OET WRITING

GUIDE
Your Ultimate Guide to Write a
Perfect A-Grade Letter

Dr Zeeshan Saleem
OET ONLINE ACADEMY
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Table of Content

S.No Chapter Page No

1) Health system of UK 4

2) Types of OET Letters 5

3) OET Writing Criteria 7

4) Writing Date and Address 8

5) Purpose 9

6) Content, Conciseness and clarity 12

7) Genre and Style 14

8) Layout and Organization 16

9) Language 18

10) Grammar 18

11) Active voice and Passive Voice 22

12) Punctuation 24

13) Spelling 25

14) Writing Names 25

15) Vocabulary 27

16) Connectors 27

17) Article 29
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Preface

OET Writing Guide is written by the author Dr. Zeeshan Saleem, who is the owner
of OET Online Academy. This book concludes all the information you need for the
writing subset of OET.

OET Online Academy has an experience of teaching OET for the past one year
with a 100% success rate. Excellent material is available for the other three subtests
of the OET exam; however, there was not any resource that can teach aspirants the
writing subtest. We have compiled all the necessary information under one roof that
is required to write an excellent A-grade letter.

At the end of this book, students are expected to know every point related to the
writing subset as it encourages everyone to write like professionals. This book is
designed to be convenient and easy.

Author: Dr Zeeshan Saleem

OET Online Academy

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THE WRITING PART of OET is very easy to master. However, many people find it
difficult for understandable reasons, the very important of which is “you don’t know
whether or not you are practicing it the right way”.

I am Dr Zeeshan Saleem and I have more than one year experience of teaching
OET.I run an online coaching class with the name OET ONLINE ACADEMY, where I
teach everything related to OET with special attention to the writing and speaking
subset.

After teaching hundreds of aspirants, I am writing this guide in a very easy and
understandable way to make letter writing very easy for everyone.

I will briefly explain every criterion of OET for writing. After going through this guide, I
believe that you will know every aspect of writing a perfect A-grade letter.

If you find this guide helpful, please follow us on the following links where we
regularly post helpful content and conduct free sessions.

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Health system of the United Kingdom

Understanding the health system of the United Kingdom is extremely necessary to
understand the OET writing subtest. Although there are many levels and layers of
this system, we would only discuss three levels.

❖ General Practitioner:
Commonly mentioned as GP or GP surgery in case notes,
GP is a patient’s personal doctor. He is the one who knows the patient's complete
details including medical history, family history, current disease, current medications
and progression of disease etc. If a patient doesn’t have any emergency, he will
always go to his GP.
However, you will always need an appointment to visit your GP.
A majority of common diseases and initial investigation and management for some
serious conditions will be performed by the GP and then he will refer the patient to a
specialist doctor.

❖ Specialist Doctor:
Like anywhere else in the world, these doctors specialize in a specific field like
cardiology, neurology and endocrinology etc. They only treat patients that fall under
the umbrella of their specialization. They don’t have personal patients. In this case,
the patient will still need an appointment to visit them.

❖ Emergency department:
If a patient encounters any emergency, he can go to any nearby Emergency
Department. There is no need for an appointment to visit here. The doctors in
Emergency Department will perform all the necessary procedures and stabilize the
condition of the patient.

Knowing the above levels is important to select the relevant information for the
reader in writing a letter. We will discuss this in the “Types of letters” section.
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Types of OET Letters

➢ There are four major types of OET Letters

a) Referral letter
b) Discharge letter
c) Update letter
d) Transfer letter

➢ Referral letters

Referral letters are the most common type of letters encountered in the OET Exam.
In this specific type, the patient's GP refers him to a specialized doctor for some
specific sort of treatment. As the reader of the letter doesn’t know about the patient,
you will write the patient’s relevant history, family history, allergies and current
medications.

Suppose your patient is suffering from arthritis, bone fracture, hyperthyroidism and
kidney stones. Your task is to write a referral letter to an endocrinologist. Here, you
will give complete details about the patient’s hyperthyroidism; however, you will
include the other diseases in the “personal history” paragraph.

Now, let's suppose the same patient is being referred to a Rheumatologist. You will
include complete details about his arthritis; however, the other diseases are written
in personal details paragraph.

So, as you can see here, we are including and elaborating on the information while
keeping the reader in mind.

➢ Subtypes of Referral letters include

1. Normal Referral
2. Urgent Referral with an Emergency condition associated with patient
3. Urgent Referral without Emergency condition

These letters only differ in the “layout and organization” of details and
paragraphing; however, their content remains the same. You will get further details
about these types as you go through this guide.
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➢ Discharge letters

The second most common type of letter in the OET exam is a discharge letter. Here,
a specialized doctor/department has treated the patient for some specific disease
and now, the patient is being discharged back to his GP for continued care.

