OET C+ Plan Week 3: Case Notes and Letter Purpose

This week's sessions

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Day 1 · ✍️ Writing · about 25 minChoosing case notes: a pharmacy letterRead this week's lesson, then do the case-notes set below. For each case note, decide: must include, maybe, or leave out.
Day 2 · 🎧 Listening · about 25 minListening Part A: a physiotherapy assessmentDo the Part A set below. Predict each answer type first, complete the notes in one listen, then check your spelling on the second listen.
Day 3 · ✍️ Writing · about 25 minWrite two opening paragraphsUsing the case notes for the writing tasks on the practice test and the writing practice page, write only the opening paragraph for each: patient, reason and request, in one or two sentences.
Day 4 · 🔤 Vocabulary · about 20 minGrammar: the passive for lettersStudy the passive on this page, then rewrite five case notes as passive sentences, for example 'Ramipril was withheld because her blood pressure was low.'
Day 5 · 🗣️ Speaking · about 20 minRole-play: find out what the patient knowsChoose two role-play cards. For each, record your opening and two open questions that find out what the patient knows and how they feel. Then listen back.

This week's lesson: choose the right case notes and state your purpose

The OET letter gives you 5 minutes to read the case notes and 40 minutes to write a letter of about 180–200 words. Grade C letters often have reasonable English but fail on two things: they copy too many case notes, and the reader has to wait until the end to find out why the letter was written. This week fixes both.

Start with the reader and the purpose

Before you read the notes in detail, read the task and answer two questions:

Who is the reader? A GP, a specialist, a community nurse, a physiotherapist?
What do I want them to do? Review a dose, assess a problem, continue care at home?

Write the answer as one short line at the top of your planning: GP: review amlodipine dose, ankle swelling. Every case note you choose should support that line.

Sort the case notes into three groups

Go through the notes and mark each one:

Must include: the reason for the letter, the current problem, recent changes, results and medicines that matter to the request.
Maybe: background that helps the reader understand (living alone, other conditions that affect care).
Leave out: old, resolved problems, normal results that don't matter, and personal details that don't affect care.

Must: ankle swelling for 3 weeks, since the amlodipine dose was increased; no shortness of breath Maybe: lives alone; trouble remembering a weekly tablet → blister pack from next week Leave out: cataract surgery in 2019, good result; keen gardener; has a cat

Ask one question for each note: Does this reader need it to act? If the answer is no, it costs you words and makes the letter harder to follow.

Put the purpose in the first paragraph

The first paragraph should tell the reader who the patient is and what you're asking for, ideally in one or two sentences:

I am writing regarding Mrs Dorothy Allan, aged 81, who has developed ankle swelling since her amlodipine dose was increased, to request a review of her dose.

Then the body gives the background, and the last paragraph repeats the request in more detail. A reader who stops after line two should still know what you want.

Turn notes into sentences

Case notes use short forms; your letter must not. Write full sentences, and expand abbreviations:

Case note	In the letter
amlodipine ↑ 5→10 mg 4/52 ago	Her amlodipine was increased from 5 mg to 10 mg four weeks ago.
No SOB	She has not experienced any shortness of breath.
Pt agreed to blister pack	She has agreed to start using a blister pack.

The passive (was increased) is useful here: it keeps the focus on the treatment, not on who made the decision.

Order by importance, not by the notes

You don't have to follow the order of the case notes. Group related information (all the medicine changes together, all the social factors together) in the order the reader needs it.

This week

Do the case-notes set, then write only the first paragraph for two different tasks. By the weekly check, you'll write a full letter with a clear purpose in its first sentence.

Practice for this week

Choosing case notes: a pharmacy letter

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Listening Part A: a physiotherapy assessment

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Weekly check: A full nursing referral letter

Write the full writing task on the practice test (5 minutes reading, 40 minutes writing). Check your first paragraph: does it state the purpose and the request? Then compare your choice of case notes with the model.

Start the weekly check

When you finish, come back to your plan home: your dashboard updates with the new score.

Answers, explanations and transcripts

Finish the test first, then open each section to check your answers. Every answer has an explanation.

Choosing case notes: a pharmacy letter

Passage text

Case notes (pharmacy)

Patient: Mrs Dorothy Allan, 81, widow, lives alone, walks with a stick. Regular customer for 6 years. Daughter lives interstate, phones weekly. Keen gardener, has a cat.

Medical history: hypertension (10 yrs); osteoporosis; cataract surgery both eyes 2019, good result; appendicectomy aged 20.

Medications: amlodipine 10 mg mane (↑ from 5 mg by GP 4/52 ago); atorvastatin 40 mg nocte; alendronate 70 mg once weekly; paracetamol PRN.

Today: collecting repeat prescriptions. Swelling both ankles, 'shoes feel tight', approx. 3/52, i.e. since amlodipine dose ↑. No shortness of breath. Finding it hard to remember which day to take alendronate.

Pharmacist's plan: letter to GP (Dr Michael Barker, Parkside Medical Centre): ask for review of amlodipine dose re ankle swelling. Pt agreed to a weekly dose administration aid (blister pack) from next week.

