OET Writing Grammar

OET Grammar Reflex Dr. Wasim School of Medical Education

🧠 Present Perfect Reflex for OET Writing

🎯 MASTER RULE

Use present perfect when a condition, symptom, treatment, habit, or problem started in the past and continues up to now.
In OET letters, this is common with for, since, and over the past / over the last.

📌 THREE COMMON PRESENT PERFECT FORMS IN OET LETTERS

Present Perfect Simple

Present Perfect Progressive

Present Perfect Passive

Form: has/have + V3

• I have treated Mr Smith for 3 years.

• He has had diabetes since 2010.

Form: has/have been + -ing

• I have been treating Mr Smith for 3 years.

• He has been complaining of back pain since last week.

Form: has/have been + V3

• Mr Smith has been treated at this hospital for 3 years.

• The medications have been reviewed.

⏱️ TIME MARKER REFLEX — FOR / SINCE / OVER

FOR = duration

SINCE = starting point

OVER = change / repeated event

Use for a period of time.

• for 3 years

• for 6 months

• for 5 hours

• for the past 25 years

Use for the start of the period.

• since 2007

• since January

• since 10 am

• since last week

Use for change or repeated events.

• has deteriorated over the past 3 months

• has worsened over the last week

• has presented several times over the last year

⚡ PRESENT PERFECT MEMORY BOOSTER LINES

Condition continues until now … Use present perfect.

For + duration … He has had diabetes for 10 years.

Since + starting point … She has been on this medication since January.

Over + change … His condition has deteriorated over the past 3 months.

Over + repeated event … The patient has presented several times over the last year.

Has/have + V3 … Active result: She has reported no further pain.

Has/have been + V3 … Passive result: Follow-up has been arranged.

Has/have been + adjective … State: She has been stable since review.

✅ CORRECT vs ❌ INCORRECT — PRESENT PERFECT IN OET LETTERS
❌ Incorrect	✅ Correct	Reflex Reason
The patient was diagnosed hypothyroidism since 2007.	The patient has had hypothyroidism since 2007.	Since = present perfect.
The patient was diagnosed hypothyroidism since 2007.	The patient was diagnosed with hypothyroidism in 2007.	In + year = past simple.
She has been problems with arthritis.	She has had problems with arthritis.	Problems = noun; use has had.
She has been problems with arthritis.	She has been having problems with arthritis.	Been + -ing = continuous action.
He is smoking two packs daily for 25 years.	He has been smoking two packs daily for 25 years.	Habit continues until now.
Over the past week she remains free from severe pain.	Over the past week, she has remained free from severe pain.	Over the past = present perfect.
The ulcer is present for more than one year.	The ulcer has been present for more than one year.	Been + adjective = state.
Mr Diamond is a patient of mine since 2000.	Mr Diamond has been a patient of mine since 2000.	Since = present perfect.
Mrs Brown has been presenting on several occasions.	Mrs Brown has presented on several occasions.	Repeated events = present perfect simple.

🧠 ONE-LINE REFLEX TO REMEMBER

FOR = duration → has/have + V3 or has/have been + -ing

SINCE = starting point → has/have + V3 or has/have been + -ing

OVER = change/repetition → has/have + V3

BEEN + V3 = passive | BEEN + -ING = continuous | BEEN + adjective = state

✅ HOW TO STUDY?

Read rule → cover example → recall sentence → repeat → apply in Mock Tests

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OET Grammar Reflex Dr. Wasim School of Medical Education

🧠 Present Perfect Meaning Decoder

🎯 MASTER MEMORY RULE

Present perfect connects the past to the present.
It tells the reader that something started before now and is still relevant now.

🩺 EXAMPLE 1 — He has had diabetes for 10 years
Sentence	What it actually means
He has diabetes.	He has it right now, but we do not know for how long.
He had diabetes.	He used to have it in the past, but he does not have it now.
He has had diabetes for 10 years.	It started 10 years ago, and he still lives with it today.

💊 EXAMPLE 2 — She has been on this medication since January

Been is the past participle form of the verb to be: am / is / are → was / were → been.

When someone is on a medication, it describes a continuous state with that medicine.

Right now: She is on this medication.

In the past: She was on this medication.

Connecting past to present: She has been on this medication since January.

✅ EXAMPLE 3 — She has reported no further pain

This sentence is active because the subject performing the action comes first.

Subject: She

Action: has reported

Meaning: She herself reported no further pain, and this information is relevant now.

Memory reflex: Subject + has/have + V3 = active perfect.

📅 EXAMPLE 4 — Follow-up has been arranged

This sentence is passive because the thing receiving the action comes first.

Receiver of action: Follow-up

Action: has been arranged

Meaning: Someone arranged the follow-up, but the person who arranged it is not important.

Memory reflex: Thing receiving action + has/have been + V3 = passive perfect.

👤 EXAMPLE 5 — Mr Diamond has been a patient of mine since 2000

The word been is necessary because the sentence describes a long-term state of being.

Being a patient is not an action like “reported” or “attended”; it is a continuous role or relationship.

Right now: Mr Diamond is a patient of mine.

In the past: Mr Diamond was a patient of mine.

Connecting past to present: Mr Diamond has been a patient of mine since 2000.

Memory reflex: Long-term role/state + has/have been = present perfect state.

🧠 FINAL MEMORY LOCK

Has had + disease/problem → the patient still has it now.

Has been + on medication / a patient / stable → continuous state from past to present.

Has reported / has attended / has complained → active perfect; patient did the action.

Has been arranged / treated / advised → passive perfect; something was done to/for the patient.

✅ HOW TO STUDY?

Read rule → cover example → recall sentence → repeat → apply in Mock Tests

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OET Grammar Reflex Dr. Wasim School of Medical Education

🧠 Active vs Passive Voice Reflex for OET Writing

🎯 MASTER RULE

Use active voice when the patient or writer performs the action.
Use passive voice when the action, treatment, procedure, medication, or result is more important than the person who did it.

Passive formula: be verb + past participle
Examples: is taken, was advised, were discussed, has been arranged, will be monitored.

⚖️ WHEN TO USE ACTIVE OR PASSIVE IN OET LETTERS
Situation	Active Voice	Passive Voice
Patient action	The patient presented with chest pain.	The patient was presented with chest pain. ❌
Advice given	I advised the patient to stop smoking.	The patient was advised to stop smoking.
Treatment focus	I advised bed exercises.	Bed exercises were advised.
Medication focus	You need to take Flucloxacillin twice daily.	Flucloxacillin needs to be taken twice daily.

📌 ACTIVE → PASSIVE VERB FORMATION TABLE
Tense / Form	Active	Passive
Present simple	The patient takes aspirin daily.	Aspirin is taken daily.
Present continuous	The patient is taking aspirin daily.	Aspirin is being taken daily.
Past simple	The patient took aspirin daily.	Aspirin was taken daily.
Past continuous	The patient was taking aspirin daily.	Aspirin was being taken daily.
Present perfect	The patient has taken aspirin daily for one year.	Aspirin has been taken daily for one year.
Past perfect	The patient had taken aspirin daily.	Aspirin had been taken daily.
Future	The patient will take aspirin in the evening.	Aspirin will be taken in the evening.
Modal form	The patient should have taken aspirin.	Aspirin should have been taken.

⚡ ACTIVE–PASSIVE MEMORY BOOSTER LINES

Patient does the action … Use active voice.

Treatment/procedure is important … Use passive voice.

Was/were + V3 … Past passive: The patient was advised.

Is/are + V3 … Present passive: Aspirin is taken daily.

Has/have been + V3 … Present perfect passive: Follow-up has been arranged.

Will be + V3 … Future passive: The baby’s growth will be monitored.

✅ CORRECT vs ❌ INCORRECT — ACTIVE/PASSIVE OET ERRORS
❌ Incorrect	✅ Correct	Reflex Reason
She was performed a colostomy.	A colostomy was performed.	The procedure receives the action.
We were organized daily home visits.	Daily home visits were organized.	Focus on arrangement, not writer.
He was presented for check-up.	He presented for check-up.	Patient presented himself; use active.
The treatment options was discussed.	The treatment options were discussed.	Options = plural; use were.
She had done colonoscopy 3 years ago.	A colonoscopy was done 3 years ago.	Procedure focus; passive is better.
Her baby will need to monitor his growth.	The baby’s growth will need to be monitored.	Growth receives monitoring.
Today at my surgery attended Mr Attard.	Today, Mr Attard attended surgery.	Focus on patient; active voice.

🧠 FINAL MEMORY LOCK

Patient performs action → active: The patient presented / attended / reported.

Treatment, procedure, medication, advice receives action → passive: was advised / was performed / has been arranged.

Be + V3 → passive voice.

Do not write: “The patient was presented” when the patient came by himself/herself.

✅ HOW TO STUDY?

