MEDSAMPLE01

WRITING SUB-TEST – TEST BOOKLET

INSTRUCTIONS TO CANDIDATES
You must write your answer for the Writing sub-test in the Writing Answer Booklet.

You must NOT remove OET material from the test room.
Occupational English Test

WRITING SUB-TEST: MEDICINE

TIME ALLOWED: READING TIME: 5 MINUTES
WRITING TIME: 40 MINUTES

Read the case notes and complete the writing task which follows.

Notes:
Assume that today's date is 18 June 2018
You are a practitioner examining a 45-year old female patient, Ms Anne Hall.

PATIENT DETAILS:

Name: Anne Hall (Ms)

DOB: 19 Sep 1972
Height: 163cm Weight: 75kg BMI: 28.2 (overweight 18/6/18)

Social History: Teacher (Secondary – History, English)

Divorced, 2 children at home (born 2002, 2004)
Non-smoker (since children born)
Social drinker – mainly spirits

Substance Intake:
Nil

Allergies: Codeine; dust mites; sulphur dioxide

Mother – hypertension; asthmatic; Father – peptic ulcer

Maternal grandmother – died heart attack, aged 80
Maternal grandfather – died asthma attack
Paternal grandmother – unknown
Paternal grandfather – died ‘old age’ 94

Childhood asthma; chickenpox; measles

1983 tonsillectomy
1990 hepatitis A (whole family infected) 1992 sebaceous cyst removed
1995 whiplash injury
2006 depression (separation from husband); SSRI – fluoxetine 11 mths
2008 overweight – sought weight reduction
2010 URTI (Upper Respiratory Tract Infection)
2012 dyspepsia
2014 dermatitis; prescribed oral & topical corticosteroids
18 Jun 2018 Presenting complaint: dysphagia (solids), onset 2 weeks ago post-viral (?) URTI
URTI self-medicated with OTC (over-the-counter) Chinese herbal product - contents
unknown
No relapse/remittent course
No sensation of lump No obvious anxiety
Concomitant epigastric pain radiating to back, level T12 Weight loss: 1-2kg
Recent increase in coffee consumption
Takes aspirin occasionally (2-3 times/month); no other NSAIDs

Provisional diagnosis: gastro-oesophageal reflux +/- stricture

Plan: Refer gastroenterologist for opinion and endoscopy if required

Ôcoffee/alcohol intake
Cease OTC product
Pantoprazole 40mg daily

Writing Task:

Using the information in the case notes, write a letter of referral for further investigation and definitive diagnosis to
the gastroenterologist, Dr Jason Roberts, at Newtown Hospital, 111 High Street, Newtown.
In your answer:
●● Expand the relevant notes into complete sentences
●● Do not use note form
●● Use letter format
The body of the letter should be approximately 180–200 words.
 MEDSAMPLE01
Occupational English Test

WRITING SUB-TEST: MEDICINE

SAMPLE RESPONSE: LETTER OF REFERRAL

Dr Jason Roberts
Newtown Hospital
111 High Street
Newtown

18 June 2018

Dear Dr Roberts,

Re: Ms Anne Hall, DOB 19.9.1972

Thank you for seeing Ms Hall, a 45-year-old secondary school teacher, who presented today with a two-week
history of gastro-oesophageal reflux with possible stricture. I am referring Ms Hall to you for further investigation and
an endoscopy if required.

Ms Hall’s symptoms follow a constant course and include dysphagia for solids, epigastric pain radiating posteriorly to
T12 level, and concomitant 1-2kg weight loss. The problem commenced after an upper respiratory tract infection two
weeks ago for which she self- prescribed an over-the-counter Chinese herbal product with unknown ingredients. There
are no apparent signs of anxiety, and no sensation of a lump.

Ms Hall has recently increased her coffee consumption and takes aspirin 2-3 times a month. She has a history of
dyspepsia (2012), and dermatitis for which she was prescribed oral and topical cortisone. She ceased smoking 15
years ago. She drinks socially (mainly spirits), has a family history of peptic ulcer disease and is allergic to codeine.
Her BMI is currently 28.2.

I have recommended that Ms Hall reduces her coffee and alcohol intake and immediately stops taking the over-the-
counter product. In addition, I have prescribed Pantoprazole 40mg daily.

I would be grateful if you could provide Ms Hall with a definitive diagnosis. If you require any further information,
please do not hesitate to contact me.

