The task
Assume that today's date is 5 November 2026. It is 11:45. Quique Valentin is awaiting the ambulance arranged for immediate hospital assessment. This is original independent practice material; all patient-specific findings, reports and arrangements are fictional.
You are the general practitioner assessing Quique Valentin today. Using the case notes, write a transfer letter to Dr Maristela Solsona, Paediatric Receiving Doctor, Emergency Paediatric Service, 24 High Street. Request urgent assessment and management of suspected type 1 diabetes, distinguishing the conflicting accounts of symptom onset from your verified findings. 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?
Suspected type 1 diabetes in a child: transfer
You are the general practitioner assessing Quique Valentin today. Using the case notes, write a transfer letter to Dr Maristela Solsona, Paediatric Receiving Doctor, Emergency Paediatric Service, 24 High Street. Request urgent assessment and management of suspected type 1 diabetes, distinguishing the conflicting accounts of symptom onset from your verified findings. 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: Quique Valentin; male
- DOB: 18/06/2017; 9 yrs
- GP assessment: 05/11/26, 11:20; mother present
Social background
- Lives with mother; attends primary school
- Enjoys drawing animals and collecting stickers
- Mother complains that school receptionist is rude
- Family planning a birthday picnic for his cousin
Medical history
- Previously well; no known diabetes
- No regular medicines
- No known drug allergies
- Grommets aged 4; no ongoing ear problems
Reported symptoms
- Mother: ↑ thirst/nocturia for 3 days only; denies earlier symptoms
- Mother: bedwetting twice this week; previously dry overnight
- Mother: no vomiting or abdominal pain
- School's written report: frequent toilet visits/water-bottle refills for 2/52
- School report: tired during lessons this week
- School did not measure fluid intake or urine volume
- Mother disputes school's earlier symptom timing
- School: looks thinner; weight loss unconfirmed
Current assessment
- Weight 28 kg today; no previous measurement available
- Clinic capillary blood glucose: 18.6 mmol/L
- Fresh urine tested here: glucose 3+, ketones 1+
- Temperature 36.8°C
- Alert, conversing normally; breathing unlaboured, no deep respirations
- Pulse 98/min; BP 104/66 mmHg
- Respiratory rate 20/min
- Mildly dry oral mucosa; abdomen soft, non-tender
Assessment and transfer plan
- Suspected T1DM; DKA not excluded — blood gas unavailable here
- No insulin or IV fluids given
- 11:40: Dr Maristela Solsona accepted immediate assessment/treatment; ambulance transfer arranged
- Mother accompanying; child remains supervised in clinic until handover
- Mother understands urgent hospital assessment needed; school report accompanying letter
Who is reading, and what do they need?
Dr Solsona is the paediatric receiving doctor who accepted immediate assessment and treatment at 11:40. She needs a concise handover for a nine-year-old boy: verified findings, conflicting maternal and school histories, and transfer arrangements. Identify Quique Valentin and the 11:20 GP assessment, but prioritise information supporting urgent assessment over routine background.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Suspected T1DM; DKA not excluded; blood gas unavailable here. | Establishes the urgent assessment purpose and the unresolved diagnostic concern requiring hospital investigation. |
| Mother: thirst/nocturia for three days only, denies earlier symptoms and disputes school timing. | Preserves the mother's account without choosing between conflicting histories; her explicit disagreement can be compressed. |
| School: frequent toilet visits/water-bottle refills for two weeks; intake and urine volumes unmeasured. | Provides the contrasting timeline while distinguishing observed behaviour from measured fluid intake or urine output. |
| Clinic capillary blood glucose: 18.6 mmol/L. | Provides a verified finding central to the suspected diagnosis and urgent transfer. |
| Fresh urine tested in clinic: glucose 3+, ketones 1+. | Supplies verified glycosuria and ketonuria relevant to immediate assessment, without establishing DKA. |
| Alert, conversing normally; breathing unlaboured, no deep respirations; mildly dry mouth; soft, non-tender abdomen. | Communicates the observed presentation; the oral and abdominal findings add useful detail if space permits. |
| 11:40: Dr Solsona accepted immediate assessment/treatment; ambulance transfer arranged. | Confirms the agreed urgent handover and transport arrangement without suggesting transfer has already occurred. |
| No insulin or IV fluids given; no regular medicines; no known drug allergies. | Clarifies treatment before transfer; medication and allergy details provide concise, optional prescribing context. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Enjoys drawing animals and collecting stickers. | These interests do not help the receiving doctor assess the acute presentation or continue care. |
| Mother complains that the school receptionist is rude. | The complaint does not resolve the clinical timeline and could distract from neutral attribution of the school report. |
| Family planning a birthday picnic for his cousin. | The planned event has no stated bearing on immediate hospital assessment or transfer. |
| Grommets aged four; no ongoing ear problems. | Although medical history can appear relevant, this resolved ear issue does not assist the urgent diabetes assessment. |
| Lives with mother; attends primary school. | Usually omit or compress because identifying the mother and school as information sources already supplies sufficient context. |
A paragraph plan for this case
Open with Quique's identifiers, the 11:20 assessment, urgent purpose, verified glucose and urine results, and current clinical state; temperature 36.8°C, pulse 98/min, BP 104/66 mmHg and respiratory rate 20/min are optional supporting observations. Next, attribute the conflicting onset accounts, using bedwetting twice this week and classroom tiredness only if helpful; previously well with no known diabetes provides brief context. Close with the 11:40 acceptance, ambulance arrangement, treatment not given and mother accompanying while he remains supervised until handover; her understanding and the accompanying school report may be compressed.
Where candidates slip on this task
- Do not reconcile the mother's three-day account with the school's two-week account into one duration; attribute both and avoid presenting the school's observations as measured fluid intake or urine output.
- The school's impression that Quique looks thinner does not establish weight loss: today's 28 kg has no previous measurement for comparison, so avoid claiming a change.
- Maternal absence of vomiting or abdominal pain, normal conversation and unlaboured breathing do not exclude DKA; preserve the diagnostic uncertainty and the unavailability of a blood gas.
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
How should the conflicting symptom timelines be handled?
Use explicit attribution for the mother's three-day history and the school's written two-week observations. Do not select a single onset date or suggest either source is unreliable. The mother's dispute can be compressed because presenting both attributed accounts already makes the discrepancy clear.
Must every normal finding and background detail be included?
Prioritise the glucose and urine findings, alertness and breathing observations, unresolved DKA concern, and agreed immediate transfer. Other vital signs, negative symptoms and background history can support the handover when space permits. Their relevance does not make every detail necessary within the short letter.
Sources
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