The task
Assume that today's date is 6 November 2026. Ms Adela Figuerola is returning home after review today. This is original independent practice; all patient details, clinical findings and individual arrangements are fictional case facts.
You are a doctor in the Early Pregnancy Unit. Using the case notes, write a letter to Ms Adela Figuerola's husband, Mr Aaron Dolan, with her consent, explaining her recovery advice, documented follow-up and when to seek urgent help. Address the letter to Mr Aaron Dolan, Flat 2, 18 Willow Road, NW3 1TJ, United Kingdom. Use sensitive language and address his question about a future pregnancy without promising an outcome. Allow 45 minutes: 5 minutes for reading and 40 minutes for writing. 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.
Free · no sign-up · medicine
Which case notes belong in this letter?
Miscarriage recovery: advice
You are a doctor in the Early Pregnancy Unit. Using the case notes, write a letter to Ms Adela Figuerola's husband, Mr Aaron Dolan, with her consent, explaining her recovery advice, documented follow-up and when to seek urgent help. Address the letter to Mr Aaron Dolan, Flat 2, 18 Willow Road, NW3 1TJ, United Kingdom. Use sensitive language and address his question about a future pregnancy without promising an outcome. Allow 45 minutes: 5 minutes for reading and 40 minutes for writing. 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.
Mark every line: Include keeps the specific detail; Compress keeps the relevant gist in fewer words; Omit leaves it out. Then compare your choices with our reviewed analysis. Some choices are optional.
Download practice checklist (PDF)
One-page worksheet. Answers and reasons are on the linked webpage, so you can practise before checking.
Case notes
Patient details
- Name: Ms Adela Figuerola
- DOB: 14/02/1994 (32 yrs)
- Address: Flat 2, 18 Willow Road, NW3 1TJ, United Kingdom
- Husband: Mr Aaron Dolan; same address
- Patient consents to husband receiving written recovery advice.
Social background
- Both distressed; husband requests practical instructions for home.
- Husband available to help with household tasks.
- Enjoys knitting; recently joined a craft group.
- Husband complained that reception staff were unfriendly.
Medical history
- No chronic medical conditions.
- Appendicectomy in childhood; no ongoing problems.
- First pregnancy; no previous pregnancy loss.
Assessment
- 22/10/26: USS confirmed intrauterine pregnancy.
- 05/11/26: bleeding, cramps and passage of tissue at 9/40.
- 05/11/26: repeat USS confirmed complete miscarriage.
Treatment/Progress
- No miscarriage medication or surgery required currently.
- 06/11/26: light PV bleeding; mild cramps ↓.
- Afebrile; observations stable; no dizziness.
- Home today with husband.
Documented treating-team plan
- Team advice: rest PRN; avoid intercourse until symptoms resolve.
- Supplied urine pregnancy test: use 26/11/26 (3/52 after miscarriage).
- Team: positive test OR symptoms persist despite negative → contact Early Pregnancy Unit for assessment.
- Team: fever, worsening pain or offensive discharge → unit same day; unavailable → NHS 111.
- Team: pad soaked soon after application, severe abdominal pain or fainting → call 999 immediately; do not await follow-up.
- Doctor's telephone review booked 27/11/26.
- GP can arrange counselling for patient or husband.
- Team explained emotional recovery varies; offer support without pressure.
- Husband asks if next pregnancy guaranteed successful; team: cannot promise outcome; discuss trying when symptoms resolved and both ready.
Who is reading, and what do they need?
