TCF is accepted for healthcare registration in the United Kingdom, Ireland, Australia and New Zealand, by ECFMG and some nursing routes in the United States, and by a growing number of regulators in Canada, the Middle East and Asia. Most regulators ask for Grade B (350) in each sub-test. Acceptance is set by each regulator for each profession, so the body that will register you has the final word.
- Regulators, not countries, decide whether they accept TCF, and they decide profession by profession.
- Grade B (350) in each sub-test is the most common requirement.
- Some regulators accept a C+ (300) in Writing or let you combine two sittings; others need every grade in one sitting.
- Your result usually has to be recent, often within two years of your application.
- Always check the regulator's current rules before booking, because they change.
Where is TCF accepted?
The table below lists the main regulators known to accept TCF and the grade they have usually asked for. It is a starting point, not a substitute for the regulator's own website.
| Country | Examples of regulators that accept TCF | Usual requirement |
|---|---|---|
| United Kingdom | Nursing and Midwifery Council (NMC), General Medical Council (GMC), Health and Care Professions Council (HCPC) | Grade B in each sub-test; the NMC has accepted C+ in Writing |
| Ireland | Nursing and Midwifery Board of Ireland (NMBI), Medical Council of Ireland | Grade B in each sub-test |
| Australia | Ahpra and the national boards, such as the Nursing and Midwifery Board and the Medical Board | Grade B in each sub-test |
| New Zealand | Nursing Council of New Zealand, Medical Council of New Zealand | Grade B in each sub-test |
| United States | ECFMG for international medical graduates; some nursing credentialing and state board routes | ECFMG: 350 in Listening, Reading and Speaking and 300 in Writing, in one sitting |
| Canada | Some provincial regulators, mainly in nursing and medicine | Varies by province and profession |
| Middle East and Asia | Some health authorities and regulators, for example in the UAE and Singapore | Varies by authority and profession |
For how grades map onto the 0 to 500 scale, see TCF scores and grades explained.
Which TCF profession should I take?
Take the version for the profession you are registering in. TCF is available for twelve professions: dentistry, dietetics, medicine, nursing, occupational therapy, optometry, pharmacy, physiotherapy, podiatry, radiography, speech pathology and veterinary science. Only Writing and Speaking change by profession. Midwives usually take the Nursing version, but check which version your regulator accepts first.
What should I check with my regulator before booking?
- Is TCF accepted for my profession? A regulator can accept TCF for nurses but not for another profession it registers.
- What is the minimum grade in each sub-test? Note whether Writing has a different minimum.
- Must all grades come from one sitting? Some regulators let you combine results from two sittings within a set period; others do not.
- How recent must the result be? Many ask for a result from within the last two years.
- Which test formats are accepted? Check whether the paper, computer and TCF@Home formats are all accepted.
- How do they receive results? Most regulators get results directly from TCF, and you may need to select them when you book or afterwards.
Is TCF or IELTS better for registration?
If your regulator accepts both, choose the test whose tasks match how you use English. For most practising healthcare professionals that is TCF, because every task is set in a healthcare context. If your regulator or visa route accepts only IELTS, that decides it. See the full TCF vs IELTS comparison.
What if I need TCF for a visa as well as registration?
Visa and registration requirements are separate. Some immigration authorities accept TCF for certain healthcare visas, and some set different scores from the regulator. Check both before you book, and aim for the higher of the two requirements.
How do I reach the grade my regulator asks for?
Start with a timed sample test to see how far each sub-test is from 350, then spend most of your time on the weakest one. The 8-week TCF study plan shows how to structure it. Exam Hero's free account includes a full-length TCF mock test with AI feedback on Writing and Speaking, so you can see where you stand against Grade B.
