NCLEX Explained: Key Differences Between the US, Canada, and Australia
Whether in the USA, Canada or Australia, international nurses need to pass the NCLEX exam and get licensed before they can practice. Let’s break it down clearly and concisely so you understand how the NCLEX is used in each country — the US, Canada, and Australia — and what the key differences are.
NCLEX in the United States
What it is
The NCLEX-RN (National Council Licensure Examination for Registered Nurses) is the standardized exam required to become a Registered Nurse (RN) in the US.
It’s developed and administered by the National Council of State Boards of Nursing (NCSBN).
Who needs it
All graduates of US nursing programs who want to become RNs.
Internationally educated nurses who want to obtain an RN license in a US state.
Key points
Nurses apply to a specific state board of nursing, which sets requirements (some require CGFNS or CES report, some require SSN, etc.).
After passing, the nurse gets a state-specific RN license, and each state has its own renewal rules.
Nurses can later apply for license endorsement if they want to practice in another state.
NCLEX in Canada
What it is
Canada adopted the NCLEX-RN in 2015 as its entry-to-practice exam for RNs in most provinces and territories.
Before this, Canadian provinces used a separate Canadian RN exam (the CRNE).
Who needs it
Graduates of Canadian nursing programs.
Internationally educated nurses who are assessed as eligible by a provincial regulatory body.
Key points
Instead of "state boards," Canada has provincial regulatory bodies (e.g., College of Nurses of Ontario, British Columbia College of Nurses and Midwives).
You apply to the province first, complete an assessment (may include additional exams or bridging programs), and then take the NCLEX-RN.
Once you pass, you receive a provincial RN license, not a "Canada-wide" license.
Nurses must meet continuing competence and renewal requirements set by their province.
NCLEX in Australia
What it is
Australia only recently began using the NCLEX-RN as part of its registration process for internationally qualified nurses and midwives (IQNMs).
As of 2020, internationally educated nurses must pass the NCLEX-RN (plus an OSCE practical exam) to qualify for Australian registration.
Who needs it
Internationally qualified nurses and midwives who do not meet "substantial equivalence" through education alone.
Key points
Nurses apply to the Nursing and Midwifery Board of Australia (NMBA).
Local Australian nursing graduates do not take the NCLEX; they are assessed through approved university programs and registration standards.
IQNMs who pass the NCLEX and OSCE receive registration with the Australian Health Practitioner Regulation Agency (AHPRA).
Once registered, they can practice anywhere in Australia — there are no state-based nursing licenses.
Key differences at a glance
Why this matters for you
If your goal is to work in the US, the NCLEX is required for everyone — it’s your primary focus.
In Canada, you still need to go through provincial assessments first, even if you pass NCLEX elsewhere.
In Australia, the NCLEX is just one step for internationally educated nurses; you also need to pass the OSCE.
Need help understanding which path is best for you?
A professional licensing partner like NEAC can guide you step by step — from choosing the right country and province/state to handling your documents and preparing for the NCLEX and other required exams.