Read active sentence → convert to passive → check who receives the action → practise in Mock Tests

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OET Grammar Reflex Dr. Wasim School of Medical Education

🧠 Past Perfect Reflex for OET Writing

Order of Events | Reported Speech | Previous vs Ago | Past Timeline | Referral Letter Accuracy

🎯 MASTER RULE

Use past perfect when you need to show that one past event happened before another past event.
In OET referral letters, past perfect helps the reader understand the clinical timeline clearly.

📌 MAIN FUNCTIONS OF PAST PERFECT
Function	OET Example	Meaning
Order of events	She had not been able to conceive over the previous four months and, as a result, she was suffering from depression.	First, she could not conceive; then she became depressed.
Reported speech	At today’s consultation, Ms Leon reported that there had been blood in the toilet bowl on two occasions.	The blood was noticed before today’s consultation.

💡 HANDY HINTS — WHEN TO USE AND WHEN NOT TO USE

Hint 1: Do not use past perfect when describing only one past event.

❌ The patient had been feeling unwell last week.

✅ The patient was feeling unwell last week.

✅ The patient had been feeling unwell last week and was admitted to hospital for observation.

Hint 2: Use previous instead of ago when referring to a period before a past consultation date.

❌ She experienced symptoms over the past few weeks before the 03/07/2010 check-up.

✅ She had experienced symptoms over the previous few weeks before the 03/07/2010 check-up.

⚡ PAST PERFECT MEMORY BOOSTER LINES

Earlier past before later past … Use had + V3.

Earlier continuing symptom before past review … Use had been + -ing / had been + adjective.

Reported past event … She reported that there had been blood in the toilet bowl.

Past date + symptoms before that date … Use previous, not past.

Only one past event … Use past simple, not past perfect.

✅ CORRECT vs ❌ INCORRECT — PAST PERFECT IN OET LETTERS
❌ Incorrect	✅ Correct	Reflex Reason
She presented because she experienced heart flutter over the past few weeks.	She presented because she had experienced several episodes of heart flutter over the previous few weeks.	Symptoms occurred before the past consultation.
On review two weeks later, the frequency of headache decreased.	On review two weeks later, the frequency of headache had decreased.	Decrease happened before the review.
A review showed her health improved, BP dropped and she lost 4 kg.	A review showed her health had improved, her BP had dropped to 140/85 and she had lost 4 kg.	Condition was true at a past review.
She presented yesterday with abdominal pain and was since 24 hours.	She presented yesterday with abdominal pain, which had been occurring for the previous 24 hours.	Pain started before yesterday’s consultation.
She was admitted because she collapsed at home.	She was admitted because she had collapsed at home.	Collapse happened before admission.
Initially, she presented with chest discomfort for three weeks.	Initially, she presented with chest discomfort which had been present for three weeks.	Symptom existed before initial presentation.
Mrs Jones had taken Microgynon 30 for five years but had stopped in May 2009.	Mrs Jones had taken Microgynon 30 for five years but stopped in May 2009.	No need to repeat past perfect twice.
On rechecking, her condition has further deteriorated and an ambulance was arranged.	On rechecking, her condition had further deteriorated and an ambulance was arranged.	Deterioration happened before ambulance arrangement.

🕒 PREVIOUS vs PAST vs AGO — OET TIMELINE REFLEX
Time word	Use when	Example
Previous	The period is before a past consultation or past event.	She had experienced symptoms over the previous few weeks.
Past	The period is connected to now.	She has experienced symptoms over the past few weeks.
Ago	The event happened at a completed time before now.	She presented three weeks ago.

🧠 FINAL MEMORY LOCK

One past event only → use past simple.

Earlier past before later past → use past perfect.

Before a past consultation → use previous, not past.

Reported earlier event → use past perfect after reported that.

Do not overuse past perfect → use it only when the timeline needs clarification.

✅ HOW TO STUDY?

Read the timeline → identify the earlier past event → use past perfect only when needed → practise in Mock Tests

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OET Grammar Reflex Dr. Wasim School of Medical Education

🧠 Subject–Verb Agreement Reflex for OET Writing

🎯 MASTER RULE

The verb must agree with the real subject, not with the nearest medical word.
In OET Writing, always identify the subject first, then choose the correct verb: is/are, was/were, has/have, does/do.

📌 HIGH-YIELD SUBJECT–VERB AGREEMENT RULES
Trigger	Rule	OET-Style Example
Two subjects joined by “and”	Use a plural verb.	Hypertension and diabetes are ongoing concerns.
Singular subjects joined by “or/nor”	Use a singular verb.	Either medication or physiotherapy is appropriate.
Singular + plural with “or/nor”	Verb agrees with the nearer subject.	Neither the tablets nor the inhaler was available.
Each / everyone / anybody / nobody	These words are singular.	Each of the wounds is healing well.
Phrase between subject and verb	Ignore the middle phrase; agree with the real subject.	The patient, with multiple comorbidities, is stable.
There is / There are	Verb agrees with what follows.	There are no signs of infection.
Collective noun	Usually singular when seen as one unit.	The family is supportive.

⚡ SUBJECT–VERB AGREEMENT MEMORY BOOSTER LINES

Real subject is singular … Use is / was / has / does.

Real subject is plural … Use are / were / have / do.

Subject + “as well as” … Do not make it plural automatically.

Each / everyone / nobody … Always think singular.

There is / There are … Look after “there,” not before it.

Do not trust the nearest noun … Find the true subject first.

✅ CORRECT vs ❌ INCORRECT — SUBJECT–VERB AGREEMENT IN OET LETTERS
❌ Incorrect	✅ Correct	Reflex Reason
The treatment options was discussed.	The treatment options were discussed.	Options = plural.
There is no signs of infection.	There are no signs of infection.	Signs = plural.
The patient, with multiple comorbidities, are stable.	The patient, with multiple comorbidities, is stable.	Patient = singular.
Each of the medications were reviewed.	Each of the medications was reviewed.	Each = singular.
The family are supportive.	The family is supportive.	Family as one unit = singular.
Neither the wound nor the sutures was infected.	Neither the wound nor the sutures were infected.	Nearest subject = sutures.
The patient and his wife was informed.	The patient and his wife were informed.	Two subjects joined by and = plural.

⚠️ SPECIAL AGREEMENT TRAPS
Trap	Rule	Example
Doesn’t / Don’t	Doesn’t = singular. Don’t = plural, I, or you.	He doesn’t tolerate aspirin. They don’t smoke.
Scissors / trousers	These usually take plural verbs.	The scissors are blunt.
News / mathematics / measles	These usually take singular verbs.	The news is reassuring.
Relative pronoun: who/which/that	Verb agrees with the antecedent.	Patients who have diabetes require follow-up.

🧠 FINAL MEMORY LOCK

Step 1: Find the real subject.

Step 2: Ignore phrases between subject and verb.

Step 3: Singular subject → is / was / has / does.

Step 4: Plural subject → are / were / have / do.

Step 5: With “there is/are,” look after “there” to find the subject.

✅ HOW TO STUDY?

Find subject → ignore extra phrases → choose singular/plural verb → practise in Mock Tests

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OET Grammar Reflex Dr. Wasim School of Medical Education

🧠 Articles Reflex for OET Writing

A / An / The | Countable Nouns | Uncountable Nouns | Medical Job Titles | Common OET Errors

🎯 MASTER RULE

Before choosing a/an/the, first ask: Is the noun countable or uncountable?
If it is a singular countable noun, it usually needs an article or another determiner. If it is uncountable, do not use a/an.

📌 COUNTABLE vs UNCOUNTABLE NOUNS — ARTICLE DECISION
Noun type	Rule	OET-Style Example
Singular countable noun	Usually use a/an/the or a determiner.	The patient had an abscess on her gum.
Plural countable noun	Do not use a/an before plural nouns.	The patient had three abscesses on her gum.
Uncountable noun	Do not use a/an.	The patient has cancer.
Uncountable with quantity	Use some/any or a piece of.	Advice on diet is requested.

✅ COUNTABLE MEDICAL NOUNS — USE ARTICLE IN SINGULAR
Noun	Singular form	Plural form
abscess	The patient had an abscess.	The patient had three abscesses.
appointment	A follow-up appointment was scheduled.	The patient missed her follow-up appointments.
complaint	If you have a complaint, tell your doctor.	If you have any complaints, tell your doctor.
episode	The patient had an episode of heart flutter.	The patient reported three episodes of heart flutter.
investigation	An investigation is required.	Investigations are required.
operation	An operation is necessary.	Two operations are necessary.
test	A blood test was ordered.	Blood and urine tests were ordered.

👨‍⚕️ JOB TITLE ARTICLE REFLEX

When referring to one professional role, use an article.

✅ Mr Hagen is an accountant.

✅ She is a smoker.

✅ An appointment needs to be arranged with a physiotherapist.

✅ A social worker has been arranged to offer ongoing care.

