OET Writing · Updated 2026
OET Writing: format, the six criteria, and how letters are marked
Writing is the sub-test candidates most often have to resit. Not because their English is weak — most OET candidates already work in English — but because a clinical letter is a specific genre with specific rules, and nobody teaches those rules on the ward. This guide covers the format, the four letter types, and what each of the six official criteria actually rewards.
The format
One task, 45 minutes, profession-specific. Nurses write nursing letters, doctors write medical letters, and the same applies to dentists, pharmacists, physiotherapists and the other nine professions OET covers.
The 45 minutes split into two fixed parts. The first five minutes are reading time: you get the case notes and the task, and you may read and annotate but not write your letter. The remaining 40 minutes are yours to plan and write.
The case notes are the raw material — a patient record written in note form, often across several dates, with abbreviations and fragments. The task tells you who you're writing to and why. Your job is not to transcribe the notes. It is to decide which parts of them this specific reader needs, and to turn those into a letter.
A workable time split
- 0–5 min (reading time): read the task first, then the notes. Knowing the recipient changes what counts as relevant.
- 5–15 min: plan. Mark what goes in, cross out what doesn't, and decide your paragraph order.
- 15–40 min: write. If you planned properly, 180–200 words takes 25 minutes without rushing.
- 40–45 min: check. Tenses, articles, plurals, and whether the first sentence still states the purpose.
Ten minutes of planning feels like a lot when the clock is running. It is the difference between selecting information and copying it, and selection is what two of the six criteria are measuring.
The four letter types
Almost every OET Writing task is one of four. The type determines what your reader already knows, which in turn determines what you have to tell them.
Referral
By far the most common. You're sending a patient to a specialist, a clinic or a hospital. The request is the point: state what you want done, then justify it.
Discharge
The patient is leaving your care. The recipient — often a GP or community team — needs what happened, what changed, and what they must now do.
Transfer
Care moves sideways to another facility or team. Closer to a referral, but the receiving clinician is taking over rather than advising.
Advice or information
Written to a patient, a carer, or a non-clinical reader. The clinical content is simpler; the register is where marks are won and lost.
Read the task line carefully enough to know which one you have. Writing a referral when the task asked for a discharge summary is a Purpose failure, and Purpose is the criterion with the least room to recover.
The six criteria, one by one
Assessors mark against six criteria. Purpose is scored 0–3; the other five are scored 0–7. The bands are converted to the 0–500 scale on your Statement of Results, where 350 is a grade B — the level most regulators ask for.
What follows is what each criterion rewards, and the specific habit that most often costs candidates marks on it.
Purpose
Band 0–3Whether the reason for writing is clear immediately. The assessor should know, by the end of your first sentence, who the patient is and what you want the recipient to do.
Where marks go: Opening with the patient's full history before saying why you're writing. A letter that makes the reader hunt for the request scores low here even when everything else is strong.
Content
Band 0–7Selecting the facts this particular recipient needs, and getting them right. A specialist needs the clinical picture; a district nurse needs the care plan; a patient needs plain-language instructions.
Where marks go: Two failure modes score the same: leaving out something the recipient must know, and including old history that has no bearing on today's request.
Conciseness and Clarity
Band 0–7Saying each thing once, in the shortest form that stays accurate. Summarising three visits into one clause is the skill being measured.
Where marks go: Padding ('It is worth mentioning at this point in time that…'), repeating a fact in two paragraphs, and lifting case-note fragments verbatim.
Genre and Style
Band 0–7Register that matches the recipient. Doctor-to-doctor is dense and technical; a letter to a patient or carer is warm and jargon-free.
Where marks go: Writing to a patient the way you'd write to a consultant. Also casual phrasing in a professional letter — 'Thanks a lot for sorting this out' — and, less obviously, formality so stiff it stops sounding human.
Organisation and Layout
Band 0–7Paragraphs that each do one job, in an order the reader can follow, with correct letter conventions — recipient address, date, salutation, sign-off.
Where marks go: Following the chronological order of the case notes instead of the order the reader needs. The notes are organised for the writer; the letter must be organised for the recipient.
Language
Band 0–7Grammar, vocabulary, spelling and punctuation accurate enough that the reader is never slowed down. Range matters, but accuracy matters more.
Where marks go: Tense errors in the clinical history, missing or wrong articles, and subject-verb disagreement. These are the three that show up most in OET letters.
Why the 180–200 word range matters
The guidance is not arbitrary, and it isn't a hard limit you're penalised for crossing by a word. It describes the length at which a letter of this kind tends to work.
Under about 150 words, you almost certainly left out something the recipient needs, and you haven't produced enough language for the assessors to judge your range. Over about 230, the usual cause is that you stopped selecting and started transcribing — which reads as poor Conciseness and Clarity and, because copied fragments aren't your English, drags Language down with it.
Don't count words during the exam. Learn what 190 words looks like in your handwriting during practice, and then write to that shape.
Getting feedback while you practise
Writing improves through corrected repetition. The hard part is the correction: a letter you wrote yourself always reads fine to you, because you know what you meant. The errors that cost grades — a tense that quietly shifts the clinical timeline, an article that changes a specific finding into a general one, a register slip in a letter to a patient — are exactly the ones you can't see in your own work.
A tutor solves this and is worth it before the exam, but the turnaround makes daily practice impractical. OETgo's Writing Coach was built for the gap in between: paste a letter, choose the recipient, and get it scored per criterion with line-level annotations and a corrected rewrite. The point isn't the score — it's seeing which specific sentences cost you marks while the letter is still fresh in your head.
Score your own letter
One free correction on every new account. No credit card required.
Create free accountFrequently asked questions
How long is the OET Writing sub-test?
45 minutes in total: 5 minutes of reading time when you may read the case notes but not write, then 40 minutes to plan and write your letter. The reading time is strictly enforced — you cannot start writing early.
How many words should an OET letter be?
Aim for 180 to 200 words in the body of the letter. Addresses, the date, the salutation and the sign-off don't count. Much shorter and you haven't given the assessors enough language to judge; much longer usually means you copied case notes instead of selecting from them.
What are the six OET Writing criteria?
Purpose, Content, Conciseness and Clarity, Genre and Style, Organisation and Layout, and Language. Purpose is scored 0-3; the other five are scored 0-7. Those band scores are converted to the 0-500 scale that appears on your Statement of Results.
Do I lose marks for copying from the case notes?
Yes, indirectly. Copying whole phrases costs you under Conciseness and Clarity and under Language, because the assessors can't see evidence of your own English. Selecting a fact from the notes and expressing it in your own sentence is the skill being tested.
What grade do I need in Writing?
Most regulators require a grade B, which is 350 on the 0-500 scale. Writing is the sub-test candidates most often fall short on, and it is common to pass the other three and have to resit Writing alone.