How to Write an OET Letter That Scores Well
In OET Writing you have 45 minutes to turn a page of case notes into a formal letter, usually a referral, transfer or discharge letter. The body of the letter should be about 180–200 words. To score well, say why you are writing at the start and include only the notes your reader needs. Then check that your language is accurate and formal.
On this page
Key facts about OET Writing
Based on the official OET Writing information. Rules can change, so check oet.com before your test.
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Time
45 minutes
5 minutes reading, then 40 minutes writing
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Length
180–200 words
In the body of the letter
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Letter types
Referral, transfer, discharge
Matched to your profession
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Marking
6 criteria
Two OET assessors mark each letter
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Grade B target
2/3 and 5/7
2 out of 3 for Purpose, 5 out of 7 for the rest
Do this today (30 minutes)
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Read one task and underline three things
Who is the reader, why are you writing, and what do you want them to do? Write each one as a single short line.
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Sort the case notes into keep and leave out
For every note, ask: does the reader need this to act? Use the worked example below as a model.
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Write only your opening paragraph
Two sentences: who the patient is and why you are writing. Compare it with the model opening in this guide.
See the model opening
What the OET Writing task asks you to do
You write as a healthcare professional in your own field. You receive a task and a page of case notes about a patient. You then write a formal letter that gives another professional what they need to continue the patient's care. The task tells you who the reader is. Keep that reader in mind each time you decide what to include.
For most professions the letter is a referral, transfer or discharge letter. According to OET, you plan all three the same way: choose the details from the case notes that the reader needs to continue care. The main difference is the purpose, which you state in your opening paragraph.
| Letter type | When you write it | What the reader needs most | Example opening |
|---|---|---|---|
| Referral | You want another professional to assess, investigate or treat the patient. | Why you are referring, the key findings, and what you are asking them to do. | I am writing to refer Mrs Shah, a 54-year-old woman with worsening knee pain, for an orthopaedic assessment. |
| Transfer | The patient is moving to another ward, hospital or care facility. | Current condition, ongoing treatment, care needs and anything that must not be missed. | I am writing regarding Mr Okafor, who is being transferred to your rehabilitation unit today following a stroke. |
| Discharge | The patient is going home and someone in the community will take over care. | What happened in hospital, the plan from here, and what the reader should do or watch for. | I am writing to inform you that Mr Clarke is being discharged home today and requires ongoing wound care. |
The six OET Writing criteria in plain English
Two OET assessors mark your letter against six criteria. They do not count mistakes one by one; they judge how well your letter matches the description of each level. Purpose is marked out of 3, and the other five criteria are each marked out of 7.
| Criterion | What assessors check | What it means when you write |
|---|---|---|
| Purpose | Whether the reason for writing is clear from the start and developed throughout the letter. | State why you are writing in your first paragraph, then make sure your final paragraph asks for something specific. |
| Content | Whether the information the reader needs is included and accurate. | Include every note the reader needs to act, and copy numbers, dates and medication doses accurately. |
| Conciseness and Clarity | Whether irrelevant information is left out and the letter is an effective summary. | Cut background that changes nothing for this reader. Summarise; don't list every note. |
| Genre and Style | Whether the register, tone and abbreviations suit the reader. | Use a formal, professional tone. Avoid contractions and abbreviations the reader may not know. |
| Organisation and Layout | Whether the letter is well organised and laid out for the reader. | Group related information into clear paragraphs and put the most important information first. |
| Language | Whether grammar, vocabulary, spelling and punctuation communicate the information accurately. | Write in complete, correct sentences. Spelling and punctuation are assessed here. |
For more on what each criterion means, read our OET Writing marking criteria guide.
How to use the 45 minutes
You get 5 minutes of reading time and 40 minutes of writing time. OET says the 40 minutes is enough to write and check your letter, and you can go back to the task and case notes at any point while you write. This plan keeps you on time:
| Time | What to do |
|---|---|
| Reading time (5 min) | Read the task first. Find the reader, the purpose and the request. Then read the notes and decide what to keep. |
| Minutes 1–5 of writing | Plan four or five paragraphs in a few words each: purpose, current problem, relevant background, request and plan. |
| Minutes 5–32 | Write the letter, one planned paragraph at a time. |
| Minutes 32–40 | Check against the checklist in this guide: purpose, request, numbers, tone, spelling. |
Read the task before the case notes
The task tells you who you are writing to and why. Read it before the case notes, so that you judge each note by one test: whether this reader needs it to continue the patient's care.
