tests, but the speaking and listening skills have profession-specific content.
The OET is recognised by healthcare regulators and institutions in the UK, Ireland, Australia, New Zealand, Canada, the USA, Spain, Ukraine, Malta, the Maldives, the Philippines, Singapore, Dubai, U.A.E., Qatar and Namibia. For an up-to-date, and more detailed, list of the healthcare regulators that recognise the OET, please check this website.
Another bonus of passing the OET in the UK is that if you pass it, you do not need any further proof of your English proficiency for Tier 2 visas.
At the time of writing, it costs around £315–£325 to take the OET. Prices vary depending on if you sit all the four sub-tests on the same day or take them individually (many regulators demand that you take all for on the same day). The test price also varies slightly depending on what country you are taking it in. One good thing about taking the OET online (OET@home) is that you do not have to pay to travel to the nearest test centre.
The short answer is: it depends. You can take the OET online (OET@home) and the format is exactly the same with the speaking test, carried out on Zoom. The problem is that not all institutions and healthcare regulators accept the online version. You should check with yours to see if they allow you to take OET@home or require you to take the paper-based test (or computer test) at an official test centre.
If you are taking the OET at home, you need to feel comfortable on a computer and have the appropriate system requirements. For more details on this, check this webpage.
To sit OET@home, you will also need to use remote proctoring. This is a process in which OET moderators (called invigilators) will check to see who you say you are and look out for inconsistencies in your behaviour and answers.
There will also be limitations on your device’s functionality, such as the disabling of screenshots and the prevention of access to the internet while taking the exam.
If you have to take a paper-based or computer-based exam at a test centre, you will need to bring:
You can also bring a drinking bottle, but it must be clear with no label.
You cannot bring the following items to the test:
The OET is marked with letter grades from E (the lowest) to A (the highest). To achieve these grades, you need to obtain a number of marks from 0 (the lowest) to 500 (a perfect score) for each sub-test (reading, listening, writing and speaking).
Here is a table with the marks for E–A grade boundaries and the skills you need to demonstrate to achieve them:
| OET Score | OET grade | English Skills |
| 400–500 | A | Highly proficient. Able to communicate fluently and accurately. Can understand verbal and written communication easily. |
| 350–440 | B | Effective communicator with some inaccuracies and a few errors that do not prevent communication. |
| 300–340 | C+ | Satisfactory communicator despite occasional errors |
| 200–290 | C | Able to understand standard language but needs clarification with high-level language. |
| 100–190 | D | Can understand simple communication and routine tasks but needs clarification. Frequent errors may make communication difficult. |
| 0–90 | E | Can understand basic language but can only interact if the person they are communicating with constantly clarifies language. |
The problem is that different medical professions and different healthcare regulators require different grades. For example, the nursing OET requires Bs in reading (350), speaking (350) and listening (350), but only a C+ (300) for writing. The medicine OET (for doctors), on the other hand, demands at least a B in all four sub-sets to pass.
It is best check with your regulator for the required grade boundary for your profession.
Again, this depends on which profession and/or regulatory board you are applying to. Some regulators allow you to only resit one sub-test skill if you passed all the others the first time.
Other bodies, such as the GMC (General Medical Council), in the UK, require that a medicine OET candidate achieves all four Bs in the most recent sitting of the exam.
Alternatively, the NMC (Nursing and Midwifery Council) states that you can combine the grades from the last two sittings and combine them in order to meet the grade boundaries for each sub-set. You must sit these tests within six months of each other and take the tests for all four skills at the same time. In addition, you can score no lower than C+ for any sub-test in all four skills, and you need to achieve a B in all sub-sets when you combine the two test results.
A recognised pass combination of two tests for the NMC would look like this:
| Test/Sub-test | Reading | Listening | Writing | Speaking |
| Test 1 | B | C+ | B | C+ |
| Test 2 | C+ | B | C+ | B |
There is currently a debate about lowering the writing level to C for nursing because so many candidates pass well in all other sub-tests and just fail the writing. As the NHS needs staff, and retaking the exam is expensive, this requirement could change soon. There is also a similar debate about lowering the writing grade to C+ for doctors within the GMC.
The most important thing to remember is that it really depends on your healthcare profession and regulator, so make sure you check with them.
The OET website says that for paper-based, computer-based (at a test centre) and OET@ home exams, you will get your results in 12 working days (days that do not include weekends or holidays). You can view these results online via your OET account. You will receive your paper certificate 7 days after they give the results online.
You can make a request for a re-mark of your test if you believe there is a mistake with the results. You must make this request within the 72 hours after the OET board post the results online.
On the OET website, the price is $120 (Australian) and $95 (US) per sub-test. We are currently unable to find information on the UK price. However, based on the other currencies, it should be around £70–80.
This is a lot of money to pay for a re-mark on each skill, so it is only a good idea if you scored very close to the grade boundary. Especially, as a re-mark can make your grades go down instead of up too.
That being said, there are internet forums where people claim to have had success with a re-mark, scoring the extra points to put them in the grade boundary they needed. So it may be worth considering.
This again depends on the healthcare regulator or institution you are applying to, but bodies in the UK, such as the NMC (Nursing and Midwifery Council) and GMC (General Medical Council), state that OET results are valid for two years. The best thing to do, once again, is to check with the specific regulator or institution.
English level: The amount of preparation you need depends on your current English level. The OET grade B is equivalent to a C1 level on the CEFR (Central European Framework) for language, which is the way the English level of most students is assessed. A C1-level English learner is “Advanced”.
Tutors: A private tutor or language school can tell you what level you are. The lower your level, the more preparation you need to do. For example, if your level is A2 (pre-intermediate), it would possibly take a couple of years to be ready for the OET. If your level is B2 (upper-intermediate – the level before C1) it will take far less time.
