Of the four OET subtests, Speaking produces the most extreme variation between nationality groups. The gap between the highest and lowest performing groups is larger in Speaking than in any other subtest — and the reasons why are instructive for understanding both where to focus your preparation and why the OET format suits nurses specifically.
OET’s official 2026 data shows Hausa first-language speakers achieving a 98.1% Grade B pass rate in Speaking. Japanese first-language speakers achieve 67.2%. That is a 31 percentage point gap between two large candidate groups — on the same test, in the same year.
This article unpacks what is behind that gap, what it means for nurses from the major origin countries, and why Speaking — despite being the subtest most candidates worry least about — still catches a significant minority off guard.
The Overall Picture: Nurses Are Strong in Speaking
Before looking at nationality variation, the profession-level data is worth noting:
| Speaking Grade | % of Nursing Candidates (2026) |
|---|---|
| A | 0.2% |
| B | 82.0% |
| C+ | 16.0% |
| C | 1.7% |
| D | 0.1% |
| E | 0% |
82.2% of nurses reached Grade B or above in Speaking in 2026 — the strongest subtest result for nurses relative to the Grade B threshold. Compare this to Reading, where only 24.9% of nurses reached Grade B. The gap is extraordinary: nurses are more than three times more likely to pass Speaking than Reading at Grade B level.
The mean Speaking scaled score for nurses is 365 — already 15 points above the Grade B threshold of 350. The average nurse does not need to improve their Speaking to pass. They need to protect it.
This makes intuitive sense. OET Speaking uses two healthcare role plays with a trained human assessor. The scenarios — explaining a medication change to a patient, counselling a family member about a diagnosis, discussing a referral with a colleague — are clinical communication tasks that nurses perform in their daily work. It is not a test of general conversational English. It is a test of healthcare communication, and nurses are healthcare communicators by profession.
Speaking Performance by First Language: The Full Picture
| First Language | Mean Speaking Score | % Grade B+ | Median Grade |
|---|---|---|---|
| Hausa | — | 98.1% | B |
| Urdu | 382 | 93.2% | B |
| Pashto | — | 92.8% | B |
| Ibo/Igbo | — | 92.8% | B |
| Sindhi | — | 92.8% | B |
| Arabic | 379 | 90.1% | B |
| Dutch | 400 | 94.2% | B |
| English | 394 | 81.2% + 12.4% A | B |
| German | 394 | 89.5% | B |
| Hindi | 374 | 88.4% | B |
| Malayalam | 368 | 84.9% | B |
| Bengali | 377 | 90.8% | B |
| Filipino/Tagalog | 372 | 84.5% | B |
| Tamil | 370 | 85.3% | B |
| Telugu | 375 | 88.5% | B |
| Korean | 371 | 75.8% | B |
| Romanian | 362 | 75.5% | B |
| Cantonese | 367 | 76.0% | B |
| Japanese | 355 | 67.2% | B |
| Thai | 358 | 69.1% | B |
| Turkish | 360 | 72.9% | B |
The spread is striking. Hausa (98.1%), Urdu (93.2%), and Pashto/Ibo/Sindhi (all 92.8%) sit at the top. Japanese (67.2%), Thai (69.1%), and Turkish (72.9%) sit at the bottom — still with median Grade B, but with a meaningful tail of candidates not reaching the threshold.
Why African and South Asian Language Groups Excel in Speaking
The pattern across the data is consistent: candidates whose first languages are widely used in English-medium healthcare environments tend to perform strongly in OET Speaking.
Nigeria (Hausa, Yoruba, Ibo/Igbo first languages) shows some of the highest Speaking pass rates in the dataset. Nigerian healthcare professionals operate in English-medium clinical environments — ward rounds, handovers, patient communication, documentation — all in English. Clinical English is not a second language layered over their professional practice; it is embedded in it. When they enter an OET role play, the scenario is essentially a simulation of something they do every day.
Pakistan and Bangladesh (Urdu and Bengali first languages) show similarly strong Speaking performance. Urdu speakers achieve 93.2% Grade B in Speaking with a mean of 382. Bengali speakers achieve 90.8% with a mean of 377. Both groups are significantly above the Grade B threshold.
India (Hindi, Malayalam, Tamil, Telugu, Kannada) shows strong Speaking performance despite significant struggles in Reading. Malayalam speakers achieve 84.9% Grade B in Speaking (mean 368) — a completely different picture from their Reading performance, where only 23.2% reached Grade B. This underscores a critical point: a nurse’s Speaking ability does not predict their Reading ability, and vice versa. These are genuinely different skill sets.
Why East Asian Language Groups Score Lower in Speaking
The lower Speaking scores for Japanese, Korean, Thai, Cantonese, and Mandarin speakers reflect a well-documented linguistic phenomenon: phonological and prosodic distance from English.
Japanese, Thai, and Korean have fundamentally different sound systems from English. Japanese lacks several English consonant clusters and has a mora-timed rhythm very different from English’s stress-timed rhythm. Thai is a tonal language with different intonation patterns. Korean has different vowel distinctions and consonant endings.
These differences do not affect intelligence or clinical competence — they affect the specific acoustic features that OET Speaking assessors are trained to evaluate. Fluency, pronunciation clarity, and natural intonation all contribute to Speaking scores, and candidates whose first languages have greater phonological distance from English need more targeted speaking practice to compensate.
It is worth noting that even at the lower end of the Speaking distribution, Japanese speakers still achieve a median grade of B — the pass threshold. The 67.2% Grade B pass rate means roughly one in three Japanese speakers falls below Grade B, which is a real risk, but the majority still pass.
