The task
Assume that today's date is 22 October 2026. You saw Mr Ingleby this morning for his routine nail care and telephoned Dr Shevchenko about your findings straight afterwards.
You are the podiatrist who visits the residential aged care facility where Mr Ingleby lives. Using the information in the case notes, write a letter to his GP, Dr Daria Shevchenko, to confirm today's telephone discussion. Update her on your findings and request same-day contact with the vascular service for urgent triage of suspected limb-threatening ischaemia. Address the letter to Dr Daria Shevchenko, Visiting General Practitioner, Residential Aged Care Facility, 42 Hill Street. 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: Update letter.
Case notes
Patient details
- Name: Mr Kurt Ingleby
- DOB: 03/05/1940 (86 yrs)
- Resident since 2024, Room 14
- GP: Dr Daria Shevchenko (visits facility weekly)
Social background
- Widower; moved into care after wife's death 2024
- Smoker: approx. 15 cigs/day × 65 yrs; goes outside to smoke unaided
- States he is 'too old to quit'; declined nicotine replacement in past
- Mobilises independently with 4-wheeled walker
- Enjoys watching cricket; reads daily newspaper
- Daughter visits weekly; she and her brother disagree over sale of family home
Medical history
- Hypertension: amlodipine 5 mg mane
- Hypercholesterolaemia: declined statin 2023
- COPD: tiotropium inhaler daily
- OA both knees: regular paracetamol
- Bilat cataract surgery 2019
- Not diabetic (HbA1c normal 06/26)
- Allergies: penicillin (rash)
- Cognition intact; makes own decisions
Podiatry visit 22/10/26 (routine 3-monthly nail care)
- Nails thickened; L hallux onychogryphosis; debrided, no bleeding
- Both feet cool, shiny, hairless, L > R; capillary refill delayed L toes
- DP & PT pulses not palpable bilat (last visit 07/26: faint but palpable)
- Hand-held Doppler: monophasic signals bilat; ABI R 0.68, L 0.55
- Graze dorsum L 2nd toe 0.6 × 0.4 cm; approx. 4/52 (knocked on bed frame); not healing
- Wound base pale, dry; no erythema, exudate or odour
- Calf pain after walking approx. 20 m, relieved by rest (approx. 6/12); no rest pain
- Protective sensation intact (10 g monofilament)
- Says previous podiatrist was 'rough'; asked not to be seen by them again
Treatment
- Wound cleaned with NaCl 0.9%; non-adherent dressing applied
- Care staff to inspect feet daily and change dressing 2nd daily
- Advised: no hot water bottles/heat packs on feet; loose socks, well-fitting shoes
- Smoking cessation discussed; pt unwilling at present
Plan
- ?Chronic limb-threatening ischaemia: GP phoned today; GP to contact vascular service same day for urgent triage; arterial duplex US must not delay referral
- GP to review cardiovascular risk mx (e.g. antiplatelet, statin)
- Staff instructed: sudden new/worsening pain, pallor, coldness, numbness or weakness → call 000, immediate ED transfer & vascular assessment; wound deterioration/infection → prompt medical r/v according to severity
- Podiatry r/v 2/52 (wound check)
Who is reading, and what do they need?
Dr Shevchenko is the visiting GP who already took your phone call today. She needs to act on the vascular contact and cardiovascular risk review. She does not need a full podiatry visit record. She needs the objective findings behind the concern, what staff are doing, and the action requested of her.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| ABI R 0.68, L 0.55; monophasic Doppler signals bilaterally | These are the objective measurements supporting the suspicion and the urgency of the request, so the GP can pass them on to the vascular service. |
| DP and PT pulses not palpable bilaterally; faint but palpable in 07/26 | Shows a change since the last visit, which supports the concern and gives the GP a clear comparison. |
| Feet cool, shiny, hairless, L > R; delayed capillary refill L toes | Supports the left foot as the more affected side and backs up the Doppler results. |
| L 2nd toe graze 0.6 × 0.4 cm, about 4/52, not healing, pale dry base | The non-healing wound is the key clinical concern. Including the absence of erythema, exudate and odour tells the GP there are no infection signs today. |
| Calf pain after walking about 20 m, relieved by rest, about 6/12; no rest pain | Gives symptom history and a duration, and the lack of rest pain is relevant to how the GP judges the picture. |
| GP to contact vascular service same day; duplex US must not delay referral | This is the request the letter exists to make, with the caution about the duplex scan. |
| Smokes about 15 cigarettes a day; declined statin 2023; GP to review antiplatelet, statin | Links the risk factors to the cardiovascular review you are asking the GP to do, and shows smoking cessation was discussed but he is unwilling at present. |
| Staff told to call 000 for the listed new or worsening symptoms; review in 2/52 | Tells the GP what the facility has been instructed to do and when you will see him again. List every symptom in the notes if you mention them. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Daughter and brother disagree over sale of family home | Family conflict has no bearing on the vascular referral or the GP's actions. |
| Says previous podiatrist was 'rough'; asked not to see them again | Trap: it looks like a patient preference to pass on, but it is unrelated to the clinical question and the urgent request. |
| Widower, enjoys cricket, reads daily newspaper | Background that does not change the management or the GP's actions. |
| Bilateral cataract surgery 2019 | Not related to limb perfusion or the decisions requested. |
| Nail thickening and L hallux onychogryphosis debrided, no bleeding | Routine care that can be compressed to a brief mention at most. The ischaemia findings are the purpose. |
| Protective sensation intact; not diabetic | Only a brief mention, if any, is needed. It is secondary to the perfusion findings and does not drive the request. |
A paragraph plan for this case
Open with the purpose: confirming today's call and the request. Then give the key findings (pulses, Doppler, wound, symptoms) with relevant history and risk factors. Close with the actions: what has been done and told to staff, what you ask of the GP, and the 2-week review.
Where candidates slip on this task
- Present the diagnosis as suspected (the notes use a question mark), not confirmed, and use the notes' wording for time spans such as 4/52 and 6/12 without altering them.
- If you mention the emergency instructions to staff, give the full list of symptoms and the 000 action together, plus the separate pathway for wound deterioration or infection. Do not shorten it.
- State clearly that the vascular contact is the GP's task today and that the duplex scan must not delay it, so the request is not buried under the findings.
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
- Falls-risk foot assessment – older woman update letter
- Rheumatoid forefoot – continuity of care after relocation referral letter
- Suspected acute Charcot foot – urgent referral referral letter
Your profession's guide: OET Podiatry. Layout and structure: OET letter format.
Questions about this task
Should the letter explain the reason for the visit?
Only briefly. The visit was routine 3-monthly nail care, but the letter confirms a call about unexpected findings. Mention the context in a few words and spend the word count on the findings and the request.
Do I include the wound dressing plan?
Yes, briefly. The GP benefits from knowing the wound was cleaned, dressed with a non-adherent dressing, and that staff check the feet daily and change the dressing every second day. Keep it short.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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