OET Referral Letter: Structure, Language and What Examiners Check

Referral letters are the most common task type in OET writing. You are asking a specialist to assess and manage a problem your patient has that falls outside your scope or capacity. The examiner is checking whether your letter gives that specialist what they need to take the next clinical step, nothing more and nothing less.

What the examiner checks in a referral letter

The six OET writing criteria each apply, but three are most directly tested by the referral task:

Content: Did you select the information the specialist needs? This is determined by the referral reason and the specialist’s role. A neurologist receiving a referral for new headaches needs onset, character, associated features, red flag exclusions, and current medication. They do not need the patient’s full orthopaedic history.

Conciseness and Clarity: Is the length appropriate? Referral letters in professional practice are concise. Transcribing the full case notes loses marks.

Genre and Style: Does the letter read as professional clinical correspondence? The tone is formal but not bureaucratic. Technical language is appropriate for a specialist reader, but abbreviations must be used with judgment.

Structure of a strong referral letter

Opening paragraph: purpose and patient

One sentence identifies the referral reason, the patient, and one identifying clinical detail. See how to write the opening sentence for the full technique.

“I am writing to refer Aisha Mohammed, 34, to your gastroenterology service regarding a three-month history of dysphagia to solids, associated with significant weight loss.”

The opening paragraph then adds two or three sentences giving the specialist the minimum context they need to accept the referral.

Background paragraph: relevant history only

Select from the case notes the history that connects to the referral reason. A three-month history of dysphagia requires: dietary intake, weight loss, symptom progression, and any relevant past GI history. It does not require childhood immunisations, orthopaedic procedures, or psychosocial background unless directly linked.

One focused paragraph is almost always sufficient. If the relevant history genuinely requires two topics, for example a psychiatric history and a medication change both relevant to a neurological referral, use separate, short paragraphs.

Current status and investigations

What is the patient’s situation right now? What have you already investigated, and what did those investigations show? This paragraph tells the specialist what work has been done so they do not repeat it, and signals the urgency of the referral.

“Full blood count revealed iron-deficiency anaemia (Hb 96 g/L). Barium swallow performed on 22 May 2026 showed a structural narrowing at the lower oesophagus. CT chest and abdomen is pending.”

What you want the specialist to do

Be explicit. “Assessment and management” is appropriate for most referrals. When the referral is urgent, state why and ask for a specific response time if the case notes prompt it.

Closing convention

Restate the request and invite contact. This is Genre convention, not summary. Examiners expect it.

“I would be grateful for your assessment and management. Please do not hesitate to contact me should you require any further information.”

Information to exclude

Case notes always contain more than the referral needs. Exclude:

• Social history unrelated to the condition being referred
• Investigations that did not contribute to the referral decision
• Chronic conditions stable and unrelated to the referral reason
• Details of previous admissions not connected to the presenting issue
• Allergies unless the specialist will prescribe

The reading case notes method gives a systematic approach to this selection before you start writing.

Language patterns for referral letters

Referral request: “I am writing to refer / to request an assessment of / to seek your opinion regarding”

Presenting the history: “She presents with a six-week history of / He reported onset of / Clinical examination revealed”

Describing investigations: “Blood tests demonstrated / Imaging confirmed / ECG showed”

Closing: “I would be grateful for your assessment and management plan / I would appreciate your urgent review / Please do not hesitate to contact me”

Avoid informal register: “I think she might have X”, “Could you possibly have a look at”, “He’s been having this problem for a while.” These phrases affect Genre and Style, where clinical directness is expected even in polite formulations.

For a complete annotated example of a Band 350 referral letter, see the OET writing sample.