Australian Health Practitioner Regulation Agency - English language skills registration standard
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English language skills registration standard

Summary

To register you as a health practitioner the National Board (the Board) you are registering with needs to be satisfied you have the necessary skills to communicate in English at a level that is safe to practise your profession.

This standard sets out how you can show this to the Board and applies to the following professions:

  • Chinese medicine
  • Osteopathy
  • Chiropractic
  • Paramedicine
  • Dental
  • Pharmacy
  • Medical radiation practice
  • Physiotherapy
  • Medical
  • Podiatry
  • Occupational therapy
  • Psychology
  • Optometry

Do I need to meet this standard?

You need to meet this standard if you:

  • are applying for registration with a National Board in Australia for the first time, or
  • are applying for registration (including moving from non-practising to another registration type) and have not used English as your main language1 for a period greater than five years, or
  • hold limited registration on the basis that you were granted an exemption from this standard in the limited circumstances outlined under what are the possible exemptions to the standard? and are applying for another type of registration.

You do not need to meet this standard if you:

  • have previously met (without conditions) a National Board English Language Skills registration standard (ELS standard) to hold registration in one of the professions under the National Scheme2 and you wish to apply for registration in another profession in the National Scheme3, or
  • have previously met a National Board ELS standard to hold registration in one of the professions in the National Scheme4 and you wish to apply for a different category or division of registration in the same profession. For example, you hold provisional registration and are applying for general registration, or you hold general registration and are applying for specialist registration or non-practising registration, or
  • are applying for limited registration and meet the limited circumstances outlined under what are the possible exemptions to the standard?

How can I meet the standard?

To meet this standard, you must show the Board you are competent in the English language by using one of the four pathways in this standard. The pathways are:

  1. The combined education pathway
  2. The school education pathway
  3. The advanced education pathway, and
  4. The test pathway.

Note: The combined education pathway and the test pathway are the pathways suitable for most applicants. If you have not completed any education in a recognised country the test pathway is suitable for you.

blue home icon Combined education pathway

If you completed at least two years secondary education in English in a recognised country and your qualifications were taught and assessed in English in a recognised country, this pathway is most suitable for you.

To satisfy this pathway, you must have a combination of secondary education and qualifications, where you have carried out and successfully completed:

  1. at least two years of your secondary education which was taught and assessed solely in English in a recognised country, and
  2. your qualification(s) for your profession, which were taught and assessed solely in English in a recognised country

red home icon School education pathway

If you completed all or most of your primary and secondary school education in English in a recognised country and your qualifications were taught and assessed in English, this pathway is most suitable for you.

To satisfy this pathway, English is your main language and you have carried out and successfully completed:

  1. at least 10 years of your primary and secondary school education which was taught and assessed solely in English in a recognised country, and
  2. your qualification(s) for your profession, which were taught and assessed in any country solely in English. 

red graduation hat icon Advanced education pathway

If you have completed your qualifications and advanced education (which may also be known as tertiary) all taught and assessed in English in a recognised country, this pathway may be suitable for you.

To satisfy this pathway, you have carried out and successfully completed at least six years in total of (full-time equivalent) education, all taught and assessed solely in English in a recognised country which includes:

  1. your qualification(s) for your profession, and
  2. advanced education (tertiary) at a degree level (AQF level 7 or higher) which requires you to read, write, listen to and speak English.

A maximum of two years break while obtaining your qualifications and advanced education will be accepted.

The last period of education must have been completed no more than two years before applying for registration.

a green board icon with a tick box in the center Test pathway

If you are unable to satisfy one of the other pathways set out in this standard this pathway is most suitable for you.

To satisfy this pathway, you must achieve the required minimum scores in one of the following English language tests and meet the requirements for test results as specified in Appendix one. 

  • Cambridge (C1 Advanced or C2 Proficiency)
  • International English Language Testing System (Academic) (IELTS)
  • Occupational English Test (OET)
  • Pearson Test of English Academic (PTE Academic)
  • Test of English as a Foreign Language internet-based test (TOEFL iBT)
  • Other English language tests approved by the National Boards from time to time and published on the Board’s website with the required minimum scores. National Boards reserve the right at any time to revoke their approval of an English language test.

