SIFE case studies

“If you can meet the requirements, SIFE could be a good option for you to achieve your goal of joining the register, especially if have years of experience back home and you would like to continue being a nurse.”

Marites is a registered nurse from the Philippines, with over seven years of experience specialising in critical care and additional experience working as a nurse in Libya.

In 2018, Marites moved to the UK to join her husband. She began working as a senior care assistant in a UK nursing home and decided to pursue a preparatory nursing course from a UK university to help her progress towards NMC registration.

Though she found it challenging to balance studies, work and family responsibilities, she was “determined to continue my nursing career and maintain my skills… I was so exhausted but with the immense support of my husband, I successfully completed the course and earned a certificate.”

Despite her efforts, Marites still didn’t have the English language evidence she needed to register as a nurse in the UK. She took the OET language test but unfortunately missed one of the required scores she needed to be able to register.

Unable to progress with her NMC registration, Marites moved to the NHS to work as a healthcare assistant, where she remained for almost six years. She found it very difficult not to be able to use her nursing skills in practice:

"It is frustrating, especially when there is a shortage of nurses… I knew I am confident enough to handle the job because with my long experience as a trained nurse back home and with my specialties and expertise, I knew that I would be a great asset to the unit.”

In 2022, Marites heard from a colleague about supporting information from employers, a potential new evidence type for internationally educated nurses seeking to register with the NMC.

Hearing about SIFE, Marites was “inspired by the possibility”. To use it, Marites had to provide a letter from her school confirming the nursing course she completed in the Philippines was taught in English. She began preparing her NMC registration application and contacted her employer.

Her employer agreed to provide SIFE but warned that they had no nursing vacancies available at that time. Marites didn’t give up:

“I remained determined to stay strong and hold on to the faith that I would soon resume practising my profession.”

Marites continued with her NMC application and passed her Test of Competence in July 2023. She was then able to use SIFE to complete her registration.

Marites received her PIN in October 2023, six years after moving to the UK. She says she is very grateful that SIFE enabled her to continue her nursing practice:

“I’m happy to share that I received an offer from another ward, right after getting my PIN. The matron on that unit is familiar with my work ethic and capabilities and has been incredibly supportive. I’m so thankful. I can speak and express myself to patients. I can explain the condition or whatever is needed for the role. It gives me hope to continue my profession.”

“Thanks to SIFE I'm working as a registered nurse now. It had a positive effect on my life, being able to practise as a nurse at the same level as I did at home.”

Eby is currently working as a registered theatre scrub nurse in the UK.

In 2007, he completed a bachelor’s degree in nursing in India, where he worked as a nurse for 12 years. In 2021, he joined his wife in the UK and initially worked as a healthcare support worker in a nursing home. He then moved to a new role in a psychiatric hospital, where he was employed for two years.

Eby initially tried to join the NMC register by attempting an English language test but unfortunately he missed the required score for reading.

He knows many other internationally educated nurses who, like him, have struggled to pass language tests to complete their NMC registration:

“They have many years of experience, working here in this country for more than 10 years. They can speak to the patients very well and they have good communication skills, but they are really worried about the [language test] exams, they have a lot of fear of the exams.”

Having struggled to meet the test score requirement, Eby was excited when he got an email from the NMC about a new evidence type to help international applicants demonstrate their language skills: supporting information from employers.

He found out more about the SIFE process and realised that as he had been working with the same UK employer for more than a year, he could be eligible to apply using it.

He spoke with his employer and explained what he knew about SIFE.

“I showed them all the details and frequently asked questions, and after that they were happy to proceed – they were really helpful, really supportive.”

Eby’s manager was confident in his English language capabilities, having seen his skills in practice over time.

“Because I’m working in a psychiatric hospital, our main work is to communicate with the patients. I think they [the employers] were happy with how I’m communicating, getting a good rapport with the patients – they were not worried about my language.”

Eby feels that without SIFE, it could have taken him another year or two to complete his NMC registration and be able to work as a nurse. He believes that SIFE could have a positive impact for many.

“The UK is still short of nurses. There are many [internationally educated] nurses working in this country as a senior carer or as a support worker. If they can get registration as a nurse, they can work in the same field, they can be a part of the NMC register – they can do what they were doing in their home country, which can [support] the nurses in this country.”

Thanks to this opportunity and the help of his employer, Eby says:

“Now I can work as a registered nurse, especially in theatres as a scrub practitioner. It makes me more confident and comfortable that I can work, that I can do something which I was doing before [in India]. So that gives me a positive effect in my life.”

“SIFE is a life-changer.”

Eldho completed his nursing education in India, where he practiced for several years. In the south part of Kerala, where he’s from, becoming a nurse is very common. There are four nurses in his own family – himself, his wife, his sister, and his brother-in-law.

Eldho moved to the UK in 2016, with the ambition of becoming a registered nurse in this country. While living in India, he had gained a nursing degree that was taught and examined in English.

“When I studied for my pre-registration nursing qualification, everything – all the communication, instructions, exam – was in English.”

However, he struggled to meet the language test score requirements to gain NMC registration: “In the beginning, it was difficult for me to understand the accent [in the UK] – people speak very fast. I didn't lose my hope to become a nurse. Emotionally, it affected me. But I kept trying.”

Eldho began working in the NHS as a support worker in theatre, while going through the process for NMC registration. He moved to his current employer to work in a Band 2 role, and continued to improve his English skills.

“Eventually I came to understand and communicate fluently with all of my colleagues, and my managers supported me.”

Eldho heard about a new process, SIFE, that could help international nurses demonstrate their English language skills if they were having difficulty passing a language test. Eldho’s manager had seen first-hand the improvement in his language skills over the course of a year and was keen to support his SIFE application.

“I explained the situation to my manager. They knew my skills and knowledge and they were very happy with me – they wanted me to be a nurse in their own department.”

Encouraged by his employer, Eldho completed his OSCE and CBT training. He was nervous but was fortunate to get a great training instructor. The instructor helped him to regain confidence in his existing skills and abilities, and Eldho passed his OSCE on the first attempt. He was ready to complete his application using the SIFE process.

When Eldho received his SIFE form, his manager, while very supportive, was unsure of the process. Eldho was able to explain the steps and the information required. With his manager’s help, he gathered the two forms of English language evidence he needed for SIFE: a letter proving that he had trained and qualified in English, plus the supporting information from his employer.

Eldho submitted his complete NMC application and received his PIN, becoming a registered nurse in February 2023. Since completing his registration, Eldho has started a support group to help other internationally educated professionals who want to join the NMC register using SIFE.

Eldho suggests to anyone thinking of using SIFE to look at the NMC pre-application checklist first. This checklist shows what evidence is needed, who to contact and what guidance to read before starting an application.

Eldho is extremely grateful for what he’s been able to achieve through SIFE.

“My managers were very, very supportive and I’m very thankful to them – there is no words to express my thanks. SIFE is like a life-changer.”