The task
Assume that today's date is 21 October 2026. Ms Mellor has just had her final session with you and moves to Brisbane on 1 November 2026.
You are a physiotherapist at an outpatient sports physiotherapy clinic in Melbourne. Using the information in the case notes, write a letter to Ms Morag Sinclair, a sports physiotherapist in Brisbane, referring Ms Mellor for continuation of her staged rehabilitation. Address the letter to Ms Morag Sinclair, Sports Physiotherapist, Sports and Exercise Physiotherapy, Level 1, 88 River Road, Toowong QLD 4066. 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: Referral letter.
Case notes
Patient details
- Name: Ms Natalie Mellor
- DOB: 03/08/1992 (34 yrs)
- Address until 31/10/26: 12 Elm Street, Brunswick VIC
- New address from 01/11/26: Unit 5, 30 Park Road, Milton QLD
- First physio appt 22/07/26; 22 sessions attended
Social background
- Accountant; transferring to Brisbane office, starts 03/11/26
- Netball (goal defence), state league; in season trains 3×/wk + weekly match
- Goal: return to competitive netball for 2027 season (starts March 2027)
- Lives with partner; partner staying in Melbourne until Dec
- Mother (attends some sessions) says pt 'too impatient, will wreck knee again'
- Enjoys gardening and reading
Medical history
- Mild asthma — salbutamol PRN; well controlled
- L ankle sprain 2019 — fully recovered
- Allergies: nil known
- R knee injury 12/05/26: non-contact, pivoting on landing during netball match
- MRI: complete R ACL rupture; small lateral meniscus tear
Surgery
- 15/07/26 R ACL reconstruction — hamstring (semitendinosus-gracilis) autograft + partial lateral meniscectomy
- Orthopaedic surgeon reviews 6/52 & 12/52: no restrictions; progress per protocol
- Pt complained to reception about clinic car parking fees
Assessment 21/10/26 (14/52 post-op)
- No effusion (stroke test 0); pain 0–1/10 after exercise
- R knee ROM: full extension; flexion 135° (L 145°)
- Quadriceps strength (handheld dynamometry): R = 72% of L
- Hamstring strength (handheld dynamometry): R = 78% of L
- Single-leg squat: mild dynamic knee valgus R
- Straight-line jogging since 12/52: 2 × 10 min, symptom-free
Current programme
- Gym 3×/wk: progressive quads & hamstring strengthening (leg press, split squats, bridges)
- Balance/proprioception; double-leg jump and landing drills
- Adherence good; home programme 2×/wk
Return-to-sport criteria (discussed with pt)
- Not before 9/12 post-op (i.e. not before mid-April 2027)
- Quads & hamstring strength ≥ 90% of uninjured side; hop test battery ≥ 90%
- Also: good landing/change-of-direction mechanics, full team training symptom-free, psychological readiness (ACL-RSI questionnaire)
- Pt understands she will miss the March season start; disappointed but accepting
Plan
- Refer to sports physio in Brisbane to continue staged rehab from early Nov
- Next stage: progress strength & running volume; introduce single-leg plyometrics, then agility/change of direction when criteria met; address valgus control
- Hop testing & ACL-RSI when strength improves; ongoing injury prevention programme after return to netball
- Copies of op report and strength test results enclosed
Who is reading, and what do they need?
Ms Sinclair is a Brisbane sports physiotherapist who has not met the patient and will take over a staged ACL programme from early November. She knows protocols and terminology, so she needs measured baselines, current exercises, the agreed return-to-sport criteria and what comes next, not general background or personal detail.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| 15/07/26 R ACL reconstruction, hamstring autograft + partial lateral meniscectomy | Tells the receiving physio the graft and meniscal procedure being rehabilitated; the surgeon's 6/52 and 12/52 reviews set no restrictions, so progression follows protocol. |
| No effusion; pain 0–1/10 after exercise; full extension, flexion 135° (L 145°) | Gives an objective baseline at 14/52 post-op so the new physio can compare findings and judge progression. |
| Quadriceps R = 72% of L; hamstrings R = 78% of L | These dynamometry results show the gap to the 90% strength criterion and justify the strength progression requested. |
| Single-leg squat: mild dynamic knee valgus R | Supports the plan item to address valgus control; the receiving physio must know the finding, stated as recorded without any added sequencing. |
| Jogging 2 × 10 min symptom-free since 12/52; gym 3×/wk, balance, double-leg landing drills | Shows what she currently tolerates so the next stage starts from the right point; adherence is good, with home programme twice weekly. |
| Return-to-sport: not before 9/12; strength and hop ≥90%; mechanics; training; ACL-RSI | All the listed criteria were discussed with her and are the targets for the next physio; she understands she will miss the March season start. |
| Next: progress strength and running; single-leg plyometrics, then agility when criteria met | This is the core request. Keep the conditional wording of the notes, including hop testing and ACL-RSI once strength improves. |
| New address from 01/11/26 in Milton; op report and strength results enclosed | Lets Ms Sinclair contact her after the move and tells her which documents accompany the referral. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Mother says she is 'too impatient, will wreck knee again' | Third-party opinion, not a clinical finding; the notes record good adherence. Looks relevant to compliance but would misrepresent the patient. |
| Complained to reception about clinic car parking fees | An administrative complaint with no bearing on rehabilitation or the receiving clinic. |
| L ankle sprain 2019, fully recovered | Resolved, unrelated to the right knee; no effect on the next stage. |
| Gardening, reading, partner staying in Melbourne until December | Personal and social detail that does not change the rehabilitation plan. |
| Mild asthma, salbutamol PRN, well controlled | Trap: it is medical history, but the notes link it to nothing in rehab. Omit or reduce to a very brief mention. |
A paragraph plan for this case
Open with the purpose of the referral, her move on 1 November, and the surgery with its date. Use the middle paragraph for current findings and programme, then the return-to-sport criteria. Close with the requested next stage, enclosures and her new contact address.
Where candidates slip on this task
- State the valgus finding and the plan to address valgus control exactly as recorded. Do not add any ordering relative to landing or agility work; double-leg landing drills are already in her programme.
- Include every return-to-sport criterion, not just strength, and keep the notes' timing of not before mid-April 2027. Do not suggest she will definitely be ready by then.
- Report strength as percentages of the uninjured side and do not claim hop test results; hop testing and ACL-RSI are planned for when strength improves. Avoid adding trends or targets beyond the notes.
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 Physiotherapy. Layout and structure: OET letter format.
Questions about this task
Should the letter mention she will miss the March season start?
Yes, briefly. The notes say she understands she will miss it and is disappointed but accepting, which links her 2027 goal to the criteria-based timeline. Leave out her mother's comments about impatience.
Which findings show she is not yet ready to return to sport?
Quadriceps at 72% and hamstrings at 78% against the 90% target, mild dynamic valgus on single-leg squat, and hop testing and ACL-RSI still to be done. Present them as findings, not as predictions.
Sources
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