After posting entries about what I experienced during my UKRN application from taking the IELTS for UKVI to sitting the Computer Based Test (CBT), it took me a while before I was able to finally organize my thoughts about what truly happened during my OSCE (Objective Structured Clinical Examination). Laziness aside, I think I might’ve just slipped through repression as a defense mechanism after it all. LOL.
It was in April of 2018 when I first came to the UK, with only 37kg of what I could fit of my life into my luggage, armed with big hopes and dreams. As redefining as it was, I still quite vividly remember how it was also a bunch of blurry, uncertain moments that just had me jump from one experience to the other, not entirely knowing what I was doing. All I knew then was that after all of the initial triumph that I felt after acing the IELTS and the CBT, I could feel that my struggles were far from over.
A few months prior..
After passing the CBT, I was given instructions regarding all of the paperwork that I needed to complete. Disorganized as I am as a person, I actually do like administrative stuff. Paperwork is totally my jam. There’s just something about the sense of collection, completion, and organization of documents that I find weirdly satisfying. The guide with the downloadable forms that the NMC (Nursing and Midwifery Council) will send you after passing the CBT is pretty detailed anyway, so it’s relatively easy to follow. Just make sure (and this is very important, from what I’ve gathered from reliable sources) that your documents are as official as possible, as it will be inspected by the NMC, which is the nursing and midwifery sector of the UK government. This generally means that everything has to be on letterhead paper, with official seal and signature, neatly folded inside a letterhead envelope, the works. Then it has to be sealed, signed (by the assigned signatory of the institution where the document is coming from) over the sealed flap, and then taped shut.
It sounds like a lot of work, but try not to panic and just do one thing at a time, and you’ll eventually get there. Once you have everything you need, you’ll have to send them to the NMC office in the UK (except for your PRC certificate, which you’ll have to pay for at the PRC office and they’ll send it directly to NMC themselves). For added peace of mind, I would suggest sending your documents via a trusted international courier that offers tracking services, as not only is it much faster, you’d also have proof that the NMC received your documents.
After all of this frustrating business, on comes the most painstaking among the requirements, which is having to wait for your decision letter (DL) from the NMC one to two months after sending all these forms in. According to the NMC, they “aim to assess applications within 60 calendar days of receiving all your supporting evidence.” The timeline greatly varies, though, as some may encounter problems with their documents, but once your paperwork is complete, agencies usually don’t have to wait for a decision letter before they can send you here. Some of those from my batch didn’t have a DL, and we all received a letter of sponsorship from our UK employer.
Back to business..
The OSCE is the second and final test of competence for internationally-trained nurses and midwives, the first being the CBT (my blog post about the latter can be found here). Note that “international” here means coming from outside EU (European Union) countries. It’s a practical exam wherein the candidates are tasked to execute common, but specific, nursing procedures under time pressure (15 minutes or less for each station) and while being closely observed by an invigilator.
The OSCE may only be taken in one of the three testing centers in the UK: Oxford Brookes University in Swindon, University of Northampton in Northampton, and Ulster University in Northern Ireland. I have enumerated them in order of the average passing rates from lowest to highest. I took mine at the University of Northampton together with my other friends who were scheduled to take it on the same day. We rented an Airbnb place for the night before our exams to make sure that we arrive early, and it was a lot of fun, if not for the gloomy dark cloud (a.k.a. OSCE) hanging over us the entire time haha.
So basically, the OSCE involves performing simulated patient scenarios and is grouped into two parts: APIE (assessment, planning, implementation, and evaluation), and two nursing skills (there’s a specific list of skills that you need to master for this bit). All of these account to six (6) stations, all of which you need to pass in order to get your NMC PIN. What you will be doing for the nursing skills part is only revealed during the exam itself, so you need to be able to perform each one confidently because you’ll never know what they’ll have you do until you’re already at the station. Also, note that any form of communication with other candidates count as a form of cheating, and mobile phones are not allowed throughout your exam.
I would love to go into detail about the stations, but seeing as how I signed a legal document forbidding me to do so, I’m afraid that I can’t. Anyway, don’t worry because I’m absolutely certain that you will be sufficiently briefed about all this by your new hire trainers upon arrival to the UK.
