OET Writing: The Complete Guide (2026)

One letter. Forty five minutes. Six criteria that decide everything. The format, the Criteria Map, and the two complete guides underneath it.

By Dr. Nasir BukhariUpdated 23 August 20266 min read
OET Writing: a page of clinical case notes beside the finished referral letter written from them, the whole task in forty five minutes.

Quick answer: OET Writing gives you 45 minutes, 5 for reading the case notes and 40 for writing, to produce one profession specific letter of around 180 to 200 words, usually a referral or discharge letter. It is scored from 0 to 500 against six criteria. Most regulators ask for grade B at 350, and some, like the UK's NMC, accept grade C+ at 300 in writing specifically, so always check your own regulator's current rules.

Writing is the sub test where students feel most alone, because there is no option to pick and no audio to follow. Just case notes, a blank page, and a clock. But here is what three years of teaching this task has shown me: Writing is the most learnable sub test of the four. It has a fixed structure, fixed criteria, and a fixed logic, and once you hold the system, every letter becomes the same letter with different details. This page gives you the whole map: the format, the six criteria and exactly which of my systems answers each one, and then it sends you into my two complete guides, the letter structure and the sentence formation.

OET Writing at a glance

Time45 minutes: 5 minutes reading, 40 minutes writing
Reading timeSurvey the case notes, decide what to pick and what to omit
Writing timeMark, highlight, build your pattern, and write
TaskOne letter based on case notes, specific to your profession
LengthAround 180 to 200 words, introduction to closing
Letter typesReferral and discharge are very common, transfer is rare
Score scale0 to 500, against six assessment criteria

How OET Writing is scored

Your letter is judged against six official criteria, and the grade bands are the same 0 to 500 scale as every sub test.

The bands, and the line that matters. Every OET sub-test reports 0 to 500. C 200–290 C+ 300–340 B 350–440 A 450–500 350 · MOST REGULATORS 0 100 200 300 400 500 Most regulators require grade B at 350 in all four skills. Some accept C+ at 300 in Writing only. Check your own regulator.

One fact many candidates never learn: the writing requirement is sometimes lower than the others. Most regulators ask for grade B, but the UK's NMC, for example, accepts grade C+ in writing while demanding B in the other three skills. Check your regulator's current rules before you set your target, because knowing your true target changes how you spend your preparation time.

The Criteria Map. Six criteria, six systems.

Here is the crown of this page. The exam publishes six criteria, and most students read them once and forget them. My students map each criterion to a system, so every criterion has an answer before the exam begins.

The Criteria Map

Six criteria. Six systems. Nothing left to judgement.

The exam publishes six criteria and most candidates read them once and forget them. Give each one a named system and the exam stops being a verdict and becomes a checklist.

01Purpose
The Three Things Introduction — name, diagnosis, purpose, in three lines.
The Urgent Flag — if the notes say immediate, your introduction says urgent.
02Content
The Task First Rule — the recipient decides what dies.
The Story Method — build the six beat story before writing a word.
03Conciseness and clarity
The 215 Word Truth — 215 words scored 400.
The Compression Ruledespite changing medications carries three failed drugs in three words.
04Genre and style
The Name Rule — full name in the Re: line, last name in the body, name at every new paragraph.
The Professional Passivea diagnosis was made, not I diagnosed her.
05Organisation and layout
The Rearrangement Logic — urgent puts the current condition first, discharge tells the story in order, transfer copies discharge.
06Language
The Starter Frames and The Connector Chain — the blank page and the flow.
The small rules: with complaints of, the and connector, and never a fragmented sentence.

Purpose is marked out of 3. The other five are marked out of 7. Raw total 38, scaled to 500. Every criterion has an answer before the exam begins.

When every criterion has a system, the exam stops being a judgment and becomes a checklist.

The letter structure. One pattern, three letters.

Referral, discharge and transfer are one letter wearing three coats. The frame never changes: recipient address, date, salutation, regarding line, the three line introduction, the body arranged by the Rearrangement Logic, the plan, and the closing. What the exam is really testing is whether you can select the right information for the right reader and arrange it in the right order. My complete letter guide walks the whole structure with the real Mrs. Jagosh case, from the Task First Rule to the closing line.

Read the complete guide: The OET Referral Letter, with Discharge and Transfer.

The sentence craft. From case notes to flowing English.

The other half of Writing is the sentence level, and it is where students freeze: they know everything and cannot start. My sentence system kills the blank page with starter frames for every situation, gives your letter its flow with the connector chain, and protects your marks with the small rules examiners actually count. Plus the two disciplines that finish the job: the 25 minute benchmark, and the one flow proofread checking verbs, prepositions, flow, and completeness.

Read the complete guide: OET Writing Sentence Formation.

How to prepare. The weekly system.

Writing improves through a loop, not through reading tips. The loop has three turns.

The weekly system

Writing improves through a loop, not through tips.

Three turns, three times a week. Random writing gives random letters.

Turn one

Write

One letter under real conditions. Five plus forty, from real case notes, no pausing.

Turn two

Read

Read good graded letters afterwards. You absorb how information is presented, and your own letters start sounding like it.

Turn three

Correct

With a trained eye. The mistakes you cannot see are the ones that repeat forever.

Three times a week. Your letters change within a month.

Each turn feeds the next. Writing without correction repeats the same faults; correction without writing has nothing to work on. The loop is the unit, not the letter.

Write one letter under real conditions, 5 plus 40, from real case notes. Read good graded letters afterward, because when you read a strong letter you absorb how information is presented, and your own letters start sounding like it. Correct with a trained eye, because the mistakes you cannot see are the ones that repeat forever. Run the loop three times a week, and your letters change within a month. Random writing gives random letters. The loop gives grade As.

Start the loop today with the writing correction programme.

Reading, Listening and Speaking complete your exam. The systems are here: OET Reading, OET Listening and OET Speaking.

Your letters, marked by the exam's standards. My writing correction program takes your real letters and returns them corrected mistake by mistake, criterion by criterion, so every letter you write teaches you the next one.

Get Your Letters Corrected

About the author. Dr. Nasir Bukhari, MBBS, is an OET Certified teacher. He completed OET's official Teacher Training in all four skills, Reading, Listening, Writing and Speaking, certified by OET's Head of Education. He has taught OET to healthcare professionals in more than 40 countries. He is the founder of CliniVerba, the house behind OET HQ.