The MCQ and the OSCE test different things, are run by different organisations, and are not both held in the same country

Outcomes-based assessment is the name Ahpra and the NMBA give to the two-exam stage that Stream B candidates complete. The two exams are not two halves of one paper. They test different things, they are delivered by different organisations in different countries, they cost different amounts, and only one of them can be sat outside Australia.

This page sets out the administrative facts each exam is published under — what it is, who runs it, where it is held, what it costs, how long the clock runs, and how the result travels. It does not cover clinical content, and it does not predict any result.

The order is fixed, and the MCQ comes first

NMBA’s assessment stages page places outcomes-based assessment last in a sequence: Stream B candidates pay the assessment fee, then complete Orientation Part 1, then the Portfolio stage, and only then the two exams. The MCQ page states the order inside that stage: “Candidates must pass the MCQ exam before they can proceed to the Objective Structured Clinical Exam (OSCE).”

There is no route that runs them in the other order and no route that skips the MCQ except two named carve-outs, both on the MCQ page:

• registered nurse candidates “who have passed the NCLEX-RN exam within 10 years of establishing their portfolio”, with evidence uploaded at the Portfolio stage; and
• midwifery candidates “who have passed the Midwifery Council of New Zealand’s modified National Midwifery Exam since 2020”, who “must contact Ahpra before submitting their Portfolio”.

Note that the first carve-out is measured against the date your portfolio is established, not the date you apply for registration.

What the MCQ is, and why there is no single “the MCQ”

NMBA describes the purpose in one line: “The multiple-choice question (MCQ) exam assesses the candidate’s professional knowledge.” The important detail is what follows — there are three separate exams, run by three different organisations, according to the division you intend to register in:

“The MCQ exam for RNs is the National Council Licensure Examination for Registered Nurses (NCLEX-RN). The National Council of State Boards of Nursing (NCSBN) develops and delivers the NCLEX-RN through Pearson VUE test centres in most countries.”

“The MCQ exam for ENs is a paper-based exam delivered by Ahpra at any Ahpra office in Australia.”

“The MCQ exam for midwives is delivered through Aspeq test centres in most countries.”

Three consequences follow, and they are routinely missed.

The registered nurse MCQ is a United States licensure exam. Australia did not write it. Ahpra’s role is to confirm eligibility — the registered nurse page says the Exams Team “will confirm your eligibility within 4 weeks to sit the NCLEX-RN MCQ exam” — after which registration and payment happen through Pearson VUE, and fee information sits on the NCLEX website rather than on any Ahpra page. Candidates testing outside the United States also pay “an additional international scheduling fee”.

The enrolled nurse MCQ cannot be sat outside Australia. It is paper-based, delivered at Ahpra offices, and booked by emailing the Exams Team for a form: “they must email the IQNM Exams Team to request a copy of the Enrolled Nurse MCQ Examination Form – AENE-40.” Candidates nominate a preferred Australian capital city. So for enrolled nurse candidates, both exams are in Australia — a planning fact worth knowing early.

The NCLEX-RN result is portable in both directions. Ahpra accepts a score transferred in from another nursing regulatory body — “Candidates can upload a copy of their NCLEX-RN candidate report at the portfolio stage” — and will transfer a score out to another body on application, with a fee. Ahpra also names two bodies that will not accept transfers from it: “The Texas Board of Nursing and British Columbia College of Nurses and Midwives have advised Ahpra that they will not accept NCLEX-RN score transfers or score verifications from Ahpra.” If you are running parallel applications, check that line before paying for a transfer.

What the OSCE is

NMBA’s description sets the benchmark explicitly, and the benchmark is the thing to read twice:

“The Objective Structured Clinical Exam (OSCE) is a clinical exam to assess the candidate’s knowledge, skills and competence as a graduate-level nurse or midwife from an Australian NMBA-approved program of study.”

The comparator is an Australian new graduate, not an experienced nurse. There are separate OSCEs for registered nurses, enrolled nurses and midwives.

It is held in Australia and nowhere else. NMBA answers the question directly — “Can I complete the OSCE online or in another country?” — with: “No. The OSCE is an in-person exam held in Australia only.” The stated reason is that it “is completed in a clinical simulation environment to ensure that IQNMs can meet the standard of practice expected in Australia.”

Two venues are named: Adelaide Health Simulation in Adelaide, and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists in Melbourne. Both pages add the same instruction: “No contact should be made” with either venue, and all queries go to the Exams Team.

One caution about that pair. The venues are stated cleanly on the enrolled nurse page. On the registered nurse page, the text sitting under the heading “OSCE for registered nurses” reads “The EN OSCE is delivered at two locations”, and the paragraph after it is headed “How often is the EN OSCE held?” — the enrolled nurse wording appears to have been copied across without being changed. We are not going to convert that into a statement about where the registered nurse OSCE is held, because Ahpra has not made one on that page. What is stated for every division is that the OSCE is in Australia and in person, and that the Exams Team allocates the venue with your invitation. Confirm your own venue from the invitation and the confirmation letter, not from the website.