As GP already knows the patient, so past medical/surgical/personal details are

irrelevant and should not be included. What GP doesn’t know is
1. What happened to the patient during his hospital admission
2. What is the current status of his disease
3. What I am supposed to do further to take care of this patient
You will include details of what GP don’t know. So, the content of the letter will
revolve around the above-mentioned points. Always keep yourself in the reader’s
shoes and think about, what should and should not be included.

❖ Update letter

I consider update letters a subtype of discharge letters. Here, the patient is not being
discharged from the hospital; however, the writer writes this letter to inform and
update his GP or family about the current status of the patient and his ongoing
management. The letter will completely follow the pattern of discharge letter but keep
in mind, the patient is not being discharged.

❖ Transfer Letter

These are the least common type of letters encountered in the exam. Here, the
patient is being transferred to another place; to another GP or Specialist Doctor due
to a change of location or to another department within the same hospital.

So, the reader doesn’t know the patient, and you are supposed to include his
relevant personal details, past and current medical/surgical/allergy/medication
history.

Some of the case notes may include the word “discharge” so, carefully read the
case notes to understand the type of letter.

If a patient is being transferred to another place, the letter will follow the pattern of a
“Referral letter” on the contrary, if a patient is being transferred to another
department within the same hospital, such as from Surgical ICU to the ward, the
letter will follow the pattern of a “Discharge letter”.
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Understanding OET Writing Criteria

Click on the following link to download the detailed criteria for writing a letter:
Writing Criteria
Here, I will briefly explain what does these words mean

1. Purpose: The purpose of the letter should be immediately clear to the reader
“why is this letter being written and what does the reader needs to do further”.
As you know, healthcare professionals always lack time, so they should
immediately know the purpose of a patient’s visit.

2. Content: Everything that you have written is important to the case and reader,
and there is no extra information

3. Conciseness and clarity: There should not be any extra information and the
letter should have an appropriate length (neither too long nor too short)

4. Genre and Style: The method of writing should be clinical/formal and

appropriate according to the discipline of the reader. You should use a polite
language

5. Organization and layout: it means the flow of information should be logical.

The most important information should be written first in a priority-wise
manner.

6. Language: Language means spelling, sentence structure, use of tense,

vocabulary and grammar.

As you can see that OET has a variety of criteria to judge your letter. You should
know what these words mean and how are you going to present your letter to the
reader.
Now I will expand on each criterion and will give you examples for demonstrating
them in your letters.
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Writing date and address

There are certain variations in the writing date and address. However, here we will
only read one variation that is standardized by OET.

First, you write Today’s date on the top left side of the letter (this will be your exam
date in the real letter). After this, you leave one line and write the full name of the
doctor, his designation/position, and his address. Again, leave one line and write
“Dear Dr XYZ.
Again, leave a line and write details of the patient (Name and Date of birth/age) titled
RE (regarding)

25/11/2022--------------------------------------------------Date

Dr Zeeshan Saleem----------------------------------------Name
Neurosurgeon----------------------------------------------Designation
Neurosurgical Unit----------------------------------------Address
XYZ Hospital
Islamabad

Dear Dr Saleem---------------------------------------Write only the second name

Re: Mrs Amina Haider D.O.B:12/07/1996 or Aged: 26 year

Use of punctuation in address and greeting lines.

Dear Mrs. Alice, ✓

Dear Mrs Alice ✓

Very commonly asked questions about the use of punctuation in address and
greeting are following
➢ Should I put a comma at the end of each line of the address?
➢ Is it correct to put a comma at the end of the greeting? [as in example 1
above]
➢ Should I put a full stop after a person’s title? [as in example 1 above]
➢ Do I need a comma after Yours sincerely/faithfully?
The answer is that putting a comma or a full stop in each of these situations is
acceptable. Not putting a comma or a full stop is also acceptable. Time has changed
the way we use punctuation. In effect, we have become lazier: omitting punctuation
which was standard in the past.

This means, if you add the punctuation in the situations given above, or if you don’t,
you will have used equally acceptable English.
It’s understandable why students become very concerned about little things like
correct punctuation. It’s good to remember though that it forms only 1 of 6
assessment criteria. Therefore, it shouldn’t be given more weight in your preparation
than more important things such as the structure and content of the letter
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Purpose
The purpose of the OET letter is extremely important as it is going to be the first
point of contact with your accessor. It will impart an impression in the mind of the
examiner about your understanding and level of competency in writing a letter.
Therefore, it should be your key focus point.

For the purpose to be considered a masterpiece, it should include four things

a) Who
b) disease
c) why
d) any special request (if given)

1. Who: It means “Who” is the patient

i. Name of the patient

ii. Age of the patient: (should be omitted in discharge letter)
iii. Profession (if given) of the patient
Example

➢ Mr Mark, a 26-year-old lawyer,

➢ Mrs Anderson, a 50-year-old housewife

2. The disease of the patient

The second most important thing that must be present in the purpose paragraph is
the disease or presenting complaints of the patient.
Note: You can also describe presenting complaints using medical terminology as
OET is a profession-specific exam.

3. Why

It means why are you writing this letter to the reader or what part the reader is going
to play in the care of this patient.

