If you're an overseas nurse aiming for a US nursing license, you've likely heard about the Occupational English Test (OET). But how does OET fit into the US registration process? This guide cuts through the confusion: which state boards accept OET, what CGFNS requires, the minimum scores you need, and how OET stacks up against IELTS, TOEFL, and PTE.
Which US State Boards Accept OET?
The National Council of State Boards of Nursing (NCSBN) does not itself set English proficiency rules — each state board does. However, most boards follow the NCSBN model, which accepts OET as an alternative to IELTS or TOEFL. As of 2025, over 40 state boards (including California, Texas, Florida, New York, and Illinois) accept OET for RN licensure.
Boards that explicitly accept OET include:
- California Board of Registered Nursing
- Texas Board of Nursing
- Florida Board of Nursing
- New York State Education Department (Office of the Professions)
- Illinois Department of Financial and Professional Regulation
Always verify on your target board's official portal, as policies can shift. For the most current list, check the OET's USA acceptance page or the individual board's website.
CGFNS CES Report Requirements
Before you can take the NCLEX, most foreign-educated nurses must obtain a Credentials Evaluation Service (CES) report from the Commission on Graduates of Foreign Nursing Schools (CGFNS). The CES report verifies your education and registration, and it also requires proof of English proficiency.
CGFNS accepts OET scores as part of the CES application. You'll need to submit your OET results directly to CGFNS. The minimum score required by CGFNS is the same as most state boards: at least 350 in each of the four subtests (Listening, Reading, Writing, Speaking), which corresponds to a Grade B or higher.
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OET Minimum Scores for USA: 350 / Grade B
For US nursing registration, the standard OET requirement is a minimum score of 350 in each subtest (Listening, Reading, Writing, Speaking). This is equivalent to a Grade B on the OET scale. No overall average — you must hit 350 in every section.
If you score below 350 in one subtest, you can retake only that subtest (OET allows single-subtest retakes). This is a major advantage over IELTS, where you'd need to retake the entire exam.
How OET Compares to IELTS, TOEFL, and PTE
| Test | Minimum Score (Typical) | Retake Policy | Healthcare Focus | |------|------------------------|---------------|------------------| | OET | 350/Grade B each | Single subtest retake | Yes – nursing scenarios | | IELTS | 7.0 overall (no band <6.5–7.0) | Full retake | No – general academic | | TOEFL iBT | 94–100 (varies) | Full retake | No | | PTE Academic | 65–76 (varies) | Full retake | No |
OET's healthcare context makes it easier for nurses to perform well — the listening and reading passages involve patient consultations, and the writing task is a referral letter. Many Indian nurses find OET more intuitive than IELTS.
The Typical CGFNS → NCLEX → State Board Sequence
Here's the step-by-step pathway for most overseas nurses:
- 1Take OET and achieve 350+ in all four subtests.
- 2Apply for CGFNS CES – submit your nursing education documents, registration, and OET scores.
- 3Receive CES report – CGFNS verifies your credentials and issues a report.
- 4Apply to your chosen state board for authorization to take the NCLEX.
- 5Register for NCLEX via Pearson VUE.
- 6Pass NCLEX-RN – the national licensing exam.
- 7Obtain state license – the board issues your RN license.
Some states allow you to apply directly without CGFNS if you have a Social Security Number or meet other criteria, but CGFNS is the safest route for most international nurses.
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Where to next?
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