The Occupational English Test (OET) Writing sub-test is a crucial component for healthcare professionals, such as nurses, doctors, pharmacists, and physiotherapists, aiming to work in English-speaking countries like Australia, the UK, New Zealand, or Ireland. 

For many, achieving a Grade B (350-440 out of 500) in the Writing sub-test is essential for professional registration. 

This sub-test requires writing a formal letter, such as a referral, discharge, or transfer letter, based on case notes, and it tests your ability to communicate clearly and professionally in a healthcare context. 

In 2025, with updates to OET’s scoring and the inclusion of modern scenarios like telehealth, mastering this sub-test is more important than ever. 

This article provides simple, practical tips to help you secure a Grade B, covering the test format, assessment criteria, preparation strategies, common mistakes, and practice methods. By following these steps and using resources like oetpro.com, you can boost your confidence and performance.

Understanding the OET Writing Sub-Test in 2025

The OET Writing sub-test is designed to mimic real-world tasks healthcare professionals face, such as writing letters to colleagues or patients. It lasts 45 minutes, with 5 minutes for reading case notes and 40 minutes for writing a letter of 180-200 words. 

The task is profession-specific—for example, nurses might write a discharge summary, while doctors might draft a referral to a specialist. 

In 2025, the test has evolved to include scenarios reflecting current healthcare trends, such as virtual consultations or post-pandemic care protocols.

To achieve a Grade B, you need to score between 350 and 440 points, demonstrating clear, accurate communication with minor errors that don’t hinder understanding. 

The letter must be formal, well-organized, and tailored to the recipient (e.g., another healthcare professional or a patient’s family). 

Most regulatory bodies, like the UK’s Nursing and Midwifery Council (NMC) or Australia’s AHPRA, require a B in Writing, though some accept a C+ (300-340) for specific roles. 

The test is scored across six criteria: Purpose, Content, Concise and Clarity, Genre and Style, Organization and Layout, and Language. Understanding these is key to targeting a Grade B.

Assessment Criteria for a Grade B

To score a Grade B, you must perform well across all six criteria, each scored from 0-7 in 2025:

1. Purpose (0-3): Clearly state the letter’s purpose (e.g., referral, discharge) early, ideally in the first sentence. A Grade B requires immediate clarity about why you’re writing.

2. Content (0-7): Include all relevant case note details, omitting irrelevant ones. For B, you must cover key information accurately, with minor omissions or inaccuracies.

3. Concise and Clarity (0-7): Be brief yet precise, avoiding repetition or vague terms. A Grade B shows focused writing with minimal redundancy.

4. Genre and Style (0-7): Use formal, professional language suited to the recipient (e.g., technical for doctors, simpler for patients). For B, your tone should be consistently appropriate with slight lapses.

5. Organization and Layout (0-7): Structure the letter logically (introduction, body, conclusion) with clear paragraphs. A Grade B letter is well-organized, with minor formatting issues.

6. Language (0-7): Use accurate grammar, spelling, and vocabulary. For B, errors should be minimal and not affect clarity.

A Grade B typically equates to scores of 5-6 across most criteria, balancing accuracy and professionalism without perfection.

Step-by-Step Tips for Writing a Grade B OET Letter

Here are practical, easy-to-follow tips to achieve a Grade B in 2025:

1. Understand the Task and Case Notes

• Read Carefully: Spend the full 5 minutes analyzing the case notes. Highlight key details like the patient’s condition, treatment, and required actions (e.g., referral to a specialist).

• Identify the Recipient: Note whether the letter is for a doctor, nurse, patient, or family member. This determines your tone and vocabulary.

• Focus on the Task: The case notes specify the purpose (e.g., “refer for further assessment”). Ensure your letter addresses this directly.

• Example: For a nurse writing a discharge letter, prioritize current symptoms, medications, and follow-up care over the patient’s full history unless relevant.

2. Plan Your Letter

• Outline Before Writing: Jot down a quick structure during the reading time: purpose, main details (e.g., diagnosis, treatment), and action requested.

• Select Relevant Information: Choose 5-7 key points from the case notes. For Grade B, include all critical details but avoid overloading with minor facts (e.g., skip childhood illnesses unless specified).

• Time Management: Plan for 5-7 minutes to outline, 25-30 minutes to write, and 3-5 minutes to proofread.

3. Structure Your Letter Clearly

• Standard Format: Use a professional layout:

• Date and Address: Include the date and recipient’s name/title (e.g., “Dr. Jane Smith, Cardiologist”).

