Why numbers deserve their own practice
Numbers appear in almost every Part A consultation: how long a symptom has lasted, how much of a medicine the patient takes, how often, a blood pressure reading, an age, a weight, a date. They are short and fast, and one wrong digit changes the clinical meaning.
You may write numbers as digits. '2.5 mg' is clearer and faster than 'two and a half milligrams'. Include the unit if it is said and not already printed in the notes.
- symptoms for approx. ____ - takes ____ of metformin twice daily - BP at pharmacy last week: ____ - weight: ____ (lost 4 kg since March) - next appointment: ____
Thirteen or thirty?
Teens (13 to 19) and tens (30 to 90) are the classic trap. In careful speech the stress is different: thir-TEEN, but THIR-ty. Teens also end with a clear 'n' sound; tens end with a light 'ee' sound.
| Teen | Ten | What to listen for |
|---|---|---|
| thirteen (13) | thirty (30) | stress on the end vs the start; final 'n' |
| fourteen (14) | forty (40) | note: forty has no u |
| fifteen (15) | fifty (50) | long 'ee' + n vs short 'ee' |
| sixteen (16) | sixty (60) | same pattern |
| eighteen (18) | eighty (80) | one t in eighteen |
Doses, decimals and units
- 'Point five' and 'nought point five' and 'zero point five' all mean 0.5. Always write the 0 before the point: 0.5 mg, never '.5 mg'.
- 'Two and a half milligrams' = 2.5 mg. 'Half a tablet' = half a tablet (write what you hear).
- Units: mg (milligrams), mL (millilitres), kg (kilograms), units (for insulin). 'Micrograms' is often written in full to avoid confusion with milligrams.
- If the unit is printed after the gap, do not write it again: '____ mg daily' needs only '20'.
Notes: 'atorvastatin ____ mg at night'. Doctor: 'So that's forty milligrams of atorvastatin, at night.'
40 mg
40
Why: 'mg' is already in the notes. Writing it again repeats the notes.
And the warfarin, Mrs Kowalski, how much are you on at the moment?
It changes. This week it's three and a half milligrams, except on Sundays, when it's three.
Notes: 'warfarin ____ mg daily (3 mg on Sundays)'. Answer: 3.5. The Sunday dose is already printed, so you only need the main dose.
Frequencies and durations
Write the frequency in the form you heard, as long as it fits the line. Do not convert one form into another: 'every eight hours' and 'three times a day' are not always the same instruction.
| You hear | You can write |
|---|---|
| twice a day | twice a day / twice daily / 2x daily |
| every six hours | every 6 hours / 6-hourly |
| three times a week | three times a week / 3x per week |
| a fortnight | a fortnight / fortnight (if 'a' is printed, just 'fortnight') |
| eighteen months | 18 months |
| between four and six tablets | 4-6 / four to six |
Dates, times, readings and phone-style numbers
Speakers in Part A come from many countries. British and Australian speakers usually say the day first: 'the third of May'. American speakers usually say the month first: 'May third'. Both mean the same date.
- Write dates with the month as a word: 3 May or May 3. Avoid '03/05', which could be read as March 5.
- Blood pressure: 'one-forty over ninety' = 140/90. 'One-twenty-eight over eighty-four' = 128/84.
- Temperature: 'thirty-eight point five' = 38.5 (degrees Celsius).
- 'Oh' often means zero in times and phone-style numbers: 'seven oh five' = 7:05; 'oh four one two' = 0412.
- Times: '7 am', '7am' and '7:00' are all clear. Add am or pm if the speaker says it or the context needs it.
And how much did your son weigh at his last check?
Fifteen kilos. Sorry, no, fourteen. Fifteen was what I was hoping for.
Answer: 14 kg (or 14 kilos). 'Sorry, no' cancels the first number.
Practise numbers in context
- Listen to a short sentence with a number in it. Write only the number and unit.
- Check it. If you confused a teen and a ten, say both numbers aloud ten times, stressing them correctly.
- Mix types: doses, dates, times, readings. On test day they come without warning.
- Finally, read your answer in the line. Does a dose of 50 mg of this drug, or a BP of 14/90, make sense? Context can catch a mishearing.
Check yourself
4 quick questions. Tap an answer to see why.
1 Doctor: 'Her temperature was thirty-eight point two this morning.' Notes: 'temp this morning: ____ degrees'. What do you write?
2 Patient: 'I'm on fifteen milligrams. No wait, that was the old dose. It's fifty now.' What is the current dose?
3 An American speaker says 'the appointment is on June fourth'. Which written form is safest?
4 Notes: 'paracetamol ____ hourly as needed'. Nurse: 'You can take it every four to six hours if you need it.' What do you write?