4. Any special request:

Although not always given, any request about some specific test or procedure given
in the “writing task or plan” must be included in the purpose paragraph.

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EXAMPLES

❖ Suppose you have a patient Andrew Harrison who is a 60-year-old

labourer. His presenting complaints include hyperthyroidism, hypertension,
atrial fibrillation and a fractured bone. You are asked to write a referral letter
to a cardiologist for further assessment and management. You are also asked
to request the reader to perform an ECG. You would write the purpose
paragraph as follow

➢ “I am writing to refer Mr Harrison, a 60-year-old labourer whose presenting

complaints and initial investigations are consistent with atrial fibrillation.
Now, your expertise is requested for further assessment including an ECG
and appropriate management.”

❖ Suppose you have treated Mr Mike, who is a 50-year-old schoolteacher, for a

myocardial infarction in the cardiology ward at Brisbane Hospital. He has
spent one month in the hospital. Now, Mr Mike is stable and is discharged
today to his GP for continued care and monitored treatment.

➢ “I am writing regarding Mr Mike, who has been treated for myocardial

infarction at Brisbane Hospital. Now, he is stable and ready to be discharged
into your care to continue his treatment.”

Regarding the above example, you can see that we have included all four essential
elements for the purpose paragraph Who, Disease and Why and special request.

The important thing to note is that multiple complaints of the patient were given in the
case notes but in the purpose, we have only mentioned one complaint that was
specific to the reader, in this case, the cardiologist.

Although, the other complaints are also important to mention as these will affect his
treatment for Atrial fib, these will be mentioned in the “Personal details” paragraph.
You will find more about paragraphing in the “organization and layout” section.

So, we have picked everything specific for the reader to know in the “Purpose”
paragraph. This means the reader will immediately get an idea of the situation and
the role he would play in the care of the patient.

Suppose you were asked to refer the same patient to an Orthopedic Surgeon or an
Endocrinologist. What visiting complaints would you include in the “Purpose”
paragraph? Try to answer it yourself
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GOLDEN TIP
Writing a perfect purpose paragraph is time consuming in the real exam. Try to
follow the below given format for writing a perfect purpose paragraph of referral and
discharge letters

❖ Referral Letter

➢ I am writing to refer/Thank you for seeing/accepting Mr X, a xx-year-old

*Profession* whose presenting complaints/ signs and symptoms/ initial
investigation are suggestive of ***** disease. Now, he needs your expertise
for further evaluation and management.

(Please note: The Word management will be replaced with the exact word that is
used to request the reader in the management plan or writing task given at the end
of the letter)

➢ Discharge Letter

➢ I am writing regarding Mr X, who has been treated for *** disease in our
clinic/ward/institute. Now, he is being discharged/ ready to be discharged into
your care for continued and monitored treatment.

GOLDEN TIP:
You can immediately find the type of letter (referral/discharge) in the “Writing
Task” given at the end of the case notes. So, before you start, just go to the end of
the case notes and look at the writing task. Sometimes, it may not be given in the
writing task however, you can easily understand by going through the case notes.

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Content, Conciseness and Clarity

Content is the second criterion and "conciseness and clarity" is the third criterion
used for assessment; however, they are often grouped because many skills,
strategies and questions that apply are similar to these.

The Content is the information you have included in your letter. In

contrast, Conciseness and Clarity assess the information you have omitted from
your letter.

Everything you include in the body of the letter should be relevant to the type of
letter (Referral, discharge or other types) and reader. It means

1. Is there any existing professional relationship between the reader and the
patient, if so what information does he already know?
2. What aspect of the patient's care will he undertake?

Selecting the information that is relevant/irrelevant may be a hard task but it will
become extremely simple if you place yourself in the reader’s shoes and think “is it
something that I should be knowing and is it going to affect the care of the
patient”. This strategy will simplify the process of selecting relevant information. You
can learn more from the following examples.

➢ Example
➢ Suppose your patient Mr Harry Potter has inflammatory bowel disease. He
smokes 10 cigarettes per day and consumes 14 units of alcohol per week. He
broke his arm when he was a child and his father had a traffic accident at the
age of 50. His mother has type 1 diabetes and his sister has hypothyroidism.
You will refer your patient to a gastroenterologist; what would be your
content?

In the above example, everything is relevant except for the history of arm fracture
and traffic accident as both of these things will not affect his care one way or the
other and it is not important for the reader to know.

➢ Now, suppose Harry’s father had alopecia at the age of 40. Do you think this
is important for the reader to know?
YES. Because alopecia is an autoimmune disease and so is IBD, that shows
he has a family history of Autoimmune diseases.

➢ Now, suppose the same patient is being discharged back to his GP. What
would be the content of the letter?

➢ As GP already knows the complete details of the patient, you will only need to
mention what has changed since GP last saw him. Progression of his
disease and change in his medication and diet is going to be the content of
the letter.
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Please keep in mind to accurately represent the content by not altering the meaning
of words given in case notes and time-frame of events by choosing the wrong tense.

