The task
Assume that today's date is 3 November 2026. Mr Munir Abouzeid is being discharged home today. Allow 45 minutes: 5 minutes for reading and 40 minutes for writing.
This is original independent practice. You are the hospital doctor preparing Mr Munir Abouzeid's discharge correspondence. Write to his general practitioner, Dr Nisreen Najjar, General Practice, 24 Practice Road, VIC 3000, Australia. Summarise his progress, communicate the gastroenterology team's prescribed steroid taper and continuing treatment, and request community monitoring while the specialist team retains responsibility for treatment changes. 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.
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Which case notes belong in this letter?
Ulcerative colitis after inpatient treatment: discharge
This is original independent practice. You are the hospital doctor preparing Mr Munir Abouzeid's discharge correspondence. Write to his general practitioner, Dr Nisreen Najjar, General Practice, 24 Practice Road, VIC 3000, Australia. Summarise his progress, communicate the gastroenterology team's prescribed steroid taper and continuing treatment, and request community monitoring while the specialist team retains responsibility for treatment changes. 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.
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One-page worksheet. Answers and reasons are on the linked webpage, so you can practise before checking.
Case notes
Patient details
- Name: Mr Munir Abouzeid
- DOB: 19/03/1987 (39 yrs)
- Admitted 28/10/26; discharge home 03/11/26
Social background
- Lives with partner; independently manages medicines
- Office worker; concerned about toilet access when returning
- Asked not to share partner's private employment dispute
- Complained about repetitive ward meals
Medical history
- Ulcerative colitis diagnosed 2021; GP knows background
- Established oral mesalazine; unchanged prescription held by GP
- No known drug allergies; no previous bowel surgery
- Ankle sprain in 2023; fully recovered
Admission and progress
- 28/10: bloody diarrhoea, nocturnal urgency and abdominal cramps
- Stool culture and C. difficile testing negative
- IV corticosteroids given under gastroenterology; symptoms improved
- 02/11: eating normally; abdominal cramps largely settled
- CRP ↓ during admission; renal function stable
- 03/11: two stools/day, no visible blood; mild residual urgency
Specialist discharge treatment
- Prednisolone prescription: 40 mg mane, 03–09/11 inclusive
- From 10/11: ↓ 5 mg every 7 days; 5 mg 22–28/12; stop 29/12
- Continue established oral mesalazine unchanged, including when well
- Gastroenterology supplies steroids and owns taper; contact team before alterations
- Patient accurately explains schedule; advised against abrupt cessation
- Written medication information and specialist contact details supplied
Community plan
- GP 10/11: stool frequency/bleeding, hydration, medicine tolerance; FBC, CRP, renal function → gastroenterology
- Gastroenterology appointment confirmed 17/11; specialist reviews response and taper
- Ongoing fatigue; requests advice about returning to work
- Recurrent bloody diarrhoea/fever → urgent assessment; severe abdominal pain/heavy rectal bleeding → emergency care
- Patient understands improvement does not mean cure; ongoing follow-up required
- Partner available to accompany him to appointments
Who is reading, and what do they need?
Dr Najjar already knows Mr Abouzeid’s ulcerative colitis background and holds his unchanged mesalazine prescription. The GP needs his discharge condition, precise steroid schedule, monitoring date and specialist responsibilities. Use his name and date of birth for identification. Independent medicine management is optional context; practical recovery concerns deserve more attention than a repeated disease history.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| IV corticosteroid response; discharge: two stools/day, no visible blood, mild residual urgency. | Establishes the discharge baseline while preserving the remaining symptom that community review should reassess. |
| Prednisolone 40 mg each morning, 03–09 November inclusive. | Specifies the initial prescribed dose, timing and inclusive dates without requiring the GP to reconstruct them. |
| From 10 November: reduce 5 mg weekly; 5 mg 22–28 December; stop 29 December. | Makes the reduction interval and final treatment dates unambiguous across the full specialist-prescribed course. |
| Continue established oral mesalazine unchanged, including when well. | Prevents symptomatic improvement or completion of steroids being mistaken for permission to discontinue ongoing treatment. |
| Gastroenterology supplies steroids, owns taper; contact team before alterations. | Separates GP monitoring from specialist responsibility for prescribing and treatment changes. |
| GP 10/11: stool frequency/bleeding, hydration, tolerance; FBC, CRP and renal function to gastroenterology. | Defines the requested community review, all monitoring components and where results must be sent. |
| Gastroenterology 17/11; ongoing fatigue and request for return-to-work advice. | Identifies specialist follow-up and a practical recovery issue, including toilet access when returning to office work. |
| Recurrent bloody diarrhoea/fever: urgent assessment; severe abdominal pain/heavy rectal bleeding: emergency care. | Preserves every recorded escalation trigger; consolidate the complete safety advice in one place. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Partner’s private employment dispute. | The confidential third-party matter has no stated relevance to the patient’s treatment or community monitoring. |
| Repetitive ward meals. | The service complaint does not affect the prescribed treatment or follow-up request. |
| Ankle sprain in 2023, fully recovered. | A resolved unrelated injury contributes nothing to this discharge handover. |
| Ulcerative colitis diagnosed in 2021; GP knows background. | The established GP does not need the diagnosis history retold before receiving the new discharge instructions. |
| Partner available to accompany appointments. | Optional attendance support can be omitted because no difficulty accessing follow-up is documented. |
| Stool culture and C. difficile testing negative. | Potentially useful admission context can be compressed or omitted; the treatment plan and current condition take priority. |
A paragraph plan for this case
Open with the admission and discharge dates, a brief account of the bloody diarrhoea, nocturnal urgency and cramps, the IV corticosteroid response and the current bowel pattern; normal eating, settled cramps, falling CRP and stable renal function are optional supporting progress details. Give the exact prednisolone course, continuing mesalazine and specialist ownership together, optionally adding supplied medication information, contact details and concise allergy or surgical negatives. Close with the complete 10 November GP review, 17 November specialist appointment, work concerns and one consolidated escalation section.
Where candidates slip on this task
- Keep 40 mg each morning through 9 November inclusive, begin weekly 5 mg reductions on 10 November, and distinguish the final dose from the stop date.
- The patient can explain the taper and was advised against abrupt cessation; do not reinterpret GP monitoring as authority to independently change the specialist-owned course.
- Two stools daily without visible blood represents improvement, while mild urgency and fatigue remain; avoid declaring cure, complete symptom resolution or automatic fitness for office work.
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
Should the letter supply a mesalazine dose or transfer taper decisions to the GP?
Neither is supported. The GP holds the unchanged mesalazine prescription, so continuing the established regimen is sufficient. Give the recorded prednisolone schedule accurately and identify gastroenterology as the supplier and decision-maker to contact before alterations.
How should the escalation advice be handled?
Group recurrent bloody diarrhoea or fever with urgent assessment, and severe abdominal pain or heavy rectal bleeding with emergency care. Summarise this recorded plan without adding symptoms, emergency telephone instructions or patient education not documented in the case notes.
Sources
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