Nursing shortages mean most developed healthcare systems are actively recruiting internationally trained nurses — but the registration process, licensing exam, English-test requirement, and pay differ substantially by country. This guide compares the six most common destinations side by side.
Quick Comparison Table
| Country | Registration Body | Licensing Exam Required | English Test Accepted | Visa/Demand Outlook | Approximate Salary Range (typical, USD equivalent) |
|---|---|---|---|---|---|
| United States | State Boards of Nursing (via CGFNS credential evaluation) | NCLEX-RN (Next Generation NCLEX format) | IELTS Academic (most widely accepted), TOEFL iBT, OET (growing but not universal) | Strong long-term demand; employer-sponsored visa routes exist but process can be lengthy | ~$70,000–$95,000+ (varies significantly by state and setting) |
| United Kingdom | NMC (Nursing and Midwifery Council) | CBT + OSCE (overseas route) or direct registration for NMC-accredited UK graduates | IELTS Academic, OET, TOEFL iBT | High demand via Health and Care Worker visa; well-established international recruitment pipeline | ~$35,000–$55,000 (NHS band-dependent) |
| Canada | Provincial nursing regulatory colleges (e.g. CNO in Ontario) | NCLEX-RN (most provinces) | IELTS Academic, OET (accepted in most provinces), CELBAN in some cases | Strong demand; multiple provincial/federal immigration pathways for nurses | ~$60,000–$85,000 (varies by province) |
| Australia | AHPRA / NMBA (Nursing and Midwifery Board of Australia) | AHPRA-approved bridging program or exam pathway for overseas-qualified nurses (confirm current route) | IELTS Academic, OET, PTE Academic, TOEFL iBT | High demand; skilled-visa occupation lists commonly include nursing | ~$60,000–$100,000 (varies by state and experience) |
| Germany | Regional recognition authority (Anerkennung process) | No separate licensing exam, but formal qualification-recognition process required | German language (B2 level plus specialist language exam) — English tests are not the relevant requirement | Growing demand and active recruitment programs, but the German-language requirement is a major practical barrier for English-only candidates | |
| Ireland | NMBI (Nursing and Midwifery Board of Ireland) | NMBI overseas registration pathway (verify current exam/assessment requirements) | IELTS Academic, OET (Grade B in most sub-tests, verify current Writing threshold) | Solid demand; active international recruitment, including via Irish hospital group programs |
Read every figure in this table as an approximate, typical range. Registration processes, exam requirements, visa rules, and salaries all change and vary by state/province/institution — confirm current details directly with the relevant regulator (listed below) before making a decision.
Registration Bodies — Direct Links to Confirm Current Requirements
| Country | Official Regulator Site |
|---|---|
| United States | Individual state Board of Nursing + cgfns.org |
| United Kingdom | nmc.org.uk |
| Canada | Relevant provincial nursing college (varies by province) |
| Australia | ahpra.gov.au |
| Germany | anerkennung-in-deutschland.de |
| Ireland | nmbi.ie |
The English-Test Question by Country
This is the one factor that trips up the most candidates when comparing countries:
- US, UK, Canada, Australia, Ireland: all commonly accept IELTS Academic, with OET also widely accepted (though acceptance varies by specific state/province/regulator — never assume). See our OET vs IELTS for Nurses comparison for a full breakdown.
- Germany: the outlier. English test scores are not the relevant requirement — you need German language proficiency (commonly B2 level plus a specialist medical-German language exam) as part of the Anerkennung (qualification recognition) process. This is worth flagging clearly because candidates sometimes assume an English test will suffice for any Western European destination — it will not for Germany.
Which Country Is "Easiest" to Get Into?
There's no single answer — it depends on your starting point:
- If you already have a UK-recognised or Ireland-recognised nursing qualification and strong English: the UK or Ireland registration process is often more direct than the US NCLEX-RN pathway, which requires CGFNS credential evaluation first.
- If you want the highest typical salary: the US generally offers the highest pay range among these six, but has the most document-heavy pathway (credential evaluation, state-specific rules, NCLEX-RN).
- If English proficiency is your strength but you don't speak German: Germany should generally be deprioritised regardless of salary, since the language requirement is a hard barrier, not a soft preference.
- If you want the broadest choice of accepted English tests: Australia accepts the widest range (IELTS, OET, PTE, TOEFL), giving candidates more flexibility if one test format suits them better than another.
Prepare for IELTS with Gabble — IELTS Academic is accepted across nearly every major nursing destination on this list except Germany. Gabble's AI-powered speaking and writing feedback gives instant, criterion-based scoring to help you reach the specific per-skill score your target country's regulator requires.