For International Medical Graduates (IMGs) · Last updated: 11 May 2026

OET for Doctors — Pass Writing First Time

Writing on the OET rewards selection, brevity, and structured handover — not the comprehensive free-writing doctors do every day. Since 2014 we have corrected thousands of doctor letters against the six OET criteria. Profession-specific case notes, 24-hour turnaround, built for the 2026 ECFMG single-sitting rule.

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Quick answer

Internationally trained doctors need Grade B (350) in each of the four OET sub-tests for GMC (UK) and ECFMG (USA) registration. From 2026, ECFMG requires all four Grade B passes in a single sitting; sequential pass-and-retake is no longer accepted. The GMC has no Grade C+ Writing concession. AHPRA (Australia) does: it has accepted Grade C+ (300) in Writing since 18 March 2025, with Grade B in Listening, Reading and Speaking. Writing is the most retaken sub-test — typically due to Conciseness & Clarity losses from clinical narrative habits.

Key takeaways for doctors

Required grade: GMC and ECFMG require Grade B (350) in Writing. AHPRA accepts Grade C+ (300) in Writing since 18 March 2025, with B in the other three.
2026 ECFMG rule: All four B grades in a single sitting. Sequential-pass strategy no longer accepted.
Most common letter type: Discharge or transfer letter, addressed to another doctor.
Top criterion lost: Conciseness & Clarity, followed by Genre & Style when the addressee is non-clinical.
Validity: 2 years from test date at most regulators.

2026 ECFMG Rule — Single Sitting Required

If you are an internationally trained doctor pursuing US residency through ECFMG, the OET requirements changed in 2026. All four sub-tests — Listening, Reading, Writing, Speaking — must now be achieved at Grade B (350) in a single sitting. Combining results from multiple sittings is no longer accepted.

This raises the bar significantly on Writing, where IMG candidates historically have the lowest first-attempt pass rate. Sequential pass-and-retake is no longer a viable strategy. Targeted Writing preparation is now essential — not optional.

Required OET Scores by Regulator (Medicine)

Regulator

Country

Required (Writing)

Combine sittings

GMC

United Kingdom

B (350)

Check with GMC

AHPRA

Australia

C+ (300) since 18 Mar 2025

Yes (12 months)

ECFMG

United States

B (350)

No — single sitting (2026)

MCNZ

New Zealand

B (350)

Yes

Medical Council

Ireland

B (350)

Yes

MCC

Canada

B (350)

Yes

The Three Letter Types Doctors Write Most

1. Discharge letter

Inpatient summary to the patient's GP. Tests your ability to condense an admission into actionable next steps — diagnosis, treatment given, medications on discharge, follow-up plan.

Marking watch-out: Conciseness — discharge tempts narrative recap. Resist.

2. Transfer letter

Patient handover to a specialist team or another facility. Often emergency or peri-operative context. Addressee usually expects to act on the letter immediately.

Marking watch-out: Purpose — open with the reason for transfer in the first sentence, not the patient's history.

3. Emergency / referral letter

Urgent referral to a specialist or on-call team. Tests your ability to convey clinical urgency without melodrama.

Marking watch-out: Genre & Style — match the register to clinical urgency. "Please see urgently" is acceptable; over-hedging weakens Purpose.

The Four Mistakes That Cost Doctors Their Grade

Daily clinical writing builds habits that work in the hospital and against you in the OET. These four patterns show up across thousands of doctor letters we have corrected — each fixable in 2-3 targeted submissions.

Comprehensive narrative recap

Costs marks in: Conciseness & Clarity

Including the full admission history when the addressee already needs only the discharge summary. Fix: select only what the addressee must know to act.

Over-clinical register when writing to non-clinicians

Costs marks in: Genre & Style

Using full medical jargon when the addressee is a community service or patient family member. Fix: adjust register to the recipient — clinical for clinical, accessible for non-clinical.

Buried purpose

Costs marks in: Purpose

Spending two sentences on patient demographics before stating why you're writing. Fix: reason for writing in the first sentence.

Run-on sentences with multiple sub-clauses

Costs marks in: Language

Long clinical-style sentences that obscure the main message. Fix: one clinical fact per sentence in the opening paragraph; longer constructions only where needed.

How Our Service Helps Doctors Specifically

Medically-aware correctors

Correctors familiar with clinical handover conventions, GMC vocabulary, and IMG-specific writing patterns.

Doctor case-notes library

Practice case notes spanning emergency, peri-operative, specialty, and primary-care contexts.

Six-criteria feedback per letter

Per-criterion scoring (Purpose, Content, Conciseness & Clarity, Genre & Style, Organisation & Layout, Language) — no single black-box grade.

ECFMG single-sitting ready

For 2026 ECFMG candidates: corrections explicitly geared toward Grade B in a single attempt — no "just pass Writing later" strategy.

Frequently Asked Questions

What OET score do international doctors need for the GMC? +

The GMC requires at least Grade B (350) in each of the four OET sub-tests — Listening, Reading, Writing, and Speaking. An OET certificate is valid for two years. Australia is different: AHPRA and the Medical Board of Australia have accepted Grade C+ (300) in Writing since 18 March 2025, with Grade B still needed in Listening, Reading and Speaking.

What changes in 2026 for doctors targeting US (ECFMG) registration? +

From 2026, ECFMG requires that all four OET sub-tests are passed at Grade B in a single sitting. The previous strategy of passing sub-tests sequentially across multiple sittings is no longer accepted. For internationally trained doctors targeting US residency, this raises the bar significantly on writing preparation, where the failure rate is highest.

What letter type do doctors typically write in OET Writing? +

Doctors most often write discharge letters or transfer letters, frequently in emergency or specialist contexts. The addressee is usually another doctor (GP, specialist, on-call team). Less commonly, a counselling letter to the patient or family member is tested.

Why do IMG doctors lose marks despite writing clinically every day? +

Daily clinical free-writing rewards comprehensiveness and detail. The OET Writing sub-test rewards the opposite — selection, brevity, and structured handover. Across our thousands of doctor letters, the most common criterion lost is Conciseness & Clarity, followed by Genre & Style (register mismatch when writing to a non-clinical addressee).

How long should doctors spend preparing for OET Writing? +

For first-time candidates, 4-6 weeks with 4-8 corrections is sufficient if you start with the criteria in mind. For re-takers, 6-8 weeks with 8-12 corrections is more typical. Doctors targeting ECFMG single-sitting must prepare all four sub-tests in parallel; do not under-invest Writing because it is the historic failure point.

Related guides for doctors

The Six OET Writing Criteria

What examiners look for, criterion by criterion.

OET Letter Templates

Reference structures for discharge, transfer, referral.

OET Writing Common Mistakes

Cross-profession patterns that cost marks.

All 12 OET Professions

Profession-specific guidance for nursing, pharmacy, physio and more.

OET English Requirements by Regulator

The OET grades each regulator (GMC, NMC and more) accepts.

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