Problem: writers confuse referrals with updates — asking nothing when action is needed, demanding review when information would do. Answer in brief: referral asks a question the recipient must answer; update gives information the recipient must hold. Choose by the decision test, then write diabetes, pain and falls letters within the chosen shape. This guide teaches the choice plus three clusters, and OET Writing for Pharmacists — Course 4 trains referral-vs-update judgement across 13 topic sections.
Referral vs update: the decision test
Ask: does the recipient need to decide something (review, switch, approve, assess)? Referral — with an explicit question. Or does the recipient need to know something (regimen changed, monitoring arranged, risk flagged)? Update — with the information complete and no pseudo-question tacked on. “For your information” endings on referrals waste the letter; “please advise” endings on updates confuse responsibility. The test takes ten seconds and fixes the genre before a word is drafted.
Cluster A: diabetes and metabolic
Referral shape: control failure with numbers and adherence evidence → complication or risk trigger → the escalation question (regimen intensification? education referral? complication screening?). Update shape: regimen change made with reason, monitoring arranged, thresholds for re-contact. Same facts, different jobs — the course drills both shapes on shared cases so the genre switch becomes visible.
Master the choice supervised? The full OET Writing for Pharmacists — Course 4 trains referral-vs-update judgement with diabetes and pain clusters across 13 topic sections with 35 lessons and mock tests. Explore the course →
Cluster C: pain, opioids, NSAIDs, falls
Pain letters need scores with function (“pain 6/10, stairs avoided”), current analgesia with effect and side effects, opioid specifics (dose, duration, escalation requests, aberrant behaviours reported factually), NSAID risks (age, renal, cardiac, GI history, gastroprotection), and falls synthesis (sedatives plus orthostatics plus hazards). The falls question is usually deprescribing or balance referral — propose the candidate drugs for review rather than gesturing at “polypharmacy”.
Worked example: opioid review request
Fictional case, newly written: Mr Byrne, 68, chronic back pain on oxycodone 20 mg twice daily for fourteen months; requesting dose increase; pain 5/10 unchanged; constipation and daytime drowsiness; two near-falls this month; lives alone; paracetamol and physiotherapy untried recently.
Shape (referral): “I am writing to request review of Mr Byrne’s long-term opioid therapy given limited benefit with emerging harm.” Regimen with duration and effect. Harms: sedation, near-falls, constipation. Untried alternatives named. Request: “I would appreciate GP review with a view to a tapering plan plus physiotherapy re-referral; he is open to discussion.” Decision asked, evidence complete — roughly 175 words.
FAQs
How do I report aberrant behaviour fairly?
Factually, dated, without interpretation: “requested early supply twice; states tablets lost.” The prescriber judges; your letter supplies dated facts only.
When do NSAIDs force the question?
Age over 65 with renal, cardiac or GI risk and no gastroprotection — the combination itself is the trigger. State all three facts together; the question writes itself.
What is in the course?
Thirteen topic sections on referral-vs-update choice with diabetes and pain clusters, 35 lessons and 5 complete mock tests.
The matching course
OET Writing for Pharmacists — Course 4 teaches genre judgement first: referral or update, chosen correctly — then diabetes, pain, opioid, NSAID and falls letters within the right shape. Thirteen topic sections, 35 lessons, 5 mock tests.
Sources and note
- OET Writing format per the official OET site: oet.com — Writing. Regimens above are illustrative fiction; follow local protocols in practice and current OET guidance for the exam.
- Course details verified from its public staging page (read-only): 13 topic sections, 35 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.
