OET Writing sample (medicine)

OET referral letter sample for doctors

Referral letters are the backbone of OET Writing for doctors. The reader is a specialist who has never met your patient and needs to decide how quickly to see them. This page gives you an original GP practice task, a model letter, a table showing which notes earn their place, and tips that apply to almost any referral.

The case notes

Read these notes as you would in the exam: five minutes, no writing. Try to identify the reason for referral, the level of urgency and the two or three facts the specialist would most want to know.

MEDICINE — WRITING TASK (practice)

Time allowed: Reading time 5 minutes, Writing time 40 minutes

Notes:
Today's date: 11/09/2026
You are a GP at Parkview Medical Practice, 18 Station Lane, Westford.
Patient: Mr Tomasz Nowak, DOB 22/06/1965 (61 yrs)

Social background:
- Warehouse supervisor, full-time. Married, 2 adult children
- Non-smoker. Alcohol approx. 10 units/week (beer, weekends)
- Keen cyclist; recently stopped cycling to work due to tiredness

Family history:
- Father: colorectal cancer, dx age 68 (died 2009)
- Mother: 85, hypertension

Medical history:
- Hypercholesterolaemia (2019), atorvastatin 20 mg nocte
- Osteoarthritis R knee, ibuprofen 400 mg PRN (approx. 2–3×/week)
- Appendicectomy age 19
- Bowel screening kit sent 2024, not returned
- NKDA

Consultation notes:
21/08/2026
- c/o fatigue × 3 months, SOB on exertion (cycling)
- Loose stools 3–4/day × 6 weeks (previously once daily). No blood seen
- Wt 84 kg (Feb 2026: 89 kg), unintentional
- O/E: pale conjunctivae. BP 128/78, HR 92 reg. Abdo soft,
  non-tender, no masses. PR: no masses, brown stool
- Plan: FBC, iron studies, U&E, LFT, TFT, coeliac serology, FIT

28/08/2026 (results)
- Hb 98 g/L (130–170), MCV 71 fL (low), ferritin 6 µg/L (low)
- U&E, LFT, TFT normal. Coeliac serology negative
- FIT 156 µg Hb/g (positive)
- Pt informed; possible bowel bleeding discussed
- Stop ibuprofen → paracetamol 1 g QID PRN for knee
- Ferrous sulfate 200 mg daily commenced

11/09/2026
- Stools still loose 3–4/day. Fatigue unchanged. Wt 83 kg
- Tolerating iron, mild nausea
- Pt worried re father's history; wife anxious
- Annual leave from 05/10 (3 weeks, visiting family abroad)
- L lateral elbow pain after lifting boxes, advised rest

Plan:
- Urgent referral to gastroenterology: colonoscopy ± OGD
- Continue ferrous sulfate; repeat FBC in 4 weeks
- Safety-netting: urgent review if rectal bleeding, black stools,
  severe abdominal pain or chest pain

Writing Task:
Using the information in the case notes, write a letter to Dr Anjali
Rao, Consultant Gastroenterologist, Eastbrook University Hospital,
210 Harbour Street, Eastbrook, referring Mr Nowak for urgent
investigation.

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.

What makes this a referral, not a summary

A referral letter has one job: to get the right patient seen by the right specialist at the right speed. Dr Rao does not need Mr Nowak's life story. She needs to know why you are worried (iron-deficiency anaemia, a positive faecal immunochemical test, a change in bowel habit and weight loss in a man over 60 with a family history of colorectal cancer), what you have already excluded, what you have started, and whether there is any reason to see him sooner. Those four headings become your paragraphs.

Model letter

Dr Anjali Rao
Consultant Gastroenterologist
Eastbrook University Hospital
210 Harbour Street
Eastbrook

11 September 2026

Dear Dr Rao,

Re: Mr Tomasz Nowak, DOB 22/06/1965

I am writing to refer Mr Nowak, a 61-year-old man with iron-deficiency anaemia, a positive faecal immunochemical test (FIT) and a change in bowel habit, for urgent investigation, including colonoscopy.

Mr Nowak presented on 21 August with a three-month history of fatigue and exertional breathlessness. He also reported six weeks of loose stools three to four times daily, without visible blood, and an unintentional weight loss of 5 kg since February. Apart from pallor, his examination, including rectal examination, was unremarkable.

Investigations showed a haemoglobin of 98 g/L, MCV of 71 fL and ferritin of 6 µg/L, and his FIT result was 156 µg Hb/g. Renal, liver and thyroid function and coeliac serology were normal. Notably, his father was diagnosed with colorectal cancer at 68.

I have replaced his intermittent ibuprofen with paracetamol and started ferrous sulfate 200 mg daily. Despite this, his symptoms persist and he has lost a further kilogram. He also takes atorvastatin and has no known allergies.

Mr Nowak is understandably anxious and will be abroad for three weeks from 5 October, so I would be grateful if he could be seen before then.

Yours sincerely,

Dr Sam Whitfield
General Practitioner
Parkview Medical Practice

What the model does well

• The first sentence carries the whole referral. Age, key findings, urgency and the requested investigation all appear before the reader has to scroll.
• Results are grouped. Abnormal results come first; normal results are compressed into one sentence because they matter only as exclusions.
• Family history is placed where it strengthens the concern, immediately after the results, rather than in a separate background paragraph.
• Management so far is stated clearly, including stopping the NSAID, which a gastroenterologist would want to know.
• The closing paragraph gives a concrete timing request linked to a real constraint, rather than a generic "please see him soon".

Content selection table

This selection is a guide, not an official answer key. Assessors consider whether your choices suit the reader and whether the essential information is accurate.

Tips specific to OET referral letters

Put urgency in the opening, not only the closing

If the notes say "urgent", the word should appear in your first paragraph. A specialist triaging referrals reads the opening lines first. Repeat the timing request at the end with the practical reason.

Lead with abnormal findings

Candidates often reproduce results in the order they appear in the notes. Reorder them: abnormal values that justify the referral first, relevant normal results grouped afterwards as exclusions.

Use medical language at specialist level

Writing to a consultant, you can use terms such as "iron-deficiency anaemia", "exertional breathlessness" and "unremarkable". You should still avoid note-form abbreviations like "c/o", "O/E" and "PR NAD". Expand abbreviations such as FIT on first use unless they are universally understood.

Say what you have already done

Specialists want to avoid repeating tests and need to know about medications that could influence findings. One or two sentences on management so far prevents wasted appointments and shows clinical reasoning.

Do not diagnose on the specialist's behalf

You can express concern ("to exclude colorectal malignancy") but avoid stating a diagnosis the notes do not confirm. Tentative, professional language fits the genre better.

Watch your word budget

Referral notes for doctors often include long lists of results. If you copy every value you will exceed the recommended length quickly; see the OET word count guide and the letter format guide for layout that saves words without losing clarity.

Common weaknesses in practice answers to this task

• Opening with "I am writing regarding Mr Nowak who has anaemia" and no mention of urgency or colonoscopy.
• Including cycling, beer consumption, the appendicectomy and the elbow pain, which pushes the family history to the end.
• Listing every blood test, including normal ones, with abbreviations and no interpretation.
• Forgetting the leave date, which is the only reason the specialist might offer an earlier appointment.
• Slipping into note form in the results paragraph, for example "Hb 98, ferritin low, FIT positive".

The checker preloads a practice letter containing several of these weaknesses so you can see how they affect each criterion estimate.