For doctors, the OET Writing sub-test is not a test of your medical knowledge — it is a test of your ability to communicate that knowledge concisely to a colleague. In a referral or discharge letter, unnecessary words are your enemy. The candidates who score a Grade B are not the ones with the biggest vocabulary; they are the ones whose grammar does the heavy lifting.
If you are already familiar with the four main OET letter types, you know that structure matters. But structure without strong grammar is like a diagnosis without evidence — it does not hold up. Here are five grammar rules that will keep your writing professional, clinical, and high-scoring.
1. Use Professional Reporting Verbs
Avoid informal or “weak” verbs like think or say. In clinical correspondence, you need reporting verbs that convey professional assessment and objectivity. The right verb tells the reader that you are presenting evidence, not speculation.
Rule: Use specific reporting verbs to introduce findings or recommendations.
“Examination revealed bilateral basal crackles.”
“The results indicated a possible malignancy.”
“It is suggested that he undergoes further cardiac evaluation.”
Other strong reporting verbs to add to your repertoire: demonstrated, confirmed, identified, highlighted, and warranted. You will find many of these used in context in our guide to 50 high-scoring OET writing phrases.
2. Master Nominalization — The Conciseness Hack
Nominalization is the process of turning verbs into nouns. This is the fastest way to sound more like a consultant and less like a student. It reduces your word count while increasing formality — and the OET assessor notices both.
Verbal style (too long):
“When I examined the patient, I saw that his condition had improved.”
Nominal style (OET standard):
“On examination, there was an improvement in his condition.”
Why does it work? It removes the focus from “I” and places it squarely on the clinical observation. The assessor is looking for objective, depersonalised writing, and nominalization delivers exactly that.
Here are more common conversions to practise:
- examine becomes examination — “On examination, the patient was afebrile.”
- admit becomes admission — “On admission, his blood pressure was 160/95 mmHg.”
- deteriorate becomes deterioration — “There has been a gradual deterioration in her mobility.”
- recover becomes recovery — “His recovery has been uneventful.”
If you can master nominalization alone, you will eliminate a significant number of unnecessary words from every letter you write.
3. The “Should” Inversion for Prognosis
When providing instructions for future care or potential complications, using a formal conditional structure shows a high level of grammatical control. This is a subtle move, but it signals to the assessor that your English is at a professional standard.
Standard:
“If his condition gets worse, please contact the registrar.”
Advanced:
“Should his condition deteriorate, please contact the registrar.”
The rule: Replacing “if” with “should” (and using the base form of the verb) creates a professional, authoritative tone suitable for a consultant writing to a colleague. You do not need to use this in every sentence — once or twice in a letter is enough to demonstrate control.
4. Use Passive Voice for Procedures
In clinical writing, the action (the procedure) is more important than the actor (the doctor). The passive voice is the standard for reporting treatment, and the OET assessor expects to see it.
Active:
“I performed an appendectomy under general anaesthesia.”
Passive:
“An appendectomy was performed under general anaesthesia.”
Strategy: Use the passive voice for almost all diagnostic tests, surgeries, and medication administrations to maintain an objective tone. The active voice (“I performed…”) draws attention to you rather than to the clinical facts — and in a referral or discharge letter, the recipient cares about what was done, not who did it.
Note that passive voice is not always better. For requests and recommendations at the end of your letter, the active voice is often clearer: “I would appreciate your ongoing management of this patient.” Knowing when to switch is what earns top marks.
5. Use Precise Articles with Pathologies
Misusing “a” and “the” with medical conditions is a common error that can lower your score in the Conciseness and Clarity criterion. English article rules are notoriously difficult, but in clinical writing, the patterns are predictable.
Rule 1: No article for general chronic diseases.
Correct: “The patient has hypertension.”
Incorrect: “The patient has a hypertension.”
Rule 2: Use “a” for non-specific symptoms or acute events.
Correct: “He presented with a headache and a fever.”
Rule 3: Use “the” for specific viruses or singular anatomical locations.
Correct: “He has contracted the influenza virus.”
These rules apply consistently across clinical writing, so once you learn them, they become automatic. Pay close attention to articles during your practice sessions — they are small words that carry significant weight on the OET.
Putting It All Together
These five grammar rules are not independent tricks — they work together. A single well-written sentence might combine nominalization, passive voice, and correct article use all at once:
“On examination, a reduction in respiratory function was noted, and the patient was commenced on supplemental oxygen.”
That sentence is concise, objective, clinical, and grammatically precise. It is exactly what the OET assessor wants to read.
If you are still deciding whether the OET is the right exam for your career path, our comparison of OET vs. IELTS for doctors breaks down the key differences.
Final Thought
If you take only two things from this post, make them nominalization and passive voice. These two tools alone will eliminate unnecessary words and ensure your letter meets the professional standards required for a Grade B. Start incorporating them into your practice letters today, and the improvement will be immediate.