Answer key (6 answers)

#	Question	Answer	Why
1	What is the main purpose of the letter to Dr Barker?	To ask him to review Mrs Allan's amlodipine dose because of new ankle swelling	The pharmacist's plan says it: 'ask for review of amlodipine dose re ankle swelling'. Decide the purpose before you write anything, then make every paragraph support it.
2	Which opening sentence is best?	I am writing regarding Mrs Dorothy Allan, aged 81, who has developed ankle swelling since her amlodipine dose was increased, to request a review of her dose.	It names the patient, the problem and the request in one sentence. The reader knows why you're writing before the end of line two.
3	Which case note is LEAST relevant to the GP?	She has had cataract surgery with a good result	Old, resolved problems that don't affect the request can be left out. The timing of the swelling, the absence of breathlessness and the blister pack all help the GP act.
4	Which of these should you include, because it supports your request?	The swelling began about three weeks ago, after the dose was increased	The link between the dose change and the swelling is the reason for the review, so it belongs in the letter. The other notes don't help the GP make a decision.
5	Which sentence correctly turns 'amlodipine 10 mg mane (↑ from 5 mg by GP 4/52 ago)' into a full sentence?	Her amlodipine was increased from 5 mg to 10 mg each morning four weeks ago.	A full sentence, no abbreviations (mane, 4/52), and the passive ('was increased') keeps the focus on the medicine. B sounds like an accusation, and A and D aren't proper sentences.
6	Where should the request for a dose review appear?	In the first paragraph, with the details of what you'd like repeated near the end	State the purpose early so the reader knows why they're reading, then make the request clear again near the end. Putting it only at the end is one of the most common mistakes at grade C.

Listening Part A: a physiotherapy assessment

Transcript: Part A: consultation (physiotherapy)

Physiotherapist: Hello, Mr Okafor? I'm Lena, one of the physiotherapists. Come through. So, what's been happening with your shoulder?

Patient: I fell off a ladder about three weeks ago. I was cleaning the gutters, and I landed on my right shoulder.

Physiotherapist: That sounds like a nasty fall. What's the pain like now?

Patient: It's worst when I lift my arm above shoulder height, like reaching into a cupboard. And I can't sleep on my right side at all.

Physiotherapist: If nought is no pain and ten is the worst pain you can imagine, how would you score it?

Patient: During the day, about a six. At night, it's more like an eight.

Physiotherapist: Have you had any scans?

Patient: Yes, my GP sent me for an ultrasound last week. It showed a partial tear of the rotator cuff.

Physiotherapist: Rotator cuff, that's R-O-T-A-T-O-R, cuff, C-U-F-F. The group of muscles around the shoulder joint. And what have you been doing for the pain?

Patient: Paracetamol, and a heat pack at night. That helps a bit.

Physiotherapist: What do you do for work?

Patient: I'm an electrician. I'm self-employed, so I'm quite worried about money if I can't work for long. I also play tennis on Sundays, but I've stopped for now.

Physiotherapist: That's understandable. Today I'm going to show you some gentle pendulum exercises. You let the arm hang down and swing it in small circles. Do them three times a day. For now, try to avoid lifting anything above shoulder height. I'd like to see you again in one week to check how it's going.

Answer key (13 answers)

#	Question	Answer	Why
7	Mechanism of injury: fell from a ___	ladder	Spelling counts in OET Listening: a misspelled medical word is marked wrong. Check each answer against the recording.
8	___ ago while cleaning gutters;	three weeks (also accepted: 3 weeks)	Spelling counts in OET Listening: a misspelled medical word is marked wrong. Check each answer against the recording.
9	Symptoms: pain worst when lifting arm above ___	shoulder height	Spelling counts in OET Listening: a misspelled medical word is marked wrong. Check each answer against the recording.
10	unable to sleep on ___	right side (also accepted: his right side, the right side)	Spelling counts in OET Listening: a misspelled medical word is marked wrong. Check each answer against the recording.
11	Pain score: 6/10 during the day, ___	8 (also accepted: eight)	Spelling counts in OET Listening: a misspelled medical word is marked wrong. Check each answer against the recording.
12	Investigations: ___	ultrasound (also accepted: an ultrasound)	Spelling counts in OET Listening: a misspelled medical word is marked wrong. Check each answer against the recording.
13	(ordered by GP) showed a partial tear of the ___	rotator cuff	Spelling counts in OET Listening: a misspelled medical word is marked wrong. Check each answer against the recording.
14	Current management: paracetamol and a ___	heat pack	Spelling counts in OET Listening: a misspelled medical word is marked wrong. Check each answer against the recording.
15	at night. Social: self-employed ___	electrician	Spelling counts in OET Listening: a misspelled medical word is marked wrong. Check each answer against the recording.
16	worried about ___	money (also accepted: income, finances)	Spelling counts in OET Listening: a misspelled medical word is marked wrong. Check each answer against the recording.
17	Plan: ___	pendulum exercises (also accepted: pendulum exercise, pendulum)	Spelling counts in OET Listening: a misspelled medical word is marked wrong. Check each answer against the recording.
18	three times a day; avoid lifting above shoulder height; review in ___	one week (also accepted: 1 week, a week)	Spelling counts in OET Listening: a misspelled medical word is marked wrong. Check each answer against the recording.
19	Which spelling is correct?	rotator cuff	Rotator cuff. The physiotherapist spelled it out: listen for spellings in the recording, because they often signal a word that will be tested.

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