GOLDEN TIP

The recommended length of the letter body should be between 180-200 words. You
can go 10 words below and 20 words above the recommended length but it doesn’t
mean the examiner Is going to count your words.

This length is just to give you an idea of whether you have included the right
information (the content) and excluded irrelevant (conciseness & clarity).

Because the case notes are designed by experts in a way that all the important
information can be summarized in 180-200 words.

If you are writing less than 180 words, there is a chance that you may be missing
important details. On the other hand, if you are writing more than 200 words, there is
a chance that you may have included irrelevant information or you haven’t
summarized the information effectively.

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Genre and Style

“Genre and style” is the 4th criterion used to mark your letter. You are writing your
letter to another professional. Therefore, you should write in a style that is formal,
respectful, non-judgmental, requesting and it should align with the reader’s
specialty and knowledge. It accesses how you present information to the reader and
about the patient.

➢ Formal Writing

➢ Informal:
• Thanks for having a look at Priya.
• Priya is a heavy smoker and drinker.
• She is overweight.

➢ Formal:
• Thank you for seeing Mrs Priya Sharma.
• Mrs Sharma smokes 10 cigarettes daily and consumes 14 units of alcohol
weekly.
• Her weight is 90kg/ Her weight is above the normal range for her height.

As you can see these phrases are respectful to the reader’s role and are polite
expressions about the patient, using her full name as part of the introduction.
Further, we are using figures while avoiding clinical judgments. The reader already
knows the recommended norms of these values.

➢ Starting and ending your letter

How you start and end the letter is important to get a formal tone right from the start
and leave the right impression at the end. You always write purpose at the start of
letter and closing sentence at the end of letter.
It is also common to end with a closing sentence that offers the reader the
opportunity to contact you or to show appreciation for their involvement.

For example:

➢ If you require further information, please do not hesitate to contact me.

➢ Thank you for your continued management of this patient.

You should end your letter with proper words.

There is a wide variety of ending such as Sincerely and Regards; however, they are
mostly accepted in US English. The two most commonly used endings in British
English are
1. Yours sincerely
2. Yours Faithfully
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If you know the name of the reader, you should end your letter with “Yours
Sincerely”; however, if you don’t know the name of the reader, such as when writing
to an Emergency Department, you should end your letter with “Yours Faithfully”

❖ Contractions

Contractions are considered informal and should be avoided in OET letters

➢ Informal:
• He’s keen to return to his home.
• She didn’t follow the plan as recommended.
• He can’t run fast.

➢ Formal:
• He is keen to return to his home
• She did not follow the plan as recommended.
• He cannot run fast.

❖ Abbreviations

Abbreviations are allowed in OET letters; however, they should align with the
reader’s role and knowledge.

For example
you can abbreviate “non-insulin-dependent diabetes mellitus” as “NIDDM” when
writing to an endocrinologist.

However, you cannot write this abbreviation when you are writing to a urologist.
Similarly, you can abbreviate “Urinary tract infection” as “UTI” when writing to a
urologist, but on the contrary, you cannot choose this abbreviation when writing to
Endocrinologist.

However, there are some universal abbreviations that can be used in OET such as
“BP” for Blood pressure, CT scan, MRI etc.

Generally, avoid using abbreviations so that the chances of mistakes are minimal in
exam settings.
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Layout and Organization

Layout and organization can be effectively summarized as a “logical flow of

information with the most important event being first”

OET has not set any specific layout and organization for different kinds of letters.
They just say your flow of information should be logical. We have set some different
layouts for different types of letters so that a logical flow of information can be
followed.

❖ Referral Letters
➢ Simple Referral letter

Simple referral letters mean there is no emergency condition associated with the
patient and he will go to the specialist on a scheduled appointment date.
1. Introduction paragraph/ purpose paragraph
2. Personal details
3. Initial visit
4. Progression of disease
5. Last visit/ Today’s Visit
6. Request paragraph

It is very important that you completely elaborate the first and last visit of patient
in referral letter and just give an over view of disease progression in the visits
made in between first and last visit.
While elaborating visit in a paragraph, try to follow a logical flow of information by
writing in following sequence

a) Date of visit b) name of patient c) presenting complaints d) your examination

findings e) test ordered/ advise given

Suppose patient made 6 visits. You have to describe 1st and 6th visit in
complete details by following the above given sequence. 2 nd to 5th visit should
be summarized in two to three sentences.

➢ Urgent Referral Letter

There can be two different types of urgent referral letters.

1. Urgent referral without any emergency condition associated

If the patient has presented with a disease that requires urgent referral to the reader,
however; there is no emergency mentioned in today’s visit, you will follow the below
given layout

1. Purpose paragraph
2. First visit
3. Subsequent visit
4. Personal details
5. Request paragraph
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EXAMPLE
The patient has presented with mild respiratory symptoms or altered bowel habits;
however, he has a long-standing chronic history that has led him toward the
diagnosis of bronchogenic carcinoma or bowel cancer.