Memory reflex: one job / one role / one person type → use a/an.

🚫 UNCOUNTABLE MEDICAL NOUNS — DO NOT USE A/AN
Uncountable noun	Correct use	Memory point
advice	Advice on diet is requested.	Not “an advice.”
assistance	The patient will require assistance upon discharge.	No a/an.
cancer	The patient has cancer.	Not “a cancer.”
information	Please contact me if you require further information.	Not “informations.”
pain	The patient experienced pain on palpation.	Usually no a/an.
progress	The patient has made good progress.	Not “a progress.”
surgery	The patient chose not to have surgery.	Not “a surgery” in this use.

⚡ ARTICLES MEMORY BOOSTER LINES

One countable noun … Use a/an/the.

Plural countable noun … Do not use a/an.

Uncountable noun … Never use a/an.

One medical job title … Use a/an: a doctor, a nurse, a physiotherapist.

Specific known noun … Use the.

✅ CORRECT vs ❌ INCORRECT — ARTICLES IN OET LETTERS
❌ Incorrect	✅ Correct	Reflex Reason
Wound on her left knee has been stitched.	A wound on her left knee has been stitched.	Wound = singular countable noun.
Marvin, 7 year old boy, was admitted.	Marvin, a 7-year-old boy, was admitted.	Boy = singular countable noun.
Mr Brown has been patient of mine.	Mr Brown has been a patient of mine.	Patient = singular countable noun.
The patient has had prosthetic heart valve for year.	The patient has had a prosthetic heart valve for a year.	Valve and year are singular countable nouns.
Examination revealed abscess on her gum.	Examination revealed an abscess on her gum.	Abscess begins with a vowel sound.
X-rays reveal that she has fracture of the right ankle.	X-rays reveal that she has a fracture of the right ankle.	Fracture = singular countable noun.
Mr Jones had a heart surgery in 2009.	Mr Jones had heart surgery in 2009.	Surgery is uncountable in this use.
The patient has a cancer.	The patient has cancer.	Cancer is uncountable here.
She had a healthy soft tissue.	She had healthy soft tissue.	Tissue is uncountable here.
He had lacerated lip and swollen gum.	He had a lacerated lip and swollen gums.	Lip = singular countable; gums = plural.
The patient has pollen allergy.	The patient has a pollen allergy.	Allergy = singular countable noun.
The patient presented for regular check-up.	The patient presented for a regular check-up.	Check-up = singular countable noun.

🧠 FINAL MEMORY LOCK

Singular countable noun → use a/an/the: a wound, an abscess, a patient.

Plural countable noun → no a/an: wounds, abscesses, patients.

Uncountable noun → no a/an: advice, cancer, information, pain, surgery.

Known/specific noun → use the: the patient, the wound, the right ankle.

One professional role → use a/an: a doctor, a nurse, a physiotherapist, a social worker.

✅ HOW TO STUDY?

Identify noun → decide countable or uncountable → choose a/an/the or no article → practise in Mock Tests

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OET Grammar Reflex Dr. Wasim School of Medical Education

🧠 Article Reflex: New vs Previously Mentioned Information

🎯 MASTER RULE

Use a/an when you introduce a countable noun for the first time.
Use the when the noun is already known, already mentioned, or specific.

OET reflex: case notes often omit articles, but referral letters must use standard grammar.

📌 FIRST MENTION vs SECOND MENTION
Situation	Article Reflex	OET Example
First mention	Use a/an for a singular countable noun.	She attended for a blood test.
Second mention	Use the because the reader now knows which one.	The results of the blood test were negative.
Uncountable first mention	Use no article.	They presented for fertility advice.

🔎 SPECIFIC INFORMATION — USE “THE”
Specific trigger	Rule	Correct OET Sentence
Specific time period	Use the with previous / last / past / next.	He has been a smoker for the last 12 years.
Following list	Use the following.	She is currently on the following medication.
Specific side / site	Use the before a specific body part/site.	The patient reported pain in the left ankle.
Above information	Use the above information.	Based on the above information, urgent admission is required.
Specific service	Use the when the service is specific.	The tooth was filled by the school dental service.

⚡ ARTICLE MEMORY BOOSTER LINES

First time + countable noun … Use a/an.

Second time / known item … Use the.

Uncountable first mention … Use no article: advice, pain, information.

Specific time phrase … Use the previous / the last / the past / the next.

Case notes omit articles … Letter must restore them.

✅ CORRECT vs ❌ INCORRECT — NEW / SPECIFIC INFORMATION
❌ Incorrect	✅ Correct	Reflex Reason
The patient has the family history of diabetes.	The patient has a family history of diabetes.	First mention + countable noun.
The pain in the right knee joint has appeared over the last two days.	Pain in the right knee joint has appeared over the last two days.	First mention of uncountable pain.
They presented for the fertility advice.	They presented for fertility advice.	Advice is uncountable.
She presented with the broken left arm following the accident.	She presented with a broken left arm following an accident.	First mention: a broken arm, an accident.
It has been forty minutes since a accident.	It has been forty minutes since the accident.	Second mention of accident.

🔎 SPECIFIC PHRASE ERRORS — USE “THE”
❌ Incorrect	✅ Correct	Reflex Reason
She was on Microgynon 30 for previous five years.	She was on Microgynon 30 for the previous five years.	Specific period.
He has been a smoker for last 12 years.	He has been a smoker for the last 12 years.	The last = specific time period.
This medication is taken for next three days.	This medication is taken for the next three days.	The next = specific period.
She is currently on following medication.	She is currently on the following medication.	The following = specific list.
The patient reported pain in left ankle.	The patient reported pain in the left ankle.	Specific body part/site.
Based on above information, urgent admission is required.	Based on the above information, urgent admission is required.	Above information is specific.

⚠️ SPECIAL ARTICLE USAGE IN OET WRITING
Area	Rule	Example
Body parts	Usually use the.	Pain in the left groin.
Disease names	Do not use an article.	The patient has high blood pressure.
Same	Always use the same.	The medication is the same as last time.
Gerunds	Usually no article before -ing noun forms.	The patient was advised to stop drinking.

✅ CORRECT vs ❌ INCORRECT — SPECIAL ARTICLE RULES
❌ Incorrect	✅ Correct	Reflex Reason
Pain in left groin.	Pain in the left groin.	Specific body part.
The patient is suffering from the high blood pressure.	The patient is suffering from high blood pressure.	Disease/condition name: no article.
The patient was diagnosed with the arthritis.	The patient was diagnosed with arthritis.	Disease name: no article.
The medication is same as last time.	The medication is the same as last time.	Always write the same.
Mr Walker has reduced the smoking.	Mr Walker has reduced smoking.	Gerund: usually no article.
The patient was advised to stop the drinking.	The patient was advised to stop drinking.	Gerund: no article.

🧠 FINAL MEMORY LOCK

First mention + countable noun → use a/an.

Second mention / specific noun → use the.

Uncountable noun first mention → no article.

Body parts and specific sites → usually use the.

Disease names → usually no article.

Same → always write the same.

✅ HOW TO STUDY?

Identify first mention or known/specific mention → choose a/an/the/no article → practise in Mock Tests

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OET Writing Tone Reflex Dr. Wasim School of Medical Education

🧠 Nominalisation & Formal Language Reflex for OET Writing

Formal Tone | Tone & Register | Casual vs Formal | Nominalisation | Professional OET Letter Language

🎯 MASTER RULE

OET letters must sound professional, formal, clear, and clinically appropriate.
Avoid casual spoken English, SMS language, vague words, contractions, and informal family words. Use standard written expressions that match a healthcare letter.

📌 NOMINALISATION — FORMAL MEDICAL WRITING TOOL
Concept	Meaning	OET-Style Example
Nominalisation	Turning an action or verb idea into a noun phrase.	The patient had a habit of thumb sucking until the age of five.
Formal summary	Used to summarise case-note details professionally.	The reduction of weight has led to improved health.
Article with noun phrase	Nominalised expressions often need an article.	The passing of urine caused discomfort.

✅ CORRECT vs ❌ INCORRECT — NOMINALISATION
❌ Incorrect	✅ Correct	Reflex Reason
The patient is complaining of discomfort during passing of urine.	The patient is complaining of discomfort during the passing of urine.	Nominalised phrase needs the article.

🧾 CASUAL → FORMAL WORD REFLEX BANK
Casual	Formal	Casual	Formal
asks for	requests	think	believe / consider
get / got	receive / received / became	so	very / therefore
but	however	kids	children
say / said	state / stated	about	regarding
really	greatly / very much	sad	depressed
a bit	slightly	till	until
like	such as / including	don’t / that’s	do not / that is

⚡ FORMAL TONE MEMORY BOOSTER LINES

Do not write “like” for examples … Use such as / including.

Do not write “thanks” … Use Thank you.

Do not write “I think” … Use I believe / I consider.

