Problem: OET writing cases feel endless — every referral seems to need a brand-new letter. Answer in brief: most doctor cases fall into three archetypes (acute specialist referral, heart-failure-style discharge referral, complex community referral), each with its own paragraph skeleton. Learn the three shapes and you can frame almost any case in the planning minutes. This guide teaches the archetype method with a worked acute referral, and OET Writing for Doctors — Course 1 trains all three with 12 topic sections and full mock tests.
Why archetypes beat memorising cases
There are infinite diagnoses but only a handful of letter jobs. An acute specialist referral asks one question: why must this patient be seen urgently, and what must the specialist know today? A discharge referral hands over: what happened, what changed, what the GP must continue. A community referraler coordinates: multiple problems, multiple services, one clear plan. When you recognise the job in the first minute, paragraph order decides itself — and paragraph order is what Organisation marks. The course this article supports trains exactly these three shapes as its foundation, with 12 topic sections and 5 complete mock tests.
Want guided practice with this skill? This article gives you the three shapes, but the full OET Writing for Doctors — Course 1 provides structured lessons on each archetype, guided practice and full mock tests. Explore the course →
Archetype A: acute specialist referral
Skeleton (4 paragraphs): purpose in one line (“I am writing to refer Mr X urgently with suspected…”); background in two lines (relevant history only); today’s findings (examination plus key results, most alarming first); request (what you want: urgent review, specific investigation, admission). Selection rule: if a fact does not change the specialist’s next action, it stays in the notes. Urgency words must be earned by findings — “urgent” followed by normal observations reads as noise.
Archetype B: heart-failure discharge referral
Skeleton: purpose (post-discharge handover after admission for…); hospital course (what was done, what changed — new drugs, devices, procedures); current status (stable for discharge with residual issues named honestly); GP actions (numbered: monitor, titrate, review dates, red flags). The classic failure is a discharge letter that reads like an admission story — examiners want the forward plan, not the history retold. Medication changes with doses belong in the GP-actions paragraph, never buried in narrative.
Archetype C: complex community referral
Skeleton: purpose (coordination of multimorbidity care); problem list, prioritised (COPD, heart failure, pneumonia — each one line with current control); services involved and gaps (who does what, what is missing); coordinated request (community review, reconciled plan, named contact). The skill here is triage on paper: lead with the unstable problem, park the stable ones in one line each, and never let three conditions produce a nine-paragraph letter.
Worked example: acute cardiology referral
Fictional case, newly written: Mr Halloran, 64, exertional chest tightness for six weeks, now crescendo on stairs, relieved by rest; BP 158/94; ECG lateral ST depression; no known diabetes; smoker until 2020.
Paragraph 1 (purpose): “Thank you for seeing Mr Halloran, 64, urgently with crescendo exertional chest pain suggestive of unstable angina.” One line, urgency earned later by findings. Paragraph 2 (background): six-week history, risk factors, no diabetes — three facts, one sentence each. Paragraph 3 (today): examination plus the ECG result, worst first. Paragraph 4 (request): “I would appreciate urgent cardiology review with a view to angiography; he has been advised to seek emergency care for rest pain.” Four paragraphs, roughly 170 words, every sentence changing the cardiologist’s next action. That discipline — purpose, background, today, request — is Archetype A in full.
Five archetype mistakes
- Writing a discharge letter as Archetype A. Forward plan missing; GP cannot act. Fix: check the task verb — “following discharge” means handover shape.
- Burying the request. The ask appears in the last line as an afterthought. Fix: paragraph 1 states it; paragraph 4 repeats it precisely.
- Unearned urgency. “Urgent” with reassuring findings. Fix: let red-flag findings carry urgency; downgrade honestly otherwise.
- Equal weight for unequal problems. Three conditions, three long paragraphs. Fix: unstable gets the paragraph; stable gets a line.
- Doses in narrative. New prescriptions hidden mid-story. Fix: all medication actions live in the final paragraph, numbered.
Timed drill: classify in 60 seconds
Read any three OET case notes and label each A, B or C with one reason, in under a minute per case. Then write only the paragraph-1 purpose line for each. If the purpose line needs two sentences, the archetype is wrong or the case is genuinely mixed — mixed cases lead with the dominant job and borrow one paragraph from the second shape. The course’s mock tests are ideal material: classify first, then write full letters under the standard 40-minute timing.
FAQs
What if a case mixes archetypes?
Lead with the dominant job. A discharge with an urgent new finding is Archetype B with an Archetype-A paragraph for the finding — say so explicitly (“A new concern has arisen…”).
How long should each paragraph be?
Aim for roughly 180–200 words total across four paragraphs: purpose one to two lines, background two to three, findings the longest, request two lines. Count during practice until the shape feels automatic.
Does every letter need GP actions?
Archetypes B and C always do; Archetype A needs a precise request instead. An action-free ending is the commonest reason a good letter scores below its content.
How does the course train this?
Through 12 topic sections covering each archetype with lessons and examples, plus 5 complete mock tests for timed performance. Attempt an archetype first, review the matching lesson, then re-test blind.
The matching course
OET Writing for Doctors — Course 1 is built for doctors who want referral writing reduced to reliable shapes: Archetype A (acute specialist referral), Archetype B (heart-failure discharge referral) and Archetype C (complex community referral), trained across 12 topic sections with lessons, examples and 5 complete mock tests. If the archetype method in this article suited you, the course gives you the full supervised volume to make it automatic.
Sources and note
- OET Writing format (45 minutes, profession-specific letter task, assessment criteria) per the official OET site: oet.com — Writing. Check current format guidance before the exam.
- Course details verified from its public staging page (read-only): 12 topic sections, archetype A/B/C training, 5 mock tests.
- Case and letter extract above are newly written and fictional; suggested structures — other valid shapes exist.
Put this into practice
Compare these course outlines and choose the practice that matches your next goal.
