Connectors and Cohesion in OET Writing: Linking Ideas Without Overloading

Connectors are the most visible cohesion device in an OET letter — and the most misused. Candidates who have practised essay writing often over-connect: stacking “Furthermore”, “Moreover”, and “Additionally” in a single paragraph in an attempt to show range. This reads as essayistic rather than clinical-professional, and it costs marks under both Organisation and Language. This guide covers how connectors are assessed, which ones work in an OET letter, and how to build cohesion without over-signposting.

For the criterion that assesses cohesion most directly, see OET writing criteria.

How connectors are assessed across the six criteria

The approved connector set for OET letters

These work in professional clinical correspondence without pushing the register into essay territory:

Additive (adding a point): In addition, / Furthermore (once per letter max)
Contrast: However, / Despite [noun phrase], / Although [clause],
Causal: Therefore, / As a result, / Consequently,
Temporal: Subsequently, / Following this, / Prior to [noun phrase],
Concession: Despite [noun phrase], / While [clause],

Avoid: Moreover, Additionally, Likewise, In contrast, To summarise, Last but not least, Firstly / Secondly / Thirdly, As mentioned above, In conclusion.

The better cohesion strategy: structure over signposting

The highest-scoring OET letters rarely feel connector-heavy. They achieve cohesion through three techniques that don’t require explicit connectors:

1. Paragraph topic sentences. Each paragraph opens with a clear topic sentence that tells the reader what this paragraph contains. The connection between paragraphs is implied by the logical sequence: reason for referral → relevant history → current status → what you need from the recipient.

2. Pronoun reference. After introducing Mr Hassan in the opening paragraph, subsequent sentences use “He” and “His” without re-stating the name. This forward-linking is cohesion — invisible and appropriate to the clinical register.

3. Lexical chains. Repeating key clinical terms across the letter (“blood pressure”, “antihypertensive medication”, “cardiovascular risk”) creates a semantic thread that holds the letter together without connectors.

Before/after: the stacked connector problem

Over-connected (essays register):
Mr Al-Saif was admitted with chest pain. Furthermore, he has a significant cardiac history. Moreover, he is currently on warfarin. Additionally, his renal function has recently declined.

Correct (professional clinical register):
Mr Al-Saif was admitted with chest pain. He has a background of ischaemic heart disease and is currently anticoagulated with warfarin. Renal function has declined over the past three months, which is relevant to his anticoagulation management.

The second version has no connectors in the traditional sense — the logic is carried by paragraph structure and clinical sequencing. This is what a Band B OET letter looks like.

Practical check during proofreading

During your proofreading pass, count the number of sentence-opening connectors. If you have more than three in a letter, replace at least one with a restructured sentence that makes the connection implicit.

For a full Organisation and cohesion analysis of your letter, use the free Writing Checker or submit for professional correction with written criterion-by-criterion feedback.