OET Writing: How to Write a Letter That Scores B in 2026

In short: the OET Writing sub-test gives you case notes and asks you to write a letter - usually a referral, discharge or transfer letter - of about 180 to 200 words in 45 minutes. Scoring B is not about beautiful English; it is about selecting the right information, transforming notes into accurate prose, and organising a letter another clinician can act on. WispGold is an independent exam-preparation provider and is not affiliated with, endorsed by, or an official representative of the OET or CBLA. Confirm current formats and score requirements on the official OET website.

Start by understanding what the task actually assesses. The six criteria - purpose, content, concision and clarity, genre and style, organisation and layout, and language - are weighted, and purpose plus content carry the most marks. That means the single biggest scoring decision is made in the first two minutes: identifying why you are writing and who will read the letter. A referral to a cardiologist, a discharge letter to a community nurse and a transfer summary to a care home each select different details from the same case notes.

Selection is the skill candidates underestimate. The notes deliberately contain more information than the letter needs, including one or two distractors. Include what the recipient needs to act: reason for referral or current status, relevant history and medications, key findings, what has already been done, and the specific request. Exclude social details that serve no clinical purpose, past events the recipient cannot act on, and everything already known to the reader. A B-level letter is noticeably shorter and sharper than a C+ letter that copies every line.

Transform, do not transcribe. Notes are fragments - "BP 148/92, hx T2DM 6 yrs, on metformin" - and your letter is continuous prose in full sentences with correct tense and voice. The most common transformation errors are tense mistakes (a past admission written in the present), dropped negatives ("no known allergies" becoming "allergies unknown", a serious clinical error), and copied abbreviations the recipient may not share. Spell out anything ambiguous, and double-check every number: doses, dates and readings must match the notes exactly.

Structure the letter the way the recipient will read it. Open with a purpose statement that names the patient, the reason for writing and what you are asking for, then move through relevant history and findings, current status and management, and close with the request plus an offer to discuss further. Use short paragraphs with one topic each. Organisation is a scored criterion, and a letter that buries its request in the final sentence loses marks it cannot afford.

Register and tone must sound like a professional writing to a colleague. Neutral, courteous and precise: "I would be grateful for your assessment of..." rather than "Please can you see him asap!!!". Avoid emotive language about patients, avoid chatty openers, and never address the reader by first name. Genre and style is marked separately from language, so correct grammar in the wrong register still costs marks.

The timing plan decides the outcome. Spend five minutes reading the notes and underlining what the specific recipient needs, thirty minutes writing, and ten minutes checking against a fixed list: purpose stated, no negatives dropped, tenses right, numbers accurate, request clear. Candidates who write until the bell and check nothing lose their easiest marks in the last ten minutes - most checkable errors are mechanical, not linguistic.

Prepare by writing real letters, not by reading tips. Take one set of case notes and write the same letter three ways - to a specialist, to a district nurse, to a family carer - and notice how selection changes with the reader. Then get each draft marked against the OET criteria, because self-marking reliably overestimates concision and organisation. Two or three marked letters a week for six weeks moves most B- or C+ candidates to a comfortable B, which is the level most registration bodies ask for.

The letter that scores B is not the longest or the most sophisticated - it is the one the reader can act on without re-reading. Choose the purpose, select ruthlessly, transform accurately and check mechanically. Our OET course includes weekly marked letters with criterion-by-criterion feedback, so you always know which of the six areas is holding your grade.