For healthcare professionals preparing to work in English-speaking countries, the OET writing sub-test is one of the most practical assessments you’ll face. Unlike generic English writing tests, it mirrors real clinical communication — the kind you’ll use every day on the job. Understanding what the examiners want, and how to give it to them, is the most direct route to a strong score.
What the Task Actually Involves
You’ll be given a set of case notes and asked to write a professional healthcare letter — typically a referral, discharge, or transfer letter. The letter is marked across six areas: the clarity of your purpose, the relevance of your content, your conciseness, your professional style, how well you’ve organised the information, and the accuracy of your language.
Each of these carries weight, which means a letter that reads beautifully but omits critical clinical details won’t score as well as you might expect. You need to get all six right.
Start With a Clear Purpose — and State It Immediately
Examiners want to know why you’re writing within the first sentence. Don’t ease into it or bury it in the second paragraph. Use a direct opening verb — refer, discharge, transfer, request — and build your introductory sentence around it.
A weak opening might say: “I am writing regarding the above-named patient.”
A strong opening says: “I am writing to refer Mr. Ahmed Hassan to your cardiology department for further investigation of his recently diagnosed arrhythmia.”
The second version tells the reader who, what, and why — all in one sentence.
Choose Your Content Carefully
One of the most common mistakes candidates make is including everything from the case notes. Not all of it belongs in the letter. Ask yourself: does the recipient need this information to continue the patient’s care? If not, leave it out.
Generally, your letter should cover the patient’s relevant medical history, their current presentation, any investigations or treatments already carried out, and what you’re asking the reader to do next. Social history or background details should only be included if they directly affect clinical management.
Be Concise — But Not at the Expense of Completeness
Conciseness doesn’t mean writing as little as possible. It means every sentence earns its place. Avoid restating information you’ve already given, padding out sentences unnecessarily, or listing every minor detail from the notes when a brief summary would do.
Group related information together rather than scattering it across the letter. For example, all medication information should appear in one place — not mentioned in the opening, again in the middle, and again at the end.
Match Your Tone to the Context
OET letters are professional documents, and your language needs to reflect that. Avoid informal expressions, contractions, and anything that sounds conversational. At the same time, don’t overcorrect into stiff, unnatural phrasing — clarity matters more than sounding impressive.
Consider who you’re writing to. A letter to a specialist can use clinical terminology freely. A letter to a patient or carer needs plain, accessible language. Matching your style to your audience is itself part of what’s being assessed.
Structure Your Letter Logically
A well-organised letter is easier to read and harder to misinterpret. A reliable structure to follow is:
- Opening paragraph: State the purpose and introduce the patient.
- Middle paragraphs: Cover the relevant history, current condition, and any treatment already given.
- Closing paragraph: Clearly state what action you want the reader to take.
Whether you organise the body of the letter chronologically or thematically depends on the scenario — but either way, the reader should be able to follow the logic without having to re-read sections.
Don’t Underestimate the Language Criterion
Grammar, spelling, punctuation, and vocabulary all contribute to your language score. The occasional minor slip won’t derail your result, but patterns of error will. Pay particular attention to:
- Subject-verb agreement
- Correct use of tense (past for history, present for current condition)
- Accurate medical terminology — an incorrectly used clinical term is worse than a simpler, correct one
- Punctuation in complex sentences
If you’re unsure of a term, use a simpler but accurate alternative rather than risk using it incorrectly.
Practical Preparation Strategies
Knowing the criteria is one thing — being able to apply them under timed conditions is another. Here are a few habits worth building into your preparation:
- Read sample letters critically. Don’t just read them as examples of good writing — identify which parts address which criterion. This trains you to think like an examiner.
- Write under exam conditions. The writing sub-test gives you 45 minutes. Practise regularly within that time limit so you’re not rushing on the day.
- Get your letters marked. Self-assessment has limits. Feedback from someone familiar with OET marking is one of the fastest ways to identify blind spots in your writing.
- Practise across different letter types. Referral letters, discharge summaries, and transfer letters each have their own conventions. Don’t just practise the one you find easiest.
The Bottom Line
The OET writing sub-test rewards candidates who can think like a clinician and write like a professional. It’s not a creative writing exercise — it’s a test of whether you can take raw clinical information and turn it into a clear, purposeful, well-structured letter that serves the patient’s ongoing care.
Master the six assessment criteria, practise consistently, and approach each letter with the reader in mind. That combination will take you a long way.