Speaking Performance by Key Nationality Groups
Philippines
% Grade B+ Speaking: 84.6% | Mean: 370 | Median: B
Filipino candidates perform solidly in Speaking. 84.6% reach Grade B, which is above the nursing profession average. Filipino English is widely used in healthcare contexts globally — Filipino nurses work in hospitals across Ireland, the UK, the UAE, and Australia before even sitting OET, giving them extensive clinical English communication experience.
The Speaking subtest is generally not where Filipino candidates lose marks. Writing (57% Grade B) and Reading are the areas requiring focused preparation for Filipino nurses.
India
% Grade B+ Speaking: 85.9% | Mean: 370 | Median: B
Indian candidates perform consistently in Speaking — 85.9% Grade B, mean 370. Like Filipino candidates, the challenge is not Speaking; it is Reading and Listening. Speaking preparation should be maintained but not over-invested in relative to the subtests where the actual gap exists.
Nigeria
% Grade B+ Speaking: 92.3% | Mean: 377 | Median: B
Nigerian candidates are among the strongest Speaking performers in the dataset. 92.3% Grade B is exceptional. This is consistent with the first-language data for Hausa (98.1%), Yoruba (90.6%), and Ibo/Igbo (92.8%) speakers. Nigerian nurses should be directing minimal preparation time to Speaking and focusing on Reading and Writing gaps.
Middle East
| Nationality | % Grade B+ Speaking |
|---|---|
| Omani | 94.8% |
| Pakistani | 93.2% |
| Saudi | 88.3% |
| Emirati | 90.0% |
| Qatari | 86.8% |
Middle Eastern candidates perform very strongly in Speaking across the board. Omani (94.8%) and Pakistani (93.2%) are among the highest nationally. Arabic first-language speakers achieve 90.1% Grade B in Speaking. For these candidates, Speaking is a strength to maintain — the preparation focus should shift to Writing and Reading.
The One Speaking Risk Nurses Underestimate
Despite the strong overall pass rates, 16% of nurses scored C+ in Speaking in 2026 — and 1.8% scored C or below. These are not negligible numbers across a global candidature.
The most common Speaking failures among nurses who otherwise have strong English are not about language proficiency — they are about role play management.
OET Speaking role plays require you to take a specific clinical role and respond appropriately to an assessor playing a patient, carer, or colleague. Candidates who fail Speaking at Grade B typically make one of three errors:
1. Not listening to the patient. The assessor introduces new information or concerns mid-role-play. Candidates who have a scripted response in mind miss this and fail to address it. OET assessors score you on how well you respond to the actual conversation, not how well you deliver a prepared speech.
2. Using inappropriate register. Speaking to a patient requires plain, reassuring language. Speaking to a colleague allows clinical terminology. Candidates who use medical jargon with a patient — “your INR is supratherapeutic” — lose marks under Genre & Style regardless of whether the information is clinically accurate.
3. Failing to structure the role play. Effective OET Speaking follows a recognisable arc: establish rapport, gather or provide information, confirm understanding, close appropriately. Candidates who jump directly to information delivery without establishing the communication context score lower on fluency and interaction measures.
How Speaking Fits Into the Full OET Picture for Nurses
Across all three data articles, a clear pattern emerges for nurses:
| Subtest | % Nurses Grade B+ | Priority for Preparation |
|---|---|---|
| Speaking | 82.2% | Low — maintain, don’t over-invest |
| Writing | 63.2% | High — FluencyX addresses this now |
| Listening | 32.3% | High — targeted practice needed |
| Reading | 24.9% | Critical — biggest gap |
Speaking is where nurses are strongest. Reading is where they are weakest. Most preparation plans are inverted — heavy on Writing (already relatively close to Grade B), light on Reading (the biggest gap of all).
On Reading: At FluencyX, we know how critical Reading is for nurses — the data makes it undeniable. We are working hard to bring you a comprehensive, guaranteed OET Reading preparation product. When it launches, it will be built with the same criterion-specific rigour as our Writing tool. Stay tuned — and in the meantime, use the data in this article to make sure your Reading preparation is getting the time it deserves.
What Good OET Speaking Preparation Looks Like
For the minority of nurses who do need to improve their Speaking — particularly candidates from Japanese, Korean, Thai, Turkish, or Romanian language backgrounds — here is where to focus:
Pronunciation drills are not enough. The OET Speaking assessment is holistic — it rewards natural clinical communication, not phonetically perfect English. A nurse who communicates clearly, listens actively, and manages the role play competently will score higher than one with perfect pronunciation but a scripted, robotic delivery.
Practise responding, not performing. Record yourself doing role plays — then listen back specifically to moments where the “patient” introduced new information. Did you respond to it? Did you acknowledge it before moving on? Active listening is the most commonly underpractised Speaking skill.
Know the two role play types. OET Speaking always involves two role plays. Both are healthcare scenarios. One will typically involve a patient or carer; the other may involve a colleague or another healthcare professional. The register, vocabulary, and communication style should adjust accordingly.
Time your role plays. Each role play is approximately five minutes. Candidates who have not practised under time conditions often either rush (too brief, insufficient information exchange) or over-run (losing marks for failing to close appropriately).
For full annotated sample OET letters demonstrating the clinical communication standards that carry across Writing and Speaking, see our OET sample letters collection.
Start With Writing — Your Fastest Path to Grade B
Speaking is already your strongest subtest. Writing is where most nurses are closest to Grade B but still falling short — often on a single criterion. FluencyX gives you criterion-specific Writing feedback in seconds, so you know exactly what to fix before exam day.
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