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OET Medicine · Referral Letter

Medicine Referral Letter: Suspected TIA (Urgent)

An urgent GP referral to a rapid-access TIA clinic for a patient with a resolved episode of arm weakness and speech disturbance.

Task

Using the information in the case notes, write an urgent letter of referral to the Rapid Access TIA Clinic.

Case notes

  • Mrs Linda Shaw, 67, yesterday evening: sudden weakness of right arm and slurred speech, resolved completely after about 20 minutes.
  • Seen today: neurological examination normal. BP 164/96, pulse 88 irregularly irregular.
  • ECG today: atrial fibrillation, previously undiagnosed.
  • History: hypertension on amlodipine 5 mg. No anticoagulant. Non-smoker.
  • Started aspirin 300 mg today per local pathway; advised not to drive.
  • Had a cataract operation in 2023. Husband drove her to the surgery.

Try it yourself first: five minutes to plan, 40 minutes to write, 180–200 words in the body of the letter.

Model answer

The Stroke Physician
Rapid Access TIA Clinic
City General Hospital
6 October 2026
Re: Mrs Linda Shaw, aged 67
Dear Doctor, I am writing to urgently refer Mrs Linda Shaw, a 67-year-old woman, who experienced a likely transient ischaemic attack (TIA) yesterday evening. I would be grateful if you could assess her within 24 hours. Yesterday, Mrs Shaw developed sudden weakness of her right arm and slurred speech, which resolved completely after approximately 20 minutes. When I examined her this morning, she had fully recovered and her neurological examination was entirely normal. Of particular concern, her pulse was irregularly irregular, and an ECG today confirmed atrial fibrillation, which had not previously been diagnosed. Her blood pressure was elevated at 164/96. She has a history of hypertension, treated with amlodipine 5 mg daily, and she is not taking any anticoagulant. In line with our local pathway, I have started aspirin 300 mg daily and advised her not to drive until she has been reviewed by your team. I would appreciate your further investigation and advice regarding anticoagulation in view of her new atrial fibrillation. Thank you in advance for your prompt attention to this patient. Please do not hesitate to contact me should you require any further information. Yours sincerely, Dr Michael Tran General Practitioner

Body word count: 186 (target 180–200, excluding the address, date, salutation and sign-off).

Why this letter works

Purpose

“Urgently refer… within 24 hours” makes the urgency unmistakable from the first sentence.

Content

The new atrial fibrillation is singled out with “Of particular concern”, because it changes management (anticoagulation).

Conciseness & Clarity

Only stroke-relevant history is included; the cataract operation is omitted.

Organisation & Layout

Event → examination → key risk factor → action taken → specific request.

Genre & Style

Addressed to a role (“Dear Doctor”) because no named recipient is given — correct OET practice.

What was left out — and why

  • The cataract operation and who drove her — irrelevant to stroke risk.

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