How to Write the First Sentence of Your OET Letter

The first sentence of your OET letter does one job: it tells the reader immediately why you are writing. Examiners assess Purpose before they assess anything else. Under the current criteria, Purpose scores 0–3. A score of 3 requires the purpose to be “immediately apparent and sufficiently developed.” That judgment starts at sentence one.

This post explains what a strong opening sentence contains, how it varies by letter type, and what specific phrases guarantee a low Purpose score.

The three-part structure

A purposeful first sentence answers three questions at once:

1. Who is the letter for? (recipient role, not name)
2. What is being requested? (the action, not just the topic)
3. Which patient? (name plus one identifying detail)

Working these three elements into one sentence takes practice, but it is the most reliable way to guarantee Purpose is apparent from the first line.

Weak: “I am writing regarding Mrs. Nguyen, who was recently seen in our clinic.”

The reader knows the patient’s name. They do not know whether this is a referral, a discharge letter, a request for records, or something else. Purpose is absent.

Strong: “I am writing to request an urgent cardiology review for Linh Nguyen, 61, following a new episode of angina at rest.”

The recipient (cardiologist), the action (urgent review), and the patient (identified with age and presenting issue) are all present.

Variations by letter type

The three-part structure applies to all letter types, but the action phrase changes.

Referral: “I am writing to refer David Okonkwo, 47, to your physiotherapy department following a left shoulder labral repair on 14 May 2026.”

Discharge: “I am writing to inform you of the discharge of Rosa Fernandez, 73, from Ward 6B, following a five-day admission for community-acquired pneumonia.”

Transfer: “I am writing to arrange the transfer of James Mbeki, 58, to your rehabilitation unit, where he will continue recovery from a right hip replacement.”

Advice: “I am writing to advise you regarding the ongoing pain management plan for Amara Singh, 39, who was seen in our chronic pain clinic on 3 June 2026.”

Notice that each sentence is complete before any clinical history appears. The recipient’s role is implied by the letter’s salutation. You do not need to write “Dear Dr. Chen, I am writing to a cardiologist.” The action phrase carries that meaning.

Phrases that guarantee a low Purpose score

These openers appear frequently in OET scripts and consistently score 0 or 1 for Purpose:

• “I am writing with regards to the above-mentioned patient.”
• “Please find enclosed a referral for your consideration.”
• “I wish to bring to your attention the case of [patient name].”
• “Further to our recent discussion, I am writing regarding [name].”
• “I am writing in connection with the patient named above.”

All of these signal that something exists: a referral, a case, or a discussion. None state what action is needed or why. An examiner reading any of these sentences cannot determine the letter’s purpose without reading further. That is the defining feature of a Purpose score below 2.

When purpose needs development as well

A score of 3 for Purpose requires the purpose to be “immediately apparent and sufficiently developed.” The opening sentence establishes it as apparent. Development happens in the first paragraph: why the referral is needed, what the discharge plan requires, what the transfer involves.

A single well-structured opening sentence followed by two sentences of purposeful context satisfies both conditions. A long opening sentence that tries to do everything at once typically ends up unclear.

Pair this opening structure with the approach to reading case notes for the recipient. The purpose of the letter is defined by who receives it and what they need to do. Getting that right during the reading stage makes the opening sentence straightforward to write.

For the full breakdown of how Purpose is scored alongside the other five criteria, see the OET writing criteria guide.