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Writing sub-test

About the Writing sub-test
The Writing sub-test takes 45 minutes. It is profession-specific. You take this part of OET using materials specifically for your profession – a nurse does the task for nursing, a dentist does the task for dentistry, and so on. In each test, there is one task set for each profession based on a typical workplace situation and the demands of the profession.

The task is to write a letter, usually a referral letter. Sometimes, especially for some professions, a different type of letter is required: e.g. a letter of transfer or discharge, or a letter to advise or inform a patient, carer, or group.

Along with the task instructions, you’ll receive stimulus material (case notes and/or other related documentation) which includes information to use in your response.

The first five minutes of the test is reading time. During this time, you can study the task and notes (but not write, underline or make any notes of your own).

For the remaining 40 minutes, you write your response to the task. You write in the printed answer booklet provided, which also has space for rough work. You can write in pen or pencil.

Why is the Writing sub-test in this format?
Although work is now mainly done on a computer, most medical professionals still have to prepare letters as part of their regular practice.

The writing task, taken directly from the workplace context, requires you to select and organise relevant information and present it in a clear, accurate form that is appropriate for the intended reader. Preparing such a letter with only limited time is a reality for practising professionals.

Preparing for the Writing sub-test
To help you prepare for the Writing sub-test, you can:

  • Try the Writing material from the sample test
  • Buy more, profession-specific Writing practice materials from the OET Bookshop
  • Note down useful phrases and sentence patterns from your general reading in English
  • Make use of some of the many free online resources for English-language learners which can help you develop the writing you need (e.g. formal letter writing, general grammar practice). These include:
  • Online Writing Lab at Purdue University
    Useful writing resources list
  • Englishmed.com: English learning resources with a medical focus

Please note: the OET Centre is not responsible for the content of external websites.

What Writing skills are tested?
Your letter is assessed against five criteria:

• Overall task fulfilment – including whether the response is of the required length
• Appropriateness of language – including the use of appropriate vocabulary and tone in the response, and whether it is organised appropriately
• Comprehension of stimulus – including whether the response shows you have understood the situation and provided relevant rather than unnecessary information to your reader
• Control of linguistic features (grammar and cohesion) – including how effectively you communicate using the grammatical structures and cohesive devices of English
• Control of presentation features (spelling, punctuation and layout) – including how these areas affect the message you want to communicate

How can I improve on each criterion?

Overall task fulfilment

• write enough so the assessors have a sufficient sample of your writing – the task requires approximately 180-200 words in the body of the letter
• Don’t write too much – you may need to select content carefully to keep to the required word count
• Use your own words as much as possible – don’t simply copy sections from the case notes
• Avoid writing that is too formulaic – if you include elements that do not fit the task, it indicates a lack of flexibility in your writing
• Don’t include information that the intended reader clearly knows already (e.g. if you are replying to a colleague who has referred a patient to you)

Appropriateness of language

• Organise the information clearly – remember, the sequence of information in the case notes may not be the most appropriate sequence of information for your letter
• Highlight the main purpose of your letter at the start – this provides the context for the information you include
• Be clear about the level of urgency for the communication
• Always keep in mind the reason for writing – don’t just summarise the case notes provided
• Focus on important information and minimise incidental detail
• Be explicit about the organisation of your letter, where appropriate: e.g. ‘First I will outline the problems the patient has, then I will make some suggestions for his treatment.’
• Consider using dates and other time references (e.g. three months later, last week, a year ago) to give a clear sequence of events where needed
• Stick to the relatively formal tone that all professional letters are written in
• Avoid informal language, slang, colloquialisms and spoken idiom unless you are sure this is appropriate (e.g. use ‘Thank you’ rather than ‘Thanks a lot’)
• Avoid SMS texting abbreviations in a formal letter (e.g. use ‘you’ not ‘u’)
• Give the correct salutation: if you are told the recipient’s name and title, use them
• Show awareness of your audience by choosing appropriate words and phrases: if you are writing to another professional, you may use technical terms and, possibly, abbreviations; if you are writing to a parent or a group of lay people, use non-technical terms and explain carefully

Comprehension of stimulus

• Show you have understood the case notes fully
• Be clear about the most relevant issues for the reader
• Don’t let the main issue become hidden by including too much supporting detail
• Show clearly the connections between information in the case notes if these are made; however, do not add information that is not given in the notes (e.g. a suggested diagnosis), particularly if the reason for the letter is to get an expert opinion
• Take relevant information from the case notes and transform it to fit the task set
• Be explicit if the stimulus material includes questions that require an answer – don’t ‘hide’ the relevant information in a general summary of the notes provided

Control of linguistic features (grammar and cohesion)

• Show that you can use language accurately and flexibly in your writing
• Make sure you demonstrate a range of language structures – use complex sentences as well as simple ones
• Split a long sentence into two or three sentences if you feel you are losing control of it
• Review areas of grammar to ensure you convey your intended meaning accurately: particular areas to focus on might include:
    o articles – a/an, the (e.g. ‘She had an operation.’, ‘on the internet’)
    o countable and uncountable nouns (e.g. some evidence, an opinion, an asthma)
    o verb forms used to indicate past time and the relationship between events in the past and now (past simple, present perfect, past perfect)
    o adverbs that give time references (e.g. ‘two months previously’ is different from ‘two months ago’)
    o prepositions following other words (e.g. ‘Thank you very much for seeing …’, ‘sensitivity to pressure’, ‘my examination of the patient’, ‘diagnosed with cancer’)
    o passive forms (e.g. ‘he was involved in an accident’ NOT ‘he involved in an accident’)