There is no published exam calendar. NMBA states: “There is no set frequency on how often the EN OSCE is held. Candidate demand for the OSCE is monitored and the IQNM Exams team will contact candidates when exam days become available.” You are invited to a date; you do not book one. Invitation emails carry a response deadline, and a confirmation letter with date, time and location arrives “four to eight weeks before the scheduled exam period”.

Ahpra publishes a table of example patient charts and forms that OSCE candidates may be asked to interact with, with the caveat that “The examples in the table are not an extensive suite”. That table is on the OSCE page itself and is the only preparation material Ahpra provides beyond the candidate handbooks; NMBA states on both exam pages that “The Board and Ahpra do not endorse any external […] preparation programs.”

The deadlines, which are where cases actually close

Each stage runs its own clock and each expiry closes the case rather than pausing it. The published periods:

• MCQ. “Once your portfolio has been established, you have 180-days to complete the MCQ exam otherwise your IQNM case will be closed.”
• NCLEX-RN scheduling. “Candidates have 90 days from receiving their ATT to schedule and sit the exam.” Extensions are discretionary and limited to “extenuating circumstances… unplanned events that occur outside of the candidate’s control”.
• OSCE payment. “Candidates have 120-days to make payment of the OSCE fee from when their IQNM case is set to the OSCE stage.”
• OSCE scheduling. “Candidates have 180-days after paying the OSCE fee to schedule their exam date otherwise their IQNM case will be closed.” In this instance the fee is refunded.
• Withdrawal. A candidate who cannot attend “must contact the IQNM Exams Team via email at least five full business days before an allocated exam date and time”, excluding weekends and Australian public holidays.

In every case NMBA says the case can be reopened on request. A closed case is an administrative state, not a bar — but it is a delay, and the OSCE clock in particular runs while you are arranging travel.

Results, feedback and how long a pass lasts

Turnaround differs by exam: enrolled nurse MCQ results are sent “within two weeks”, NCLEX-RN results “within six weeks”, and OSCE results “within eight weeks of their exam date”.

There is no appeal on the mark and no re-mark. NMBA states: “The IQNM Exams Team cannot provide additional feedback or a recheck of OSCE results… The OSCE is a regulatory exam and no further feedback or a recheck of your result is available.” What you do receive is “a result letter which includes a breakdown of the station mark and performance standard they achieved for each station”.

The validity rules are two different clocks and the shorter one is the one that bites:

“An OSCE passing result is valid for a period of five years, however: Passing the OSCE only satisfies the NMBA’s recency of practice registration standard for a maximum of two years. If the application for registration is made more than two years from receiving the OSCE pass result you will need to provide additional evidence to meet the NMBA recency of practice registration standard.”

So a pass survives five years, but after two years it stops doing the work of demonstrating recency and you must evidence that separately. A pass older than five years requires re-sitting the OSCE — “You will not be required to retake the relevant multiple-choice question (MCQ) exam” — and someone already registered with the NMBA never has to re-sit it.

What the exams cost

From NMBA’s schedule of fees, effective 18 September 2025: the IQNM assessment fee covering assessment and orientation is A$410; the enrolled nurse MCQ is A$250; the OSCE is A$4,000. Registered nurse and midwife MCQ fees are not in this schedule — NMBA notes that “fees for the Registered nurse and midwife MCQs are set by the MCQ provider”, so the NCLEX-RN and Aspeq fees are published by NCSBN and Aspeq respectively and are not ours to restate here.

Review fees are also published, and they are steeply tiered: an initial assessment review is A$300, a preliminary internal review A$575, and a tertiary external review A$2,500. If you are weighing whether to challenge a stream assignment, those are the actual numbers.

What to do with this

1. Work out your division first, because it determines which MCQ you sit, in which country, and at whose price. If your country has only one level of nurse registration, NMBA’s rule is that “your qualification will be assessed at the registered nurse level” — see where an overseas nursing qualification maps.
2. If you already hold an NCLEX-RN pass, check its date against the ten-year rule before your portfolio is established, not after.
3. Budget the OSCE as a trip, not a fee. It is in Australia, at one of two venues, on a date you are invited to, with roughly four to eight weeks of confirmed notice.
4. Read the candidate handbooks for your division and profession. They are the only exam-specific material either body endorses.
5. If your Stream B assignment is the thing you actually disagree with, that is a review of the qualification assessment, not an exam question — and it is addressed to Ahpra.

This site summarises published rules. It is not Ahpra or the NMBA, it does not deliver or mark these exams, and nothing here is a prediction of a result or advice about clinical practice. Ahpra states that candidates who need to travel to Australia for the OSCE should contact the Department of Home Affairs about visas — Ahpra “cannot provide candidates advice or support to get an Australian Visa” — and neither can we.