OET Writing Guide: Referral Letters & Assessment Criteria
A practical walkthrough of the OET Writing sub-test for medicine — how the letter is scored, how to structure a referral letter, how to use your time, and the mistakes that most often cost marks.
The task at a glance
In the OET Writing sub-test, you get a set of case notes and write a letter. Most often this is a referral letter to another healthcare professional. You have 45 minutes: 5 minutes to read the case notes, then 40 minutes to write. Aim for about 180–200 words.
Use the reading time well. You cannot write in the first five minutes. Spend them choosing which case-note details matter for your reader and your purpose. That one decision drives most of your score.
The six assessment criteria
Each letter is marked by trained assessors against six criteria. Understanding what each one rewards is the fastest way to raise your band.
Purpose
Is the reason for writing clear in the opening lines? Assessors check that the recipient immediately understands why the letter was sent and what is being requested.
Content
Have you selected the case-note details that matter for this reader and this purpose — and left out the rest? Accuracy and relevance both count.
Conciseness & Clarity
Every sentence should earn its place. Redundancy, repetition, and padding lower this score; clear, economical phrasing raises it.
Genre & Style
A referral letter is clinician-to-clinician communication. Register, tone, and conventions should match a professional medical letter, not an essay or a chat message.
Organisation & Layout
Logical paragraphing, a sensible order of information, and correct letter layout (address, date, salutation, sign-off) all support readability.
Language
Grammar, vocabulary, spelling, and punctuation are assessed for both range and accuracy. Errors that obscure meaning cost the most.
How to structure a referral letter
- 1
Sender and recipient details, the date, and an appropriate salutation.
- 2
An opening that states the purpose and introduces the patient (name, age, relevant identifiers).
- 3
A body that presents the clinically relevant history in a logical order — current presentation, relevant background, and management to date.
- 4
A clear request or recommendation: what you want the recipient to do next.
- 5
A professional closing and sign-off.
Common mistakes that cost marks
- Copying the case notes wholesale instead of selecting what the reader needs.
- Burying the reason for writing instead of stating it up front.
- Going well over the recommended length with redundant detail.
- Using an informal or essay-like tone rather than a professional letter register.
- Listing events out of order, so the clinical story is hard to follow.
- Letting grammar or spelling errors obscure clinical meaning.
Pre-submission checklist
- Purpose stated in the first two sentences.
- Only case-note details relevant to this reader included.
- Information ordered logically and grouped into clear paragraphs.
- Tone is professional and clinician-to-clinician throughout.
- A specific request or recommendation is made.
- Roughly 180–200 words; no padding or repetition.
- Proofread for grammar, spelling, and punctuation.
Want a specialist to check your letter against these criteria?
OETlab runs a hierarchical, criterion-aligned audit of your referral letters and returns structured feedback within 12–24 hours.
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