I know nothing about the IELTS. However, as far as the endorsement....different facilities have different requirements. For example, I live in OH and applied at a couple of Indiana hospitals. Needless to say, I didn't want to fork over the money for an IN license without a job offer. One hospital said they wouldn't consider my application until I had an IN license. However, at the other hospital I was given a job offer and will start as soon as I have my IN license. It can take several weeks. So, if I were you I would contact the specific HRs in which you are applying through to see if you could wait until a job offer to get an endorsement. I wish you well!