The task
Original independent practice. All patient details, findings and individual care arrangements are fictional. Assume that today's date is 3 November 2026. Mr Pantoja is being discharged home today. Allow 45 minutes: 5 minutes reading and 40 minutes writing.
You are the surgical ward doctor caring for Mr Roberto Pantoja following bariatric surgery. Using the case notes, write a discharge letter to his general practitioner, Dr Nelly Altamirano, General Practice, 18 Station Road, SE1 7AB, United Kingdom. Request community recovery review and explain specialist responsibility for nutritional monitoring, pending results and his supplement formulation enquiry. This letter does not request medication prescribing or reconciliation. 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: Discharge letter.
Free · no sign-up · medicine
Which case notes belong in this letter?
Recovery after bariatric surgery: discharge
You are the surgical ward doctor caring for Mr Roberto Pantoja following bariatric surgery. Using the case notes, write a discharge letter to his general practitioner, Dr Nelly Altamirano, General Practice, 18 Station Road, SE1 7AB, United Kingdom. Request community recovery review and explain specialist responsibility for nutritional monitoring, pending results and his supplement formulation enquiry. This letter does not request medication prescribing or reconciliation. 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: Mr Roberto Pantoja
- DOB: 09/02/1978 (48 yrs)
- Admission 31/10/26; discharge home 03/11/26
Social background
- Lives with partner, who helps prepare meals
- Works from home; transport available for appointments
- Complained about ward meal trays
Medical history
- Preoperative obesity; previous weight-management history held by GP
- Remote knee arthroscopy; fully mobile
- No known drug allergies
- 31/10: laparoscopic sleeve gastrectomy; no operative complications
Postoperative progress
- 01/11: nausea; oral fluid intake limited
- Discharge deferred; observation and dietitian review arranged
- 02/11: nausea settled; practising slow, small sips
- Individual dietitian's texture plan supplied
- Partner attended dietetic discussion
- 03/11: afebrile; abdomen soft, non-tender
- Wounds clean; walking independently
- Now tolerating fluids and prescribed liquid diet; no vomiting/dysphagia; clinically hydrated
- Renal function/electrolytes within laboratory reference limits
Nutrition monitoring and separate prescribing handover
- 02/11: ferritin/vitamin D sampled at bariatric team's request; pending
- Bariatric service retains specialist nutritional monitoring
- Team to review pending results and inform patient/GP by 06/11; GP chase service if absent
- Hospital issued separate medication handover to patient and GP
- Bariatric team retains prescribing; no GP prescribing/reconciliation requested
- Pt enquires about chewable supplement formulation; has not changed products
- No substitution/conversion authorised; no tablet count inferable; team/pharmacist to telephone patient by 04/11; patient chase via service if absent
Discharge plan
- Contact bariatric service via hospital switchboard for results, nutrition or supplement queries
- GP review 06/11: intake, hydration, wounds; contact bariatric service if concerns
- Bariatric dietitian review booked 10/11; ongoing specialist follow-up retained
- Advice given: recurrent vomiting → urgent assessment; severe abdominal pain → emergency department
Who is reading, and what do they need?
Dr Altamirano is Mr Pantoja’s GP and holds his weight-management history. She needs recovery checks, escalation arrangements and clear ownership of pending results and the formulation enquiry. Keep patient identifiers and discharge timing brief. Examination findings, mobility, laboratory results, allergy status and home support are optional context when they help her act; specialist responsibilities and timed follow-up need greater detail.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| 31/10: laparoscopic sleeve gastrectomy; no operative complications. | Establishes the procedure and timing underlying the requested community recovery review. |
| Tolerating fluids/prescribed liquid diet; no vomiting/dysphagia; clinically hydrated. | Provides the current recovery status against which the GP can assess intake and hydration. |
| Ferritin/vitamin D sampled 02/11; results pending. | Identifies the outstanding investigations requiring specialist review and communication. |
| Team reviews results, informs patient/GP by 06/11; GP chases service if absent. | Makes result ownership, the communication deadline and responsibility for a missing update actionable. |
| Specialist nutritional monitoring/prescribing retained; separate medication handover; no GP prescribing/reconciliation requested. | Defines the division of responsibility and prevents the recovery review becoming an unintended medication request. |
| Chewable formulation enquiry; no product change or authorised substitution/conversion; no tablet count inferable. | Explains the unresolved formulation question without presenting an enquiry as permission to change supplements. |
| Team/pharmacist calls by 04/11; patient chases service if absent; queries via hospital switchboard. | Gives the formulation enquiry a deadline, a responsible team and an accessible follow-up route. |
| GP review 06/11: intake, hydration, wounds; contact bariatric service if concerns. | States the requested community action, retaining all three review areas and the escalation arrangement. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Complained about ward meal trays. | A service complaint does not explain the current recovery needs or alter the GP’s requested actions. |
| Preoperative obesity; previous weight-management history held by GP. | The GP already holds this background; repeating it would displace the specific postoperative handover. |
| Remote knee arthroscopy; fully mobile. | The remote procedure has no documented consequence for this recovery review; current mobility can be summarised separately. |
| Nausea and limited intake delayed discharge; nausea settled 02/11. | Compress this resolved inpatient sequence, if retained, to preserve space for current tolerance and timed follow-up responsibilities. |
| Works from home; transport available for appointments. | Although apparently relevant to discharge planning, neither detail identifies a barrier requiring the GP’s intervention. |
| Postoperative advice already given. | A recap of completed counselling is optional alongside the requested recovery review and specialist handover. |
A paragraph plan for this case
Open with discharge home on 03/11 after the 31/10 sleeve gastrectomy and the GP review request for 06/11. Next summarise current intake and hydration, adding examination findings or the supplied texture plan, partner involvement and 10/11 dietitian appointment only if useful. Close with specialist monitoring and prescribing responsibility, the pending-results deadline and GP chase arrangement, then the formulation callback deadline and patient follow-up route.
Where candidates slip on this task
- Keep the two deadlines separate: the team/pharmacist’s formulation call is due 04/11, while the team’s results update and the GP’s recovery review are due 06/11.
- Do not turn the chewable enquiry into an approved change: no substitution or conversion is authorised, no tablet count is inferable, and the patient must chase a missing callback.
- Keep specialist nutritional monitoring and prescribing with the bariatric service; the separate medication handover does not create a GP prescribing or reconciliation request in this letter.
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
- Discharge to GP after pneumonia with new atrial fibrillation discharge letter
- Discharge to GP after gallstone pancreatitis discharge letter
- Discharge to community nurse: cellulitis and leg wound care discharge letter
Your profession's guide: OET Medicine. Layout and structure: OET letter format.
Questions about this task
How much of the nausea and delayed discharge belongs here?
The initial nausea, limited fluids and deferred discharge explain the inpatient course but are optional. Current fluid and prescribed liquid-diet tolerance, hydration and absence of vomiting or dysphagia provide the main recovery information. A brief account of the resolved nausea can be retained if space allows.
Who follows up the results and the chewable formulation enquiry?
The results section needs the bariatric team’s review and notification to patient/GP by 06/11, with the GP chasing any missing update. The formulation section needs the team/pharmacist’s call by 04/11 and the patient’s chase route. Neither section creates GP prescribing or reconciliation work; no substitution or conversion is authorised.
Sources
Last checked 22 Oct 2026. 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.