How much does taking the OSCE cost?
Before July 16, 2018, failing any part of each of the two sets meant having to retake the entire set, but the NMC made revisions to this rule and you will now be required to re-sit only the part of the set/s in which you failed. If this happens, this would also mean that you will be paying for your retake out of pocket, which is either for the full (£992) or partial (£496) cost of the exam. Your initial shot at the OSCE (£794) is usually paid for by your employer, and you are only allowed to take the OSCE three times. If you fail on the third attempt, the NMC will close your application, and you would need to go through the process again (i.e. find another employer to sponsor your application).
Countless times, our OSCE instructors have reminded us that these procedures are tasks that we’ve performed as nurses loads of times, so we should know what to do already. Looking back, I have to agree. The only thing is that during our shifts, apart from anxious relatives breathing down our necks every now and then, there weren’t examiners watching and grading your every move. And you know how oddly conscious you become of every single thing when you know that you’re being scrutinized, right? It’s like as if the pressure goes up to your ears and then covers your brain with a blanket and it suddenly stops working. Scary? Yes, it was absolutely terrifying, with the Hawthorne effect and all that. It was so daunting that upon seeing my friends after I sat my exams, I immediately burst into tears, remembering all of my slip-ups and thinking of reasons why I was sure that they’d fail me.
Turns out they didn’t.
According to this guide authored by the NMC, applicants are informed of the result of the OSCE (full/partial pass or fail) within five working days after their scheduled exam. I took mine on a Thursday (July 12) and I received my results on the following Monday (July 16). I was anxiously checking my email every 15 minutes or so, when I suddenly saw the notification that I just received a new email. One glance at the word ‘congratulations’ was all it took for all my worries in the world to go away. I was in the highest spirits—I was so, soooo happy, but most of all, I was relieved. I was saving up for an electronic Yamaha keyboard and I really didn’t want to pay to re-sit the exams LOL.
Some people say that it’s “easier” to become a UKRN than a USRN because the NCLEX is difficult (and the waiting time is longer). Please keep in mind that this is highly subjective, and I think that it’s tough to even try and compare because their licensure processes are not at all alike. For the record, no, I have not tried taking the NCLEX yet, and I’m not sure if I even wanted to, but I did use NCLEX practice exams for the local board exams before. I have to agree that it wasn’t easy either, but at least it’s a bit like the CBT, wherein you just need to answer questions with nothing but your critical thinking skills to either hold you back or help you get that license. The OSCE is.. well, a completely different world from that, and one which I initially thought was a bit primitive. After taking it, however, I now think that requiring internationally-trained candidates to go through the OSCE does make a lot of sense.
I started working as a pre-registered nurse here in the UK shortly upon arrival, and we had several paid study and practice days prior to our “big day.” The thing that ticked me off a little bit was that it was the Recruitment team who chose our OSCE dates for us, and they scheduled mine in mid-July. Remember that this was back in April, and I was worried sick and restless for almost three months before I was finally able to take the final test. If given the choice, I probably would’ve chosen late May or early June because I already felt a bit ready then. Stretching it out way too long just caused more undue pressure and stress. But as it is, I’m just glad that it’s finally over, because even after passing the OSCE after the first try, I would never want to take that exam again. EVER.
On fight, flight, and failing..
Of all the examinations I had to take before I got my NMC PIN, I’d have to say that the OSCE was by far the most unpleasant. Don’t get me wrong—I do think it’s absolutely necessary, as there certainly are variances between nursing practice here and everywhere else in the world, but I’m just going by the experience as a whole. The way it made me feel and all of the acne breakouts it caused were just plain horrible. But then again, the OSCE is designed to ensure that international nurses are able to practice safe and effective nursing care, so I’m all for it. Failing it, though, doesn’t mean that you’re not qualified, so don’t be too hard on yourself. Again, there are so many physical and psychological factors that would influence the way you perform the tasks (oh, there are going to be recording cameras for quality purposes btw) that it’s real easy to mess up. So if you fail, don’t fret. Just shrug it off, and go try again. Besides, at the end of the day, when you already have your PIN, people are not gonna ask how many times you tried. Not that it matters, anyway. 🙂