Choose the notes the reader needs
Go through the notes one line at a time. Keep a note if it would change what the reader does, and leave it out if it would not. Old operations that have fully healed, hobbies and family details usually go. Allergies, current medication, recent changes and anything the reader must monitor usually stay.
Put the information in order of importance
Case notes are usually in date order, but your letter should put the most important information first. This order works for most letters:
- Why you are writing, and who the patient is.
- What happened and what has been done so far.
- Background that affects the reader's care, such as other conditions, medication or living situation.
- What you want the reader to do, with follow-up and warning signs.
- A short, polite closing line.
Turn the notes into full sentences
Case notes use fragments and abbreviations. Your letter needs full, formal sentences. Combine related notes into one sentence where you can, and use time words such as on admission, since then and currently so the reader can follow what happened.
Check your letter
Leave the last eight minutes for checking. Read the letter once as the reader would and make sure your purpose and your request are clear. Then read it again for accuracy: names, dates, doses and spelling.
From case notes to a finished letter
The case below is fictional and written by our team for practice. It is a nursing discharge task, but the same method works for every profession.
The case notes (shortened)
- Patient: Mr Peter Clarke, DOB 14/03/1958 (68). Retired bus driver. Lives alone in a second-floor flat with a lift.
- Social: daughter visits weekly. Ex-smoker (quit 2010). Two beers at weekends. Enjoys gardening.
- History: type 2 diabetes (2012), insulin glargine 20 units at night. Hypertension, ramipril 5 mg daily. Appendicectomy 1985.
- 20 Oct: admitted. Left lower leg red, swollen, warm after a scratch while gardening. Temp 38.4°C. Blood glucose 14.2 mmol/L. Diagnosis: cellulitis.
- Treatment: IV flucloxacillin for 3 days, then oral flucloxacillin 500 mg four times daily, 5 days remaining. Wound cleaned, non-adherent dressing. Insulin glargine increased to 24 units at night.
- Progress: area of redness reduced by half. Afebrile for 48 hours. Blood glucose 6–9 mmol/L. Walking independently with a stick.
- Discharge plan, 26 Oct: district nurse to change dressing every 2 days, check that redness is not spreading, review blood glucose. GP review in 1 week. Return to hospital if fever, spreading redness or blood glucose above 15 mmol/L.
- Patient: anxious about managing his dressing. Prefers morning visits.
Deciding what to keep
| Case note | Decision | Why |
|---|---|---|
| Cellulitis, treatment and progress | Keep | This is why the patient needs community care. |
| Flucloxacillin dose and days remaining | Keep | The reader must make sure the course is finished. |
| Type 2 diabetes and insulin change | Keep | The reader is asked to review his blood glucose, and diabetes slows wound healing. |
| Dressing plan, warning signs, GP review | Keep | This is the core of your request. |
| Lives alone, anxious about dressing, prefers mornings | Keep | It affects how and when the reader visits. |
| Hypertension and ramipril | Leave out | Stable and unchanged; it does not affect the care you are asking for. |
| Smoking, alcohol, hobbies, job, flat, appendicectomy | Leave out | Background that changes nothing for this reader. |
Model letter
The body of this letter is 199 words, inside the 180–200 target. The numbers match the notes below the letter.
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Purpose first
The first sentence says who the patient is, why he is being discharged and exactly what care is needed. The reader knows the point of the letter from the start.
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Only the relevant story
Admission, treatment and progress are summarised in three sentences. The scratch while gardening stays because it explains the cause. His other social details do not.
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Exact doses and dates
Medication, dose, frequency and remaining days are copied accurately. Content rewards accuracy, and the reader needs these details to act.
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Background with a reason
Diabetes is included because the reader will monitor blood glucose. Stable hypertension is left out because it changes nothing for this reader.
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A clear request
The polite request lists three specific tasks. This develops the purpose and tells the reader what to do.
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Patient-centred details
Living alone, anxiety and a preference for morning visits help the reader plan visits. They are kept because they affect care.
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Safety net
Follow-up and warning signs close the clinical content, so the reader knows when to escalate.
Turning case notes into sentences
Case notes are written in short fragments. In your letter, turn them into complete sentences and combine related notes where you can. These examples use the case notes above.
Admission details
Copied notes
20 Oct admitted. L leg red, swollen. Temp 38.4.
Letter sentence
Mr Clarke was admitted on 20 October with a red, swollen left leg and a fever of 38.4°C.
Full date, full words and a complete sentence the reader can follow at a glance.
Treatment
Copied notes
IV fluclox x3/7 then PO 500mg QID.
Letter sentence
He received intravenous flucloxacillin for three days and is now taking oral flucloxacillin 500 mg four times daily.