Do not start formal sentences with “But” … Use However,

Do not start formal sentences with “So” … Use Therefore,

Do not use SMS language … Write you, not u.

Do not use contractions … Write do not / that is.

✅ CORRECT vs ❌ INCORRECT — FORMAL LANGUAGE IN OET LETTERS
❌ Casual / Inappropriate	✅ Formal / Appropriate	Reflex Reason
She prefers fluids only like apple juice and lemonade.	She prefers fluids such as apple juice and lemonade.	Like is casual for examples.
Thanks for seeing Mr Brown.	Thank you for seeing Mr Brown.	Thanks is casual.
I think she is suffering from schizophrenia.	I believe she is suffering from schizophrenia.	Believe is more formal.
I would really appreciate your attention.	I would greatly appreciate your attention.	Really is spoken language.
About his dietary habits, he eats oily food.	Regarding his dietary habits, he eats oily food.	Regarding is more suitable.
She had lots of pain.	She had a lot of pain.	Lots is spoken language.
There was nothing significant in his social history.	There were no significant findings in his social history.	More formal written expression.
Please contact me if u need additional information.	Please contact me if you need additional information.	No SMS language.
She has got postpartum haemorrhage.	She has had postpartum haemorrhage.	Got is casual.

🔗 CONNECTORS, FAMILY WORDS & VAGUE LANGUAGE
❌ Casual / Weak	✅ Formal / Strong	Reason
But her blood pressure was normal.	However, her blood pressure was normal.	However is more formal.
So I recommended reassessment.	Therefore, I recommended reassessment.	Therefore is more formal.
She was disorientated sometimes.	She was disorientated at times.	At times is more formal.
This pain was exaggerated by hot and cold things.	This pain was exacerbated by hot and cold stimuli.	Things is casual.
Her husband was upset because she was not interested in the kids.	Her husband was upset because she was not interested in the children.	Children is formal.
Mark’s dad also suffers from this condition.	Mark’s father also suffers from this condition.	Father is formal.
He had a habit of thumb sucking till the age of five.	He had a habit of thumb sucking until the age of five.	Until is formal.
She was so anxious.	She was very anxious.	Very is more objective.

🩺 PRECISION WORDS — MAKE THE LETTER SOUND PROFESSIONAL
❌ Weak / Casual	✅ Professional	Reason
Owen has big tonsils.	Owen has enlarged tonsils.	Enlarged is clinical.
His vitals were stable.	His vital signs were stable.	Use full expression.
Follow up is requested.	A follow-up visit is requested.	Complete noun phrase.
Chest pain at roughly 1.45 pm.	Chest pain at approximately 1.45 pm.	Approximately is more formal.
I requested some blood tests.	I requested additional blood tests.	Some is vague.
All the rest of the examinations were normal.	The remainder of the examinations were normal.	More formal wording.

🧠 FINAL MEMORY LOCK

OET letters are formal documents → avoid spoken/casual expressions.

Like → such as / including.

But / So at sentence start → However / Therefore.

Don’t / that’s / u → do not / that is / you.

Kids / dad / mum → children / father / mother.

Roughly / around / some → approximately / further / additional.

Best OET tone → formal, precise, polite, factual, and clinically relevant.

✅ HOW TO STUDY?

Read casual phrase → convert to formal phrase → use it in a sentence → practise in Mock Tests

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OET Writing Reflex Dr. Wasim School of Medical Education

🧠 Medical Terminology Reflex for OET Writing

Abbreviations | Acronyms | Technical Notes | Full English Sentences | Formal Letter Style

🎯 MASTER RULE

OET case notes may contain abbreviations, acronyms and technical shortcuts, but the letter must use complete English words and full sentences.
A referral or discharge letter is not a case-note report. It must be formal, clear and understandable for the reader.

📌 WHY MEDICAL ABBREVIATIONS MUST BE EXPANDED
Reason 1	OET is an English test, so the writer must show the ability to convert technical note-form language into standard written English.
Reason 2	Some letters may be written to non-health professionals, such as social workers or family members.
Reason 3	A referral letter requires formal letter-writing conventions, including complete words, complete sentences and clear professional style.

💡 HANDY HINT

It is a test of English, not Latin. Where possible, avoid Latin-based acronyms and write the meaning in full English.

🧾 COMMON OET CASE-NOTE ABBREVIATIONS — EXPAND IN LETTERS
Short form	Full expression	Short form	Full expression
Abdo	abdomen	mane	in the morning
AC	before meals	NAD	no abnormality detected
ADL	activities of daily living	nocte	in the evening
BD / bid	twice a day	OPG	orthopantomogram
BP	blood pressure	P / PR	pulse / pulse rate
C/O	complains of	PMH	past medical history
cap	capsule	PRN	as required / when required
DOB	date of birth	QID	four times a day
ECG	electrocardiograph	R	right
FBC	full blood count	tab	tablet
FTA	failed to attend	TDS / tid	three times a day
IV	intravenous	w/o	without
hx	history	yrs / y	years / year
L	left	3/12	three months

✅ ACCEPTABLE SHORT FORMS — MEASUREMENTS
cm	centimetre	ml	millilitre
g	gram	mg	milligram
kg	kilogram	mmHg	millimetres of mercury

⚡ MEDICAL TERMINOLOGY MEMORY BOOSTER LINES

Case note has abbreviation … Expand it in the letter.

Latin timing terms … mane = in the morning; nocte = in the evening.

BD / TDS / QID / PRN … Write twice daily / three times daily / four times daily / as required.

R / L … Write right / left.

PR / BP / FBC / ECG … Write pulse rate / blood pressure / full blood count / electrocardiograph.

Measurement abbreviation … Usually acceptable: mg, ml, kg, cm, mmHg.

✅ CORRECT vs ❌ INCORRECT — MEDICAL TERMINOLOGY IN OET LETTERS
❌ Incorrect / Note-like	✅ Correct / Letter style	Reflex Reason
Metformin 500 mg mane and nocte.	Metformin 500 mg in the morning and at night.	Expand Latin timing terms.
Aldomet 250 mg bid.	Aldomet 250 mg twice a day.	BD / bid = twice daily.
Aperients PRN.	Aperients when required.	PRN = as/when required.
Prednisolone 5 mg 1 t/sid.	Prednisolone 5 mg tablet once a day.	Expand tablet and dosing frequency.
Tenderness over the R. iliac fossa.	Tenderness over the right iliac fossa.	R = right.
A 45yr old woman.	A 45-year-old woman.	Use complete age expression.
Pain had been present for 24 hrs.	Pain had been present for 24 hours.	Write hours in full.
Her mother died of MI.	Her mother died of myocardial infarction.	Expand medical acronym.
PR 88/min.	A pulse rate of 88 beats per minute.	Expand pulse rate clearly.
Treatment & progress.	Treatment and progress.	Write “and” in full.
Discharged on Dec. 30 2009.	Discharged on December 30 2009.	Expand month name in formal writing.
Lab work was planned.	Laboratory work was planned.	Lab = laboratory.

🧠 FINAL MEMORY LOCK

OET case note abbreviation → expand into full English in the letter.

Latin timing words → write in the morning / at night / twice daily / as required.

R / L → right / left.

PR / BP / FBC / ECG → pulse rate / blood pressure / full blood count / electrocardiograph.

& → and.

Measurement units → mg, ml, kg, cm and mmHg are acceptable short forms.

✅ HOW TO STUDY?

Read abbreviation → expand full expression → convert into a complete sentence → practise in Mock Tests

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OET Writing Reflex Dr. Wasim School of Medical Education

🧠 Referring to a Patient in OET Letters

🎯 MASTER RULE

In formal OET letters, refer to the patient consistently and professionally.
Write the patient’s full name in the Re: line, then use this patient, title + surname, or appropriate pronouns in the body. Do not mix first names, surnames and titles randomly.

📌 PATIENT TITLE RULES
Title	Use for	OET Reflex
Mr.	Adult men, married or single.	Mr. Thomas Hacker
Mrs.	Married women, including widows.	Mrs. Carol Brady
Ms.	Married or unmarried women.	Ms. Green
Miss	Young girls or unmarried women.	Miss Green — no full stop.
Master	Young boys; now uncommon and old-fashioned in the body of the letter.	Usually use the child’s first name or full name instead.

🧾 HOW TO REFER TO THE PATIENT IN THE LETTER
Expression	Best use	Example
Full name	Use in the Re line or address details.	Re: Mrs. Carol Brady
This patient	Useful in the opening sentence if the name is already in the Re line.	I am writing to refer this patient for respite care.
Title + surname	Standard formal body reference.	Mrs. Brady is depressed and withdrawn.
First name	Often acceptable for children.	Alfie is an only child.
Pronouns	Use after the patient has been clearly identified.	She has not been eating much recently.

💡 HANDY TIP — HOW OFTEN TO USE THE NAME

Best reflex: Write the patient’s full name in the Re: line, then use the patient’s name or title + surname once per paragraph if needed. After that, use pronouns.