2. Urgent referral with an emergency condition

If the patient has presented with some emergency condition that is immediately life
threatening such as an acute cardiac event, a respiratory event such as
exacerbation of asthma, anaphylactic shock, severe dehydration, patient having
unstable vitals or any other life-threatening event, you will follow the following layout
for the organization of your letter.

1. Introduction paragraph/ purpose paragraph

2. Today’s visit
3. Initial visit and progression paragraph
4. Personal history (least important)
5. Request paragraph

The purpose of the above-mentioned layout is to give more importance to the

emergency condition that the patient has presented with, so key information is not
buried in the body of the letter.

❖ Discharge letter

A discharge letter is written when a specialist has treated a patient and now he is
ready to be discharged. The letter will be written in the following organization and
layout

1. Introduction/purpose paragraph
2. Admission paragraph
3. Hospital stay, treatment record, post-op care, progression of the disease
4. Today’s assessment, change/ addition of treatment, any special request
mentioned
5. Personal details (if not written to the patient’s GP) it is rarely needed.
6. Request paragraph

❖ Transfer Letter

➢ For Intradepartmental transfer (within the hospital setting), it will follow the
referral letter format

➢ When the patient is being transferred to some other facility, follow the
organization and layout of a discharge letter
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Language

Each of the above-mentioned criteria has an element of language. However, this

section specifically looks at whether or not you have written them correctly.

Language includes: grammar, vocabulary, punctuation and spelling.

Now, I will briefly elaborate on each of these sub-criteria.

Most of the aspirants give their total attention to the obvious elements of language,
by considering that their whole letter will be judged on these elements.
It is a part that is a little difficult and time-consuming to master. However, these sub-
criteria of language are not more important than the other above-mentioned criteria.

If you find difficulty in mastering these criteria, still you don’t need to stress it out.
Just try not to make any major mistakes.

❖ Grammar

The English language has 12 tenses. However, the following are the three most
common tenses used in OET letter writing.

a. Present perfect
b. Simple past
c. Past perfect

Although grammar is a minor criterion, grammatical mistakes are most obvious in

letter writing and they impart an impression of imperfection on the mind of the
accessor. Here I have tried to explain these tenses in the simplest possible way for
everyone to master them.

➢ Present Perfect:

The present perfect tense is used to describe an event which starts in the past and
continues until the present. Mastery of this pattern is essential for writing successful
referral letters. Three common ways to form present perfect when writing referral
letters are as follows:

Tense Example
Present perfect simple I have treated Mr Smith at this hospital
has/have + past participle for three years.

Present perfect progressive I have been treating Mr Smith at this

has/have+ been+ verb +ing hospital for three years.

Present perfect passive Mr Smith has been treated at the

has/have+ been+ past participle hospital for the past three years
 P a g e | 19

Present perfect is often combined with for/since/over.

Compare the usage below and note the time markers used.

❖ For
➢ for is used to show the duration of time e.g. I have been treating Mr Smith for
the past three years.

❖ Since
➢ since is used to show the start of time e.g. I have been treating Mr Smith
since 2003.

❖ Over
➢ Over has the same use as that of “for” however, it is specifically used to show
change over time e.g. Mr Smith’s condition has been progressively
deteriorating for the past 3 months.

Some common mistakes while writing present perfect tense are

Mistake Correct

The patient was diagnosed with The patient has had hypothyroidism
hypothyroidism since 2007 since 2007. (Present perfect)
Explanation: Past tense cannot be The patient was diagnosed with
used with “for” or “since” hypothyroidism in 2007 (simple past)

He is smoking 2 packs of cigarettes a He has been smoking two packs of

day for the past 25 – 30 years. cigarettes a day for the past 25-30
years.
(Present perfect progressive)
 P a g e | 20

Simple Past or Present Perfect:

There is often confusion about whether to use simple past or present perfect tense.
The basic rule to remember is if you are referring to a particular time in the past then
you must use simple past tense.

If you are referring to a time that starts in the past and continues up to now, use the
present perfect tense.

There are some common time markers used with simple past and present perfect. It
is important to study, learn and use these tenses correctly when writing referral
letters as you must refer to both past events and periods leading to the present.

Time markers with simple past Time markers with present perfect
He sucked his thumb until he was 5. He has been sucking his thumb for five
years.
The patient stopped taking medication The patient has stopped taking
yesterday medication recently
The patient didn’t respond to The patient hasn’t responded to
treatment treatment yet.

He first came to see me in 2004.

He has been seeing me since 2004

Mrs Kelly had diverticulitis when she Mrs Kelly has had diverticulitis for the
was a teenager. last 12 years

GOLDEN TIP
Most people write “Today’s Visit” in the present tense. Although, it’s not wrong to use
present tense, but preferred tense is simple past tense. Whatever tense you use,
either present or past, make sure you write complete paragraph in that specific
tense.