NOTE: We will only accept test results from:

  1. one test sitting, or
  2. a maximum of two test sittings in a 12-month period

and only if the requirements for test results, such as when the test must be taken, type/modality of test and the required minimum scores, specified in this standard are met as set out below.

The Medical Board of Australia will also accept successful completion of the profession specific New Zealand Registration Examination (NZREX) or Professional and Linguistic Assessments Board test (PLAB test).

What are the possible exemptions to the standard?

The Board may grant an exemption to this standard when you apply for limited registration in the following circumstances:

  • to perform a demonstration in clinical techniques, or
  • to carry out research that involves limited or no patient contact, or
  • to carry out a period of postgraduate study, examination or assessment, or supervised practice

while working in an appropriately supported environment that will ensure patient safety is not compromised.

The Board reserves the right at any time to revoke an exemption and/or require an applicant to complete a specified English language test.

  • Further information about the evidence that you must give the Board to prove that you meet this standard is set out in the relevant application form.
  • You are responsible for the cost of English language tests.
  • Your test results will be verified independently with the test provider.
  • If you meet this standard based on an English language test taken before you transitioned to non-practising registration you will be asked to declare that you have continued to use English as your main language when you apply to move from non-practising to provisional, limited, general or specialist registration.

This registration standard was approved by the Ministerial Council on 14 November 2024.

Registration standards are developed under section 38 of the National Law and are subject to wide-ranging consultation.

Advanced education (which may also be known as tertiary education) means successful completion of education at a level comparable to an Australian bachelor degree (AQF7) or higher which leads to an award of a degree or above. The advanced education can be in any field, however, programs that are fully completed online will not be accepted. This is because this pathway requirement is to show the applicant’s exposure to English at this level and requires applicants to give evidence of the course requirement to read, write, listen to and speak English in the education environment. Your qualification does not need to be completed before the advanced education you wish to count. A maximum of two years break while obtaining your qualifications and advanced education will be accepted in the advanced education pathway and all other criteria set out in the pathway must be satisfied.

AQF means the Australian qualification framework which is the national policy for regulated qualifications in Australian education and training. You can find out more about a bachelor degree at AQF level 7 on the Australian Qualifications Framework website.

Board-approved program of study means an accredited program of study approved by the Chinese Medicine, Chiropractic, Dental, Medical Radiation Practice, Medical, Occupational Therapy, Optometry, Osteopathy, Paramedicine, Pharmacy, Physiotherapy, Podiatry or Psychology Boards of Australia under section 49(1) of the National Law and published in the Board’s list of approved programs of study on the Board’s website.

Continuously working means working for at least 26 weeks full-time equivalent per year. For example, 52 weeks part-time work (five days per fortnight) which in total adds up to the equivalent of 26 weeks full-time.

Continuously working can include some periods of leave. However, as this requirement is to demonstrate exposure to English in the working environment the minimum hours worked per year must total 26 weeks full-time equivalent.

Full-time equivalent

For the purpose of:

  • education, is the successful completion of a course load which meets the education provider’s definition of full-time enrolment and does not include recognised prior learning. For example, a student enrolled in a full-time four-year undergraduate degree would be expected to complete the degree in four years. This is set by the relevant educational institution. This could include a combination of part-time courses, which together make up a full-time course load. For example, two part-time courses taken at the same time, each consisting of a 50 per cent course load that together meet the full-time load requirement. This pathway requirement is to show exposure to English in the education environment. For that reason, concurrent education, accelerated courses, fast track courses and/or additional education taken during semester breaks cannot be counted for more than one full-time equivalent course load. For example, an applicant that has studied two programs in a year concurrently, one at half full-time equivalent and the other at three quarters full-time equivalent, could only count a maximum of one full-time equivalent year. Where a course is delivered in a shorter time such as an accelerated or fast-tracked course (for example a four-year course delivered over three years) only the duration of the delivery of the course is to be counted (i.e. the three-year course delivery period in this example)
  • work means the equivalent to working full time hours typically ranging from 35 to 38 hours per week.

Please refer to the evidence guide and FAQs for further examples.

