Paraphrasing in OET Writing
Paraphrasing is one of the most important skills assessed in OET writing. Examiners penalise candidates who copy case notes verbatim because it fails to demonstrate professional communication competence. According to the official OET criteria published by Cambridge Boxhill Language Assessment, the Content criterion specifically evaluates whether candidates can transform stimulus material into their own professional language.
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What Examiners Look For in Paraphrasing
OET assessors trained by CBLA assess paraphrasing primarily under the Content criterion, but effective paraphrasing also contributes to your scores in Language and Conciseness & Clarity.
Copying vs Paraphrasing
Copying means transferring case note phrases word-for-word. Paraphrasing means expressing the same clinical facts in your own professional sentences. Examiners can easily identify copied text because case notes use abbreviations, incomplete sentences, and shorthand that would not appear in a clinical letter.
Accuracy Must Be Maintained
Paraphrasing does not mean changing the meaning. The clinical information must remain accurate. Changing 'hypertension' to 'high blood pressure' is acceptable; changing 'Type 2 diabetes' to 'sugar problem' is not. Precision matters in clinical correspondence.
Professional Register Expected
Good paraphrasing transforms informal case note shorthand into the formal register expected in healthcare correspondence. 'Pt c/o SOB on exertion' becomes 'The patient reports experiencing shortness of breath on exertion.' The transformation shows linguistic competence.
Grade B Standard
At Grade B level (score of 350+), candidates are expected to demonstrate competent paraphrasing with only occasional instances of direct copying. Systematic copying throughout the letter will result in scores below the Grade B threshold in Content.
5 Paraphrasing Techniques for OET Writing
These five techniques can be applied individually or in combination. Practising each one separately will help you develop a natural paraphrasing ability that does not slow you down during the exam.
Change Sentence Structure (Active/Passive)
Switching between active and passive voice is one of the most effective ways to paraphrase clinical information. Case notes often use abbreviated active structures, so transforming them into passive constructions creates natural clinical correspondence.
Case Notes
"Dr Singh ordered blood tests. Results showed elevated WBC."
Paraphrased
"Blood tests were arranged, which revealed an elevated white blood cell count."
Key principle: Use passive voice for procedures and investigations (tests were ordered, medication was commenced) and active voice for patient actions (the patient reports, Mr Khan presents with).
Use Synonyms Appropriately (Medical Context)
Replace general words with synonyms while keeping established medical terms unchanged. The goal is to demonstrate vocabulary range without sacrificing clinical precision. Expand abbreviations and shorthand into their full professional forms.
Case Notes
"Pt c/o increasing pain in R knee. Pain worse when walking."
Paraphrased
"The patient reports worsening discomfort in the right knee, which is exacerbated by ambulation."
Important
Do NOT paraphrase precise medical terms. "Hypertension" should stay as "hypertension", not "high blood pressure" (unless writing to a non-medical reader). Medication names, diagnoses, and procedure names should remain unchanged.
Combine or Split Information
Case notes often present information as isolated facts. Combining related points into a single sentence demonstrates clinical understanding and improves cohesion. Conversely, complex case note entries may need to be split into clearer, separate sentences.
Case Notes (Separate Facts)
"Hx: T2DM. Dx 2014. Metformin 500mg bd. A1c 8.2%."
Combined
"Mrs Ahmed has a 10-year history of Type 2 diabetes mellitus, currently managed with Metformin 500mg twice daily, with a most recent HbA1c of 8.2% indicating suboptimal glycaemic control."
Key principle: Combine facts that belong together clinically. A condition, its duration, its treatment, and its current status form a natural unit of information.
Change Word Forms (Noun, Verb, Adjective, Adverb)
Transforming word forms allows you to restructure sentences while preserving the original meaning. This technique is particularly effective for demonstrating vocabulary range, which is assessed under the Language criterion.
improvement (noun) → has improved (verb)
"Improvement in mobility" becomes "Her mobility has improved significantly"
admission (noun) → was admitted (verb)
"On admission" becomes "When she was admitted"
significant (adjective) → significantly (adverb)
"Significant weight loss" becomes "Her weight has decreased significantly"
diagnose (verb) → diagnosis (noun)
"Diagnosed with asthma" becomes "Following a diagnosis of asthma"
Reorder Information by Relevance
Case notes present information in the order it was recorded. Your letter should present information in the order that makes most sense for the reader. Reorganising information by clinical relevance demonstrates both comprehension and professional judgement.
Case Note Order
"DOB: 15/03/1965. Occupation: retired teacher. Hx: HTN, OA. Admitted 01/03 with fall. X-ray: # NOF. Surgery: hemiarthroplasty 02/03."
Clinical Relevance Order
"Mrs Taylor, a 60-year-old retired teacher, was admitted on 1 March following a fall at home. X-ray confirmed a fractured neck of femur, and she underwent a hemiarthroplasty the following day. Her relevant medical history includes hypertension and osteoarthritis."
Key principle: Lead with the reason for admission, then procedure, then relevant background. The reader needs to understand why this letter exists before processing supporting details.
Common Paraphrasing Mistakes That Cost Marks
Over-Paraphrasing Clinical Terms
Some candidates try to paraphrase everything, including precise medical terminology. Replacing 'hypertension' with 'high blood pressure' when writing to a specialist, or changing 'Metformin' to 'diabetes medication', reduces clinical precision and can confuse the reader.
- • Changing drug names to generic descriptions
- • Replacing diagnoses with vague lay terms
- • Altering medical abbreviations incorrectly
Changing the Clinical Meaning
Inaccurate paraphrasing that alters the clinical meaning is worse than copying. If the case notes say 'intermittent chest pain' and you write 'constant chest pain', you have introduced a clinical error that could mislead the reader.
