OET Writing for Doctors: How to Write a Referral Letter That Scores Well

The OET Writing sub-test gives you 45 minutes, including five minutes of reading time, to write a letter based on case notes. For doctors it is usually a referral, discharge, transfer or advice letter. The body is normally about 180 to 200 words. Many candidates find this the hardest part of the exam, because it tests judgement as well as language.

What the examiners look for

Letters are assessed on six criteria: purpose, content, conciseness and clarity, genre and style, organisation and layout, and language. In practice, this means that the reader should understand at once why you are writing, find the information they need, and be able to read the letter without effort.

Step 1: read the task and decide the purpose

The task tells you who you are writing to and why. A referral letter asks a specialist to see the patient. A discharge letter tells the GP what happened in hospital and what to do next. Write one sentence in your head that states the purpose, such as "I am writing to refer Mr Smith for urgent assessment of chest pain on exertion."

Step 2: select, do not copy

The case notes always contain details that do not belong in the letter. Social details, hobbies, family events and facts that do not change what the reader will do are usually distractors. Ask for every item: will this help the reader to decide or act? If not, leave it out.

Step 3: plan the paragraphs

A reliable structure for a referral letter is:

1. Opening: the patient, the purpose and the main problem.
2. Current problem: symptoms, duration, examination findings and results.
3. Relevant background: medical history, medicines, allergies, risk factors.
4. What you have done: treatment and tests so far.
5. Request: exactly what you want the reader to do.

Each paragraph should have one theme, and you should not follow the order of the notes.

Step 4: write with the right style

• Use full sentences, not note form.
• Use a formal, polite tone, and no contractions such as "doesn't".
• Open with "Dear Dr Smith" and close with "Yours sincerely". If the name is not known, use "Dear Sir or Madam" and "Yours faithfully".
• Include a Re: line with the patient's name and date of birth.
• Use correct tenses, for example the past for completed events and the present for current status.

A short model opening

Dear Dr Mehta

Re: Mr Graham Pearce, date of birth 22 June 1968

I am writing to refer Mr Pearce, a 58-year-old bus driver, for urgent assessment of probable stable angina. For the past four weeks he has had central chest tightness on walking uphill or climbing stairs, which lasts about five minutes and is relieved by rest.

Mistakes to avoid

• Writing far over or under the word guide.
• Including irrelevant social details.
• Leaving out the request at the end.
• Copying phrases directly from the notes, including abbreviations.
• Using informal words such as "got" or "a lot of".

Practise by comparing

The best way to improve is to write a letter, then compare it with a model and a checklist, noticing what the model included and what it left out. Repeat this with different letter types.

Ready to practise? OET Practice for Doctors has full listening and reading tests in the real format, writing letters with model answers and speaking role-plays. Try the free listening test to see how it works.

Practise for the OET on HighYield

Put this into practice with HighYield OET Practice for doctors, a full practice area built around the real exam. Start with the free listening test, then work through every sub-test:

• OET Listening practice tests: Parts A, B and C with audio
• OET Reading practice tests: Parts A, B and C with answers and evidence
• OET Writing tasks: referral letters with model answers and scoring
• OET Speaking role-plays: doctor role-plays to rehearse out loud