Research to date has produced conflicting findings concerning the relative harshness and other characteristics of language- trained raters versus 'naive' native speaker or occupational expert raters. This question is considered in the context of a recent standard- setting project carried out for the Occupational English Test, an occupation specific test of English for overseas- trained health professionals. 20 audio recordings of role plays from recent administrations of the tests were each rated by 10 trained ESL raters and 10 medical practitioners. Broad similarities in judgements indicate reliance on ESL-trained raters can be justified.