Yours sincerely,

Doctor
Occupational English Test

WRITING SUB-TEST: MEDICINE

TIME ALLOWED: READING TIME: 5 MINUTES
WRITING TIME: 40 MINUTES

Read the case notes and complete the writing task which follows.

Notes:
Assume that today's date is 10 February 2019
Mrs Priya Sharma is a patient in your general practice who is concerned about her glucose level control.

PATIENT DETAILS:

Name: Mrs Priya Sharma

DOB: 08 May 1958 (Age 60)
Address: 71 Seaside Street, Newtown

Social background:
Married 40 years – 3 adult children, 5 grandchildren (overseas).
Retired (clerical worker).

Family history: Many relatives with type 2 diabetes

Nil else significant

Medical history: 1999 – type 2 diabetes

Nil significant, no operations
Allergic to penicillin Menopause 12 yrs
Never smoked, nil alcohol
No formal exercise

Current Drugs: Metformin 500mg 2x /day

Glipizide 5mg 2x/morning
No other prescribed, OTC, or recreational

29 Dec 2018
Discussion: Concerned that her glucose levels are not well enough controlled – checks levels often
(worried?)
Attends health centre – feels not taking her concerns seriously Recent blood sugar levels
(BSL) 6-18
Checks BP at home
Last eye check October 2017 – OK Wt steady, BMI 24
App good, good diet
Bowels normal, micturition normal
 O/E: Full physical exam: NAD
BP 155/100
No peripheral neuropathy; pelvic exam not performed
Pathology requested: FBE, U&Es, creatinine, LFTs, full lipid profile, HbA1c
Medication added: candesartan (Atacand) tab 4mg 1x/morning
Review 2 weeks

Pathology report received:

FBE, U&Es, creatinine, LFTs in normal range
GFR > 60ml/min
HbA1c 10% (very poor control)
Lipids: Chol 6.2 (high), Trig 2.4, LDLC 3.7

Review of pathology results with Pt Changes in medication recommended

Metformin regime changed from 500mg x2/day to 750mg 2x/day
Atorvastatin (Lipitor) 20mg 1x/morning added Glipizide 5mg 2x/morning
Review 2 weeks

30 Jan 2019 Home BP in range Sugars improved

Pathology requested: fasting lipids, full profile

Pathology report received: Chol 3.2, Trig 1.7, LDLC 1.1

Pathology report reviewed with Mrs Sharma

Fasting sugar usually in 16+ (high) range
Other blood sugars 7-8
Refer to specialist at Diabetes Unit for further management of sugar levels

Writing Task:

Using the information in the case notes, write a letter of referral to Dr Smith, an endocrinologist at City Hospital,
for further management of Mrs Sharma’s sugar levels. Address the letter to Dr Lisa Smith, Endocrinologist, City
Hospital, Newtown.
In your answer:
● Expand the relevant notes into complete sentences
● Do not use note form
● Use letter format
The body of the letter should be approximately 180–200 words.
 MEDSAMPLE02
Occupational English Test

WRITING SUB-TEST: MEDICINE

SAMPLE RESPONSE: LETTER OF REFERRAL

Dr Lisa Smith
Endocrinologist
City Hospital
Newtown

10 February 2019

Dear Dr Smith,

Re: Mrs Priya Sharma

DOB: 08/05/58

Thank you for seeing Mrs Priya Sharma, a type 2 diabetic, for further management of her blood sugar levels.

Mrs Sharma was diagnosed with NIDDM in 1999. She has been monitoring her BP and sugar levels at home since
then. She has a strong family history of diabetes and is allergic to penicillin. Her weight is steady (BMI of 24) and an
eye examination in October 2017 indicated no issues.

She initially presented on 29/12/18 concerned that her blood sugar levels were no longer well controlled. Her BP
that day was 155/100 and her recent sugar levels were ranging between 6 and 18mmol/L. Her medication
included metformin 500mg twice a day and glipizide 5mg twice in the morning. I instituted Atacand 4mg once in the
morning.

A pathology report received on 05/01/2019 showed HbA1c levels of 10% and GFR greater than 60ml/min. Her
cholesterol was high (6.2).

On 12/01/19, I prescribed Lipitor 20mg in the morning. I also increased her metformin regime to 750mg twice daily.
Since then, her home-monitored BP has been within range and her cholesterol has fallen to 3.2. Her non-fasting blood
sugars are 7-8mmol/L, but her fasting blood sugar levels are usually in the 16+ range, which is high. Therefore, I am
referring her to you for your specialist advice.

