OET Writing Format & Exam Pattern: Complete Test-Day Guide
OET writing sub-test format: 45-minute structure, reading time, case notes, the three letter types, what gets marked, and how the timing breaks down.
The OET writing sub-test is 45 minutes. You receive patient case notes, a task instruction, and an answer booklet. You write one professional letter. That is the entire test.
This guide covers the exact structure, what happens minute by minute, what the case notes look like, the three letter types, and word count guidance — everything you need to walk in with full confidence.
| Component | Detail |
|---|---|
| Total duration | 45 minutes |
| Reading time | 5 minutes (writing not permitted) |
| Writing time | 40 minutes |
| Number of tasks | 1 (a single professional letter) |
| Materials provided | Case notes, task instructions, lined answer booklet |
| Permitted items | Identification only — no dictionaries, no devices |
What Happens, Minute by Minute
Minutes 0–5: Reading Time
You receive two documents: the case notes and the task instructions. Writing is not permitted yet, but you may annotate the case notes.
Use reading time as decision time, not passive reading time:
- Read task instructions first — who are you writing to, and why?
- Read the case notes fully once.
- Re-read, underlining only information relevant to the stated purpose and reader.
- Decide what to leave out — this decision is as important as what to include.
Most common reading-time mistake
Candidates read passively. By the end of reading time, your entire letter plan — purpose, structure, which case notes to include — should exist in your head. If you start writing without a plan, you will write a disorganised letter.
Minutes 5–45: Writing Time
The invigilator announces writing time. You have exactly 40 minutes.
A proven time allocation:
| Phase | Duration | What to do |
|---|---|---|
| Planning | 3–5 minutes | Note your paragraph structure. Do not write yet. |
| Writing | 25–30 minutes | Follow your plan. Write complete sentences. |
| Review | 3–5 minutes | Check opening sentence, grammar, closing request. |
If you run out of time, your letter is assessed as written. An incomplete letter with a missing closing will be penalised on Organisation & Layout and Purpose.
At 45 Minutes: Submission
Writing stops. Your letter is submitted as written. No extensions.
What the Case Notes Look Like
OET case notes are a structured clinical summary — typically 150–250 words. They are profession-specific: nurses, doctors, physiotherapists, and pharmacists each receive different scenarios.
Patient demographics
Name, age, gender, occupation, and reason for current episode.
Presenting complaint
The clinical issue that initiated this care episode.
Medical history
Relevant past diagnoses, surgeries, and long-term conditions.
Current medications
Names, doses, and frequencies. Often only 1–2 are relevant to the letter.
Examination findings
Observations and clinical assessment results.
Management plan
Treatment, referral, or discharge plan — usually the most critical for your purpose statement.
Critical rule on case note usage
You do NOT need to use every item in the case notes. Including everything is one of the most common reasons for failing the Content criterion. Select only what the specific reader needs.
The Three OET Letter Types
Referral Letter
What it is: A letter requesting specialist care or further assessment for a patient.
Who writes it: Any healthcare professional.
Who receives it: A specialist, consultant, or allied health professional who has not previously managed this patient.
Typical purpose statement: “I am writing to refer [Name], a [age]-year-old [occupation], for specialist [specialty] assessment following [clinical reason].”
Discharge Letter
What it is: A letter communicating what happened during a hospital stay and the ongoing care plan.
Who writes it: Hospital or ward team.
Who receives it: GP, community nurse, or primary care team.
Typical purpose statement: “I am writing to advise that [Name] was admitted to [ward/facility] on [date] and was discharged on [date] following [reason for admission].”
Transfer Letter
What it is: A letter communicating a patient’s status as they move between care settings.
Who writes it: Current care provider.
Who receives it: Receiving facility or team.
Typical purpose statement: “I am writing to transfer the care of [Name] to your facility following [reason for transfer].”
Word Count: The Practical Guide
There is no official word count requirement. However, analysis of Grade B letters consistently shows the same pattern:
Missing important clinical content. Content criterion will be affected.
Possibly sufficient if well-targeted, but risks missing relevant detail.
This is where most Grade B letters sit. Covers all relevant information without padding.
Can still score well if content is all relevant. Review carefully for repetition.
Almost always contains irrelevant information. Conciseness score will be reduced.
OET Writing vs IELTS Writing: Key Differences
Healthcare professionals are sometimes unsure which exam format to prepare for. Here is the structural difference:
| OET Writing | IELTS Academic Writing | |
|---|---|---|
| Tasks | 1 letter | 2 tasks (graph + essay) |
| Total time | 45 minutes | 60 minutes |
| Content | Clinical case notes | Academic / general topics |
| Profession-specific? | Yes | No |
| Assessment criteria | 6 clinical communication criteria | 4 general writing criteria |
| Handwriting or typing? | Both options available | Paper only (most centres) |
For a detailed comparison including cost, preparation time, and registration body requirements, see OET vs IELTS for healthcare professionals →
Frequently Asked Questions
What is the format of the OET writing test? The OET writing sub-test is 45 minutes: 5 minutes reading time + 40 minutes writing time. One task — a single professional letter based on patient case notes.
How many sub-tests does the OET have? Four: Listening (50 min), Reading (60 min), Writing (45 min), and Speaking (~20 min).
What type of letter do you write in OET? Referral, discharge, or transfer letters — determined by the case notes you receive on the day.
How long should an OET letter be? 180–200 words is the target. Under 150 usually lacks content; over 250 usually includes irrelevant information.
Understanding the format is the foundation of preparation. The next step is practising under realistic conditions with feedback from a qualified teacher.
Our OET writing correction service returns detailed feedback within 24–72 hours. The 5-letter Development Pack gives you enough practice letters to see measurable improvement across all 6 criteria.
Frequently asked questions
Common questions on this topic — full answers below.
What is the format of the OET writing test?
How many sub-tests does the OET have?
What type of letter do you write in OET?
How long should an OET letter be?
Is OET computer-based or paper-based?
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