- • Changing severity (mild to moderate)
- • Altering frequency (intermittent to constant)
- • Misinterpreting abbreviations
Insufficient Paraphrasing
Changing only one or two words while keeping the rest of the case note structure intact is not paraphrasing. Examiners expect genuine transformation of sentence structure and expression, not minimal word substitution.
- • Swapping only one synonym per sentence
- • Keeping case note sentence structure intact
- • Only expanding abbreviations without restructuring
Practice Examples: Weak vs Strong Paraphrasing
Study these three examples to see the difference between ineffective and effective paraphrasing. Each example starts with the original case notes, followed by a weak attempt and a strong attempt.
Example 1: Patient History
Original Case Notes
"Hx: HTN x 15 yrs, controlled w/ Amlodipine 10mg od. T2DM dx 2018, Metformin 1g bd. BMI 34. Smoker 20/day x 30 yrs."
Weak Paraphrasing
"The patient has a history of hypertension for 15 years, controlled with Amlodipine 10mg once daily. He has Type 2 diabetes mellitus diagnosed in 2018 and takes Metformin 1g twice daily. His BMI is 34. He is a smoker, 20 per day for 30 years."
Issue: This only expands abbreviations. The sentence structure mirrors the case notes exactly, and information is listed in the same order with the same patterns.
Strong Paraphrasing
"Mr Patel has a long-standing history of hypertension, which has been managed with Amlodipine 10mg daily for the past 15 years. He was also diagnosed with Type 2 diabetes mellitus in 2018 and is currently taking Metformin 1g twice daily. It is worth noting that his BMI is 34, and he has a significant 30-year smoking history of approximately 20 cigarettes per day."
Strength: Sentence structures are varied, information is combined logically, cohesive devices connect ideas, and clinical significance is indicated ("long-standing", "significant", "it is worth noting").
Example 2: Admission and Treatment
Original Case Notes
"Admitted 15/02 via ED. c/o severe epigastric pain, nausea, vomiting x 2 days. O/E: tender epigastrium, guarding. Bloods: elevated lipase. Dx: acute pancreatitis. Mx: NBM, IV fluids, analgesia."
Weak Paraphrasing
"The patient was admitted on 15 February via the Emergency Department. She complained of severe epigastric pain, nausea, and vomiting for 2 days. On examination, there was tenderness in the epigastrium with guarding. Blood tests showed elevated lipase. She was diagnosed with acute pancreatitis. She was managed with nil by mouth, IV fluids, and analgesia."
Issue: Each case note point is converted to a separate sentence in the same order. No information is combined, and the sentence pattern ("She was...") is repetitive.
Strong Paraphrasing
"Mrs Chen presented to the Emergency Department on 15 February with a two-day history of severe epigastric pain accompanied by nausea and vomiting. Physical examination revealed epigastric tenderness with guarding, and subsequent blood tests demonstrated elevated lipase levels, consistent with a diagnosis of acute pancreatitis. She was commenced on conservative management including nil by mouth, intravenous fluid replacement, and analgesic therapy."
Strength: Related information is combined into flowing sentences. Passive and active voice are varied. Clinical reasoning connects findings to diagnosis ("consistent with"). Treatment is presented as a coherent management plan rather than a list.
Example 3: Discharge Planning
Original Case Notes
"Ready for d/c. Wound healing well. Mob w/ frame. Needs physio OPD f/u in 2 wks. Pain managed w/ Paracetamol 1g qds PRN. Dietitian referral for weight management."
Weak Paraphrasing
"She is ready for discharge. Her wound is healing well. She is mobilising with a frame. She needs physiotherapy outpatient follow-up in 2 weeks. Her pain is managed with Paracetamol 1g four times daily as needed. She needs a dietitian referral for weight management."
Issue: Each case note point becomes a separate sentence starting with "She". Abbreviations are expanded but sentence structure is unchanged. No cohesive devices connect the ideas.
Strong Paraphrasing
"Mrs Taylor is now medically fit for discharge. Her surgical wound is healing satisfactorily, and she is currently mobilising with the assistance of a walking frame. Post-discharge pain management has been arranged with Paracetamol 1g four times daily on an as-needed basis. I would be grateful if you could arrange a physiotherapy outpatient appointment within the next two weeks to continue her rehabilitation. Additionally, a referral to the dietetics service for weight management support would be appreciated."
Strength: Information is grouped by theme (current status, pain management, follow-up requests). Polite request forms are used for the follow-up actions. Cohesive devices ("Additionally", "Post-discharge") create flow between sentences.
Frequently Asked Questions
Why is paraphrasing important in OET writing?
Paraphrasing is assessed under the Content criterion. Copying case notes verbatim demonstrates that you can read the information but not that you can communicate it professionally. Candidates who copy directly receive lower scores in both Content and Language.
Should I paraphrase medical terminology in OET writing?
No. Established medical terms such as 'hypertension', 'Type 2 diabetes mellitus', and medication names should remain unchanged. Paraphrasing should focus on sentence structure, word forms, and the way information is presented, not on replacing accurate clinical vocabulary.
What is the difference between paraphrasing and copying in OET?
Copying means transferring case note information word-for-word. Paraphrasing means expressing the same clinical information in your own professional sentences while maintaining accuracy. Effective paraphrasing involves changing sentence structure, expanding abbreviations, using different word forms, and reorganising information by relevance.
How much paraphrasing is needed for OET Grade B?
For Grade B (score of 350+), the majority of case note information should be expressed in your own words with appropriate sentence structures. Occasional minor instances of direct phrasing may not significantly impact your score, but systematic copying will lower your marks.
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