The task
Assume that today's date is 21 October 2026.
You are a GP. Oscar's parents have asked you to write to his school. Using the information in the case notes, write a letter to the school principal, Mr David Rowe, advising on how the school should manage Oscar's allergy and asthma. Address the letter to Mr David Rowe, Principal, Greenhill Primary School, 45 School Lane, Greenhill. In your answer: expand the relevant notes into complete sentences; do not use note form; use letter format. The body of the letter should be approximately 180–200 words.
Length: the body of the letter should be about 180–200 words. You have 45 minutes in the test: 5 minutes to read, 40 to write. Letter type: Advice letter.
Case notes
Patient details
- Name: Oscar Nguyen
- DOB: 11/05/2019 (7 yrs); Year 2
- Weight: 24 kg
Social background
- Lives with mother (weekdays) and father (alternate weekends) — both parents have consented to sharing this information with the school
- Older sister (10) attends same school
- Plays junior football Saturday mornings
- Father reports Oscar's previous school 'handled things badly'; asked for that school to be criticised in the letter
Medical history
- Born at 36 weeks; no neonatal complications
- Eczema as an infant — resolved
- Grommets inserted age 3
- Mild asthma since age 5 — salbutamol inhaler via spacer PRN (approx. 1x/month)
- No other medications
Recent event (30/09/26)
- At a birthday party, ate satay chicken → within 10 min: lip swelling, hives, vomiting, wheeze, hoarse voice
- Ambulance called; IM adrenaline given by paramedics; observed in ED overnight; full recovery
Specialist review (14/10/26 — paediatric allergist)
- Diagnosis: peanut allergy with anaphylaxis (skin prick test 12 mm)
- Tree nuts tolerated at home (cashew, almond)
- Prescribed adrenaline (epinephrine) autoinjector 0.3 mg × 2 (one for school, one with family)
- Anaphylaxis action plan completed by allergist (copy attached)
- Asthma increases risk of severe reaction — must be well controlled
GP consultation today
- Asthma currently well controlled
- Mother trained in autoinjector use
- Mother asked about oral immunotherapy — allergist to discuss at review in 6/12
Advice for school
- Autoinjector + action plan to be kept together, unlocked, easily accessible, not refrigerated; to go with Oscar on excursions and sports days
- All staff who supervise Oscar to be trained in recognising anaphylaxis and using autoinjector
- Severe reaction (difficulty breathing, wheeze, hoarse voice, persistent cough, pale/floppy): lay flat — if breathing difficult, sit with legs outstretched; do not stand or walk; give adrenaline immediately, call ambulance, then phone parents
- If no response after 5 min, give further adrenaline if another device available; if in doubt, give adrenaline; if wheeze and unsure whether asthma or anaphylaxis → give adrenaline first, then asthma reliever
- Avoid peanut-containing foods in classroom activities; no food sharing; inform canteen
- Salbutamol inhaler, spacer and written asthma action plan to be available at school
Who is reading, and what do they need?
Mr Rowe is a school principal with no medical training. He needs to know the diagnosis, what to put in place and exactly what staff must do in an emergency. Both parents have consented to sharing the information. Use plain language, explain what is needed, and keep unrelated medical history out.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Peanut allergy with anaphylaxis; asthma since age 5 | The principal needs the two conditions he is being asked to manage, stated clearly and without unnecessary history. |
| Birthday party 30/09: reaction after satay chicken; adrenaline, ED, full recovery | A short account shows why the plan matters and what a reaction looked like. Keep it brief. |
| Both parents consented to sharing information with the school | Confirms the GP is entitled to share the details and reassures the reader. |
| Autoinjector and action plan together, unlocked, accessible, not refrigerated, go on excursions | These are practical arrangements the school must set up, including where the device goes and when it travels. |
| All staff supervising Oscar trained in recognising anaphylaxis and using autoinjector | Training is a key action for the school. The two prescribed devices (one for school, one with family) can fit here. |
| Severe reaction signs and steps: lay flat, adrenaline immediately, call ambulance, phone parents | The signs and the full emergency sequence must be given so staff can act. Include sitting with legs outstretched if breathing is difficult and not standing or walking. |
| No response after 5 min: further adrenaline; if in doubt, give; wheeze unsure: adrenaline first | These are part of the complete emergency steps and must appear with the first-line actions, not be dropped for space. |
| Avoid peanut foods in class; no food sharing; inform canteen; asthma reliever, spacer, plan at school | Prevention and asthma preparedness are the remaining school actions. Asthma being well controlled but raising reaction risk explains why. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Father asked for the previous school to be criticised in the letter | Inappropriate and unrelated to the advice. A professional letter should not criticise another school; the GP would not act on this. |
| Born at 36 weeks; infant eczema resolved; grommets age 3 | Past history that is resolved or not relevant to school management of allergy and asthma. |
| Older sister at same school; junior football Saturdays | Social detail that does not change what the school must do, except that the autoinjector goes on sports days, which is covered elsewhere. |
| Mother asked about oral immunotherapy; allergist review in 6/12 | A future discussion for the family and allergist, not something the school needs to act on. |
| Skin prick test 12 mm; tree nuts tolerated at home | A trap: specialist detail the principal does not need. The school advice concerns peanut, so do not add tree nut rules not in the notes. |
| Lives with mother weekdays, father alternate weekends | Only the fact of consent matters. Custody arrangements add nothing for the school. |
A paragraph plan for this case
Open by stating the purpose, the diagnoses and parental consent, with a brief mention of the recent reaction. Then set out the school's arrangements: device and plan storage, staff training and food precautions. Place the emergency steps in a clear, complete paragraph, then asthma supplies and the attached action plan.
Where candidates slip on this task
- Include every sign and every emergency step in the right order: lay flat or sit, no standing, adrenaline first, ambulance, parents, repeat after 5 minutes, adrenaline if in doubt. Do not compress them to save words.
- Do not mention the previous school or criticise it. The father's request is not part of the medical advice, and the letter should stay neutral and professional.
- Write for a lay reader: explain terms like autoinjector and anaphylaxis simply, and keep the focus on actions. Do not add rules about tree nuts or other foods beyond peanut.
No model letter is published here. Write for the named reader from the case notes in the timed editor, then get it marked.
Write it in the timed editor and get marked on the 6 criteria
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Your profession's guide: OET Medicine. Layout and structure: OET letter format.
Questions about this task
Can I shorten the emergency instructions to stay within the word count?
No. They are the most important part of the advice for the school. Save words by compressing the background, such as the party reaction, and leave out unrelated history instead.
Should the letter respond to the father's request about the previous school?
No. Criticising another school is not part of the clinical advice and could be inappropriate. Leave it out and keep the letter focused on what Mr Rowe's school needs to do.
Sources
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