Tutors can also help you identify and work on any skill area in which you are weak and provide you with suitable material and training to help you prepare properly.
The OET website has a lot of free sample papers, advice and videos of candidates taking the speaking test, so that is probably the best place to start.
There are also many great books for OET preparation, such as the Cambridge guides for different OET professions, The Official Guide to OET (published by Kaplan and produced by the test maker), Go for OET and the OET Skills Builder series for all the sub-tests and grammar. There is also the OET Writing Strategy Guide, which is a highly detailed book just for the writing part.
In addition, there are YouTube resources devoted the OET exam. This is a great one: E2 test prep.
The IELTS (International English Language Testing System) is another exam that you can take to prove your English level is sufficient to enter the medical profession. Your decision on whether to take the IELTS or OET should depend on several factors:
Cost: IELTS is cheaper (around £180) than the OET (around £320).
Content: IELTS tests the same four skills: reading, listening, writing and speaking. It is also a similar length to the OET: the IELTS reading, listening and writing take around two and a half hours to complete, and the speaking test is 14 minutes. One difference is that you take the IELTS speaking test on a different day, whereas you sit all the skills on the same day with the OET.
The main difference when it comes to content is that there are only two types of IELTS exams: general or academic. If you want to work in the medical profession, you should take the academic test. However, even though this test contains academic material, it is much more general than the OET, which prepares you for communication in your profession. The OET’s professional relevance is the main reason people choose it over the IELTS.
You need to think about price vs. relevance when choosing whether to take the IELTS or OET.
Validity time: As we said earlier, the time your results are valid for depends on the regulator or institution you are applying to. However, like the OET results, many regulators and institutions state that the IELTS is valid for two years in the UK. The scores also have similar conditions for combining grades. For example, doctors need to achieve the required IELTS grades in one sitting, but nurses can combine grades from two sittings.
You need to achieve an average score of 7.5 with no score lower than 7.0 for any skill in the IELTS test to meet the language skill requirements for doctors. Nurses need to obtain an average of 7.0 for the whole exam with no lower than 7.0 in reading, listening and speaking, and no lower than 6.5 for writing.
The IELTS 7.0 and 7.5 scores are equivalent to a C1 level on CEFR. Therefore, the grade requirements to pass each test are similar. Here is a table that compares OET and IELTS grades with CEFR levels:
| OET Score | OET Grade | IELTS Score | CEFR Level |
| 400–500 | A | 9 8.5 8 | C2 C2 C2 |
| 350–440 | B | 7.5 7 | C1 C1 |
| 300–340 | C+ | 6.5 | B2 |
| 200–290 | C | 6 5.5 | B2 B2 |
| 100–190 | D | 5 4.5 | B1 B1 |
| 0–90 | E | 0–4 | A2 & A1 |
As you can see, you still need to have an advanced CEFR level to achieve a 7.0 and 7.5 in IELTS. So, in terms of grade boundaries the difficulty is the same.
That being said, there are rumours that the OET is easier than IELTS because there is a higher first-time pass rate for OET test takers. 73% of OET candidates pass first time, whereas most academic IELTS candidates score around 6.5, which is below the grade boundary needed.
This isn’t necessarily because the OET is easier, but rather because the candidates taking the OET have far more experience with the test material (medical English material, such as reading prescriptions, X-rays, writing referrals, etc.) than they do writing academic essays on another topic, as you have to do for the IELTS.
As a result, another thing you should consider before choosing the OET or IELTS is your knowledge of medical English. If you have a lot of experience in this area, the OET will be less difficult, whereas if your medical English knowledge is limited, it may be better to take IELTS.
As we mentioned earlier, the writing sub-test is often the one that most candidates score lower on. Consequently, the grade boundary for this skill is lower for some professions, and there is a debate among regulators to push this grade down further, even for doctors.
It may not necessarily be that the writing sub-test is any harder than the other three skills. This is because people do not practise writing as much as they do other skills when they are learning a language. Also, even though we write more than ever these days (text messages, social media posts, emails), we don’t typically practise well-structured writing for formal purposes.
It is difficult to definitively say which sub-test is the hardest – it really comes down to the individual. Some people find the time pressure hard on the reading and listening questions, so practising under similar conditions will help them feel less stressed in this area.
Others might have interference problems with their accent that prevent them from being understood clearly. In saying that, it is important to note that a ‘perfect’ accent is not needed for the OET if the moderators can understand you – i.e. you don’t need a standard American, British or Australian accent to pass.
As we said before, the OET requires you to have an advanced English level. The mistake most candidates make is taking the exam before they have the appropriate language skills. It is not a basic language skills test. The OET is a comprehensive exam that requires you to have a deep understanding of English as well as the ability to independently produce the language you will need in your career.
It is important to know your English level before taking the exam so that you can do the appropriate amount of preparation, which may be a lot more than you think!
The OET is quite expensive, especially if you have to resit the exam. Therefore, it is essential that you have the right guidance and do sufficient preparation before taking it. At OTUK, we have tutors that can assess your level, advise you on preparation time and train you with suitable and up-to-date material so that you have the highest possible chance of success on exam day.
Contact us today to book your free 15-minute consultation and find out how our online coaching can take your OET prep to the next level!
Sam Savage is a TEFL-qualified English tutor and writer from England. After gaining his TEFL qualification, he started teaching English in Spain in 2009. During this time, he also worked as an editor/translator for art organisations and publications in Madrid. He later returned home and graduated from the University of Gloucestershire with a MA in Critical and Creative Writing. In his free time, he enjoys all things cultural, especially writing fiction. Sam is also a published author.
