The task
Original independent practice. Findings, microbiology results and agreed treatment arrangements are fictional case facts, not universal prescribing instructions. Allow 45 minutes: 5 minutes for reading and 40 minutes for writing. Assume that today is 3 November 2026. Dr Devoy has accepted Mr Spinka for transfer today. The receiving team has already confirmed the antibiotic plan and laboratory forwarding arrangements on the accompanying handover sheet. Summarise continuing treatment; administrative responsibilities need not be repeated.
You are the doctor arranging Mr Fritz Spinka's hospital transfer. Using the case notes, write a transfer letter to Dr Heather Devoy, Cardiothoracic Receiving Doctor, Cardiothoracic Receiving Unit, 46 Clinic Road, SW1A 2AA, United Kingdom, explaining the reason for urgent surgical assessment, his current condition, microbiology status and continuing treatment. 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: Transfer letter.
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Which case notes belong in this letter?
Infective endocarditis: transfer
You are the doctor arranging Mr Fritz Spinka's hospital transfer. Using the case notes, write a transfer letter to Dr Heather Devoy, Cardiothoracic Receiving Doctor, Cardiothoracic Receiving Unit, 46 Clinic Road, SW1A 2AA, United Kingdom, explaining the reason for urgent surgical assessment, his current condition, microbiology status and continuing treatment. 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 and background
- Name: Mr Fritz Spinka
- DOB: 18/02/1968 (58 yrs)
- Admitted 31/10/26; transfer today, 03/11/26
- Lives with partner; independent before illness
- Office-based employment; currently on sick leave
- Known bicuspid native aortic valve; no prosthetic valve
- Remote ankle sprain; fully recovered
- Partner alleges delayed diagnosis by another practice; not investigated
Admission and initial management
- 31/10: 2/52 fever, night sweats, fatigue; new diastolic murmur
- Admission blood cultures before antibiotics: Streptococcus oralis, penicillin susceptible
- IV antibiotics started after cultures, under infection-specialist advice
- 01/11 TTE: aortic vegetation
- 02/11 infection review: changed to IV ceftriaxone
- No known drug allergies
Progress: 2–3 November 2026
- 02/11 repeat blood cultures collected
- 03/11 repeat cultures: no growth to date; final results pending
- Fever settled; fatigue persists
- Breathless on minimal exertion; no resting respiratory distress
- 03/11 TOE: leaflet perforation, severe aortic regurgitation; no abscess identified
- Alert; no focal neurological deficit on today's examination
- BP 118/72 mmHg; pulse 94/min; SpO2 96% on room air
- Renal function unchanged from admission
Agreed transfer plan: 3 November 2026
- Dr Heather Devoy accepts urgent transfer for surgical assessment; operation not yet agreed
- Continue IV ceftriaxone during transfer and after arrival, under agreed infection-team plan
- Today's ceftriaxone administered; medication orders reconciled directly between prescribers
- Final repeat-culture report → receiving infection team automatically; delivery arrangement confirmed on handover sheet
- Monitored ambulance today; echo reports, microbiology and medication records accompany
- Deterioration before departure → immediate senior review; update receiving unit
- Patient agrees to transfer; partner informed
Who is reading, and what do they need?
Dr Devoy has accepted Mr Spinka, aged 58, for urgent surgical assessment. She needs a focused account of the current valve damage, breathlessness, culture results and continuing ceftriaxone. The antibiotic plan and automatic delivery of final culture results are already confirmed on the accompanying handover sheet. Background and examination details may be selected to support this account.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Dr Heather Devoy accepts urgent transfer for surgical assessment; operation not yet agreed. | Defines the accepted transfer purpose. Describe assessment without predicting an operation. |
| 03/11 TOE: leaflet perforation, severe aortic regurgitation; no abscess identified. | Provides the current valve findings driving urgent surgical assessment. |
| Breathless on minimal exertion; no resting respiratory distress. | Conveys the current respiratory burden without suggesting distress at rest. |
| Admission blood cultures before antibiotics: Streptococcus oralis, penicillin susceptible. | Identifies the confirmed organism and susceptibility for the receiving team's infection care. |
| 03/11 repeat cultures: no growth to date; final results pending. | Makes clear that the repeat result remains provisional. |
| Continue IV ceftriaxone during transfer and after arrival, under agreed infection-team plan. | States the treatment that must continue across the transfer. |
| Final repeat-culture report → receiving infection team automatically; delivery arrangement confirmed on handover sheet. | May briefly reassure the reader about follow-up; the confirmed delivery arrangement need not be repeated. |
| Monitored ambulance; echo reports, microbiology and medication records accompany; today's ceftriaxone administered; orders reconciled. | Offers optional practical information about transport, available records and medication status. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Office-based employment; currently on sick leave. | Employment arrangements do not help the receiving team assess the urgent valve problem. |
| Remote ankle sprain; fully recovered. | Resolved ankle history has no stated relevance to this transfer. |
| Partner alleges delayed diagnosis by another practice; not investigated. | An uninvestigated complaint must not be presented as an established clinical event. |
| Lives with partner; independent before illness. | Baseline independence may be compressed for context, but immediate cardiac and infection needs take priority. |
| Fever settled; fatigue persists. | This response can be briefly acknowledged but must not displace current valve damage, breathlessness or pending microbiology. |
| Partner informed of transfer. | Completed family notification adds little to the receiving team's immediate clinical decisions. |
A paragraph plan for this case
Open with the accepted urgent surgical assessment and the valve damage and breathlessness that explain it. Summarise the admission microbiology, provisional repeat cultures and continuing ceftriaxone. Add selected background, current observations or transport details where useful. A daily investigation chronology and repetition of the confirmed administrative arrangements are unnecessary.
Where candidates slip on this task
- Prioritise today's TOE findings. The earlier TTE vegetation is optional diagnostic background; a chronological account of both studies is unnecessary.
- Keep confirmed admission microbiology separate from preliminary repeat cultures: no growth to date is not a final negative result and does not establish that infection has cleared.
- State that IV ceftriaxone continues under the agreed plan. Reconciled orders and confirmed laboratory forwarding do not require a detailed allocation of responsibilities or an invented dose or duration.
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 request an operation or describe one as planned?
The agreed purpose is urgent surgical assessment. Explain this using the leaflet perforation, severe aortic regurgitation and exertional breathlessness. An operation has not yet been agreed, but a separate disclaimer is unnecessary if the assessment purpose is clear.
How much antibiotic and pending-result detail is appropriate?
Identify IV ceftriaxone and its continuation during transfer and after arrival under the agreed infection-team plan. State that repeat cultures show no growth to date and final results are pending. The receiving team already has the confirmed treatment and laboratory delivery arrangements, so these need not be repeated. Do not add a dose, schedule or course length.
Sources
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