OET Writing is the only sub-test where the result depends heavily on decisions you make before you write a single sentence. Case notes contain much more information than the reader needs. Candidates who sort that information well usually find the writing itself straightforward.
The task in brief
- Input: case notes about a patient, usually around two pages, with headings such as patient details, history, assessment, treatment and plan
- Task: a letter to a named reader, most often a referral, but sometimes a discharge, transfer, update or advice letter
- Time: 5 minutes reading + 40 minutes writing
- Length: about 180–200 words in the body
- Profession-specific: nurses write nursing letters, pharmacists write pharmacy letters, and so on
The six criteria and what they reward
| Criterion | Scale | What it rewards |
|---|---|---|
| Purpose | 0–3 | The reader understands why you are writing, immediately and clearly |
| Content | 0–7 | All information the reader needs is included and accurate |
| Conciseness & Clarity | 0–7 | Irrelevant details are left out; information is summarised effectively |
| Genre & Style | 0–7 | Professional tone and register suitable for the reader |
| Organisation & Layout | 0–7 | Logical paragraphs and a clear letter layout |
| Language | 0–7 | Accurate grammar, vocabulary, spelling and punctuation |
Four of the six criteria are about what you include and how you arrange it. Only one is purely about language accuracy.
Step 1: use the reading time well (5 minutes)
Answer three questions and note them on the page:
- Who is the reader, and what do they already know? A specialist needs clinical detail; a patient's carer needs plain explanations.
- What is the purpose? Usually stated in the task: for example, referral for further assessment, or continued care after discharge.
- What does the reader need to do? This decides what counts as relevant.
Then scan the notes and mark each item as essential, useful background or not needed.
Step 2: select the right information
Ask of every note: would this reader be worse off without it?
| Usually include | Usually leave out |
|---|---|
| Reason for writing and the request | Normal findings that do not affect the plan |
| Relevant history and current condition | Social details unrelated to the problem |
| Current medication or treatment where relevant | Minor past issues that are resolved |
| Changes, test results and concerns that drive the request | Information the reader already has |
| What you want the reader to do | Routine details that do not change the next step |
The line between relevant and irrelevant depends on the reader and purpose. The same detail might be essential in a referral to a dietitian and irrelevant in a letter to a physiotherapist.
Step 3: plan your paragraphs
A common, effective layout:
- Opening: who the patient is and why you are writing (the purpose)
- Background: relevant history, briefly
- Current situation: recent assessment, findings, treatment and concerns
- Request / plan: what you are asking the reader to do, and any follow-up
Group information by topic, not by the date order of the notes. The reader wants a clear story, not a chronological log.
Step 4: write clearly and concisely
Transform notes into sentences.
Notes: 3/7 hx SOB on exertion; ankle oedema bilat. Letter: Over the past three days, Mrs Silva has experienced shortness of breath on exertion and swelling in both ankles.
Summarise where you can.
Instead of listing five normal test results, write: Routine blood tests were within normal limits.
Make the request explicit.
I would be grateful if you could assess her and advise on further management.
Step 5: check the letter (last 3–4 minutes)
- Is the purpose clear in the first paragraph?
- Did you include everything the reader needs to act?
- Are dates, doses and names copied correctly?
- Are tenses consistent?
- Is the tone right for this reader?
Adapting to different readers
The same case can produce very different letters depending on who reads it:
| Reader | What they need | Tone and language |
|---|---|---|
| Specialist doctor | Clinical detail relevant to the referral question, results, current medication | Professional, precise, standard medical terminology |
| GP after discharge | Summary of the admission, treatment given, discharge plan, follow-up needed | Professional and concise |
| Community or home-care nurse | Practical care needs, wound care, mobility, medication schedule | Clear, practical, action-focused |
| Patient or carer | What happened, what to do next, warning signs, who to contact | Plain language; explain or avoid medical terms |
Always ask: what will this reader do after reading my letter? Everything in the letter should help them do it.
Opening sentences that state the purpose
A good opening names the patient and the purpose in one or two sentences:
- I am writing to refer Mr Ahmed Karimi, a 58-year-old retired teacher, for assessment of his worsening lower back pain.
- Thank you for continuing the care of Ms Lucy Tran, who was discharged today following treatment for a fractured wrist.
- I am writing to update you on Mrs Elena Russo's progress since her referral to our clinic in March.
Avoid vague openings such as "I am writing about my patient", which leave the purpose unclear.
Summarising history efficiently
Long histories are where most letters lose Conciseness & Clarity marks. Compare:
Weak: In 2015 she had her appendix removed. In 2018 she had a sprained ankle. In 2019 she was diagnosed with type 2 diabetes. In 2020 she started metformin.
Stronger: She has a history of type 2 diabetes, diagnosed in 2019 and managed with metformin.
The appendectomy and the sprained ankle are left out because they do not affect the reader's decisions in this case. In a different case, they might be relevant, which is why selection always depends on the purpose.
Common mistakes
- Copying notes in order. Hard to follow, and usually includes irrelevant detail.
- Burying the purpose in the last paragraph.
- Adding clinical information that is not in the notes. Stick to the case.
- Note-style language: missing articles and verbs, or unexplained abbreviations.
- Wrong register for a patient or carer: technical jargon without explanation.
- Overlong letters. Far above 200 words is often a sign of weak selection, which affects Conciseness & Clarity.
A 40-minute writing plan
| Minutes | Step |
|---|---|
| 0–5 | Write the opening and purpose |
| 5–30 | Write background, current situation and request paragraphs |
| 30–36 | Add the closing and sign-off |
| 36–40 | Check accuracy, tense, spelling and tone |
Practise with feedback on each criterion
Improvement in OET Writing comes from writing many different letters, then comparing your selection decisions with feedback. Look for patterns: do you keep including social history that does not matter, or leave the request vague?
EnglishHub's OET simulator follows the real format, with 50 full mock tests, 200 practice sets and AI feedback on your letters and role-plays. The first mock is free: start an OET mock test, or go to the OET practice hub. To see how the letter score fits into your overall result, read OET scores explained.
EnglishHub is an independent practice platform and is not affiliated with OET or Cambridge Boxhill Language Assessment. The example sentences above are illustrative and not taken from official OET materials.
Frequently asked questions
How long should an OET letter be?
The guidance is about 180 to 200 words for the body of the letter, not counting the address, date, salutation and sign-off. It is a guide, not a strict limit, but going far over usually means you included irrelevant information.
Is the OET letter always a referral letter?
No. Referral letters are common, but the task can also be a discharge, transfer, update or advice letter, written to another health professional, a patient or a carer, depending on your profession and the case.
Can I write during the 5-minute reading time?
The 5 minutes is for reading and planning the case notes. Use it to decide your purpose, reader and which notes are relevant, so that you can start writing immediately when the 40 minutes begin.
What are the OET Writing criteria?
Purpose (0–3), Content (0–7), Conciseness & Clarity (0–7), Genre & Style (0–7), Organisation & Layout (0–7) and Language (0–7).
Should I use abbreviations from the case notes?
Write in full sentences and avoid note-style abbreviations, unless an abbreviation is widely understood by the reader. When writing to a patient or carer, use plain language throughout.
