Which Exam Should I Choose? English Test Requirements for AHPRA Registration

Updated 24 October 2026. AHPRA changed its minimum scores for English tests taken on or after 23 April 2026. The figures below are from the current registration standard; tests taken on or before 22 April 2026 are assessed under the old table.

If you’re preparing for OET or planning your medical career in Australia, understanding AHPRA’s English requirements is a crucial first step.

This guide explains each approved test clearly, compares their characteristics, and helps you choose the most suitable option based on your strengths.

English Tests Required for Medical Registration

To work as a doctor or nurse in Australia, you must register with the Australian Health Practitioner Regulation Agency (AHPRA), which oversees medical registration across the country.

AHPRA requires you to meet one of the approved English language standards.

Below are the accepted tests and the minimum scores for tests taken from 23 April 2026:

IELTS Academic: Overall 7.0 or higher (L/R/S 7.0, W 6.5). Unchanged
OET: Listening 350, Reading 360, Writing 350, Speaking 360. Before 23 April 2026 this was B in L/R/S and C+ (300) in Writing
PTE Academic: Overall 63 or higher (L 58, R 59, W 60, S 76). Before 23 April 2026 this was overall 66 with 66 in L/R/S and 56 in W
TOEFL iBT: Total 91 or higher (L 22, R 22, W 23, S 24). Before 23 April 2026 this was total 94 with 24 in L/R/W and 23 in S
Cambridge C1 Advanced: Overall 178 (L 175, R 179, W 180, S 194); C2 Proficiency: 185 in L/R/S and 176 in W

Reference: English language skills
https://www.ahpra.gov.au/Registration/Registration-Standards/English-language-skills.aspx

Results from one sitting, or from two sittings within 12 months, are accepted, with a minimum floor in every component of both sittings (for OET: 320 Listening, 340 Reading, 350 Writing, 350 Speaking). Only tests taken at a test centre count: OET@Home and other home-based versions are not accepted.

All of these tests assess the four core language skills: Listening, Reading, Speaking, and Writing. Each takes approximately 2–3 hours and is similar in difficulty to advanced academic English exams.

Since there are several options, the next sections compare their characteristics to help you choose the most suitable test.

IELTS

IELTS is one of the most widely taken English exams in the world, with millions of test-takers globally every year. It is available frequently in major cities, and in some locations—such as Shinjuku—sessions are held nearly daily.

Scores are reported in band levels from 0 to 9.0 in 0.5 increments. You must achieve at least 7.0 in Listening, Reading, and Speaking and 6.5 in Writing.

Because the scoring range is narrow, a difference of 0.5 is significant. For many learners, improving by 1.0 band can take roughly one year.

For IMGs, Reading and Listening are manageable with consistent study. However, achieving 7.0 in Speaking is especially challenging. Many candidates spend 1–2 years trying to raise Speaking from 6.5 to 7.0.

IELTS is a strong test for building general academic English ability, but because Writing and Speaking are highly demanding, it may not be the most efficient route to achieve the required scores.

OET

OET is specifically designed for healthcare professionals. Its purpose is to measure whether non-native medical practitioners possess the English skills required to work safely in clinical settings.

All candidates take the same Reading and Listening tests, but the Writing and Speaking tasks differ depending on your profession (e.g., medicine, nursing, pharmacy).

Scores are reported in both letter grades (A–E) and numerical values (0–500):

A: 450–500
B: 350–440
C+: 300–340

For tests taken on or after 23 April 2026, AHPRA no longer uses the letter grades. It asks for 350 in Listening and Writing and 360 in Reading and Speaking. The practical change is Writing: a 300–340 (C+) used to be enough, and now it is not. If you are combining two sittings, no component in either sitting may fall below 320 (Listening), 340 (Reading), 350 (Writing) or 350 (Speaking). How the 0–500 scale maps to marks and grades is explained in our guide to OET passing requirements.

Compared with IELTS, OET’s Writing and Speaking are often easier to prepare for because the content reflects real medical communication—referrals, handovers, consultations, and clinical scenarios.

However:

The Reading test contains tricky distractors, and choosing the correct answer can be difficult.
The Listening test is fast and often features strong Australian accents, which many IMGs find challenging.

Still, OET is the only test among the four that directly prepares you for real clinical communication and aligns closely with AMC preparation.

For these reasons, OET is generally the most recommended option for IMGs.

PTE Academic

PTE (Pearson Test of English Academic) is an AI-scored general English exam. Its topics are similar to IELTS and broadly academic.

Among major English-speaking countries, Australia is the only nation that accepts PTE for medical registration. One of its biggest advantages is the very fast results, usually released within 24–48 hours.

Each skill is scored from 10 to 90. From 23 April 2026 AHPRA asks for an overall 63 with Listening 58, Reading 59, Writing 60 and Speaking 76. The Speaking minimum went up sharply, which matters because PTE Speaking is the section most affected by voice and microphone quality.

Many IMGs find it easier to score well in Reading and Writing. However, Listening and Speaking scores can vary widely depending on:

voice clarity
speaking speed
microphone quality
memory-based tasks

Because scoring is automated, candidates with quiet voices, slow speech rates, or lower confidence may receive unexpectedly low results.

PTE is not the best starting point. It is better considered after attempting IELTS or OET, especially if you struggle with performance-based evaluation.

TOEFL iBT

TOEFL, created by ETS, assesses whether candidates can handle the English used in North American academic environments.

Topics are academic, similar to IELTS, but more specialized—space science, biology, natural sciences, anthropology, and history are common.

Each section is scored out of 30 for a total of 120. AHPRA requires:

Total ≥91 (tests from 23 April 2026; previously 94)
Listening ≥22, Reading ≥22, Writing ≥23
Speaking ≥24

For IMGs, TOEFL is often regarded as the most difficult of the four exams. The Listening passages are long and complex, and the integrated Speaking/Writing tasks require you to listen, read, and respond under strict time limits.

Because achieving the required Speaking and Writing scores is extremely challenging, TOEFL is generally not recommended as a primary route.

Conclusion

To summarise:

IMGs can choose from four English tests.
OET is the strongest choice, especially considering AMC preparation and clinical relevance.
Those uncertain about their English level may begin with IELTS, then switch to OET once they reach Band 6.5.
For most IMGs, OET offers the quickest and most realistic path to meeting AHPRA’s requirements.

IELTS has abundant study materials and is familiar to many candidates. Achieving an overall 7.0 is not extremely difficult, but Speaking 7.0 remains a major barrier.

A strategic approach is:

Build foundational skills with IELTS (target 6.5).
Transition to OET for clinically focused preparation.

Because OET reflects real medical communication, motivation tends to increase, and the skills learned translate directly to clinical practice in Australia.

For detailed comparisons between IELTS and OET, see:
https://oet-bank.com/oet-b-vs-ielts-7/

Registration & Pathways