Consistency rule: Do not mix first name, surname and full name randomly. Choose one formal pattern and keep it consistent.

📄 SAFE OET PATIENT-REFERENCE FORMAT

Date

Recipient details

Dear Sir/Madam,

Re: Mrs. Carol Brady
DOB: 4 February 1968

I am writing to refer this patient, a 42-year-old married woman who was diagnosed with stage 4 ovarian cancer on 22 May 2009.

Mrs. Brady is depressed and withdrawn. She has not been eating much recently.

⚡ PATIENT REFERENCE MEMORY BOOSTER LINES

Name already in Re line … Use this patient in the opening sentence.

Adult male … Use Mr. + surname.

Adult female, marital status unclear … Use Ms. + surname.

Miss / Master … No full stop because they are not abbreviations.

First name only … Acceptable mainly for children, not adults.

Never use title + first name only … Do not write Mr Thomas or Mrs Carol.

✅ CORRECT vs ❌ INCORRECT — REFERRING TO A PATIENT
❌ Incorrect	✅ Correct	Reflex Reason
Mr. Langer is an only child.	Alfie is an only child.	Mr. is for adult men.
Thank you for seeing my patient, Master Alfie Langer, a 7-year-old boy.	Thank you for seeing my patient, Alfie Langer, a 7-year-old boy.	Master sounds old-fashioned in the body.
Mr. Peter presented today.	Mr. Holmes presented today.	Do not use title + first name only.
I am writing to refer Miss. Green.	I am writing to refer Miss Green.	Miss is not an abbreviation.
Dear Dr., I am writing this letter...	Dear Doctor, I am writing this letter...	Do not use Dr. without surname.

🧠 FINAL MEMORY LOCK

Write full patient name in Re line → then use this patient / title + surname / pronouns.

Use title + surname → not title + first name only.

Mr. is for adult men → not boys.

Miss and Master → no full stop.

Dear Dr. alone is incorrect → use Dear Doctor or Dear Dr + surname.

Consistency wins → do not keep changing how you refer to the patient.

✅ HOW TO STUDY?

Check patient age and gender → choose correct title → write full name in Re line → stay consistent → practise in Mock Tests

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OET Writing Presentation Reflex Dr. Wasim School of Medical Education

🧠 Control of Presentation Features for OET Writing

🎯 MASTER RULE

A high-scoring OET letter must look like formal medical correspondence, not case notes.
Control the visible features: date, address, salutation, Re line, paragraphs, closing, punctuation, capitals and spelling.

📌 FORMAL OET LETTER FORMAT — 6 PARTS
Part	Rule	Safe OET Example
1. Date	Place at the top left or top right. Write in full or use numbers.	30 December 2009 / 30/12/09
2. Address	Use capital letters for job titles, names and street names. Commas are not needed when address details are on separate lines.	Dr. Blair Howell Admitting Doctor 28 George Street Spring Hill
3. Salutation	Use the recipient’s name if given. Use a comma or colon. If no name is given, use professional title or Sir/Madam.	Dear Dr. Jones, Dear Sir/Madam, Dear Nurse,
4. Subject / Re line	Include patient name and age or DOB only. Do not overload this line with occupation, marital status or sentences.	Re: Julie Crosby, 25 years of age Re: Dylan Charles, DOB 04/12/2010
5. Body	Use paragraphs: introduction, relevant history, current condition/discharge plan, and conclusion/request.	Body word count is usually around 180–200 words.
6. Closing	Write one space below the body. Only the first word is capitalised, followed by a comma.	Yours sincerely, Sincerely, With best regards,

✅ CORRECT vs ❌ INCORRECT — LETTER FORMAT
❌ Incorrect	✅ Correct	Reflex Reason
30 Dec. 09	30 December 2009 / 30/12/09	Use full month or standard numeric date.
To Dr. Blair Howell, Admitting doctor, 28, George street,	Dr. Blair Howell Admitting Doctor 28 George Street	No “To”; no unnecessary commas; capitalise titles and street names.
Dear Dr Jones	Dear Dr. Jones,	Comma or colon required.
Re: Julie Crosby, 25 yr receptionist, single	Re: Julie Crosby, 25 years of age	Do not overload Re line.
Your's sincerely,	Yours sincerely,	No apostrophe in Yours.
Hello Dr. Jones, Hi Dr. Jones, Thanks,	Dear Dr. Jones, Yours sincerely,	Avoid casual greetings and email-style closings.

📌 COMMA REFLEX RULES FOR OET LETTERS
Comma Rule	Use	OET Example
Adverbial phrase	Use a comma after introductory context, date, emphasis, mood or contrast.	On examination, there was slight tenderness. Please note, he has a prosthetic heart valve.
Appositive	Use commas around extra identifying information after a noun.	Mr Jones, a 57-year-old man, was admitted.
Conditional sentence	If-clause first = comma. If-clause at end = no comma.	If you have any questions, please contact me. Please contact me if you have any questions.
Complex sentence	Dependent clause first = comma. Dependent clause at end = no comma.	Because of her deteriorating condition, she was admitted. She was admitted because of her deteriorating condition.
Comma splice	Do not join two full sentences with only a comma.	He has no dental experience. Therefore, he is worried about the pain.
That-clause	Do not place a comma before essential that-clauses.	Please note that Daniel has an allergy to peanuts.
Series/list	Use commas for three or more items; use and before the final item.	She has hypertension, hypothyroidism and glaucoma.

✅ CORRECT vs ❌ INCORRECT — COMMAS
❌ Incorrect	✅ Correct	Reflex Reason
On review today Mr Walker has reduced smoking.	On review today, Mr Walker has reduced smoking.	Introductory phrase needs comma.
I am writing to refer Mr Jones a 57-year-old man.	I am writing to refer Mr Jones, a 57-year-old man.	Appositive needs comma.
He has an allergy to nuts, once he was hospitalised.	He has an allergy to nuts and was once hospitalised.	Avoid comma splice.
Please note that, Daniel has an allergy.	Please note that Daniel has an allergy.	No comma after that.
Mr Farrah, presented today.	Mr Farrah presented today.	Do not separate subject and verb.
Initial examination revealed, complete edentulous jaws.	Initial examination revealed complete edentulous jaws.	Do not separate verb and object.

🔠 CAPITALISATION REFLEX RULES
Category	Rule	Examples
Drug names	Brand names are capitalised. Chemical/generic names are lower case.	Ritalin / penicillin / amoxicillin
Diseases	Disease names are usually lower case.	diabetes / epilepsy / high blood pressure
Eponyms	Capitalise the name part.	Parkinson’s disease / Bell’s palsy
Procedures and body parts	Usually lower case.	x-ray / caesarean section / knee / heart
Proper nouns	Capitalise specific people, institutions, places, addresses and titles before names.	Mater Hospital / Monash Road / Doctor Smith
Common nouns	Do not capitalise general professions or institutions.	doctor / nurse / university student / hospital
Months, days and I	Capitalise months, days, holidays and the pronoun I. Do not capitalise seasons.	March / Wednesday / Christmas Day / spring / I

✅ CORRECT vs ❌ INCORRECT — CAPITAL LETTERS
❌ Incorrect	✅ Correct	Reflex Reason
He is Epileptic.	He is epileptic.	Disease/adjective lower case.
Type 2 Diabetes	type 2 diabetes	Disease name lower case.
Allergic to Penicillin.	Allergic to penicillin.	Generic drug lower case.
Mr. duane thomson	Mr. Duane Thomson	Names are proper nouns.
emergency department / Mater hospital / Monash road	Emergency Department / Mater Hospital / Monash Road	Specific names need capitals.
Please see your Pharmacist.	Please see your pharmacist.	Common noun lower case.
march / wednesday / Spring / i	March / Wednesday / spring / I	Months, days and I need capitals; seasons do not.

⚖️ PHYSICAL DESCRIPTION & MEASUREMENT REFLEX
❌ Incorrect / Weak	✅ Correct / Professional	Reflex Reason
Advice was given to reduce her weight.	Advice was given to reduce weight. The patient was advised to reduce weight.	No pronoun needed after reduce.
She had lost her weight.	She had lost weight. Her weight has reduced from 61 kg to 50 kg.	No pronoun after lose weight.
He is obese with a 99 kilos weight and a 170 cm height.	He is obese with a weight of 99 kg and a height of 170 cm. He weighs 99 kg and is 170 cm tall.	Use correct noun or verb form.
A periodontal pocket of depth 4–9 mm.	A periodontal pocket depth of 4–9 mm. A periodontal pocket with a depth of 4–9 mm.	Correct measurement phrase order.
He was overweight 85 kg with respect to his height 173 cm.	He was overweight at 85 kg with respect to his height of 173 cm.	Convert note-style wording into a full sentence.

