OET Writing Sub-Test for Nurses 2026: Format, Marking and How to Reach Grade B

The OET Writing sub-test for nurses asks you to write a professional letter, usually a referral, from case notes in 45 minutes. You need to select the relevant facts, organise them clearly and write in safe, professional English.

Most nurses aiming for the UK, Ireland, Australia or the Gulf need Grade B. The fastest improvement comes from learning the letter structure, practising under time pressure and getting feedback on your selection and language.

You receive case notes about a patient and a task that tells you who you are writing to and why. You have about five minutes of reading time, then about 40 minutes to write a letter of roughly 180 to 200 words.

The letter is normally a referral, discharge or transfer letter. The reader is another health professional, so your writing must be clear, concise and clinically safe.

You are marked on purpose, content, conciseness and clarity, genre and style, organisation and layout, and language. A good letter does well on all of these, not just grammar.

Examiners look first at whether you understood the purpose of the letter. A referral letter must explain why the patient needs specialist care, what has been done and what follow-up is needed.

Content matters most: include the relevant history, examination findings, investigations, treatment and current status, and leave out detail that does not help the reader. Copying the case notes word for word is a common error.

— Start with the purpose and the patient. — Group related facts into clear paragraphs. — Use professional, polite language throughout. — End with a clear request or plan.

Use a simple structure every time: opening purpose, relevant history and background, current condition and findings, treatment and management so far, and closing request and follow-up. This keeps your letter organised under time pressure.

Begin with one or two sentences that state the purpose, for example that you are referring the patient for assessment or follow-up. Then give only the background the reader needs to understand the referral.

In the middle paragraphs, present findings in a logical order and use linking words to guide the reader. Close with what you are asking for, any urgency, and what you have told the patient.

Including irrelevant detail is the most common mistake. If a fact does not affect the referral, leave it out. Examiners reward selection, not a long list of everything in the case notes.

Other costly errors are missing the urgency, writing in a chatty tone, using abbreviations the reader may not know, and giving unclear instructions about medication or follow-up. Safety and clarity matter more than fancy vocabulary.

Time management also matters. If you spend too long reading, you will rush the letter and make avoidable language errors. Practise reading the notes in five minutes and writing in the time that remains.

Week one: learn the structure and study two or three sample letters. Write one untimed letter and compare it with a model to see what you missed or included unnecessarily.

Week two: write three timed letters and review each one for purpose, selection and organisation. Keep a list of useful phrases for referrals, follow-up and medication instructions.

Weeks three and four: write timed letters every other day and get feedback from a teacher or experienced colleague. In the final week, practise one full OET Writing paper under exam conditions and review it the same day.

If you are a nurse working towards OET for a Gulf or European role, browse the open nursing roles on steadstaff.com and apply to the ones that match your experience and English-test status. Keep your CV and test results current.

State your OET Writing grade or target date clearly in your application, because employers often shortlist nurses who are close to meeting the language requirement.