OET Writing Mistakes for Doctors: 8 Errors That Cost You Grade B

Most lists of OET writing mistakes are written for first-time candidates – “don’t forget the date line”, “remember to sign off”. If you are an experienced doctor aiming for Grade B, you have already moved past those. The mistakes that are actually holding strong clinicians back are subtler, more strategic, and often invisible until someone names them. This post names them. Below are eight errors that even competent doctors make on exam day – including one major mindset shift that almost nobody talks about, but that can quietly transform the way every letter you write lands with the assessor.

If you are looking for the structural overview of each letter type first, our sibling guide on OET writing for doctors breaks down referrals, transfers, discharges, and advice letters. This one goes deeper on the errors that cap your grade once you already understand the formats.

1. Writing to Demonstrate Clinical Knowledge Instead of Communicating to the Recipient

This is the single biggest mindset shift most OET candidates never make – and it is the one that will change how your letters feel to an assessor.

OET assessors are not examining your medicine. They do not mark you on whether you noticed the subtle cardiac finding, whether you ordered the right test, or whether your differential was elegant. They assess whether your letter enables the recipient to provide safe continuing care. The five OET criteria are Purpose, Content, Conciseness & Clarity, Genre & Style, and Organization & Layout plus Language. Notice what is missing from that list: clinical brilliance.

Doctors are trained, from medical school onwards, to show clinical reasoning. Case presentations, ward rounds, and exams all reward the person who mentions the most relevant detail, explains their thinking, and demonstrates what they noticed. This instinct is deeply embedded – and it is exactly what sabotages OET letters.

In OET writing, the question is not “what do I want to show I noticed?” It is “what does the person reading this need to know to provide safe continuing care?” Every sentence must answer that question. If a sentence does not help the recipient act, it does not belong in the letter – no matter how clinically astute it makes you look.

Think about what happens on exam day. A doctor is writing a referral to a cardiologist. The case notes mention a twenty-year-old surgical history, a family history of bowel cancer, and a recent episode of palpitations with an abnormal ECG. The instinct is to include everything – “I am a thorough clinician, I noticed it all”. But the cardiologist does not need the bowel cancer family history to manage palpitations. Including it dilutes the signal. The recipient has to wade through clinically interesting but operationally useless information to find what actually matters.

The fix is a single question asked before every sentence: “Does the recipient need this to do their job?” If yes, keep it. If no, cut it – even if it was the most clinically interesting detail in the notes. This is not dumbing down your medicine. It is professional communication, which is exactly what OET is testing.

Once you internalise this shift, the rest of the criteria get easier. Purpose sharpens because every sentence serves the recipient. Content tightens because you have a filter. Conciseness improves automatically. The letter stops being a performance of clinical knowledge and becomes what it is supposed to be: a handover.

2. Dumping Every Case Note Detail

Case notes in OET tasks are deliberately over-stuffed. They include dozens of pieces of information – social history, medications from three years ago, unrelated past admissions, parental occupation, incidental findings. The trap is feeling obligated to include all of it because “it was in the notes”.

OET explicitly tests relevance and conciseness under the Purpose and Content criteria. Candidates must select what matters for the specific letter type and the specific recipient. Family history of a genetic condition is essential in a referral to a geneticist. It is pointless in a referral to the community nurse for a dressing change.

Before you write, spend five to eight minutes reading the notes and highlighting only what the recipient needs to act on. Everything else stays on the scratch paper. If you cannot articulate why a piece of information serves the recipient’s next step, it is not relevant enough to include.

3. Copying Phrases Directly from the Case Notes

OET assessors can see exactly what was in the case notes. They know which phrases are yours and which were lifted. Direct transcription – especially of multi-word clinical descriptions – is a silent grade dropper under Language and Conciseness & Clarity.

You must paraphrase. The case notes might say:

“Pt c/o SOB x 3/7 after climbing stairs. PMHx HTN, T2DM.”

Your letter should render this as:

“The patient has reported shortness of breath over the past three days, particularly on exertion such as climbing stairs. His medical history includes hypertension and Type 2 diabetes mellitus.”

Notice what changed: the abbreviations are expanded, the timeframe is stated in full words, and the sentence structure is your own. The assessor now sees English that you produced, not English that was handed to you. For a bank of phrases that make paraphrasing faster and more consistent, see our guide to 50 high-scoring OET writing phrases.

4. Overusing Medical Abbreviations and Shorthand

In a real clinical shift, doctors write “Pt”, “Hx”, “NAD”, “c/o”, “SOB”, and “PMHx” without a second thought. These shortcuts save time on a ward round. In an OET letter, most of them must be expanded into full words, because the letter is formal professional correspondence, not a bedside note.