❖ Past Perfect
Past Perfect is an important tense in referral letters. The main functions of this
tense are:

➢ When used with a simple past it allows the writer to distinguish the order of
events:

Example
➢ “She had not been able to conceive for the previous four months and as a
result, she was suffering from depression”
 P a g e | 21

This means: first she could not conceive, and then she became depressed.

When used in reported speech. The case notes may describe the patient's condition
at a time in the past, i.e. patient found blood in the toilet bowl 2 times. This can be
written in the referral letter as follows:

➢ At today’s consultation, Ms Leon reported that there had been blood in the
toilet bowl on 2 occasions.

So, the main benefit of using past perfect is that it allows the writer to express the
order in which certain health events.

Do not use past perfect when describing one past event as it is not necessary.
Compare

❖ The patient had been feeling unwell last week. (Incorrect if 1 past event
described)

➢ The patient was feeling unwell last week. (correct)

➢ The patient had been feeling unwell last week and was admitted to the
hospital for observation. (Correct, as 2 past events need to be distinguished)

Incorrect Correct

➢ She presented to me on ➢ She presented to me on

03/07/2010 for a regular check- 03/07/2010 for a regular check-
up because she experienced up because she had experienced
several episodes of heart flutter several episodes of heart flutter
over the past few weeks. over the previous few weeks.

➢ On review two weeks later, the ➢ On review two weeks later, the
frequency of headaches frequency of headaches had
decreased decreased.

➢ A review on 25/04/10 showed the ➢ A review on 25/04/10 showed the

patient’s general health has patient’s general health had
improved and her blood pressure improved and her blood pressure
dropped to 140/85 and she lost 4 had dropped to 140/85 and she
kg. had lost 4kg.

➢ Mrs Jones had taken Microgynon ➢ Mrs Jones had taken Microgynon
30 for the previous 5 years but 30 for the previous 5 years but
had stopped in May 2009. stopped in May 2009.
 P a g e | 22

Use of Active Voice and Passive Voice

In writing a referral letter, it is necessary to use a variety of verb forms including both
active and passive verbs. Using active verbs is good when you wish to create a
personal tone or impart subjective information.

However, passive verbs and sentence structures enable the writer to be more
objective and focus attention on what is most important in a sentence such as the
patient, procedures and treatment rather than on themselves.

Compare
Active Voice: Passive Voice:
➢ I advised the patient to stop ➢ The patient was advised to stop
smoking. smoking (focus on the patient)
➢ I advised her to do bed exercises ➢ Bed exercises were advised to
to prevent further complications prevent further complications
such as deep vein thrombosis such as deep vein
thrombosis. (focus on the
treatment)
➢ You need to take Flucloxacillin ➢ Flucloxacillin capsules need to
capsules twice a day for a be taken twice a day for a
duration of 2 weeks. duration of 2 weeks. (focus on
the medication)

To form the passive, use the be verb (be, is/ are; was/were; has been/have been) +
past participle.

Present simple continuous Present simple continuous

➢ The patient is taking aspirin daily ➢ Aspirin is being taken daily.
Past simple Past simple
➢ The patient took aspirin daily. ➢ Aspirin was taken daily.
➢ The patient took 3 tablets daily. ➢ 3 tablets were taken daily.

Past simple continuous Past simple continuous

➢ The patient was taking aspirin ➢ Aspirin was being taken daily.
daily.

Present perfect Present Perfect

➢ The patient has taken aspirin ➢ Aspirin had been taken daily for a
daily for a period period of one year.

future Future
➢ The patient will take aspirin in the ➢ Aspirin will be taken in the
evening evening.

Modal form Modal form

➢ The patient should have taken ➢ Aspirin should have been taken
aspirin in the evening. in the evening.
 P a g e | 23

Making subject and verb agree:

❖ When the subject of a sentence is composed of two or more nouns or

pronouns connected by and, use a plural verb.
➢ She and her friends are at the fair.

❖ When two or more singular nouns or pronouns are connected by or/nor,

use a singular verb.
➢ The book or the pen is in the drawer.

❖ When a compound subject contains both a singular and a plural noun or

pronoun, joined by or/ nor, the verb should agree with the part of the subject
that is nearer the verb.
➢ The boy or his friends run every day.
➢ His friends or the boy runs every day.

❖ If one subject is singular and one is plural, the verb agrees with the nearer
subject.
➢ Neither the television nor the radios work.
➢ Neither the radio nor the television works.
 P a g e | 24

Punctuation:

Punctuations not only add beauty to the letter but also make it grammatically correct
and easy to understand.

The two most commonly used punctuations in OET letters are

1. Comma
2. Semicolon

❖ COMMA

The uses of "comma" include

➢ Context: On examination, there was slight tenderness in the right fornix.