Limited registration means a type of registration National Boards may grant to practitioners who do not qualify for general or specialist registration, but who hold relevant qualifications in the profession to practise under a form of limited registration. Limited registration may be renewed for a maximum of three times, after which a new application can be made. National Boards may have different requirements for limited registration.

Main language means the language primarily used for reading, writing, listening, and speaking and the language known best and most comfortable with and used most frequently on a day-to day basis.

National Law means the Health Practitioner Regulation National Law, as in force in each state and territory.

National Scheme means the National Registration and Accreditation Scheme.

NZREX means New Zealand Registration Examination administered by the Medical Council of New Zealand.

PLAB test means the Professional and Linguistic Assessments Board test (or equivalent) administered by the General Medical Council of the United Kingdom.

Primary education means Australian school years from year one (1) or first year through to year six (6) inclusive (or equivalent).

Qualifications means the qualifications in the relevant health profession which you are relying on to support your eligibility for registration under Part 7 of the National Law.

Recognised country means one of the following countries or territories:

Antigua and Barbuda Dominica New Zealand
Anguilla
Falkland Islands
Republic of Ireland
Australia
Gibraltar
Saint Helena, Ascension and Tristan da Cunha
The Bahamas
Grenada
St Kitts and Nevis
Barbados
Guernsey St Lucia
Belize
Guyana
St Vincent and the Grenadines
Bermuda
Isle of Man
Trinidad and Tobago
British Indian Ocean Territory
Jamaica
United Kingdom
Canada
Jersey
United States of America
Cayman Islands
Malta
US Virgin Islands

Other recognised countries approved by the National Boards from time to time will be published on the Board’s website. National Boards reserve the right at any time to revoke their approval of a recognised country.

Secondary education means Australian school years seven (7) through to twelve (12) inclusive (or equivalent), even when year seven is classified as primary education in a particular state or territory.

Test results means the official results provided by the English language test provider. If you are providing test results from two test sittings as set out in this standard, the results from both sittings must meet the requirements of this standard.

Two test sittings in a 12-month period means that the dates of the sittings must not be more than 12 months apart. For example, if your first test sitting was on 1 March, the second sitting must be no later than 1 March of the following year. If you are providing test results from two sittings, you may provide results of any two tests taken within a 12-month period as set out in this standard. Results cannot be combined from different test providers.


This standard will be reviewed at least every five years.

Last reviewed: 2024

What are the test results requirements that I must meet?

The following requirements apply to the English language test results:

  1. Test results will be accepted if they were obtained:
    1. within the two years before the date you lodge your application for registration, or
    2. more than two years before the date you lodge your application for registration if, in the period since the test results were obtained, you:
      1. have been continuously working:
        • as a registered health practitioner in the Chinese medicine, chiropractic, dental, medical radiation practice, medical, occupational therapy, optometry, osteopathy, paramedicine, pharmacy, physiotherapy, podiatry or psychology profession (starting within 12 months of the test date) where English was the main language of practice in one of the recognised countries, or
        • in another relevant health, disability or aged-care related role where English was the main language of practice in one of the recognised countries and your role requires you to read, write, listen to and speak English in the working environment, and
      2. lodge your application for registration within 12 months of finishing your last period of employment, or
    3. more than two years before the date you lodge your application for registration if in the period since the test result was obtained, you:
      1. have been continuously enrolled in a Board-approved program of study (which started within 12 months of the test date) and successfully completed subjects in each semester, with no break from study apart from the education provider’s scheduled holidays, and
      2. lodge your application for registration within 12 months of completing the Board-approved program of study

For the purposes of calculating time, if an applicant relies on test results from two sittings in a 12-month period, time begins to run from the date of the earlier sitting.

Results from different test providers cannot be combined.

Test requirements

The table below includes the versions of the tests approved by the National Boards. Additional versions or modalities of the tests may be approved from time to time and will be published on the Ahpra or Board websites.

