OET for US nurses: VisaScreen, state boards, and the Speaking bar
The US flips the usual OET pattern on its head: while the UK’s NMC and New Zealand’s NCNZ concede on Writing (Australia did too, for tests taken up to 22 April 2026), the American requirement puts its full weight on Speaking.
Requirements checked against official sources: July 2026
Who actually requires the test
Three different bodies confuse almost every internationally educated nurse:
- NCLEX itself has no English requirement. The exam is the same for everyone.
- Your state board of nursing decides NCLEX eligibility and licensure — and most boards require English evidence when your nursing education wasn't in English. OET is accepted by more than 40 state boards (per OET's official US recognition list) — check your specific board's rule.
- VisaScreen — the federally mandated certificate for occupational visas/green cards, issued by TruMerit (formerly CGFNS) — accepts OET for RNs since 2022.
The requirement, precisely
| Speaking | Listening | Reading | Writing |
|---|---|---|---|
| 350 (B) | 300 (C+) | 300 (C+) | 300 (C+) |
The VisaScreen pattern (as published by TruMerit and OET’s US recognition pages), also used by most OET-accepting state boards: all four in one administration (no combining), taken at a test centre on paper or computer — OET@Home is not accepted. Results are valid for two years. Boards set their own variations, so confirm yours before booking.
Speaking is the whole game
With Listening, Reading and Writing needing only C+, the US requirement concentrates entirely on the Speaking sub-test’s two five-minute role-plays: a Grade B performance across nine criteria, five of which measure clinical communication — rapport, cue-picking, structure, information gathering and giving. That is a skill you build by doing, and it is the hardest sub-test to practise alone — which is exactly the gap OEZ closes with nursing role-plays played against an AI patient and marked on those same nine criteria, with your pace and hesitation measured from the audio. Read how the Speaking marking works, then run a scored mock before you book.
Full speaking role-plays with an AI patient, timed writing tasks, and marking modelled on OET’s published criteria. No card needed.