OET Writing Guide

OET Writing Format & Exam Pattern

Exactly what happens in the OET writing sub-test: the 45-minute structure, the reading time, the case notes, the letter types, and what you write on. No surprises on exam day.

Practise With Expert Feedback Full test guide →

45 min

Total duration

5 min

Reading time

40 min

Writing time

1 letter

Number of tasks

The OET Writing Sub-test: Step by Step

1

Reading time begins (5 minutes)

You receive the case notes and the writing task. You may NOT write during this time, but you can underline or annotate the case notes. Use this time to identify the purpose of the letter, who you are writing to, and which case note information is relevant to that reader.

2

Writing time begins (40 minutes)

The writing period starts. You write your letter on the provided answer booklet. Most candidates spend 3–5 minutes planning, 25–30 minutes writing, and 3–5 minutes reviewing. The examiner does not see your planning notes — only your final letter.

3

Letter is completed and submitted

At the end of 40 minutes, writing stops. Your completed letter is the only thing assessed. There are no multiple choice or fill-in-the-blank questions. The entire OET writing sub-test score is determined by this single letter.

What the Case Notes Look Like

The case notes are a structured clinical summary of a patient. They are profession-specific — nurses, doctors, physiotherapists, and pharmacists receive different scenarios.

Patient demographics

Name, age, gender, occupation, and reason for current care episode.

Presenting complaint

The current clinical issue that initiated this care episode.

Medical history

Relevant past diagnoses, surgeries, and long-term conditions.

Current medications

Names, doses, and frequencies of current medications.

Examination findings

Observations and findings from physical or clinical assessment.

Management plan

The treatment, referral, discharge, or follow-up plan — this is often key to your purpose statement.

Typical case notes: 150–250 words. You do NOT need to use every detail in your letter.

OET Letter Types

The specific letter type is determined by the clinical scenario. All types follow the same professional structure: purpose → background → current situation → action.

Referral Letter

From:
Any healthcare professional
To:
A specialist, consultant, or allied health professional

Requesting further assessment, specialist care, or a service not available in the current setting.

Read the guide

Discharge Letter

From:
Hospital/ward team
To:
GP, community nurse, or primary care team

Communicating what happened during a hospital stay and the ongoing care plan after discharge.

Read the guide

Transfer Letter

From:
Current care provider
To:
Receiving facility or healthcare team

Communicating a patient's care needs and current status when moving between facilities or care settings.

Read the guide

Word Count Guidance

Under 150 words Too short

Likely missing important clinical information. The Content criterion will be affected.

150–179 words Borderline

May be sufficient if well-targeted, but risks leaving out relevant detail. Review content selection carefully.

180–200 words Ideal

This is the target range for most Grade B letters. Covers all relevant information without unnecessary padding.

200–250 words Acceptable

Slightly long but can still score well if all content is relevant. Review for repetition and irrelevant detail.

Over 250 words Too long

Almost always includes irrelevant information. Conciseness and Clarity scores will be reduced.

How OET Writing differs from IELTS Writing

OET Writing

  • 1 task: professional letter
  • 45 minutes total
  • Based on patient case notes
  • Profession-specific scenarios
  • Assessed on 6 clinical communication criteria

IELTS Writing

  • 2 tasks: graph description + essay
  • 60 minutes total
  • Academic or general topics
  • Same for all professions
  • Assessed on 4 general writing criteria
Full OET vs IELTS comparison →

Frequently Asked Questions

What is the format of the OET writing test?
The OET writing sub-test is 45 minutes long: 5 minutes reading time + 40 minutes writing time. You write one professional letter based on provided patient case notes. There are no multiple choice questions — the entire test is the single letter task.
How many sub-tests does the OET have?
The OET has 4 sub-tests: Listening (50 min), Reading (60 min), Writing (45 min), and Speaking (~20 min). Most registration bodies require Grade B (350+) in Writing and Speaking.
What type of letter do you write in OET?
The most common types are referral, discharge, and transfer letters. The type depends on the clinical scenario in the case notes. All follow the same professional structure: purpose → background → current situation → action.
How long should an OET letter be?
There is no strict word count. The ideal range is 180–200 words. Under 150 words usually lacks sufficient clinical detail; over 250 words often includes irrelevant content that reduces your Conciseness score.

Related OET Writing guides

Continue your preparation with these related resources.

OET Scoring Criteria →

How the 6 criteria are assessed and where most candidates lose marks.

Grade B Sample Letters →

20 worked sample letters by profession × scenario with line-by-line annotations.

Mistake Clinics by Profession →

10 profession-specific mistake clinics — wrong vs right examples per criterion.

Grade A vs B vs C Compared →

Three letters from the same case notes at three bands — what moves you up one.

Related guides: OET writing criteria · OET writing test format

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