The reader, Mr Aaron Dolan, shares Adela Figuerola's address: Flat 2, 18 Willow Road, NW3 1TJ, United Kingdom. She consents to this advice. Both are distressed; he requests practical instructions and can help with household tasks. As she returns home with him, he needs plain-language recovery guidance, precise follow-up dates and clear escalation routes; the notes establish no medical expertise.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| 5 November 2026 ultrasound: complete miscarriage. | Establishes the confirmed diagnosis underpinning the recovery advice without requiring a detailed account of the loss. |
| Light bleeding, easing mild cramps; rest as needed; avoid intercourse until symptoms resolve. | Combines a brief recovery update with practical guidance Mr Dolan can help implement at home. |
| Supplied pregnancy test: 26 November; doctor's telephone review: 27 November. | Preserves the three-week testing date and separately booked review so Mr Dolan can distinguish the two follow-up steps. |
| Positive test or persistent symptoms despite negative result: contact Early Pregnancy Unit for assessment. | Preserves both assessment triggers, preventing a negative test from being treated as permission to disregard continuing symptoms. |
| Fever, worsening pain or offensive discharge: unit same day; unavailable: NHS 111. | Gives every documented same-day trigger and the fallback service, making the escalation route usable when the unit cannot be reached. |
| Pad soaked soon after application, severe abdominal pain or fainting: call 999 immediately; don't wait. | Preserves every documented emergency trigger and immediate action, preventing delay until the scheduled follow-up. |
| Emotional recovery varies; support without pressure; GP can arrange counselling for either partner. | Offers sensitive, practical support for both distressed partners without prescribing a grieving timetable. |
| No guaranteed pregnancy outcome; discuss trying once symptoms resolve and both feel ready. | Directly addresses Mr Dolan's question while preserving uncertainty and the team's conditions for discussing another pregnancy. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Enjoys knitting; recently joined a craft group. | These interests do not change the requested recovery instructions, follow-up or urgent-help decisions. |
| Husband complained that reception staff were unfriendly. | The service complaint does not advance home recovery advice and would distract from sensitive communication. |
| Childhood appendicectomy; no ongoing problems. | The resolved operation has no documented connection to the current recovery plan. |
| No chronic medical conditions. | This background adds little to the husband's ability to follow the specific home-care and escalation instructions. |
| 22 October ultrasound confirmed an intrauterine pregnancy. | Although apparently relevant, the earlier scan adds chronology without changing today's advice; the later confirmation provides the necessary diagnostic context. |
| Age 32; first pregnancy; no previous pregnancy loss. | These details may provide brief context, but they do not justify a prognosis or need to displace practical advice. |
A paragraph plan for this case
Open with the purpose and the 5 November ultrasound confirmation, compressing the preceding bleeding, cramps and tissue passage if context helps. Use the next paragraph for current recovery and practical home support; medication or surgery being unnecessary currently, stable observations, absence of fever and dizziness are optional context rather than a required checklist. Group the dated test, review and complete escalation instructions together, then close with variable emotional recovery, available counselling and the limits of reassurance about another pregnancy.
Where candidates slip on this task
- Calculate three weeks from the 5 November miscarriage, giving 26 November for testing; keep the separately booked 27 November telephone review distinct.
- Preserve all documented escalation triggers, the same-day unit contact, the unavailable-unit fallback and immediate emergency action; this UK case specifically uses NHS 111 and 999.
- Avoid promising a successful subsequent pregnancy or imposing a fixed grieving period; discuss trying only after symptoms resolve and both partners feel ready.
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
More Medicine letter tasks
- Advice to a school principal: child with peanut anaphylaxis and asthma advice letter
- Parkinson's disease with swallowing concerns: advice advice letter
- New coeliac disease: advice advice letter
Your profession's guide: OET Medicine. Layout and structure: OET letter format.
Questions about this task
Does a complete miscarriage make the pregnancy test and review optional?
The ultrasound result explains the current diagnosis, but the documented follow-up still applies. Distinguish the supplied test on 26 November from the telephone review on 27 November, and retain both assessment triggers: a positive result or persistent symptoms despite a negative result.
How much reassurance about another pregnancy belongs in this advice letter?
Address his question directly through the team's stated uncertainty, without adding success rates or assuming that a first pregnancy loss predicts another outcome. Retain symptom resolution and both partners' readiness when discussing trying again. Variable emotional recovery and counselling for either partner provide useful supporting context.
Sources
Last checked . Rules and prices change: confirm on the official page before you book or apply.
OETAce is an independent practice site. OET is a registered trademark of Cambridge Boxhill Language Assessment (CBLA); we are not affiliated with or endorsed by CBLA. All practice material here is original.