Yours sincerely,

Doctor
Occupational English Test
WRITING SUB-TEST: MEDICINE
TIME ALLOWED: READING TIME: 5 MINUTES
WRITING TIME: 40 MINUTES

Read the case notes and complete the writing task which follows.

Notes:

Assume that today's date is 30 August 2019

You are a doctor at Newtown Medical Clinic. Mr Barry Jones is a regular patient of yours.

PATIENT DETAILS:

Name: Mr Barry Jones

DOB: 11 Jun 1973 (age 46)
Address: 54 Woods Street, Newtown

Reason for presenting: Wants to return to work after back injury – employer supportive

Medical history: 1988 – Appendix removed

Social background: Married – Susan Jones, 3 children

Work – drives forklift in a large warehouse (requires prolonged sitting/
occasional heavy-lifting)
Current medications: Naproxen (non-steroidal anti-inflammatory drug)
Carisoprodol (muscle relaxant, blocks pain)

Condition history:
Presentation: Hurt back lifting heavy box off floor at work
4 days since initial strain
No rest, pain worsening

X-ray: No disc problems

Diagnosis: Lower back strain – severe

Treatment: Exercise: walking daily – gradual Ótime/distance

Referral to physio
Prescription: naproxen and carisoprodol
30 days off work and certificate to give to employer
To review in 30 days
 Progress: Back: Still sore
Moving very stiffly
Physio: Exercises ‘very painful’ but Pt is compliant
Exercise: Walking up to 10 min per day

Treatment: Extended time off work – 30 days. To review in 30 days

Progress: Back: Recovering well – still in pain

Still moving very stiffly
Physio: Attending regular appointments
Exercise: Walking 15-20 mins per day – ‘very tiring’

Treatment: ÓNaproxen dose

Extended time off work – 30 days. To review in 30 days

Progress: Back: Recovering well – still in pain

Moving stiffly but ÓROM
Pain Óafter 20-30 mins of sitting or lying down
Physio: Still attending appointments

Exercise: Walking 30 mins per day – ‘tiring’

Discussions: Pt bored, discouraged, wants to return to work. Restless

Treatment: Return to work if no lifting & with regular breaks

Letter to OT requesting assessment of workplace (advise on
duties Pt can perform, etc.)

Writing Task:

Using the information in the case notes, write a letter to Ms Graham, an occupational therapist, detailing Mr
Jones’ situation and requesting an assessment of his workplace. Address the letter to Ms Jane Graham, Newtown
Occupational Therapy, 10 Johnston St, Newtown.

In your answer:
●● Expand the relevant notes into complete sentences
●● Do not use note form
●● Use letter format
The body of the letter should be approximately 180–200 words.
 MEDSAMPLE03
Occupational English Test

WRITING SUB-TEST: MEDICINE

SAMPLE RESPONSE: LETTER OF REFERRAL

Ms Jane Graham
Newtown Occupational Therapy
10 Johnston St
Newtown

30 August 2019

Dear Ms Graham

Re: Mr Barry Jones

DOB: 11.06.1973

I am writing to request a workplace assessment for the above patient Mr Jones. He is a forklift driver but has been off
work for three months after he injured his back at work trying to move a heavy box off the floor.

Mr Jones has been seeing a physiotherapist for the past three months. He currently walks for 30 minutes per day
although he reports that this is quite tiring.

Mr Jones has been compliant with his physiotherapy and is recovering from his injury as expected. He is eager to
return to work in some capacity but still gets some discomfort in his back if he sits for prolonged periods. Given that he
is required to sit for long periods at work and occasionally required to perform heavy lifting, I do not believe he is ready
to return to work in his previous capacity, but may return if it can be arranged for him to avoid heavy lifting and take
regular breaks. Mr Jones’s employer is supportive of his return to work.

Could you please conduct an evaluation of Mr Jones’ workplace and provide advice as to what duties he could
perform there consistent with his recovery.

Please contact me should you require any further information.

Yours sincerely

Doctor
Occupational English Test

WRITING SUB-TEST: MEDICINE

TIME ALLOWED: READING TIME: 5 MINUTES
WRITING TIME: 40 MINUTES

Read the case notes and complete the writing task which follows.

Notes:

Assume that today's date is 30 August 2019.

You are a doctor in a city clinic. Mr Knowles is a new patient in your surgery.

