Problem: cardiac and neurovascular cases carry the highest urgency language in OET — and the highest penalty for getting urgency wrong. Answer in brief: cardiology letters grade urgency explicitly (emergency, urgent, routine) with findings to match; stroke letters timestamp everything; MSK letters quantify function. This guide teaches all three with a worked ACS referral, and OET Writing for Doctors — Course 7 trains stroke, heart failure, ACS, AF, bradycardia and back and knee pain across 11 topic sections.
Grading urgency: emergency, urgent, routine
Every cardiology letter should place itself on this ladder in paragraph 1 — and the findings must match the rung. Emergency (call/shock/ongoing ischaemia): findings show instability now. Urgent (unstable angina, TIA, symptomatic AF): findings show risk within days. Routine (stable angina workup, chronic AF review): findings show control with a question. Mismatched rungs — “routine” with crushing rest pain — destroy credibility faster than any grammar slip.
Cardiology: HF, ACS/STEMI, AF, bradycardia
Heart failure: decompensation signs (weight gain, oedema, orthopnoea), precipitant, current diuresis — plus echo status. ACS/STEMI: pain character, radiation, duration, associated symptoms, ECG and troponin (or “awaited”), aspirin given. AF: rate vs rhythm symptoms, stroke risk factors, anticoagulation status and the actual question (rate control? cardioversion? anticoagulation choice?). Bradycardia: symptoms on exertion, rate documented, drug causes reviewed, escape plan. Each needs its rung named and its already-given treatment stated.
Drill these presentations supervised? The full OET Writing for Doctors — Course 7 trains stroke, heart failure, ACS/STEMI, AF and bradycardia letters across 11 topic sections with 75 lessons and mock tests. Explore the course →
Stroke and neurovascular: timestamp everything
Onset time, arrival time, scan time, needle-eligibility window — stroke letters are timelines with a patient attached. “Weakness since 07:40, seen 09:05, CT requested” lets the reader compute eligibility instantly. Add deficits (NIHSS-style plain description), glucose (hypoglycaemia mimics), and thrombolysis/thrombectomy candidacy as the explicit question. Never bury onset in paragraph 3.
MSK: back and knee pain that quantifies function
Red flags first (saddle numbness, bladder change, night pain, weight loss, hot swollen joint), then function in numbers: walking distance, stairs, sleep disturbance, work impact, analgesia tried with effect. Imaging findings quoted exactly (“L4/5 disc protrusion contacting the theca”) beat paraphrase. The request names the service and the intervention question (physiotherapy? injection? surgical opinion?).
Worked example: suspected ACS referral
Fictional case, newly written: Mr Osei, 58, retrosternal pressure for 90 minutes at rest, radiating to left arm with sweating; BP 148/92, pulse 104; ECG anterior ST depression 2 mm; troponin awaited; aspirin 300 mg and GTN given with partial relief; no prior cardiac history.
Shape: “Thank you for seeing Mr Osei, 58, as an emergency with suspected acute coronary syndrome.” Character, radiation, duration, associated symptoms. Examination plus ECG (troponin awaited, will forward). Treatment given. Request: “I would appreciate emergency cardiology assessment with a view to angiography.” Emergency rung, matched findings, zero decoration — roughly 175 words.
FAQs
What if troponin or CT is still awaited?
Say exactly that, with who forwards the result and when. “Awaited” with a forwarding plan shows safe practice; omitting the test looks like it was never considered.
Can I upgrade urgency to be safe?
Only with findings to match. Systematic over-grading trains readers to discount you — and examiners to discount Content. Grade honestly; document safety-netting separately.
What is in the course?
Eleven topic sections on stroke and neurovascular, heart failure, ACS/STEMI, AF, bradycardia and musculoskeletal back and knee pain letters, with 75 lessons and 5 mock tests.
The matching course
OET Writing for Doctors — Course 7 is the cardio-neuro-MSK course: urgency grading, heart-failure, ACS, AF and bradycardia referrals, timestamped stroke letters and quantified MSK referrals — 11 topic sections, 75 lessons, 5 mock tests. For the highest-stakes presentations, train here.
Sources and note
- OET Writing format per the official OET site: oet.com — Writing. Clinical urgency frames are illustrative; follow local protocols in practice and current OET guidance for the exam.
- Course details verified from its public staging page (read-only): 11 topic sections, 75 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.
