hi everyone!ielts is not necessary if you are applying under the live-in caregiver. a speak test is what you should pass inorder to proceed to medical. this is a rest given by an approved third party where you will be facing a camera and a monitor and wears a headset. the questions are audible while being flashed in the screen. then your answer (by way of speaking) is being recorded. if i remember well, they have 2 questions that is general(more of like testin your englis conversational skills)...example, hiw dis you celebrate your last bday, what is your most memorable occassion, etc. and the 4 last questions was abt caregiving skills, examples are (in my case): what are the s/s of an allergic reaction, how will you promote oral hygiene to your 72yo client with dentures, which of the ff is not a sign of mycardial infarction(mi) with choices a,b,c,d, your 8yo client fell from stairs, what will you do...you are given 120seconds or 2mins for each question. tip:don't speak while the voice recording is speaking, so that your voice don't overlap and the officer who will review your video will clearly understand your answers. and lastly, before you undergo speaktest, the embassy will send you a letter with instructions/infos of what, where, when...good luck!