The task
Assume that today's date is 22 October 2026. Mrs Menzies is moving interstate on 14 November 2026.
You are a podiatrist at a private podiatry practice. Mrs Menzies has been your patient since 2021. Using the information in the case notes, write a letter to Mr Kofi Wishart, Senior Podiatrist at the community health centre near her new home, referring Mrs Menzies for ongoing callus care, orthosis review and footwear advice. Address the letter to Mr Kofi Wishart, Senior Podiatrist, Podiatry Department, Community Health Centre, 40 Ocean Road. 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: Mrs Carys Menzies
- DOB: 03/05/1965 (61 yrs)
- Current address: 12 Banksia Street
- Moving interstate 14/11/26 → new address: Unit 5, 28 Harbour Street
- Pt of this practice since 2021
Social background
- Widowed; moving to live near daughter
- Retired primary school teacher; walks approx. 30 min daily with dog
- Enjoys knitting and crosswords
- Pt says daughter's partner is 'difficult' — reason she won't live with them
Medical history
- Rheumatoid arthritis (seropositive) dx 2009; GP arranging new rheumatologist after move
- Meds: methotrexate weekly + folic acid; hydroxychloroquine daily
- Short courses of prednisolone for flares; last course 02/26
- Osteopenia — calcium + vitamin D
- Appendicectomy 1988
- Not diabetic; non-smoker
- Allergy: zinc oxide adhesive tape → contact dermatitis
Podiatry assessment (15/10/26)
- Bilat. forefoot: hallux valgus, subluxed 2nd–4th MTPJs, clawed lesser toes; plantar fat pad displaced distally
- Painful plantar callus under 2nd & 3rd MTP heads bilat., R > L; pain 6/10 on walking before debridement
- Hx superficial ulcer under R 2nd MTP head 03/24 → healed in 6/52 with offloading; nil recurrence
- DP & PT pulses palpable bilat.; protective sensation intact (monofilament)
- Small hard corn dorsum R 2nd toe (shoe pressure on clawed toe)
- Nails NAD
- Skin otherwise intact; no current breakdown
Treatment / progress
- Scalpel debridement of callus q6/52 → pain ↓ to 2/10; tolerated well; no bleeding or skin breakdown
- Custom full-length EVA orthoses with metatarsal domes + shock-absorbing forefoot cushioning; issued 04/25
- Orthoses: top covers worn, cushioning compressed; domes still correctly positioned → need re-cover or replacement
- Usual footwear: extra-depth, wide toe box lace-ups; recently wearing slip-on flats while packing → ↑ forefoot pain
- Applies urea-based emollient to callus areas daily
- Complained that reception overcharged her at last appt
- Asked about cost of new orthoses
Plan
- Last debridement 15/10/26; next due late 11/26
- Refer to podiatry at new community health centre: ongoing callus debridement q6/52, orthosis review/re-cover, footwear advice
- Pt advised: report any skin break, heat, swelling or discharge promptly (immunosuppressed); avoid medicated corn plasters
- Copy of orthosis prescription to be enclosed with letter
Who is reading, and what do they need?
Mr Wishart is a senior podiatrist who has never seen this patient and will take over her care after she moves. He needs the diagnosis, relevant medications and allergy, forefoot findings, treatment response, orthosis condition, footwear problem and when the next debridement is due. Technical terms are fine.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Seropositive RA since 2009; methotrexate weekly, hydroxychloroquine; GP arranging new rheumatologist | Explains the foot pathology and the immunosuppression that makes skin breaks significant. |
| Allergy: zinc oxide adhesive tape → contact dermatitis | Directly affects dressings and padding choices at the new clinic. |
| Hallux valgus, subluxed 2nd–4th MTPJs, clawed lesser toes; callus under 2nd and 3rd MT heads | Describes the deformity and the callus sites to be treated. |
| Superficial ulcer R 2nd MTP head 03/24, healed with offloading; none since | Ulcer history shows the risk if callus is not managed, but with no recurrence. |
| Pulses palpable, protective sensation intact, not diabetic, skin intact | Gives the vascular and neurological baseline and confirms no current breakdown. |
| Debridement q6/52: pain 6/10 before, 2/10 after; last 15/10/26, next due late 11/26 | States treatment interval and response, and the next due date falls after her move, so the new clinic must pick it up. |
| Orthoses issued 04/25: covers worn, cushioning compressed, domes positioned correctly | Supports the request for orthosis review and re-cover or replacement. |
| Slip-on flats while packing → more forefoot pain; report skin break, heat, swelling, discharge | Links footwear to pain and gives the advice she received, which the new clinician should reinforce. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Daughter's partner is 'difficult' — reason she won't live with them | Private family opinion with no clinical relevance. |
| Complained that reception overcharged her at last appt | A billing complaint, not suitable for a clinical referral. |
| Asked about cost of new orthoses | Looks relevant to orthosis review, but it is a funding matter she can raise with the new clinic. |
| Retired teacher; knitting and crosswords; widowed | Social detail that does not alter the podiatric plan. |
| Appendicectomy 1988; nails NAD; osteopenia on calcium and vitamin D | Unrelated or normal findings that add length without helping the next clinician. |
A paragraph plan for this case
Open with the referral request and the move date, then give her rheumatoid arthritis, medications and allergy. Follow with forefoot findings and treatment response, then orthosis and footwear issues, ending with timing of the next debridement and the enclosure.
Where candidates slip on this task
- The next debridement is due in late November 2026, after the move on 14 November, so make clear the new clinic will need to arrange it; do not suggest it is already booked.
- Include the zinc oxide tape allergy clearly, because it affects padding and dressings. Leaving it out is a patient-safety omission even though it sits among general history.
- Report the skin-break advice completely (skin break, heat, swelling or discharge) together with avoiding medicated corn plasters, and do not claim she is diabetic or that she has current ulceration.
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 Podiatry letter tasks
- Suspected acute Charcot foot – urgent referral referral letter
- Falls-risk foot assessment – older woman update letter
- Aged care resident – suspected peripheral arterial disease update letter
Your profession's guide: OET Podiatry. Layout and structure: OET letter format.
Questions about this task
Should I mention the small corn on the right second toe?
Yes, briefly. It is linked to shoe pressure on a clawed toe, which supports the footwear advice request. It is a secondary finding, so give it less space than the plantar callus.
Do I need to state the date of the prescription enclosure?
No. The notes only say a copy of the orthosis prescription is enclosed. Mention the enclosure and the 04/25 issue date of the orthoses, and do not invent details of the prescription.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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