OET Writing Guide: Criteria, Letter Types & Common Mistakes

The Writing sub-test lasts 45 minutes: 5 minutes of reading time (during which you may not write) and 40 minutes of writing time. You receive a set of case notes about a patient and a task instruction telling you who to write to and why.

The task is profession-specific — nurses receive nursing scenarios, doctors receive medical scenarios, and so on across all 12 OET professions. In almost every case the output is a formal letter of 180–200 words (body only, excluding the address block and salutation).

Your job is not to copy the case notes. It is to select the information the reader needs, reorganise it logically, and present it in accurate, formal professional English.

Since the 2019 update, OET Writing is assessed against six criteria. Purpose is graded 0–3; the other five are graded 0–7. Knowing what each criterion rewards tells you exactly where to focus.

Notice that half of the criteria have nothing to do with grammar. Candidates who plateau at a C+ usually lose marks on Content and Conciseness — selection problems, not language problems.

The referral letter is by far the most common task, but you should be ready for discharge, transfer and update letters too. Typical scenarios look like this:

Whatever the type, the fundamentals are identical: state the purpose in the first sentence, group information into logical paragraphs, and close with a clear request or expectation.

A safe, assessor-friendly structure looks like this:

• Address block and date — copy the recipient details exactly as given in the task.
• Salutation — Dear Dr Smith, if a name is given; Dear Sir/Madam, if not.
• Reference line — Re: Mr John Brown, DOB 14/03/1962.
• Paragraph 1 — Purpose — one or two sentences: who the patient is and why you are writing.
• Paragraphs 2–3 — Relevant history and current condition — grouped by theme, not by the chronology of the case notes.
• Final paragraph — Request — what you want the reader to do, plus an offer of further information.
• Sign-off — Yours sincerely (named recipient) or Yours faithfully (unnamed), followed by your role, e.g. Charge Nurse.

Use full sentences throughout — the note-form style of the case notes must be converted into connected prose.

Case note selection is the single biggest score differentiator. During the 5 minutes of reading time:

• Read the task instruction first, not the notes. Who is the reader? What do they already know? What will they do with your letter?
• Mark each note as include / exclude / maybe. A community nurse taking over wound care does not need the patient's full surgical history — but does need allergies, mobility status and dressing regimen.
• Group, don't transcribe. Three separate notes about medication belong in one sentence, not three.
• Recent and relevant beats old and complete. The current admission or presenting problem always carries more weight than background history.

A useful test for every sentence you write: “Does the reader need this to act safely?” If not, cut it.

• Copying case notes verbatim — note form ("pt c/o chest pain 3/7") must become prose ("The patient has complained of chest pain for three days").
• Including everything — letters over 220 words almost always contain irrelevant content and lose Conciseness marks.
• Burying the purpose — if the reader cannot tell why you are writing by the end of sentence one, Purpose marks are gone.
• Wrong tense discipline — past events in past tense, current status in present tense, plans in future forms. Mixed tenses inside one time frame is the most common Language error.
• Informal register — no contractions, no "a lot of", no "get better". Write "improve", "significant", "commenced".
• Unexplained abbreviations — use only abbreviations any healthcare reader would know (BP, GP); expand anything specialty-specific.

A plan that consistently works for high scorers:

Never skip the review phase — five minutes of proofreading is routinely worth a full grade band on Language.

Reading about writing does not improve writing. The loop that works is: write a letter under timed conditions → get criterion-level feedback → rewrite. Feedback is the bottleneck for most candidates — a study partner can spot awkward phrasing, but only criterion-referenced feedback tells you whether the problem is Content, Conciseness or Language.

Our Writing practice section gives you real OET-style case notes and instant AI feedback graded A–E across the official criteria, including missed key points and inline corrections — so every practice letter teaches you something specific.