Accuracy, not decoration
The Language criterion, scored from 0 to 7, looks at the accuracy of your grammar, vocabulary, spelling and punctuation, and whether errors slow the reader down or change the meaning. Health professionals care about language because they need to find information quickly and trust it.
You do not need rare words or long, complex sentences. A letter of clear, correct sentences of medium length is safer than an ambitious letter full of errors. Focus on the structures that appear in almost every letter.
Tenses for the patient's story
| Tense | Use it for | Example |
|---|---|---|
| Past simple | Finished events, especially with a time | She was admitted on 4 October. He fell at home last week. |
| Present perfect | Something that started in the past and continues, or a recent change with no exact time | He has been taking metformin since 2019. Her pain has improved. |
| Present simple | Current facts and situations | She lives with her daughter. He takes two puffs twice daily. |
| Past perfect | An event before another past event | He had stopped his tablets two weeks before he was admitted. |
| Future forms | Plans and arrangements | She is due to have her sutures removed on 30 October. He will be reviewed in clinic in six weeks. |
He has been admitted on 4 October with chest pain.
He was admitted on 4 October with chest pain.
Why: A finished event with a specific date needs the past simple, not the present perfect.
She takes warfarin since 2021.
She has been taking warfarin since 2021.
Why: 'Since' with an ongoing situation needs the present perfect.
Her dressing will be changed yesterday.
Her dressing was changed yesterday and is next due on Friday.
Why: Check that each verb matches the time in the notes. Mixing up completed and planned actions changes the meaning.
The passive for clinical actions
In clinical letters, who did the action is often less important than what was done. The passive (be + past participle) keeps the focus on the patient and the treatment.
We gave him intravenous fluids and the doctors started him on antibiotics.
He was given intravenous fluids and started on antibiotics.
Why: The passive is shorter and keeps the patient as the subject.
She was discharge yesterday.
She was discharged yesterday.
Why: The passive needs the past participle: discharged, admitted, prescribed, referred.
Articles: a, an, the or nothing
- a / an for a single thing mentioned for the first time: 'a 54-year-old man', 'a fall', 'an MRI scan' (an before a vowel sound, so 'an MRI' but 'a urine test').
- the for something already mentioned or clearly known: 'a wound on her left foot ... the wound is now 2 cm wide'.
- No article for most conditions, uncountable nouns and general meanings: 'She has diabetes.' 'He was given oxygen.' 'Smoking slows healing.'
- to hospital is the usual British and Australian form; American English uses 'to the hospital'. Both are understood.
Patient had fall at home and sustained fracture of wrist.
Mrs Kaur had a fall at home and fractured her right wrist.
Why: Note-form drops articles. In a letter, 'a fall' and a possessive like 'her wrist' are needed.
Reporting results and linking ideas
Reporting tests
A chest X-ray showed right lower lobe consolidation.
showed / revealed + a findingBlood tests revealed a raised white cell count.
revealed + a noun phraseAn ECG was normal.
When there is no abnormal findingHer HbA1c was 8.4%.
Reporting a single value
Blood tests revealed normal.
Blood tests were normal.
Why: 'Revealed' needs an object: 'revealed no abnormality' or 'revealed low iron'.
| Meaning | Linking words | Example |
|---|---|---|
| Cause | because, as, due to + noun | As he lives alone, he will need daily visits. His admission was due to a fall. |
| Result | therefore, as a result, so | Her kidney function was reduced; therefore, her metformin dose was lowered. |
| Contrast | although, however, despite + noun or -ing | Although his pain has improved, he still needs help with stairs. Despite taking her inhaler, she wakes at night with a cough. |
Despite he was given antibiotics, his fever continued.
Although he was given antibiotics, his fever continued.
Why: 'Despite' is followed by a noun or -ing form, not a full clause. Use 'although' before a subject and verb.
Punctuation of lists and numbers
- Lists: 'She takes metformin, ramipril and atorvastatin.' A comma before 'and' is optional; be consistent.
- Units: write a number with its unit, such as '5 mg', '38.4°C' or '3 cm'. Write doses and frequencies in words when that is clearer: 'twice daily', not 'bd'.
- Ages: 'a 54-year-old man' (hyphens, before a noun) but 'he is 54 years old' (no hyphens).
- Dates: choose one style, such as '4 October 2026', and use it throughout.
- Avoid starting a sentence with a figure: 'Three days later ...', not '3 days later ...'.
He is a 67 years old man, he lives alone.
He is a 67-year-old man who lives alone.
Why: Hyphenate the age before a noun, and join the two ideas instead of using a comma between two sentences.
Errors that come from expanding notes
Most language errors in OET letters come from turning notes into sentences too quickly. Check for these four.
| Problem | Weak | Better |
|---|---|---|
| Missing verb | Mr Ali admitted with chest pain. | Mr Ali was admitted with chest pain. |
| Missing subject | Lives alone and walks with stick. | He lives alone and walks with a stick. |
| Symbols left in | BP ↑, c/o dizziness. | His blood pressure is raised, and he complains of dizziness. |
| Wrong word form | She is depend on her husband. | She is dependent on her husband. |
Notes: '2/10 adm - SOB, productive cough. CXR: L basal consolidation. IV abx 3/7 -> oral. Hx asthma since childhood. Lives c partner.'
Ms Petrova admitted 2/10 with SOB and productive cough, CXR revealed consolidation L base. Given IV abx 3 days then oral. She has asthma since she was child, live with partner.
Ms Petrova was admitted on 2 October with shortness of breath and a productive cough, and a chest X-ray showed consolidation at the base of her left lung. She received intravenous antibiotics for three days and was then changed to oral antibiotics. She has had asthma since childhood and lives with her partner.
Why: The better version adds the missing verbs and articles, uses the past simple for the admission, the present perfect for the long-term asthma, and replaces every abbreviation a reader might stumble over.
Check yourself
4 quick questions. Tap an answer to see why.
1 Which sentence is correct?
2 Which sentence reports a result correctly?
3 Choose the correct linking word: '___ his breathing has improved, he still needs oxygen at night.'
4 The note says 'Lives c daughter, indep ADLs'. Which sentence is the best expansion?