➢ Date: On today’s visit, the patient was pale and sweaty.
➢ Emphasis: Please note, the patient is allergic to penicillin.
➢ Mood: Unfortunately, the patient’s condition has worsened. Note, mood or
comment adverbs, such as unfortunately or regrettably convey the health
professionals' concern toward the patient’s condition and are therefore
effective ways of displaying empathy.
➢ Contrast: The patient's condition has improved. However, a follow-up visit is
required.
➢ Clauses: Use commas to separate an independent clause from a dependent
clause. A dependent clause needs more information to clarify its meaning.
➢ Connector: If your sentence starts with a connector sentence, the coma
would follow the connector sentence

Example.

➢ However, she was fragile.

➢ Therefore, aspirin was instituted.
 P a g e | 25

Semicolon

if you use a connector in a sentence, the semicolon would be used before the
connector word and the comma would be used after it, as follow

➢ His blood pressure had improved; however, he was still experiencing

dizziness and fainting
➢ He presented with diabetes mellitus; therefore, metformin was instituted.

The use of semicolons in OET letters is using it with a connector in a sentence.

There are two punctuation marks used with connector sentences. One is a semi-
colon and another is a comma.

Spelling

Spelling is important in Writing but you won’t need to be perfect to achieve a B-

Grade. However, some misspelled words will stand out more than others.

If spelling is something you find difficult, it’s good to choose a few common words
you often get wrong and focus on improving your accuracy of these words in one
week. The next week you can choose a few different words. The key is to not try to
do too many in one go. Little and often is going to be more successful.

One of the best ways to correct spelling mistakes is to type your letter in “Ms Word”
or “Grammarly”. They will point out your spelling mistakes and you can make a
separate file for spellings that you commonly misspell.

Writing names of Medications

The brand name of the medication should be written in capital letters and the generic
name of the medication should not be capitalized. If you find difficulty in the exam
understanding whether it is a brand name or a generic name, just copy the word
from the case notes as it is.

Example:
❖ Brand Names: Need capitalization
➢ Panadol
➢ Zyrtec
➢ Tylenol
➢ Claritin
➢ Eurax
❖ Generic Names: Don’t need capitalization
➢ aspirin
➢ metformin
➢ metoprolol
➢ diazepam
➢ fluconazole
 P a g e | 26

Writing Names of people

If you are writing the name of a person for the first time, use the appropriate title and
write full name. After that, you should only use the second name with a title to
mention that person.

If you are mentioning the name of a person who is less than 16 years old, only use
his/her first name without a title.

The other very important thing to remember is to mention the patient by his/her name
at the start of every paragraph. After that, you should use the pronoun
(he/she/his/her/him).

Writing Names of Diseases

Capitalize the disease that is written after the name of a person like Grave’s disease,
Hashimoto Thyroiditis, Parkinson’s Disease, Wilms Tumor, etc

All the other diseases should be written in small letters like hypertension, rheumatoid
arthritis, diabetes mellitus etc.

Writing Title with the name

The basic rules regarding titles are as follows:

➢ Mr is used for adult men, married or single

➢ Mrs is used for married women including widows
➢ Ms is used to refer to both married or unmarried women
➢ Miss is used for young girls or unmarried women
➢ Master is used for young boys but is rare nowadays as it has become old
fashioned. It is still commonly used on an envelope, but not in the body of the
letter.

Both miss & master are not abbreviations so no punctuation is required.

It is very important to note that the title should be used with the second name only

For example
If a person’s name is Thomas Edison, the correct way of writing his name is Mr
Edison, (Mr Thomas Edison is very formal and should only be used in RE: line.
 P a g e | 27

Writing Drugs and their dosages

Most of the time, you only need to write name of the drug from case notes, as you
assume the other person is also a healthcare professional and he knows the dose
being given. The only case where you must write dose of drug being given is when
there’s a change in dose as you go through the case notes. The correct way of
writing drug along with its dose is as follow

Suppose you patient is using aspirin, 75mg once daily, metformin 500mg, twice daily
and 20mg of furosemide, once daily.

The correct way of writing them in letter is as follow:

His current medication include: Aspirin; 75mg, once daily, metformin; 500mg, twice
daily and furosemide; 20 mg, once daily.

So, put semi-colon after name of drug and comma after dose.

Vocabulary

OET is very different from IELTS and other English language assessment exams in
the sense that you need a very basic English and vocabulary bank to score A-grade.

Even if you don’t use complex words to show your English proficiency, you can still
score an A grade. The only important thing about vocabulary is to avoid the
repetition of words.

Example:
➢ His ultrasound showed multiple stones in the gallbladder.
➢ His Urine analysis revealed leukocytosis.
We have changed “showed” with “revealed” to avoid repetition of words.

➢ Metformin was started.

➢ Antibiotics were instituted.

We have changed “started” with “instituted” to avoid repetition in the second

sentence.