⚡ PRESENTATION FEATURES MEMORY BOOSTER LINES

Address lines separated … No commas needed.

Dear Dr. Jones … Add comma or colon.

Re line … Name + age/DOB only.

Introductory phrase … Usually add comma.

Subject + verb … Do not separate with comma.

Disease names … Usually lower case.

Proper nouns … Capitalise names, institutions and specific addresses.

🧠 FINAL MEMORY LOCK

OET letter format → Date → Address → Salutation → Re line → Body → Closing.

Re line → keep it short: patient name + age/DOB.

Comma reflex → after introductory phrases; around appositives; not between subject and verb.

That-clause reflex → no comma after that.

Capital reflex → proper nouns capital; diseases and common nouns usually lower case.

Physical description reflex → use complete sentences and correct measurement phrases.

✅ HOW TO STUDY?

Check format → check commas → check capitals → check spelling → convert notes into formal sentences → practise in Mock Tests

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OET Difficult Words Reflex Dr. Wasim School of Medical Education

🧠 Difficult Words Reflex for OET Writing

🎯 MASTER RULE

Many OET errors come from confusing similar-looking words.
Before writing, ask: Is this word a verb, noun, adjective, or preposition pattern? Then choose the correct sentence structure.

📌 COMPLAIN vs COMPLAINT
Word	Rule	OET Example
Complain	Verb. Use complain of / complain about.	The patient complained of severe abdominal pain.
Complaint	Noun. It is countable, so use a complaint / complaints.	The patient presented with a complaint of severe abdominal pain.

🧾 SUGGEST / RECOMMEND vs ADVISE
Verb	Rule	Correct Pattern
Suggest	Do not use him/her immediately after suggest.	I suggested that he see you next week.
Recommend	Do not use him/her immediately after recommend.	I recommended that he rest for three days.
Advise	Can be followed by object pronoun + to.	I advised him to see you next week.

📌 EXPLAIN vs TELL / ADVISE vs ADVICE
Word Pair	Rule	Correct OET Example
Explain	Use explain to + person.	I explained to them that unsuccessful conception was not unusual.
Tell	Tell can be followed directly by the person.	I told them that unsuccessful conception was not unusual.
Advise	Verb.	Please advise the patient on how to take the medication.
Advice	Noun. Uncountable: not an advice, not advices.	I gave advice to the patient regarding her medication.

⚡ REQUEST / AFFECT / EFFECT REFLEX
Word	Rule	Correct Example
Request as verb	Do not add for after requested.	The patient requested new dentures.
Request as noun	Use request for.	The patient made a request for new dentures.
Affect	Verb.	She has been affected by glaucoma.
Effect	Noun.	The treatment has had no effect.

🧠 WIDOW / HISTORY / ALLERGY / CONFIDENCE
Word	Rule	Correct Example
Widow	Woman whose husband has died.	Mrs Saunders is a 58-year-old widow.
Widower	Man whose wife has died.	Mr Saunders is a 60-year-old widower.
Widowed	Adjective for either man or woman.	A 58-year-old widowed woman.
History	Use present tense: history still exists.	She has a history of heart palpitation.
Allergy	Noun. Countable.	He has an allergy to nuts.
Allergic	Adjective.	He is allergic to nuts.
Confident	Adjective.	She is not confident in social situations.
Confidence	Noun.	She has no confidence in social situations.

⚖️ SMALL WORDS THAT CHANGE MEANING
Word	Rule	Correct Example
Few / a few	Use with plural nouns. Few = negative; a few = some.	There are a few ways to identify threadworms.
Little / a little	Use with uncountable nouns. Little = negative; a little = some.	The patient has little eye contact.
During	Followed by a noun.	He twisted his ankle during a game of squash.
While	Followed by a phrase or -ing form.	He twisted his ankle while playing squash.
Following	Means after an earlier event.	She was admitted following a collapse at home.

🎂 YEARS vs YEAR — AGE REFLEX
Pattern	Rule	Correct Example
A 63-year-old man	Hyphenated age phrase before noun. Use year, not years.	I am writing to refer this patient, a 63-year-old man.
63 years old	After the number, use years old.	This patient is 63 years old.
At age	Use years of age / age of / years old.	Her father died at the age of 50.
Until age	Use until the age of five / until he was five years old.	He had a habit of thumb sucking until the age of five.

✅ CORRECT vs ❌ INCORRECT — DIFFICULT WORDS
❌ Incorrect	✅ Correct	Reflex Reason
The patient complaints of chest pain.	The patient complains of chest pain.	Complain = verb.
I have suggested him to see you.	I suggested that he see you.	Suggest is not followed by him/her.
I explained them the advice.	I explained the advice to them.	Use explain to.
Please advice the patient.	Please advise the patient.	Advise = verb.
The side affects are unknown.	The side effects are unknown.	Effect = noun.
She is allergy to sulphur-containing drugs.	She has an allergy to sulphur-containing drugs.	Allergy = noun.
He twisted his ankle during playing squash.	He twisted his ankle while playing squash.	While + -ing.
This patient is 63 year old.	This patient is 63 years old.	Years is plural after number.

🧠 FINAL MEMORY LOCK

Complain = verb → complains of pain.

Complaint = noun → a complaint of pain.

Suggest/recommend → suggest that / recommend that, not suggest him.

Advise = verb; advice = noun → advise the patient / give advice.

Affect = verb; effect = noun → affected by treatment / treatment effect.

During + noun; while + -ing → during hospitalisation / while recovering.

Age reflex → a 63-year-old man, but he is 63 years old.

✅ HOW TO STUDY?

Read word pair → identify verb/noun/adjective → apply the correct pattern → practise in Mock Tests

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OET Preposition Reflex Dr. Wasim School of Medical Education

🧠 Phrasal Verbs & Prepositions Reflex for OET Writing

🎯 MASTER RULE

In OET Writing, many high-scoring sentences depend on the correct verb + preposition pattern.
Do not translate word by word. Memorise the fixed clinical patterns: admitted to, associated with, diagnosed with, evidence of, presented with, suggestive of, and treated with.

📌 A–C HIGH-YIELD PATTERNS
Expression	Reflex meaning	OET-style sentence
admitted to	Use for hospital admission.	The patient was admitted to our hospital in March 2008.
associated with	Use for linked symptoms.	The shortness of breath was associated with chest tightness and coughing.
advised to	Verb pattern: advised to + verb.	She was advised to return the next day for a blood test and follow-up consultation.
advice on	Noun pattern: advice on + topic.	Advice on recommended vaccines will be necessary.
allergies	Noun form.	She is not on any medication and has no known allergies.
allergic to	Adjective pattern: allergic to + substance.	Please note, the patient is allergic to penicillin.
arrived at / arrived in	At = place/building; in = country/city.	The patient arrived at my surgery in a depressed state. The family arrived in Australia in 2007.
believe	Formal opinion/request marker.	I believe the patient needs urgent assessment and hospital admission.
borderline	Used before condition/risk finding.	She was noted to be overweight and has borderline hypertension.
consistent with	Use for signs matching diagnosis.	He presented with signs and symptoms consistent with prostatic enlargement.
commence / commence on	Active: commenced him on. Passive: was commenced on.	IV fluids were commenced. I commenced him on omeprazol 20 mg daily.
confidence in	Use with ability/skill area.	She lacks confidence in caring for her baby in terms of breastfeeding and bathing.

📌 D–H HIGH-YIELD PATTERNS
Expression	Reflex meaning	OET-style sentence
discharged on	Use with discharge date.	He will be discharged on the 12th of August.
deteriorate	Use for worsening condition.	Since 28 July, her condition has deteriorated with occasional disorientation.
deny	Use for symptoms patient says are absent.	She denied vomiting.
difficulty in	Difficulty in + -ing/noun phrase.	Mr MacIntosh presented with difficulty in passing urine.
diagnosed with	Verb pattern.	The patient was diagnosed with high-grade lymphoma.
diagnosis of	Noun pattern.	Histological results confirmed the diagnosis of high-grade lymphoma.
evidence of	Use for examination/investigation findings.	Examination findings revealed evidence of an enlarged prostate.
enclosed	Use for attached documents/results.	I have enclosed the radiograph for your convenience.
to follow	Use for diet/advice instructions.	The patient was advised to follow a low-fat diet.
history	Use for duration or family background.	The patient first attended with a one-day history of lower abdominal pain.

📌 I–P HIGH-YIELD PATTERNS
Expression	Reflex meaning	OET-style sentence
indicate	Use for what patient/family has stated.	The family has indicated that they need an interpreter.
indicative of	Use for finding suggesting diagnosis.	There was slight swelling in the right groin indicative of inguinal hernia.
inconspicuous	Use for no notable features.	His family and social history is inconspicuous.
known	Use for established condition/background.	She is a known asthmatic since childhood.
make an appointment for	Appointment + for patient.	I have made an appointment for her through your receptionist.
on examination	Use before physical findings.	On examination, her blood pressure was 180/90 mmHg.
on occasions	Use for repeated episodes.	She had noted blood in her motions on two separate occasions.
provisional	Use for tentative diagnosis.	Provisional diagnosis suggests prostate cancer.
presented at	Use for clinic/place.	Mr Gates presented at my clinic yesterday at 7 pm.
presented to	Use for clinician/doctor.	Today, he presented to me complaining of a regular dull ache in the groin.