• Use connecting words and phrases (‘connectives’) to link ideas together clearly (e.g. however, therefore, subsequently)
• Create a mental checklist of problems you have with grammar and go through this when you review your response. Areas to focus on might include:

    o number agreement, e.g. ‘The test result shows that…’, ‘There is no evidence…’, ‘He lives…’, ‘one of the side effects’
    o complete sentences, i.e. the main clause includes ‘subject and verb’, e.g. ‘On examination showed that…’ should be ‘Examination showed that…’ or ‘On examination it was found that…’
    o gender agreement, e.g. ‘Mrs Jones and her daughter’
    o tense agreement, e.g. ‘Examination on 15 May 2006 revealed she is overweight.’ [creating confusion over whether she is still overweight at the time of writing]

• Control of presentation features (spelling, punctuation and layout)Take care with the placement of commas and full stops:
    • Make sure there are enough – separating ideas into sentences
    • Make sure there are not too many – keeping elements of the text meaningfully connected together
• Leave a blank line between paragraphs to show clearly the overall structure of the letter
• Don’t write on every other line – this does not really help the reader
• Check for spelling mistakes and for spelling consistency throughout your writing (e.g. with a patient’s name):
    • Remember that many of the words you write are also in the case notes – check that the spelling you use is the same
    • Be consistent in your spelling: alternative spelling conventions (e.g., American or British English) are acceptable as long as your use is consistent
• Don’t use symbols as abbreviations in formal letters
• Avoid creating any negative impact on your reader through the presentation of the letter
    o Use a clear layout to avoid any miscommunication
    o Make sure poor handwriting does not confuse the reader over spelling and meaning
    o Write legibly so the assessor can grade your response fairly using the set criteria
• Watch out for words that are commonly confused or misspelled such as: 
    o advise (verb), advice (noun)
    o severe (meaning serious or acute) not sever
    o loose (adjective), lose (verb): to lose weight
    o loss (noun), lost (verb, past and past participle form; adjective): e.g. his loss of weight
    o were, where
    o which, not wich
    o planned, not planed
    o until, not untill

Taking the test

Dos and don’ts

• Do take time to understand the task requirements
• Do make sure you understand the situation described in the case notes
• Do think about how best to organise your letter before you start writing
 Don’t include everything from the case notes – select information relevant to the task

How can I help myself during the Writing sub-test?


• Have a spare pen or pencil ready just in case
• Fill in the cover pages for the task booklet and the answer booklet correctly
• Use the five minutes’ reading time effectively to understand the task set:
    o What is your role?
    o Who is your audience (the intended reader)?
    o What is the current situation?
    o How urgent is the current situation?
    o What is the main point you must communicate to the reader?
    o What supporting information is necessary to give to the reader?
    o What background information is useful to the reader?
    o What information is unnecessary for the reader? Why is it unnecessary?

• Consider the best way to present the information relevant to the task:
    o Is a chronological sequence helpful (summarising each consultation in turn)?
    o Should the current situation be explained at the start of the letter (perhaps in an emergency situation)?
    o Use the space provided to plan your letter (though a draft is not compulsory)

• Organise what you want to say before you start writing in full to get a clear idea of how much detail you can include
• Use the names and addresses given
• You can invent addresses if none are given
• Set out the names, addresses, date and other information to start the letter clearly
• Indicate each new paragraph clearly as you write, perhaps by leaving a blank line
• Write clearly: don’t make it difficult for the assessor to read your response

Checking at the end

• Make sure your letter communicates what you intend
• Make sure you meet the basic task requirements:
    o length of the body of the text approximately 180-200 words
    o full sentences, not note form
    o appropriate letter format
• Check for any simple grammar and spelling errors that you may have made
• If a page is messy, use clear marks (e.g. arrows, numbers) to show the sequence in which the parts of your text should be read
• Cross out clearly anything you do not want the assessors to read

How is the Writing sub-test assessed?
The Writing sub-test is scored by experienced assessors who receive ongoing training, monitoring, and feedback on their performance after each administration of the test.

Assessors give a score from 1 to 6 for each of the five criteria listed above using a detailed set of level descriptors to guide their decisions. A score of 6 is the highest for each criterion. The five criteria are equally weighted in the scoring and analysis process.

Each candidate’s script is graded by two assessors independently. Neither assessor knows the scores the other assessor gives or the scores awarded to the candidate for other sub-tests.

The two separate sets of raw scores for each candidate’s script are analysed for the whole group of candidates taking the sub-test at the same administration. A multi-faceted Rasch analysis of the data is done using FACETS software (Linacre 1989). This analysis takes account of patterns of assessor behaviour and compensates for assessors whose scores are consistently lenient or severe.

After the initial analysis, any scripts which have misfitting scores (i.e. which do not fit the pattern expected for the analysis) are re-scored by a third assessor (again without any knowledge of the previous scores given) and the statistical analysis is repeated.

The final score for each candidate’s script is therefore not a simple mean average of the two (or three) assessors’ raw scores. Instead, it is a ‘fair score’, compensating for particular assessors’ severity or leniency.
Read more about OET assessment procedures