OET Referral Letter Guide
The referral letter is the most common letter type in the OET Writing sub-test, appearing in approximately 60-70% of exam sittings. This guide explains the structure examiners expect based on the official OET assessment criteria developed by Cambridge Assessment English, how to select relevant information from case notes, and the professional tone that earns Grade B (350/500) and above.
View Correction Packages
What Examiners Assess in Referral Letters
The OET Writing sub-test is assessed using criteria developed in collaboration with Cambridge Assessment English. For referral letters specifically, examiners evaluate six key areas on a scale of 0-7.
Overall Task Fulfilment
Does the letter achieve its communicative purpose? Is the referral request clear and actionable for the receiving clinician?
Appropriateness of Content
Has the candidate selected only relevant case note information that supports the specific reason for referral?
Comprehension of Stimulus
Does the letter demonstrate accurate understanding of the case notes, including medical terminology and clinical context?
Conciseness & Clarity
Is the letter free from unnecessary repetition? Are ideas expressed efficiently using professional medical English?
Genre & Style
Does the letter follow conventions of clinical correspondence? Is the tone appropriately professional and collegial?
Organisation & Layout
Are paragraphs logically sequenced? Does the letter flow from purpose to background to request without abrupt transitions?
Referral Letter Structure
A well-structured referral letter guides the reader from the reason for writing through to a clear request. Each section serves a specific communicative function.
Opening: Purpose Statement
State the reason for referral in the first sentence. Identify the patient by name, age, and the core clinical issue. The receiving clinician should immediately understand why they are reading this letter.
Example
I am writing to refer Mrs Patel, a 62-year-old patient, for cardiology assessment following recurrent episodes of atypical chest pain.
Relevant Medical Background
Include only the history that is directly relevant to the referral. This may include past diagnoses, surgeries, allergies, or chronic conditions that the specialist needs to know. Omit unrelated background details from the case notes.
Example
She has a history of type 2 diabetes, managed with metformin, and underwent coronary angioplasty in 2019.
Current Clinical Presentation
Describe the patient's current symptoms, recent examination findings, and investigation results. Use professional medical English and paraphrase information from the case notes rather than copying it verbatim.
Example
On examination, her blood pressure was elevated at 165/95 mmHg. An ECG performed on 14 March revealed ST-segment changes in the lateral leads.
Treatment Provided So Far
Briefly outline what has been done to date, including current medications, interventions, and any interim management. This helps the specialist understand what has already been trialled.
Example
She was commenced on aspirin 100 mg daily and her antihypertensive medication was increased. A chest X-ray was unremarkable.
Closing: Specific Request
End with a clear, explicit request. State what you need the specialist to do: assess, investigate, advise, or manage. Include an offer to provide further information and a professional sign-off.
Example
I would appreciate your assessment and further investigation to exclude significant coronary artery disease. Please do not hesitate to contact me if you require any additional information.
Common Referral Scenarios in OET
OET referral tasks reflect real-world clinical situations that healthcare professionals encounter regularly. Understanding the most common scenarios helps you prepare effectively.
GP to Specialist Referral
The most frequent scenario. A general practitioner refers a patient to a hospital specialist (cardiologist, neurologist, orthopaedic surgeon) for further investigation or management of a condition that exceeds primary care scope.
- Clear reason for escalation
- Summary of primary care investigations
- Current medications and allergies
- Specific question for the specialist
Hospital to Community Referral
A hospital clinician refers a patient to community services such as physiotherapy, occupational therapy, community nursing, or mental health services for ongoing rehabilitation or support after an acute episode.
- Reason for community service involvement
- Functional status and limitations
- Goals of community intervention
- Safety considerations or precautions
Nurse to Specialist Referral
Common in the OET Nursing test. A ward nurse or practice nurse refers to a specialist nurse (diabetes educator, wound care nurse, mental health nurse) or requests a medical review for a clinical concern.
- Observed clinical changes
- Nursing assessments and findings
- Patient concerns or reported symptoms
- Urgency of review requested
Inter-Specialty Referral
A specialist refers the patient to another specialty within the hospital. For example, a gastroenterologist referring to a surgeon, or an endocrinologist referring to an ophthalmologist for diabetic eye screening.
- Current specialist management summary
- Reason this additional specialty is needed
- Relevant investigation results
- Coordination of care considerations
Tone and Register in Referral Letters
OET examiners assess genre and style as a distinct criterion. According to the official OET assessment criteria, the letter must demonstrate an appropriate register for professional clinical correspondence.
Inappropriate Tone
Issue: Too informal. "Really struggling," "lung doctor," and "I think" are not appropriate for clinical correspondence between professionals.
Appropriate Tone
Strength: Professional medical terminology, collegial request tone, and a clear action for the specialist.
Key Tone Principles
- Write as a colleague, not as a student addressing a superior — the tone should be professional and equal
- Use hedging language where appropriate: 'would appreciate,' 'would be grateful,' 'kindly' rather than demands
- Avoid overly academic or complex sentence structures — clarity is more important than sophistication
- Use standard medical abbreviations only where widely understood (BP, ECG, BMI) and write others in full
- The closing should offer availability and express professional courtesy, not urgency or desperation
How Referral Letters Differ from Other OET Letter Types
While all OET letters share basic conventions, each letter type has distinct requirements. Understanding these differences is essential for appropriate content selection.
Referral vs Discharge Letter
A referral letter asks another clinician to see the patient for the first time. A discharge letter summarises what happened during a hospital stay and provides follow-up instructions. Referral letters focus on presenting the clinical problem; discharge letters focus on summarising the solution.
Referral vs Transfer Letter
A referral letter can be routine or semi-urgent. A transfer letter is written when a patient is actively being moved to another facility, often with clinical urgency. Transfer letters require more emphasis on current status, observations, and immediate care needs.
Content Selection Differences
In a referral letter, you select information that helps the specialist understand why the patient needs to be seen. In other letter types, you select information that supports continuity of care. This distinction directly affects which case note details to include or exclude.
Frequently Asked Questions
What is the correct structure for an OET referral letter?
An OET referral letter follows a five-part structure: (1) a clear purpose statement identifying the patient and reason for referral, (2) relevant medical background and history, (3) current clinical findings and recent investigations, (4) treatment provided so far, and (5) a specific request stating what you need from the receiving clinician. According to the official OET assessment criteria developed with Cambridge English, examiners assess how logically and coherently you organise these elements.
How long should an OET referral letter be?
An OET referral letter should be approximately 180-200 words. The task allows 40 minutes and candidates are expected to write a concise, professional letter. Writing significantly under or over this range can affect your score. Examiners assess content selection — including only relevant information from the case notes is more important than writing a lengthy letter.
What are the most common mistakes in OET referral letters?
The most common mistakes include: copying case notes word-for-word instead of paraphrasing, including irrelevant clinical details that do not support the referral purpose, writing a vague purpose statement that fails to specify the reason for referral, using an inappropriate tone (too informal or too academic), and poor organisation where the letter lacks logical flow from background to current situation to request.
How does an OET referral letter differ from a discharge or transfer letter?
A referral letter requests specialist assessment or opinion and is typically written to a colleague who has not yet seen the patient. A discharge letter summarises care provided and outlines follow-up instructions for the patient's ongoing GP or community care. A transfer letter communicates urgent clinical handover when a patient is being moved between facilities. Each letter type requires different content selection, tone, and level of urgency according to OET assessment criteria.
Get Expert Feedback on Your Referral Letters
Our OET-specialist correctors provide detailed feedback on your referral letters, covering all six assessment criteria. Identify exactly where you lose marks and how to improve.