Connectors in OET

Sentence connectors are an essential tool for writing proficiently in English. Their
purpose is to join information together within a sentence.
By using them, the writer adds additional useful detail to the sentence. They can be
used to perform many different functions in the sentence.
 P a g e | 28

For example

➢ some connectors add emphasis to the main idea, (clearly, significantly,

notably)

➢ some will define the time frame more clearly, (subsequently, finally)

➢ some show the contrast between two ideas, (however, despite)

➢ and others show cause and effect. (Therefore, consequently)

Connectors are sometimes used to start a sentence, while at other times they can be
placed in the middle position of a sentence.

When writing a formal healthcare letter, it is important to choose the right connector
as this sets a professional tone for your writing.

There are often several possible connectors which can convey the same meaning,
but some are more suitable for the OET writing context.

These are
➢ Simple connectors (also called conjunctions): and, but, or, later, as, too,
because.

➢ Complex connectors: however, therefore, although, unless, subsequently,

additionally, otherwise

You should avoid using these below given connectors in OET writing, as it is
different from simple academic writing to which most of the candidates are used to.

• Academic connectors: furthermore, moreover

• Informal connectors: besides, meanwhile, apart from that, later on
• Outdated connectors: hence, thus, thereafter

GOLDEN TIP
Don’t use a connector if it doesn’t add any value to the sentence

➢ We do not recommend beginning a new sentence with some simple

connectors, such as:
• also, so, and, but

These are fine to include in the middle of the sentence, but choose a more formal
alternative for the start of your sentence, such as:
• Additionally, Therefore, However

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 P a g e | 29

Articles in OET

The use of an article is very important in OET writing and I will give complete details
along with examples to make it easy to understand.

Whether an article is required or not depends on the noun that follows.

For this purpose, nouns can be classified into two types:
i. countable
ii. uncountable nouns.

The difference is based on whether the noun can be counted or not.

For example

➢ Complaint is a countable noun as it can be counted. Therefore, it is possible

to say 1 complaint or 2 complaints.

➢ Advice, on the other hand, cannot be counted so it is not possible to say 1

advice or 2 advices.
➢ The correct expression is some/any advice or a piece of advice.

❖ Countable nouns
These nouns have a singular form and a plural form.

➢ Singular:
In the singular form an article is usually used before the noun.

Example:
➢ The doctor received a complaint from her patient.

Exceptions:
➢ The article can be left out if it is replaced with another determiner such
as his/her or this /that or any/each/every.
Example:
➢ The doctor listened to each complaint.
➢ Her complaint was recorded.
Here, instead of using article “the” we have replaced it with a
determiner “each” and “Her”

➢ Plural:
In the plural form, the article is usually not used before the noun.
➢ The doctor received complaints from her patients.
 P a g e | 30

❖ Examples

Singular form Plural form

Abscess
The patient had an abscess on the gum The patient had 3 abscesses on her
gum
Complaint
He presented with a complaint of chest He presented with complaints of chest
pain. pain, dispones and anxiety.

Episode
He suffered from an episode of chest His episodes were associated with
pain. nausea and vomiting.

Remember:
➢ Always use articles when referring to a particular job such as:
doctor/dentist/nurse/pharmacist/physiotherapist/teacher

➢ Always use article "the" when referring to a particular time such as:
For the past three days, on the previous visit, on the subsequent visit.

❖ Uncountable nouns:

These nouns cannot take a plural form such as:

cancer, anesthesia and information.

For these words, no article is required.

However, the definite article “the” as well as quantifiers such as “some” and “any”
can be used before the noun.

Examples
Advice Advice on the diet is requested
Pain The patient experienced pain on
palpation
Progress The patient had made a good progress
Treatment The condition did not respond to
treatment.
 P a g e | 31

➢ Indefinite Article:

➢ A or An

When you mention something for the first time, the indefinite article a/an is required.
This signifies to the reader that it hasn’t been mentioned before.

❖ Definite Article:

➢ The

When you mention something for the second and subsequent times, we use the
definite article "the" because we are referring a something which has been
mentioned before.

Example:
Initially, she came to me on 03/07/06 for a blood test. The results of the blood test
were negative.

Correct application of this rule creates cohesion in your letter as you can connect
ideas, as in the example above, where the reader knows which blood test is being
referred to. Conversely, incorrect use can confuse the reader.

Example:
Initially, she came to me on 03/07/06 for the blood test. The results of a blood test
were negative.
In the example above the ideas are not connected and the reader will be confused.

➢ Referring to Something Specific:

The definite article “the” is used when referring to something specific. It is very
important to include this article to signify

➢ Referring to a body part:

Always use the article “the” or the specific pronoun him/her/his when you refer to a
specific body part either internal or external. Such as, the leg was swollen. The
appendix had burst. The ear was examined.

Article can be omitted if you use determiner such as

Her ear, her leg, her appendix etc

THE END
 P a g e | 32

Congratulations! You have now completed our essential guide to OET

Writing. We hope you have gained a better understanding of the test
requirements and tips for preparation.

If you want to improve your OET Writing skills, then be sure to take
advantage of the all the available resources available online.

And remember, if you need any help with your OET Writing preparation,
then don't hesitate to get in touch with us. Contact us to get the best letter
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