Clinical shorthand is expanded so that any reader understands it in a formal letter.
Progress
Copied notes
Redness ↓50%. Afebrile 48h.
Letter sentence
The area of redness has halved and he has been afebrile for 48 hours.
Two notes become one sentence, which is shorter overall and easier to read.
Letter layout and tone
OET does not require a particular layout. A standard letter layout is easy for the reader to follow, so use this order:
- The reader's name, title and address, exactly as given in the task.
- The date.
- A salutation: Dear Dr Patel or Dear Ms Lee. Use Dear Sir/Madam only if no name is given.
- A reference line with the patient's name and date of birth, for example Re: Mr Peter Clarke, DOB 14/03/1958.
- Your paragraphs, separated by a blank line.
- A closing line and sign-off: Yours sincerely after a named salutation.
Keep the tone formal. Don't use contractions such as he's or don't, or casual words such as kids or OK. Write about the patient respectfully, using their title and surname.
Common OET Writing mistakes
Burying the purpose
Before
Mr Clarke is a 68-year-old retired bus driver who lives alone and was admitted on 20 October.
After
I am writing to refer Mr Clarke, who is being discharged today after treatment for cellulitis, for wound care and blood glucose monitoring.
The reader should know why you are writing from the first sentence. This is the core of Purpose.
Copying every note
Before
He enjoys gardening, drinks two beers at weekends and had his appendix removed in 1985.
After
Leave these details out.
Irrelevant notes lower Conciseness and Clarity and push the letter well past 200 words.
A vague request
Before
Please see him at home.
After
I would be grateful if you could change his dressing every two days, check that the redness is not spreading and review his blood glucose readings.
A specific request develops your purpose and tells the reader what to do.
Informal tone
Before
He's a bit worried about doing the dressing, so it'd be great if you came in the mornings.
After
He is anxious about managing the dressing himself and would prefer morning visits.
Contractions and chatty wording lower Genre and Style.
If you are writing a referral, our OET referral letter guide covers what to include when you ask a specialist to assess a patient.
Useful phrases for OET letters
Learn a few phrases for each part of the letter, then use them naturally. Don't force fixed phrases where they do not fit.
| Part of the letter | Phrases you can use |
|---|---|
| Purpose | I am writing to refer… for… / I am writing regarding… who is being transferred to… / I am writing to inform you that… has been discharged… |
| Current problem | He presented on… with… / On admission, she was found to have… / Since then, his condition has… |
| Background | She has a history of… / He is currently taking… / Of note, she is allergic to… |
| Request | I would be grateful if you could… / I would appreciate your assessment of… / Could you please… |
| Plan and safety | He will be reviewed by his GP in… / Please advise her to seek medical attention if… |
| Closing | Should you require any further information, please do not hesitate to contact me. |
For clinical words that come up across professions, see our OET medical vocabulary guide.
OET Writing checklist
- My first paragraph says who the patient is and why I am writing.
- My final paragraph asks the reader to do something specific.
- Every detail I included helps this reader continue care.
- I left out background that changes nothing for this reader.
- Names, dates, doses and numbers match the case notes exactly.
- My paragraphs follow order of importance, not the order of the notes.
- My tone is formal: no contractions or casual words.
- Abbreviations are written in full unless the reader will clearly understand them.
- The body of my letter is close to 180–200 words.
- I checked spelling, grammar and punctuation.
Practise on OET Practice
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Write a letter under real timing
Open the exam library and start the Writing sub-test of any mock test, then choose your profession. Typing unlocks when the 5-minute reading time ends, and you then have 40 minutes, just like the real test.
Open the exam library -
Keep an eye on the live word count
The word count updates as you type, so you can see whether you are close to 180–200 words before you finish.
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Get feedback on your letter
Submit when you are done. Writing and Speaking get AI-assisted feedback, reviewed by our team. You get a practice grade (A–E) and written feedback, and we email you when it is ready.
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Improve, then try new case notes
Open the result from your dashboard history and read your letter next to the feedback. Rewrite the weakest paragraph, then write a letter for another month's case notes and compare your grades over time.
Go to your history
If you are new to OET Practice, read how to prepare for OET for a weekly routine that covers all four sub-tests.
Sources
- OET Writing sub-test (opens in a new tab) — OET (oet.com)
- Study skills: assessment criteria (opens in a new tab) — OET (oet.com)
- Do you know the 3 OET letter types in the OET Writing sub-test? (opens in a new tab) — OET (oet.com)
Written by OET Practice team. Last reviewed: 26 October 2026. Read our editorial policy .