PATIENT DETAILS:
Name: Mr Adam Knowles
DOB: 22 Aug 1951 (age 68)

Social background:
Married, two grown-up children
Recently retired management consultant
Physically active, plays tennis/walks dog
Non-smoker for past 10 years
Social drinker

Family history: Nil significant

Medical background:
Severe childhood eczema
2008: gall bladder removed due to gallstones
History of depression past 4 years

Medication: 2016: started SSRI (fluoxetine)

02 Aug 2019

Discussion: Heartburn/indigestion – OTC antacids – ineffective

Pt concerned ?hernia

Objective exam: Full exam performed: NAD

Wt: 94kg
Omeprazole PPI 20 mg 2x/day for 8wks
Ordered FBC and liver function test
Review 4 wks
30 Aug 2019 No improvement in reflux symptoms
Pt’s main concern is now back pain
New symptoms: diarrhoea, pale stools, abdominal pain on eating, fatigue
Wt Ô2kg since last appointment (now 92kg)
Abdomen tender on palpation, slightly swollen
Yellow discolouration skin and eyes

Pathology report:
Bilirubin 9mg/dL (high)
Amylase 400 u/L (high)
ALT 60 u/L (slightly high)
Albumin 6 g/dL (high)
Alkaline phosphatase 120 u/L (slightly high)

Discussion: Discussion of examination findings and blood results with Pt

Plan: Urgent referral to gastroenterologist for assessment and endoscopy

?Pancreatic malignancy – patient aware of possibility

Writing Task:

Using the information given in the case notes, write a letter of referral to Dr Desai, a gastroenterologist at City
Hospital, for assessment of Mr Knowles. Address the letter to Dr Dev Desai, Gastroenterologist, City Hospital,
Easton.
In your answer:
●● Expand the relevant notes into complete sentences
●● Do not use note form
●● Use letter format
The body of the letter should be approximately 180–200 words.
 MEDSAMPLE04
Occupational English Test

WRITING SUB-TEST: MEDICINE

SAMPLE RESPONSE: LETTER OF REFERRAL

Dr Dev Desai
Gastroenterologist
City Hospital
Easton

30 August 2019

Dear Dr Desai

Re: Mr Adam Knowles

DOB: 22/08/1951

Thank you for seeing Mr Knowles, a 68-year-old retired management consultant, who requires urgent investigation of
his upper GI symptoms.

Mr Knowles has lost 2kg over the last four weeks and his abdomen is slightly swollen and tender. His eyes and skin
show signs of jaundice. His blood tests showed deranged liver function with raised bilirubin and enzymes. His amylase
was also raised at 400u/L.

He first presented to me a month ago complaining of new-onset indigestion, which had not resolved despite him self-
medicating with antacids. I prescribed a proton pump inhibitor (omeprazole 20mg twice daily) and asked to see him
in 4 weeks’ time. Today he reports having developed back pain and diarrhoea, pale stools, abdominal pain on eating,
and fatigue. His indigestion has not improved.

Mr Knowles is usually fit and well and is a non-smoker. His past medical history includes a cholecystectomy in 2008
for gallstones. He drinks socially.

I would be grateful if you could see Mr Knowles at your earliest convenience for an endoscopy and assessment as I
am concerned about the possibility of pancreatic cancer. I have discussed this possibility with Mr Knowles.

Yours sincerely

Doctor
Occupational English Test

WRITING SUB-TEST: MEDICINE

TIME ALLOWED: READING TIME: 5 MINUTES
WRITING TIME: 40 MINUTES

Read the case notes and complete the writing task which follows.

Notes:

Assume that today’s date is 15 May 2021. You have been Ms Bennet’s GP for two years and have been treating her
recently following her hospitalisation for cardiac problems.

PATIENT DETAILS:
Name: Eleanor Bennet
DOB: 06 Dec 1975 (45 y.o.)
Address: 32 Station Road, Oakville

Social background:
Commercial lawyer – frequent international travel
Divorced – 2 daughters (18 & 16 y.o.)
Children live mainly with children’s father (custody currently contested) – Pt reports extreme
stress re worries about quality of father’s childcare
Since 2019 Óalcohol intake from 10 Ò 40 units/wk; smokes 20 cigs/day
BMI 29 (overweight) – little exercise (gym x1/mth)

Family history: Father died 53 y.o. – heart disease

Older brother – mental health problems (2 suicide attempts in last 12 mths)

Medical history:
08 Feb 2021, 0800 hrs
Heart attack at airport after long-haul flight (pain in jaw, nausea, SOB)
Defibrillator applied by first-aider