Test Profession Overall score needed5 Component scores needed Test results accepted from
  • one test sitting, or
  • a maximum of two test sittings in a 12-month period only if:

Cambridge

(C1 Advanced or C2 Proficiency)

(Paper and computer at test centre only)

Chinese medicine

Chiropractic

Dental

Medical

Medical radiation practice

Occupational therapy

Optometry

Osteopathy

Paramedicine

Pharmacy

Physiotherapy

Podiatry

Psychology

Minimum score of 185

Minimum overall score of 185 in each of
the three components:

  • listening
  • reading
  • speaking

and minimum score of 176 in the one component:

  • writing.
  • you are tested in all four components in each sitting
  • you achieve a minimum score of 185 in each component for listening, reading and speaking and a minimum score of 176 for writing across the two sittings, and
  • when using two test sittings no score in any component of the test(s) for either test sitting is below 176.

IELTS

(Academic paper and computer at test centre only) 

Chinese medicine

Chiropractic

Dental

Medical

Medical radiation practice

Occupational therapy

Optometry

Osteopathy

Paramedicine

Physiotherapy

Podiatry

Psychology

Overall score of 7

Minimum score of 7 in each of the three components:

  • listening
  • reading
  • speaking

and minimum score of 6.5 in the one component:

  • writing.
  • you achieve a minimum overall score of 7 in each sitting, and
  • you achieve a minimum score of 7 in each component for listening, reading and speaking and a minimum score of 6.5 for writing across the two sittings, and
  • when using two test sittings no score in any component of the test(s) for either test sitting is below 6.5.

OET

(On paper or computer based in testing centre)

(Any profession-specific OET test can be accepted)

Chinese medicine

Chiropractic

Dental

Medical

Medical radiation
practice

Occupational therapy

Optometry

Osteopathy

Paramedicine

Pharmacy

Physiotherapy

Podiatry

Psychology

 

Minimum score of B in each of the three components:

  • listening
  • reading
  • speaking,

and minimum score of C+ in the one component:

  • writing.
  • you are tested in all four components in each sitting, and
  • you achieve a minimum score of B in each component for listening, reading and speaking and a minimum score of C+ for writing across the two sittings, and
  • when using two test sittings no score in any component of the test(s) for either test sitting is below C+.

PTE Academic

(Computer at test centre only)

Chinese medicine

Chiropractic

Dental

Medical

Medical radiation practice

Occupational therapy

Optometry

Osteopathy

Paramedicine

Pharmacy

Physiotherapy

Podiatry

Psychology

Minimum overall score of 66

Minimum score of 66 in each of the three communicative skills:

  • listening
  • reading
  • speaking

and minimum score of 56 in one communicative skill:

  • writing.
  • a minimum overall score of 66 is achieved in each sitting, and
  • you achieve a minimum score of 66 in each of the communicative skills of listening, reading and speaking and a minimum score of 56 in writing across the two sittings, and
  • when using two test sittings no score in any of the communicative skills for either test sitting is below 56.

 

TOEFL iBT

(Computer at test centre only)

Chinese medicine

Chiropractic

Dental

Medical

Medical radiation practice

Occupational therapy

Optometry

Osteopathy

Paramedicine

Pharmacy

Physiotherapy

Podiatry

Psychology

Minimum total score of 94
  • 24 for listening
  • 24 for reading
  • 24 for writing, and
  • 23 for speaking.
  • a minimum total score of 94 is achieved in each sitting, and
  • you achieve a minimum score of 24 for listening, 24 for reading, 24 for writing and 23 for speaking across the two sittings, and
  • when using two test sittings no score in any of the test sitting sections is below:
    • 20 for listening
    • 19 for reading
    • 24 for writing, and
    • 20 for speaking.

 

 
  1. Bolded terms are defined in the Definitions section of this standard.
  2. Except the Aboriginal and Torres Strait Islander Health Practice Board of Australia ELS registration standard which has different requirements.
  3. Applicants who have met the ELS standard for another profession via the English test pathway and wish to apply for registration in another profession which has a higher minimum test score may be required to provide additional evidence – in instances where a practitioner fails to provide satisfactory evidence, the Board may require the practitioner to satisfy the requirements of the ELS standard.
  4. Except the Aboriginal and Torres Strait Islander Health Practice Board of Australia ELS registration standard which has different requirements.
  5. Test scores are as advised by test providers and may change in line with score concordance research. Any change to score requirements will be published on the websites.
 

Downloads and additional resources

 
 
Page reviewed 20/03/2025