Problem: rheumatology, dermatology, eye, ENT and renal referrals each look like a new genre — different facts, different questions, different services. Answer in brief: one universal 4-paragraph skeleton carries them all; only the “question slot” changes per specialty. Learn the skeleton once plus eight question templates. This guide teaches the system with a worked ophthalmology referral, and OET Writing for Doctors — Course 9 trains endocrinology, renal, urology, rheumatology, dermatology, ophthalmology, ENT and stroke letters across 5 topic sections.
The universal skeleton
P1 purpose with specialty and suspected condition; P2 focused background (only facts this specialty uses); P3 today’s findings (the specialty’s examination plus key results); P4 the specialty’s question with timeframe. The skeleton never changes; the content filter does. A dermatology letter filters for distribution, duration and change; a urology letter filters for flow, retention and PSA trend; an ENT letter filters for hearing, discharge and vertigo pattern. Same four paragraphs, different sieve.
Eight specialty question templates
- Endocrine: optimisation vs complication workup — “review for uncontrolled diabetes with…; is intensification or complication screening indicated?”
- Renal/urology: trajectory plus threshold — declining function or retention pattern with the intervention question named.
- Rheumatology: inflammatory vs mechanical — morning stiffness duration, symmetry, raised markers, the DMARD question.
- Dermatology: lesion description plus change — morphology, distribution, evolution, biopsy vs reassurance question.
- Ophthalmology: vision timeline plus urgency — distortion onset, acuity numbers, the injection-or-review question.
- ENT: pattern plus function — hearing loss type, discharge character, vertigo triggers, audiology-or-surgical question.
- Stroke: event plus window — onset, deficit, imaging, the reperfusion-or-prevention question.
- General rule: each template ends with one interrogative sentence. If the request paragraph has no question mark implied, it is summary, not referral.
Practise all eight supervised? The full OET Writing for Doctors — Course 9 trains the universal skeleton across endocrinology, renal, urology, rheumatology, dermatology, ophthalmology, ENT and stroke topics, with 5 sections and mock tests. Explore the course →
Worked example: suspected wet AMD referral
Fictional case, newly written: Mrs Lindqvist, 74, three-week distortion of straight lines in the right eye; acuity 6/18 right, 6/9 left; Amsler distortion confirmed; no pain, no flashes; hypertensive, on amlodipine; non-smoker.
Shape: “Thank you for seeing Mrs Lindqvist, 74, urgently with suspected wet age-related macular degeneration.” Background filtered: hypertension only, no diabetes, non-smoker — each fact earns its place by altering risk. Findings: timeline, acuities, Amsler result. Request: “I would appreciate urgent macular review for possible anti-VEGF treatment; she understands the reason for urgency.” Ophthalmology sieve, universal skeleton — roughly 165 words.
Four multispecialty mistakes
- Unfiltered background. Full history regardless of specialty. Fix: ask what this specialist decides, keep only deciding facts.
- Missing numbers. “Reduced vision”, “high PSA” without values. Fix: every specialty has 2–3 numbers that matter — include them with units.
- Summary endings. The letter concludes instead of asking. Fix: final sentence must contain the question.
- Wrong-urgency defaults. Everything routine or everything urgent. Fix: each specialty has its red-flag list — check the case against it explicitly.
FAQs
Can one skeleton really fit eye and renal letters?
Yes, because the skeleton organises thinking, not facts. Purpose, background, today, question — the universals of any referral. Specialty knowledge lives in the filter and the question template, not the paragraph order.
Do rare specialties need longer letters?
No — unfamiliarity tempts overwriting, but the 180–200 word band still applies. Filter harder, not longer.
What is in the course?
Five topic sections spanning the universal skeleton plus endocrinology, renal, urology, rheumatology, dermatology, ophthalmology, ENT and stroke letters, with 18 lessons and 5 mock tests.
The matching course
OET Writing for Doctors — Course 9 completes the doctors’ series: one skeleton for every specialty — endocrine, renal, urology, rheumatology, dermatology, ophthalmology, ENT and stroke — across 5 topic sections with 18 lessons and 5 mock tests. For referral confidence in any specialty, finish here.
Sources and note
- OET Writing format 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): 5 topic sections, 18 lessons, 5 mock tests.
- Case and letter lines are newly written and fictional; other valid structures exist.
Put this into practice
Compare these course outlines and choose the practice that matches your next goal.
