OET Writing Referral and Discharge Letters

Mastering the OET Writing sub-test is a critical step for healthcare professionals seeking to work in an English-speaking environment. This task assesses your ability to communicate vital clinical information clearly, accurately, and professionally, mirroring the exact responsibilities you will have in practice. Your success hinges on understanding the specific demands of writing referral, discharge, and transfer letters based on realistic case notes.

Understanding the Task and Letter Types

The OET Writing task requires you to compose a formal clinical letter based on a set of case notes and a concise task instruction. You are always writing to another healthcare professional, such as a specialist doctor, a physiotherapist, or a community nurse. The three main letter types you must master are referral, discharge, and transfer letters, each with a distinct communicative purpose.

A referral letter is written to request the opinion, further investigation, or ongoing management of a patient by another practitioner. Its purpose is to provide a clear rationale for the referral. A discharge letter, often sent to a General Practitioner (GP) or family doctor, summarizes a patient’s hospital stay, current status, and follow-up plan. A transfer letter facilitates the handover of a patient’s care from one department or facility to another, ensuring continuity. Your first step in the exam is to identify which type of letter you are writing, as this dictates your letter’s focus and tone.

Selecting and Organizing Relevant Information

The case notes provided are raw, often fragmented data similar to a patient chart. Your key skill is triage—selecting the information that is relevant for your specific reader and purpose, while omitting irrelevant details. For a referral to a cardiologist, the patient’s social history might be secondary to their detailed cardiac symptoms and test results. For a discharge letter to a GP, medication changes and follow-up appointments are paramount.

Once selected, you must organize this information into a coherent, logical structure. The standard professional format is non-negotiable:

• Receiver’s Address & Date
• Salutation (e.g., Dear Dr. Smith,)
• Subject Line (Re: [Patient Name], [Date of Birth])
• Opening Statement: Clearly state the reason for writing in one sentence. (e.g., "I am referring this patient for your specialist opinion regarding his ongoing chest pain.")
• Body Paragraphs: Organize information thematically. A common and effective structure is:
• Introduction/History: Presenting complaint, relevant history.
• Examination/Assessment Findings: Key observations, test results, your assessment.
• Management to Date: What has already been done (treatment, advice).
• Reason for Writing/Plan: The core request or summary for the reader.
• Closing: Offer further information, thank the reader, or state you will follow up.
• Complimentary Close & Signature (Yours sincerely, [Your Name/Profession])

Employing the Formal Medical Register

The OET assesses your command of a formal, professional, and concise medical register. This means using full sentences, passive voice where appropriate ("An X-ray was performed"), and precise, objective language. Avoid colloquialisms, vague terms ("a lot of pain"), and overly emotional language.

Key linguistic tasks include:

• Transforming Notes into Prose: Convert "Pt c/o SOB, fatigue x 2/7" into "The patient presented with a two-day history of shortness of breath and fatigue."
• Using Appropriate Tense: Use past tense for completed events (presented, was examined) and present tense for current states or habitual conditions (has, suffers from).
• Demonstrating Precision: Use accurate medical terminology. For example, write "administered 5mg of lorazepam" instead of "gave a sedative."

Meeting the OET Assessment Criteria

Your letter is scored across five dimensions, each equally weighted. Understanding these is your test strategy blueprint.

1. Purpose (6 marks): Does the letter immediately and fully address the requirement stated in the task? The opening and closing must make the purpose unmistakably clear.
2. Content (6 marks): Have you included all the relevant case note information? Have you omitted irrelevant details? This directly tests your triage and selection skills.
3. Conciseness & Clarity (6 marks): Is the letter easy to read and logically organized? Are ideas grouped into paragraphs? Is the phrasing direct and unambiguous? Redundancy and poor structure cost marks here.
4. Genre & Style (6 marks): Does the letter sound like a real clinical letter? This assesses register, formality, tone, and the standard letter format.
5. Language (6 marks): This covers grammatical accuracy, spelling, punctuation, and appropriate word choice. Errors that impede communication or professionalism are penalized.

A Strategic Approach to the Exam

With only 45 minutes, a systematic approach is vital. Allocate your time wisely: 5-7 minutes to read the case notes and task, identify the letter type, and underline key information. Spend 30-35 minutes drafting and writing your letter, consciously checking against the five criteria. Reserve the final 3-5 minutes for proofreading, focusing on verb tenses, article use (a/an/the), prepositions, and spelling of key medical terms. Practice this timing repeatedly with sample tasks to build exam-condition stamina and precision.

Common Pitfalls

1. Including Irrelevant Information: Writing "everything you know" from the notes is a critical error. If a note says "enjoys gardening" and you are referring for orthopedic surgery, it is irrelevant. Including it wastes words and reduces your score for Content and Conciseness.
2. Poor Organization and Formatting: Submitting a single block of text without clear paragraphs, a subject line, or a proper opening statement makes the letter difficult to follow and fails Genre & Style. Always use the standard professional format.
3. Inaccurate Paraphrasing or Invention: You must accurately convey the information in the notes. Do not change key details (e.g., dosage, dates) or invent information not present in the case notes, even if it seems logical. This severely impacts Content and Purpose.
4. Informal or Inaccurate Language: Using contractions (can’t, didn’t), slang, or incorrect terminology ("heart attack" instead of "myocardial infarction" where precise) damages your Genre & Style and Language scores. Always aim for formal, precise clinical prose.

Summary

• The OET Writing test requires you to produce a referral, discharge, or transfer letter based on case notes, demonstrating real-world professional communication skills.
• Success depends on triage—skillfully selecting only the information relevant to your reader and the letter’s purpose while omitting irrelevant details.
• You must employ a strict professional letter format and a formal medical register, transforming fragmented notes into coherent, objective prose.
• Your work is scored against five equal criteria: Purpose, Content, Conciseness & Clarity, Genre & Style, and Language; each dimension must be consciously addressed in your writing.
• Effective exam strategy involves disciplined time management, a structured writing process, and careful proofreading to avoid common errors in relevance, organization, and language accuracy.