📌 Q–W HIGH-YIELD PATTERNS
Expression	Reflex meaning	OET-style sentence
queries	Use in formal closing.	If you have any further queries, please do not hesitate to contact me.
revealed	Use for examination findings.	Examination today revealed a significantly increased right groin swelling.
risk factors include	Use before risk list.	His risk factors include smoking, lack of exercise and a strong family history of hypertension.
routine recovery	Use for expected recovery.	He has made a routine recovery and his wounds appear to be healing well.
reluctant to	Use for unwillingness.	He is reluctant to seek treatment.
rule out	Use for excluding diagnosis.	I believe she needs an urgent assessment to rule out bipolar disorder.
remarkable findings	Use for notable findings.	There were no other remarkable findings.
suggestive of	Use for likely diagnosis.	She has signs and symptoms suggestive of ectopic pregnancy.
suspicious of	Use for concerning possible diagnosis.	She presented with symptoms suspicious of bowel malignancy.
suffering from	Use for ongoing condition/symptoms.	He is suffering from signs and symptoms suggestive of peritonitis.
treated with	Use for medication/treatment.	His hypertension has been treated with Atenolol 50 mg daily.
underlying	Use for hidden/background problem.	Assessment is requested to identify any underlying psychological problems.
under control	Use for controlled symptoms.	Currently, her pain is under control with medication.
uneventful	Use for uncomplicated course.	Her second pregnancy and delivery were uneventful.
urgent	Use for immediate attention.	I would appreciate it if you could give urgent attention to Mrs Woods’ problem.
unremarkable	Use for normal examination.	Cardiovascular examination was unremarkable.
underwent / has undergone	Past simple or present perfect for procedures.	She underwent colonoscopy three years ago. During hospitalisation, the patient has undergone an electromyogram and X-ray.
vital signs	Use instead of “vitals” in formal writing.	Her vital signs were normal, but she was overweight.
with a complaint of	Use for presenting complaint.	Mr Gates presented at my clinic with a complaint of lower back pain.

⚡ PREPOSITION MEMORY BOOSTER LINES

Hospital admission … admitted to hospital

Symptom link … associated with

Medical advice verb … advised to do something

Advice noun … advice on vaccination / medication / diet

Diagnosis verb vs noun … diagnosed with / diagnosis of

Findings … evidence of / indicative of / suggestive of

Presentation place/person/complaint … presented at clinic / presented to me / presented with a complaint of

Treatment and control … treated with / under control / reluctant to / rule out

✅ CORRECT vs ❌ INCORRECT — PREPOSITION REFLEX
❌ Incorrect / Weak	✅ Correct / Strong	Reflex Reason
The patient was admitted in hospital.	The patient was admitted to hospital.	admitted to
The symptoms were associated to chest tightness.	The symptoms were associated with chest tightness.	associated with
The patient is allergy to penicillin.	The patient is allergic to penicillin.	allergic to
The patient was diagnosed of lymphoma.	The patient was diagnosed with lymphoma.	diagnosed with
The diagnosis with lymphoma was confirmed.	The diagnosis of lymphoma was confirmed.	diagnosis of
Findings revealed evidence for enlargement.	Findings revealed evidence of enlargement.	evidence of
He presented in my clinic.	He presented at my clinic.	presented at + place
He is reluctant for treatment.	He is reluctant to seek treatment.	reluctant to

🧠 FINAL MEMORY LOCK

Admission → admitted to hospital.

Symptom connection → associated with chest pain / coughing / tightness.

Advice → advised to return; advice on vaccines.

Allergy → allergies as noun; allergic to as adjective pattern.

Diagnosis → diagnosed with; diagnosis of.

Findings → evidence of; indicative of; suggestive of; suspicious of.

Presentation → presented at clinic, presented to doctor, presented with complaint.

Management → treated with, under control, reluctant to, rule out, underwent.

✅ HOW TO STUDY?

Read expression → cover preposition → recall pattern → create one OET sentence → practise in Mock Tests

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OET Grammar Reflex Dr. Wasim School of Medical Education

🧠 Prepositions & Cohesion Reflex for OET Writing

🎯 MASTER RULE

Prepositions and signal markers make the OET letter clear, logical and easy to follow.
Use in for longer time/place contexts, on for days, dates and examination phrases, and at for exact time or activity places. Use cohesive markers only when they truly connect clinical ideas.

⏱️ PREPOSITIONS OF TIME — IN / ON / AT / NO PREPOSITION

NO PREPOSITION

Longer periods of time

in November
in spring
in 2006
in the past
in the future
in the morning
in the afternoon
in her childhood
in his twenties

Days, dates and clinical review phrases

on Monday
on 20 November
on Christmas Day
on his birthday
on review
on examination
on investigation
on presentation
on two occasions

Exact time and fixed expressions

at 6 o’clock
at night
at lunchtime
at that time
at the moment
at the age of 45
at birth

Use no preposition

yesterday
today
tomorrow
last week
this week
next week

📍 PREPOSITIONS OF PLACE — IN / ON / AT

Inside something / country / body cavity

in Australia
in hospital
in surgery
in the stomach

Surface area

on the skin
on the ground floor

Place of activity

at home
at work
at the wound site
at the clinic

✅ CORRECT vs ❌ INCORRECT — PREPOSITIONS
❌ Incorrect	✅ Correct	Reflex Reason
His father died of cancer during the age of 50.	His father died of cancer at the age of 50.	Use at the age of.
In examination today, the patient was anxious and distressed.	On examination today, the patient was anxious and distressed.	Use on examination.
Initial examination on today revealed inflamed gums.	Initial examination today revealed inflamed gums.	Today needs no preposition.
On December 2006, the patient had his wisdom teeth removed.	In December 2006, the patient had his wisdom teeth removed.	Month + year = in.
The patient’s family arrived at Australia in last year.	The patient’s family arrived in Australia last year.	Country = in; last year = no preposition.

🔗 COHESION MASTER RULE

Cohesion means linking ideas logically. In OET Writing, signal markers should show time, contrast, addition, cause, result, emphasis, concern or request. Do not use them mechanically; use them only when the relationship between the sentences is clear.

🧾 SIGNAL MARKERS A–D
Signal marker	Function	OET-style use
as well as	Addition	She suffers from oedema as well as bladder incontinence.
as a result of	Cause	The child was admitted as a result of a complication following mumps.
as a result	Result	As a result, treatment under general anaesthetic is recommended.
along with	Addition of finding	Cervical excitation was noted along with tenderness in the right fornix.
apart from this	Exception / contrast	Apart from this, no abnormalities were found.
at that time	Past time reference	At that time, her physical examination was normal.
besides that	Additional information	Besides that, he has type 2 diabetes.
because of this	Reason-result link	Because of this, he has been told to cease smoking.
based on	Evidence-based conclusion	Based on that, lymphoma is suggested.
consequently	Result	Consequently, extensive treatment was undertaken.
during	Period of care	During hospitalisation, his vital signs were monitored.
duration	Symptom length	She presented with lower abdominal pain of one-day duration.
despite	Contrast	Despite regular dental cleaning, his gum condition is only fair.

🧾 SIGNAL MARKERS F–O
Signal marker	Function	OET-style use
for this reason	Reason-result	For this reason, he was advised to exercise and follow a healthy diet.
hence	Result	The lesions are deep and hence the tooth has to be extracted.
however	Contrast	However, her gums are inflamed.
in terms of	Topic shift	In terms of her medical history, she has mild hypertension.
in order to	Purpose	Medication was prescribed in order to reduce anxiety.
in addition	Addition	In addition, he is epileptic and uses medication to control the attacks.
in the meantime	Temporary plan	In the meantime, urological assessment is required.
in case of	Safety advice	In case of irritation, redness or swelling, discontinue treatment.
may I remind you that	Polite reminder	May I remind you that both teeth will require root canal treatment.
my main concern is that	Main concern	My main concern is that the patient is reluctant to breastfeed.
it should be noted	Important note	It should be noted that they may have limited English.
over	Time period / change	Over the past week, she has remained free from severe pain.
on review today	Current review finding	On review today, the patient has reduced smoking.