Some abbreviations are universally accepted and can stay:

• BP (blood pressure)
• ECG (electrocardiogram)
• MRI, CT, X-ray
• IV (intravenous)
• mg, mmHg, and other standard units

Most profession-specific shorthand should be written in full:

• Pt becomes “the patient”
• Hx becomes “a history of”
• c/o becomes “has complained of” or “has reported”
• SOB becomes “shortness of breath”
• NAD becomes “no abnormality detected”
• PMHx becomes “past medical history”
• LOC becomes “loss of consciousness”
• OD, BD, TDS become “once daily”, “twice daily”, “three times daily”

The rule of thumb: if it is a shortcut you would only use with a fellow clinician on the same ward, expand it. If it is a universal clinical term that appears in patient information leaflets, leave it.

5. Wrong Register for the Recipient

OET letters go to several recipient types, and each one demands a different register:

• Specialist or consultant – formal, precise, assumes full clinical knowledge
• GP – formal but collegial, assumes strong clinical knowledge, often collaborative in tone
• Community nurse or allied health – formal, practical, focused on tasks and monitoring
• Patient, family member, or carer – still professional, but accessible and warmer, with plain language in place of technical terms

Candidates often default to a single “formal clinical voice” for every letter. A letter to a patient’s family asking them to monitor symptoms should not read like a cardiology referral. If you write “Please observe for signs of cardiovascular decompensation” to a worried spouse, you have failed Genre & Style even if every word is correctly spelled.

The fix is to name your recipient before you write and make deliberate choices. For a patient or family, swap “decompensation” for “your husband becoming more breathless or tired”, and “administer” for “give”. For a specialist, tighten back up. Register is not a personality trait – it is a tool you select for the audience.

6. Burying the Purpose

Doctors who open with three sentences of patient history before stating why they are writing confuse the reader. The recipient of an OET letter needs to know the purpose in the very first sentence – ideally in the first ten words.

Buried purpose:

“Mr Chen is a 67-year-old retired schoolteacher with a three-year history of hypertension and Type 2 diabetes, who initially presented to our clinic in January 2024…”

The reader is four lines in and still does not know what you want them to do.

Purpose-first:

“I am writing to refer Mr Chen, a 67-year-old man, for urgent cardiology review following an episode of chest pain with ECG changes. His background is as follows…”

Now the reader knows the action required before they encounter the clinical detail, and every subsequent sentence lands in that context. This is not just style – it is a direct hit on the Purpose and Organization criteria. For the grammar that makes purpose-first openings land cleanly, see our guide on OET writing grammar rules.

7. Going Over 200 Words

OET Writing for Doctors expects 180 to 200 words. Many candidates over-write, convinced that “one more detail” will push them up a grade. It does the opposite. Every extra sentence past 200 words is evidence, to the assessor, that you could not select. Under-writing (below 150) is also penalised because it suggests insufficient engagement with the task.

The target zone is tight: 180 to 200. Write your first draft, count, and cut ruthlessly. Usual suspects for cutting:

• Repetition of information already stated
• Social history that is not operationally relevant
• Hedging phrases like “it is worth mentioning that” – just mention it
• Explanations of clinical reasoning the recipient already knows
• Throat-clearing openings before the actual purpose sentence

If you are consistently hitting 230 words, the problem is not your writing speed – it is your selection at the reading stage. Go back to mistake #2.

8. Memorised Template Openings

“I am writing to refer the above-named patient for further management of their presenting condition.” Assessors have read that sentence thousands of times. The moment they see it, they know you are leaning on a memorised template rather than responding to the specific case.

Template openings cost you marks under Genre & Style and, more subtly, under Purpose – because generic openings do not actually name the purpose of this letter for this patient. They are scaffolding with no building on top.

Learn structures, not scripts. Know that a strong opening names the patient, their age or key identifier, the recipient’s required action, and the clinical reason in one or two sentences. Then write it fresh each time, specific to the actual case:

“I am writing to refer Mrs Patel, a 72-year-old woman with newly diagnosed atrial fibrillation, for anticoagulation review and ongoing rhythm management.”

That sentence could not have been written for any other case. That is the signal the assessor is looking for. For more on opening conventions and timed-practice habits, see our OET writing preparation tips.

What to Do With This List

Do not try to fix all eight mistakes at once. Pick the two that feel most like you and focus on them in your next three practice letters. Then move on to the next pair. The doctors who improve fastest are not the ones who know the most rules – they are the ones who eliminate their specific errors one at a time, with intent.

And if you remember only one thing from this post, let it be point one: you are not writing to demonstrate what you know – you are writing so the recipient can act safely on what they need. That single mindset shift reshapes every other decision on the page, from what you include to how you open to how you close. Get that right, and Grade B stops feeling like a ceiling and starts feeling like a floor.

Good luck – and write like a clinician handing over care, not a student showing their work.

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