Problem: many doctors lose Organisation marks with clinically accurate letters — the facts are right but the paragraphs are wrong: background bleeds into findings, the request hides at the end, discharge reads like admission. Answer in brief: install two skeletons — D1 for referrals, D2 for discharge and transfer — and let paragraph boundaries do the examining for you. This guide teaches both skeletons with a repair demonstration, and OET Writing for Doctors — Course 3 drills them across 6 topic sections with mock tests.
Trap 3: why paragraphing caps scores
Examiners cannot reward structure they cannot see. A single block of accurate text forces the reader to mine for purpose, findings and request — and tired readers downgrade. The trap is subtle because the writer knows what each sentence means; the reader only knows what each paragraph promises. The fix is mechanical, not creative: fixed paragraph jobs, topic sentences that announce each job, and nothing crossing boundaries.
D1: the referral-letter skeleton
Four paragraphs, four jobs. P1 — purpose and person: who, with what working diagnosis, and how urgently, in two lines. P2 — background: relevant history only, oldest first, ending where today begins. P3 — today: examination and results, worst first, with numbers. P4 — request: the precise ask with timeframe. Test each paragraph with one question: if I deleted this paragraph, which examiner question would go unanswered? If none, the paragraph is decoration — cut it.
Drill this skeleton on real cases? The full OET Writing for Doctors — Course 3 trains D1 and its discharge variant across 6 topic sections with lessons and mock tests. Explore the course →
D2: the discharge and transfer variant
Same four slots, different jobs. P1 — handover purpose: “following discharge after…”. P2 — hospital course: what was done and what changed (procedures, new diagnoses, drug changes summarised). P3 — status at discharge: stable enough for what, with residual issues named. P4 — GP actions: numbered monitoring, titration, review dates, red flags. The D1-to-D2 switch is the whole skill: referrals look forward to a question, discharges hand forward a plan. Writers who use D1 for everything produce discharge letters with brilliant findings and no instructions.
Repair demonstration: one letter, re-paragraphed
Fictional draft, newly written — a COPD discharge where doses, history and the plan tangle in two long paragraphs. The repair: cut the admission story to two background lines; move every drug change (tiotropium added, prednisolone weaning course, amoxicillin completed) into numbered GP actions; promote “review spirometry in six weeks, smoking-cessation referral sent” from a closing aside to action items 3 and 4; headline paragraph 1 as handover, not history. Same facts, roughly 185 words, Organisation transformed — because paragraphs now promise and deliver.
Paragraph checks in the last 5 minutes
- Read first lines only: do they tell purpose, background, today, request (or handover equivalents)?
- Find the request/actions: is it the final paragraph and is it precise?
- Scan for crossing: any finding in the background paragraph, any history in findings — move it.
- Count paragraphs: fewer than four usually means a missing job; more than five usually means decoration.
FAQs
How many paragraphs does OET want?
No fixed number is prescribed, but four job-based paragraphs fit the 180–200 word band naturally. One-paragraph letters and nine-paragraph letters both signal missing structure.
Should I use headings in the letter?
Headings suit reports, not OET referral or discharge letters, where flow between paragraphs is assessed. Use topic sentences instead — they do the same work while demonstrating cohesion.
What does the course cover besides skeletons?
Six topic sections on paragraphing traps, the D1 referral skeleton and the D2 discharge and transfer variant, with lessons and 5 complete mock tests.
The matching course
OET Writing for Doctors — Course 3 attacks the paragraphing trap directly: Trap-3 awareness, the D1 referral skeleton, the D2 discharge and transfer variant, drilled across 6 topic sections with 5 complete mock tests. If your letters are accurate but under-marked, this is the repair course.
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): 6 topic sections, D1/D2 skeleton training, 5 mock tests.
- Repair demonstration is 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.