08 Feb 2021, 0915 hrs

Emergency hospital admission (Oakville General Hospital)
Balloon-expandable stent applied via groin (arm tried initially, artery too small)

15 Feb 2021 Discharged, 4 weeks off work Ò gradual return to work

Mother moved in to give care. Pt reports Óstress (poor relationship)
Medications/treatment on discharge:
Captopril 50mg 2x/day
Atorvastatin 80mg daily
Referral for cardiac rehabilitation sessions – non-attendance
Counselling given re lifestyle changes

Presenting complaint:
15 May 2021 Side effects of captopril – dizziness and light-headedness, headaches, episodes of diarrhoea
Pt reports stress from side effects
Pt requests captopril discontinuation (side effects) – reluctant to start new meds

Plan: Referral to cardiologist re review of meds and ways to encourage lifestyle changes

Writing Task:

Using the information given in the case notes, write a letter of referral to Dr Banerjee, consultant cardiologist.
In your letter, briefly outline Ms Bennet’s history and treatment so far, requesting advice and a review of her
medication. Address your letter to Dr James Banerjee, Consultant Cardiologist, Sanditon City Hospital, Sanditon.
In your answer:
● Expand the relevant notes into complete sentences
● Do not use note form
● Use letter format
The body of the letter should be approximately 180–200 words.
 MEDSAMPLE05
Occupational English Test

WRITING SUB-TEST: MEDICINE

SAMPLE RESPONSE: LETTER OF REFERRAL

Dr James Banerjee
Consultant Cardiologist
Sanditon City Hospital
Sanditon

15 May 2021

Dear Dr Banerjee

Re: Eleanor Bennet

DOB: 06 Dec 1975

I am writing to request your review of Ms Bennet, a 45-year-old lawyer, who is concerned about possible side effects
of her cardiac medication.

Ms Bennet had an emergency admission at Oakville General Hospital on 8 February, having suffered a heart attack
following a long-haul flight. She was given a balloon-expandable stent via the groin and prescribed captopril (50mg
twice daily) and atorvastatin (80mg daily).

Ms Bennet was advised to make lifestyle changes as she is a heavy drinker (40 units/week) and smoker (20 per day),
overweight (BMI: 29) and does little exercise. She was referred for cardiac rehabilitation sessions but has failed to
attend.

Ms Bennet saw me today reporting problems with dizziness, headaches and diarrhoea. She asked to discontinue the
captopril, attributing her symptoms to side effects of this medication. She has a family history of cardiac problems and
mental health issues, with a father who died aged 53 of heart disease and a brother who is a suicide risk. She reports
extreme stress over her family situation.

I would appreciate it if you could review her medication and suggest ways to manage lifestyle changes.

Yours sincerely

Doctor
 WRITING SUB-TEST – ANSWER BOOKLET
CANDIDATE NUMBER:
LAST NAME:
FIRST NAME:
MIDDLE NAMES: Passport Photo

PROFESSION: Candidate details and photo will be printed here.

VENUE:
TEST DATE:

CANDIDATE DECLARATION
By signing this, you agree not to disclose or use in any way (other than to take the test) or assist any other person to disclose or use any OET
test or sub-test content. If you cheat or assist in any cheating, use any unfair practice, break any of the rules or regulations, or ignore any advice
or information, you may be disqualified and your results may not be issued at the sole discretion of CBLA. CBLA also reserves its right to take
further disciplinary action against you and to pursue any other remedies permitted by law. If a candidate is suspected of and investigated for
malpractice, their personal details and details of the investigation may be passed to a third party where required.

CANDIDATE SIGNATURE:

TIME ALLOWED
READING TIME: 5 MINUTES
WRITING TIME: 40 MINUTES

INSTRUCTIONS TO CANDIDATES
1. Reading time: 5 minutes
During this time you may study the writing task and notes. You MUST NOT write, highlight, underline or make any notes.

2. Writing time: 40 minutes

3. Use the back page for notes and rough draft only. Notes and rough draft will NOT be marked.

Please write your answer clearly on page 1 and page 2.

Cross out anything you DO NOT want the examiner to consider.

4. You must write your answer for the Writing sub-test in this Answer Booklet using pen or pencil.

5. You must NOT remove OET material from the test room.

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OET Writing sub-test – Answer booklet 1

[CANDIDATE NO.] WRITING SUB-TEST - ANSWER BOOKLET 02/04

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OET Writing sub-test – Answer booklet 2

[CANDIDATE NO.] WRITING SUB-TEST - ANSWER BOOKLET 03/04