What are the differences between TOEFL and IELTS

IELTS vs. TOEFL – What are the Differences?

Practicing nursing in the USA as an international nurse is a process that has many steps and requirements. After successfully passing the NCLEX RN exam that tests the professional knowledge and competency of each registered nurse, there is another test that RNs need to prepare for to continue their immigration process. This is an English language test, and different states in the U.S. may require either IELTS or TOEFL. Let’s take a closer look at the differences between IELTS vs. TOEFL.

What Are the TOEFL and IELTS Exams?

Unlike the NCLEX RN test, the Test of English as a Foreign Language, Internet-Based Test (TOEFL® iBT) or The International English Language Testing System (IELTS) (including IELTS for UKVI) accesses nurses’ language skills and satisfies one of the requirements for VisaScreen.

Both TOEFL and IELTS, are acceptable in the USA, but they are different in their structure, academic tests, and scoring criteria. The tests are focused not only on the English skills but also on the critical thinking of each candidate.

TOEFL’s structure and language are more academically focused while the IELTS has a more real-world communication feel. Both tests are quite lengthy and include reading, writing, listening, and speaking parts. Here are the differences between the tests to consider as you prepare for it.

Another difference between tests is their scoring system. TOEFL is scored out of 120 points with each section of top 30 points. IELTS system is ranging from 1 to 9 for each section with the final score calculated based on the average of all the sections.

  1. Scope
    TOEFL is for individuals who want to study abroad and is used for academic purposes. IELTS has a wider scope than TOEFL and is used for candidates who want to study, work and live in the USA.
  2. Testing Options
    Both TOEFL and IELTS are structured about the same but offer different options on how and where to take the test.

    Candidates that decide to take the TOEFL test will complete all of the parts on the same day. There are different options for taking the TOEFL test:
    – TOEFL iBT test – computer test is taken at the authorized testing center.
    – TOELF iBT Home Edition – online computer test monitored by a proctor.
    – TOEFL iBT Paper Edition – Reading, Listening, and Writing is taken on paper at the testing center, and speaking in taken online at home on the computer.

    IELTS on the other hand has two types: academic and general. Academic IELTS is for those who are applying to study abroad, whereas general is needed for candidates who wish to work and live in the USA. Unlike TOEFL, IELTS’ listening, reading, and writing sections are completed on the same day, and the speaking section can be taken before or after the other tests.
  3. Exam Duration and Structure
    Because of the complexity of the test and the different language skills being tested, both tests are about 3 hours long with short breaks in-between.

    TOEFL is divided into 4 parts with 10-minute breaks in-between. Reading and listening sections go first with 40 to 70 minutes to complete each part. Speaking and writing sections follow with 20 and 50 minutes to finish. All sections of the test are completed in one day.

    IELTS is 2 hours and 15 minutes long, has the same parts as TOEFL, but can be taken on different days. Listening, reading, and writing sections are completed on the same day with no breaks, and the speaking section can be taken up to two weeks before or after the completion of the other parts.
  4. Exam Interaction
    TOEFL is completely computer-based and is being recorded and scored after, while candidates taking the IELTS test are required to interact with the examiner for the speaking part.
  5. Scoring
    Another difference between tests is their scoring system. TOEFL is scored out of 120 points with each section of top 30 points. IELTS system is ranging from 1 to 9 for each section with the final score calculated based on the average of all the sections.

    The passing score for VisaScreen for healthcare professionals differs based on their profession and ranges from 73 to 89 for TOEFL and from 6.0 to 6.5 for IELTS takers. You can check the specific requirements for registered nurses, therapists and lab technicians, and technologists on the CGFNS webpage.
  6. Score Results
    After completing the test, candidates can check their results for TOEFL after 6-13 days and within 3 (online) to 13 days (offline) for IELTS results. Both tests are valid for 2 years after passing and can be retaken multiple times.

Which States Accept TOEFL and IELTS?

Nurses will need to consider in which state they will be getting their licensure after they receive an official ICHP Certificate before proceeding with their exam and VisaScreen. Each state has different requirements for nurses to prove their English skills to grant state licenses. Some states accept only TOEFL or IELTS, while other states accept both and some states do not have any preference.

States that only accept TOEFL:

  • California
  • Georgia
  • Kansas
  • Maine
  • Nevada
  • Ohio (accepts only TOEFL by examination, but TOEFL and IELTS by endorsement)

States or US territories that accept either TOEFL or IELTS:

  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Guam
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kentucky
  • Louisiana
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • NMI
  • North Carolina
  • North Dakota
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Puerto Rico
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • Washington DC
  • West Virginia
  • Wisconsin
  • Wyoming


If you are a nurse candidate who attended nursing school in the United Kingdom, Australia, Canada (except Quebec), New Zealand, Ireland, or the United States, the English test requirement often does not apply to you.