• Subject Line: Mention the patient’s name and purpose (e.g., “Re: Mr. John Lee, Referral for Hypertension”).

• Introduction: State the purpose clearly (e.g., “I am writing to refer Mr. Lee for further cardiac assessment”).

• Body: Organize details into 2-3 paragraphs (e.g., current condition, treatment history, requested actions).

• Conclusion: Summarize the request or next steps (e.g., “Please assess and advise on further management”).

• Closing: Use formal closings like “Yours sincerely” and your name/title.

• Paragraphing: Each paragraph should cover one main idea (e.g., symptoms, medications, follow-up). For Grade B, minor formatting errors are acceptable if the structure is logical.

4. Write Clearly and Concisely

• Be Direct: State key points upfront (e.g., “Mr. Lee has type 2 diabetes diagnosed in 2024”).

• Avoid Repetition: Don’t repeat case note details unnecessarily. For example, mention a medication once unless changes are relevant.

• Use Simple Sentences: Complex sentences can lead to errors. For Grade B, aim for clear, short sentences (e.g., “He takes metformin 500 mg daily”).

• Tailor to Recipient: Use technical terms for professionals (e.g., “hypoglycemia”) but simpler language for patients (e.g., “low blood sugar”).

5. Use Appropriate Language

• Formal Tone: Avoid casual phrases like “he’s doing okay.” Instead, use “he is recovering well.”

• Medical Vocabulary: Include accurate terms (e.g., “analgesics” for painkillers, “physiotherapy” for rehab). For Grade B, minor vocabulary errors are fine if meaning is clear.

• Patient-Centered Language: Show empathy when addressing patients (e.g., “Please reassure Mrs. Smith about her recovery”).

• Grammar and Spelling: Common errors like tense confusion (e.g., “he takes” vs. “he taken”) can lower scores. Practice basic grammar rules (e.g., subject-verb agreement).

6. Proofread Effectively

• Check for Errors: In the last 3-5 minutes, review for spelling, grammar, and missing details.

• Ensure Clarity: Confirm the purpose and key points are clear.

• Verify Format: Check for proper addressing and paragraphing.

• Example: A missing medication dose or misspelled term like “diabetes” as “diabetis” can drop you from B to C+—double-check.

7. Practice with Realistic Scenarios

• Use Case Notes: Practice writing letters based on sample case notes for your profession. oetpro.com offers free nursing-specific scenarios reflecting 2025 updates like telehealth.

• Time Yourself: Write under exam conditions (40 minutes) to build speed and accuracy.

• Vary Recipients: Practice letters to doctors, patients, and families to adapt tone and style.

8. Seek Feedback

• Self-Review: Compare your letters to OET rubrics, checking each criterion.

• Peer or Tutor Feedback: Share with colleagues or a tutor for insights on clarity or tone.

• Online Tools: Platforms like oetpro.com provide instant scoring and feedback on practice letters, highlighting areas like conciseness or grammar.

Common Mistakes and How to Avoid Them

To secure a Grade B, steer clear of these pitfalls in 2025:

1. Misinterpreting the Task: Including irrelevant details (e.g., a patient’s job history unless specified). Solution: Stick to the task instructions and prioritize current medical details.

2. Poor Organization: Writing one long paragraph or jumbled information. Solution: Use 3-4 paragraphs with clear themes (e.g., diagnosis, treatment, request).

3. Overusing Jargon: Using complex terms with non-medical recipients. Solution: Practice simplifying terms (e.g., “heart attack” instead of “myocardial infarction” for patients).

4. Grammatical Errors: Mistakes in tense (e.g., “he was prescribed” vs. “he is prescribed”) or articles (e.g., “a diabetes” vs. “diabetes”). Solution: Review basic grammar and proofread carefully.

5. Missing Purpose: Failing to state why you’re writing. Solution: Start with a clear purpose statement (e.g., “I am referring Mrs. Smith for physiotherapy”).

6. Time Mismanagement: Spending too long planning or not proofreading. Solution: Stick to a 5-30-5 minute split (plan, write, check).

Preparation Strategies for 2025

To achieve a Grade B, follow a structured preparation plan over 2-3 months:

1. Understand the Scoring: Study the six criteria and aim for 5-6 points each. Download rubrics from oetpro.com to guide practice.

2. Build Medical Vocabulary: Learn 10-15 terms daily (e.g., “hypertension,” “rehabilitation”). Use flashcards and apply them in sample letters.

3. Practice Daily: Write one letter daily, alternating tasks (referral, discharge, transfer). Focus on different professions’ scenarios to understand nuances.

