One of the biggest challenges in OET Writing is deciding which case notes the reader needs and which can be left out.
You may receive extensive information about a patient, including medical history, symptoms, investigations, treatment, medication, previous consultations and follow-up plans. However, your task is not to reproduce the complete medical record. You need to select and organise the information that helps the specific reader understand the situation and take appropriate action.
During the five-minute reading period, identify:
- Who are you writing to?
- Why are you writing?
- What does the recipient need to do?
These questions establish the purpose of the letter and provide the basis for selecting information.
Classify Information by Usefulness
Relevant information
Relevant information directly supports the purpose of the letter. It helps the recipient understand the current problem, make a clinical decision or provide appropriate care.
This may include:
- the current problem and its progression
- significant symptoms and findings
- relevant investigation results
- treatment already provided
- medication affecting care
- important risks or precautions
- the patient’s current status and
- the requested follow-up or action.
For example, in a referral for worsening knee pain, the duration and progression of the pain, examination findings, imaging results, previous treatment and effect on mobility are likely to be important.
Semi-relevant information
Some details provide useful background but are not central to the letter. Their value depends on the recipient, the purpose of the referral and their connection to the current problem.
For example, a history of osteoarthritis may be useful in a referral for chronic knee pain but unnecessary in a letter about an unrelated acute condition.
Include such information briefly only when it adds meaningful context or affects treatment and decision-making. It should not displace more important clinical details.
Irrelevant information
Information is irrelevant when it does not help the recipient understand the current situation or take the requested action.
This may include:
- unrelated past conditions;
- unnecessary social or family history
- information outside the recipient’s role
- facts the recipient already knows
- repeated details and
- old events that do not affect current management.
For example, a remote ankle injury is unlikely to be useful in a referral for a new respiratory problem unless it affects the patient’s current care.
Relevance Depends on the Task
The same detail may be useful in one letter and unnecessary in another.
A patient’s diabetes may be:
- Relevant in a referral for poor wound healing because it affects management
- Less important in a letter about another condition if it provides only limited background
- Irrelevant in an administrative letter where no clinical decision depends on it
Do not judge information solely by how serious or medical it appears. Consider its practical value to the particular reader.
A useful question is:
Will this detail help the recipient provide care or take the requested action?
If the answer is no, it probably does not belong in the letter.
Keep, Compress or Cut
After identifying potentially useful information, decide how much space each detail deserves.
Keep
Include information the reader needs to understand the situation or act appropriately.
Compress
Summarise information that is useful but repetitive or less important. This may include several related symptoms, repeated consultations, similar treatments, medication changes or a lengthy connected history.
Instead of describing every consultation separately, explain the overall progression and what led to the current referral.
Cut
Remove information that does not support the purpose of the letter, including unrelated history, unnecessary background and repeated facts.
This approach helps you avoid two common problems: omitting information the reader needs and including so much background that the main message becomes difficult to find.
Avoid Writing a Chronological Medical Record
Case notes may describe an initial presentation, investigations, treatment, follow-up and later deterioration. You do not need to reproduce this sequence in full.
Focus on the current situation and the developments that explain the requested action. Group related information rather than following the notes line by line.
A clear structure might be:
- reason for writing and current situation
- relevant history, symptoms and findings
- investigations and treatment
- current status and requested action
The exact structure will depend on the task, but each paragraph should contribute to the purpose of the letter.
Consider What the Reader Already Knows
If the recipient has already been involved in the patient’s care, repeating the entire background may be unnecessary. Focus on what has changed, why the change matters and what the recipient needs to do next.
In contrast, a professional taking over the patient’s care may need more background. The amount of information required therefore depends partly on the relationship between the writer and recipient.
Preserve Accuracy When Summarising
Concise writing must still reflect the case notes accurately. Pay particular attention to uncertainty.
For example:
Case note:
? pneumonia
Do not write:
“The patient has pneumonia.”
Instead, write:
“Pneumonia is suspected.”
Do not turn a possible diagnosis into a confirmed one simply because a definite statement sounds more professional.
Also, convert notes into complete sentences rather than copying them directly.
Case note:
SOB on exertion – 2 weeks – worsening
Letter:
She has experienced worsening shortness of breath on exertion for the past two weeks.
Do Not Write Just to Reach the Word Count
OET recommends 180–200 words for the body of the letter, but this is a guide rather than a target to fill at all costs.
If your letter is too long, check whether you have included excessive history, repeated information, described every consultation separately, repeated facts the recipient already knows or added details that are merely interesting.
If your letter is shorter, do not add irrelevant information. Check instead that you have covered the details needed to support the purpose of the letter.
A Five-Minute Selection Method
- Read the task first. Identify the recipient, purpose and required action.
- Identify the current situation. Skim the notes to understand what is happening now.
- Mark the information that supports the purpose. Note which details explain the problem, affect management or support the requested action.
- Combine related details. Group repeated consultations, symptoms or treatments into concise summaries.
- Remove information with no clear purpose. Exclude unrelated history and unnecessary background.
- Organise the letter logically. Present the selected information in a way that makes the current situation and required action easy to understand.
Example
Imagine a patient is being referred to a respiratory specialist for worsening breathlessness. The notes include:
- worsening shortness of breath for two weeks
- reduced exercise tolerance
- an abnormal chest X-ray
- inhaler treatment with limited improvement
- a previous asthma diagnosis
- a childhood ankle fracture; and
- a family history of hypertension.
The likely selection is:
- Include: worsening breathlessness, reduced exercise tolerance, abnormal chest X-ray and limited response to treatment.
- Consider briefly: previous asthma, if it affects the specialist’s assessment.
- Leave out: the ankle fracture and family history of hypertension, if they have no bearing on the respiratory referral.
The selection could change in another task because the purpose and recipient might be different.
Final Principle
The case notes are not a script to reproduce. They are a source of information from which you must construct a focused professional letter.
Select the details that support the reader’s needs, summarise connected information and remove anything that does not contribute to the purpose.
The goal is not to include everything. It is to communicate the right information clearly, accurately and efficiently
Read out Recent Blog – “7 Grammar Mistakes That Lower Your OET Writing Score And How to Fix Them” – to ensure your journey stays on track.
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