🧾 SIGNAL MARKERS P–W
Signal marker	Function	OET-style use
please note	Important warning	Please note, he has an allergic reaction to nuts.
regarding	Topic shift	Regarding his medical history, Jordan suffers from eczema and asthma.
regrettably	Unfavourable update	Regrettably, she complains of mild constipation and weakness.
recently	Recent medication/update	Recently, she has been prescribed Karvea and Oroxine.
since then	Progress after past event	Since then, he has been doing regular exercise and has lost weight.
therefore	Result / plan	Therefore, she was advised to reduce weight and exercise.
the reason for	Purpose of referral	The reason for the referral is to consider possible prostate biopsy.
up until now	Timeline to present	Up until now, Mr Hutton has led a very unhealthy life.
unfortunately	Negative prognosis/news	Unfortunately, she is not expected to survive more than three months.
with regard to	Letter opening / topic	I am writing with regard to this patient, who is under our care.

📄 EXAMPLE COHESIVE PARAGRAPH MODELS

Doctors:

Initially, I saw Mr Jones last month when he came for a check-up. At this time, his blood pressure showed mild elevation and his weight was above the normal limit. However, cardiovascular examination and urinalysis were normal. Therefore, I advised him to lose weight, stop smoking and attend a review visit within one month.

Dentists:

Initial examination on 20/02/2008 revealed that 54 had a temporary filling with a cavity extending through the furcation. Based on the bitewing radiological findings, extraction of 54 and 65 was advised, along with construction of a space maintainer. Moreover, filling of carious 55 and fissure sealant for all 6’s were advised.

Nurses:

When admitted to this hospital, Mr Jagger complained of haematemesis, anorexia and dizziness associated with weight loss and anaemia. He was also suffering from severe epigastric pain after meals. Therefore, his stool was examined and an endoscopy was performed.

⚡ PREPOSITION & COHESION MEMORY BOOSTER LINES

Month / year / long period … Use in.

Day / date / examination / review … Use on.

Exact time / age / activity place … Use at.

Today / yesterday / last week … Use no preposition.

Contrast … Use however / despite / apart from this.

Cause and result … Use because of this / as a result / therefore / consequently.

Addition … Use in addition / as well as / along with.

Purpose of referral … Use the reason for the referral / my main concern is that.

🧠 FINAL MEMORY LOCK

In → longer periods and inside places: in December, in hospital, in Australia.

On → days, dates and clinical phrases: on Monday, on examination, on review.

At → exact time, age and activity place: at 6 pm, at the age of 45, at the clinic.

No preposition → today, yesterday, tomorrow, last week, this week, next week.

Cohesion → use signal markers to show time, cause, result, contrast, addition and concern.

OET warning → do not overuse connectors; every marker must serve the clinical logic.

✅ HOW TO STUDY?

Read phrase → identify time/place/logic → choose the correct preposition or connector → practise in Mock Tests

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OET Sentence Reflex Dr. Wasim School of Medical Education

🧠 Complex Sentences Reflex for OET Writing

🎯 MASTER RULE

Complex sentences help you combine clinical details clearly and concisely.
Use them to show patient identification, contrast, purpose, reason and sequence of events. In OET Writing, the goal is not to make sentences long; the goal is to make clinical meaning logical and easy to follow.

📌 RELATIVE CLAUSES — WHO / WHICH / THAT
Type	Rule	OET Example
Defining relative clause	Defines which patient/person/thing. Usually no commas.	I am writing to refer this patient who is due to be discharged today.
Non-defining relative clause	Adds extra information. Use commas.	I am writing to refer this patient, who is due to be discharged today, for ongoing physiotherapy.
Name included	If the noun is already known by name, extra information usually needs commas.	Mrs Patterson, who is a 36-year-old married woman, is suffering from mild depression.

💡 HANDY TIP — “NO NAME = NO COMMA”

No name: The doctor who performed the operation is from Iraq.

Name given: Doctor Yousif, who is from Iraq, performed the operation.

✅ CORRECT vs ❌ INCORRECT — RELATIVE CLAUSES
❌ Incorrect	✅ Correct	Reflex Reason
Mr Holmes who lives with his wife in a government flat, is an aged care pensioner.	Mr Holmes, who lives with his wife in a government flat, is an aged care pensioner.	Name + extra information = commas.
Mr O’Riley, who lives alone in his own home, and works as a fencing contractor.	Mr O’Riley, who lives alone in his own home, works as a fencing contractor.	After second comma, sentence needs a main verb.
Mrs Peterson who recently moved to our retirement village following her husband’s death.	Mrs Peterson recently moved to our retirement village following her husband’s death.	No relative pronoun needed in a simple sentence.
I am writing to refer this 14-year-old boy to you who came to me complaining of a sprained ankle.	I am writing to refer this 14-year-old boy who came to me complaining of a sprained ankle.	Relative pronoun must follow the noun it describes.
I am writing to explain Mr Clarke’s current situation, who has been a patient of mine for a long time.	I am writing to refer Mr Clarke, who has been a patient of mine for a long time.	Who must come directly after the person.

⚖️ CLAUSES OF CONTRAST
Connector	Pattern	OET Example
Although / Even though	Although + clause	Although her condition has improved, she is still very weak.
But	Clause + but + clause	Her condition has improved, but she is still very weak.
Despite / In spite of	Despite + noun / gerund	Despite an improvement in her condition, she is still very weak.
Despite the fact that	Despite the fact that + clause	Despite the fact that her condition has improved, she is still very weak.
However	New sentence + However,	Her condition has improved. However, she is still very weak.

✅ CORRECT vs ❌ INCORRECT — CONTRAST
❌ Incorrect	✅ Correct	Reflex Reason
Although she has improved, but she is still very weak.	Although she has improved, she is still very weak. She has improved, but she is still very weak.	Do not use although and but together.
Despite of regular follow-up, plaque was detected.	Despite regular follow-up, plaque was detected.	Do not write despite of.
Despite of this advice, he drinks alcohol regularly.	Despite this advice, he drinks alcohol regularly.	Despite + noun phrase.

🎯 CLAUSES OF PURPOSE
Connector	Pattern	OET Example
in order to	in order to + infinitive verb	Further investigation is required in order to rule out bowel cancer.
so that — past	so that + would	A general anaesthetic was given so that the patient would not feel pain.
so that — future	so that + will	A general anaesthetic needs to be given so that the patient will not feel any pain.

💡 PURPOSE PHRASE TO MEMORISE

In order to rule out + disease name is a safe Grade-A phrase for introductions and conclusions.

Example: In order to rule out ectopic pregnancy, I would appreciate your urgent assessment.

🧾 CLAUSES OF REASON
Connector	Pattern	OET Example
due to / because of	due to + noun / gerund	Due to failure to progress and fetal stress, an emergency caesarean section was performed.
due to the fact that	due to the fact that + clause	Due to the fact that there was failure to progress and fetal stress, an emergency caesarean section was performed.
for this reason	Sentence. For this reason, sentence.	There was evidence of poor progress and fetal stress. For this reason, an emergency caesarean section was performed.
because	because + clause	Because there was evidence of poor progress, an emergency caesarean section was performed.

✅ CORRECT vs ❌ INCORRECT — REASON CLAUSES
❌ Incorrect	✅ Correct	Reflex Reason
The patient is feeling lonely due to lose her social contacts.	The patient is feeling lonely due to losing her social contacts.	Due to + gerund/noun.
He stopped playing sport because muscle soreness.	He stopped playing sport because of muscle soreness. He stopped playing sport because he had muscle soreness.	Because of + noun; because + clause.
His mother had difficulty due to sick.	His mother had difficulty due to her sickness. His mother had difficulty due to being sick.	Due to requires correct noun or gerund form.

⏱️ CLAUSES OF TIME
Time marker	Pattern	OET Example
ago	ago + past simple	The patient had a liver transplant 12 months ago.
during	during + noun	During hospitalisation, the patient had surgery.
when	when + time clause	When Ms Song returned today, she was pale and distressed.
while	while + clause / -ing phrase	While waiting in reception, the patient fainted.
since	since + earlier time/event	Since being admitted three weeks ago, the patient has steadily improved.

🧠 TIME CLAUSE TENSE REFLEX

Present time clause → main clause usually present/future: While you display fever and rash, you are still infectious.

Past time clause → main clause usually past: When the patient received his results, he fainted.

Present perfect main clause → time clause often present perfect: While the patient has been in hospital, his condition has improved.

✅ CORRECT vs ❌ INCORRECT — TIME CLAUSES
❌ Incorrect / Weak	✅ Correct / Strong	Reflex Reason
Today, the couple presented at my clinic. Mrs Conway informed me that her test was positive.	When the couple presented at my clinic today, Mrs Conway informed me that her test was positive.	Use when to combine related events.
The patient has had placement of a prosthetic heart valve 12 months ago.	The patient had placement of a prosthetic heart valve 12 months ago.	Ago needs past simple, not present perfect.
I first saw Mrs Smythe last week, she urgently needed a new partial denture.	When I first saw Mrs Smythe last week, she urgently needed a new partial denture.	Avoid comma splice; use a time clause.