4. Simulate Exam Conditions: Practice under a 40-minute timer to mimic test pressure. oetpro.com offers timed mocks with 2025-aligned case notes.

5. Review and Refine: Analyze practice letters against rubrics, noting errors in structure or language. Revise weak areas weekly.

6. Join Study Groups: Share letters with peers for feedback and role-play recipient responses to improve adaptability.

7. Use Technology: Record your planning process to streamline case note analysis. Apps can help with grammar checks during practice.

Benefits of Mock Tests

Mock tests are essential for Grade B success in 2025:

• Diagnose Weaknesses: Identify issues like poor conciseness or missing details.

• Build Familiarity: Get comfortable with case note formats and time limits.

• Improve Time Management: Practice pacing to complete letters within 40 minutes.

• Receive Feedback: Platforms like oetpro.com provide scores and tips, highlighting gaps in purpose or clarity.

• Boost Confidence: Regular mocks reduce anxiety, ensuring you’re test-ready.

Start with free mock tests on oetpro.com to practice profession-specific letters and track progress.

Sample Letter for Grade B (Nursing)

Case Notes:
Patient: Mr. James Brown, 60, type 2 diabetes diagnosed 2023
Current Issue: Recent hypoglycemia, adjusted metformin dose
Task: Write a referral letter to Dr. Lisa Green, endocrinologist, for further management.

Sample Letter:
3 September 2025
Dr. Lisa Green
Endocrinology Department
City Hospital
Dear Dr. Green,
Re: Mr. James Brown, 60 years old, Referral for Diabetes Management

I am writing to refer Mr. James Brown, a 60-year-old patient with type 2 diabetes diagnosed in 2023, for your assessment and management of recent hypoglycemia.

Mr. Brown presented to our clinic on 1 September 2025 with symptoms of dizziness and sweating. His blood glucose was 3.2 mmol/L, confirming hypoglycemia. He has been taking metformin 500 mg twice daily since diagnosis. 

Following this episode, his dose was reduced to 500 mg once daily, and he was advised to monitor blood sugar levels three times daily. He reports no other chronic conditions but has a history of mild hypertension, managed with lifestyle changes.

Please assess Mr. Brown’s diabetes control and recommend further treatment to prevent recurrent hypoglycemia. Kindly advise on any additional monitoring or dietary adjustments.

Thank you for your expertise. Please contact me if you need further details.
Yours sincerely,
Sarah Jones
Registered Nurse

Analysis: This letter achieves Grade B by clearly stating the purpose, including relevant details (diagnosis, symptoms, treatment), using formal language, and organizing content into concise paragraphs. Minor improvements (e.g., adding a dietary detail) could push it toward A.

Test Day Tips for 2025

• Before: Rest well, review sample letters, and test equipment for online tests.

• During: Read case notes carefully, plan briefly, and write legibly (or type accurately). Save time to proofread.

• After: Reflect on performance but focus on prep for potential retakes.

Achieving a Grade B in the OET Writing sub-test in 2025 is within reach with focused preparation. By understanding the task, structuring letters clearly, using appropriate language, and practicing regularly, you can meet the criteria for clarity, conciseness, and professionalism. 

Avoid common mistakes like poor organization or jargon overuse, and leverage mock tests on oetpro.com to refine your skills. 

With 2-3 months of daily practice, you’ll be ready to write a Grade B letter, paving the way for a rewarding career in English-speaking healthcare systems. Start today with free resources on oetpro.com and take control of your OET journey.

Frequently Asked Questions (FAQs)

Q1. What is the OET Writing sub-test?
A 45-minute task to write a 180-200-word healthcare letter based on case notes.

Q2. What score is needed for Grade B?
350-440 points, typically 5-6 on each of the six criteria.

Q3. Can I use informal language?
No, use formal, professional language suited to the recipient.

Q4. How long should I prepare?
2-3 months with daily practice for most candidates.

Q5. What if I miss a case note detail?
Minor omissions are okay for Grade B if key points are covered.

Q6. How do I improve my grammar?
Practice basic rules (e.g., tenses, articles) and proofread carefully.

Q7. Are there nursing-specific tips?
Yes, focus on patient-centered details like care plans and medications.

Q8. Can I retake only the Writing sub-test?
Yes, if you pass other sub-tests, check regulator rules.

Q9. How to manage time in the test?
Spend 5 minutes planning, 30 writing, and 5 proofreading.

Q10. Where can I practice?
oetpro.com offers free, profession-specific practice letters with feedback.