As the name indicates, the ‘purpose’ of the letter is to give the reader a quick and accurate sense of what is expected from him/her when the patient is under his/her care. This OET criterion assesses how effectively and clearly the letter conveys the reason for writing the document.
As per the OET WRITING Assessment Criteria and Level Descriptors, ‘Purpose’ is the first criterion.
The purpose is communicated in two places in the letter. It should be introduced early (introduction) in the letter and expanded or explained later (conclusion) in the letter.
Table of Contents
1. Purpose at the start of the letter
The purpose should be immediately apparent to the reader. To achieve that, it should be conveyed clearly and succinctly in the introduction.
How to convey the purpose in the introduction?
1.1 Use a keyword
Based on the type of OET letter you are asked to write, use appropriate words (verbs) that indicate the reason for writing it.
Here is the list of possible keywords that help indicate purpose clearly:
| Refer | Outline |
| Transfer | Accept |
| Discharge | Request |
| Update | Provide |
| See | Recommend |
Thank you for seeing/reviewing/providing/accepting …
I am writing to refer/urgently refer/transfer/discharge/update/request…
Mr. X is being referred/transferred/discharged to you…
Date Formats in an OET Letter
How to write Recipient’s address
Salutations in an OET letter
Reference Line
Closing Sentence
1.2 Mention the medical reason clearly
It is really important that the medical status is accurately presented in the introduction. It is typically the diagnosis/probable diagnosis/the latest condition/status of the patient.
Examples of writing medical reason clearly
- who was/has been diagnosed/provisionally diagnosed with type 2 diabetes (Note: provisional diagnosis should not be mistaken as diagnosis)
- who is possibly suffering from ischemic heart disease
- who is recovering/recuperating from pneumonia
- who underwent total hip replacement
- whose symptoms are suggestive of an acute maniac episode
- who has symptoms consistent with an ectopic pregnancy
- who is demonstrating features of schizophrenia
- who presented with signs and symptoms of acute asthma
- who presented with acute abdominal pain (only if there is no diagnosis/probable diagnosis given)
1.3 Discuss the reason generally
In the introduction, you are required to briefly/generally discuss the reason for writing the letter.
Examples of reasons
- for further assessment and management
- for further treatment/investigations/a definitive diagnosis/specialist advice
- for follow-up/continuity of care/ongoing support/regular monitoring
- for your opinion on surgical management
- for rehabilitation/palliative care
2. Purpose at the end of the letter
After the purpose is introduced in the introduction and supported with relevant details pertaining to medical/social/family history in the following paragraphs, a high–level explanation of the expected care/action by the reader should be given in the last paragraph (conclusion).
Example 1
Introduction:
I am writing to refer Mrs. Sarah Hay, a 20-week pregnant woman who has been diagnosed with moderate depression, for further support and care.)
Conclusion:
Given the above, it would be appreciated if you could arrange a psychiatric consultation for Mrs Hay’s depression and daily visits by a community mental health nurse throughout her pregnancy.
(Here, the expected ‘further support and care’ is clearly explained in the conclusion.)
Example 2
Introduction:
I am writing to transfer Mr. Jerry Daniel, a 45-year-old asthmatic who is recovering from a head trauma and hospital-acquired pneumonia, for further rehabilitation and support.)
Conclusion:
Given the above, Mr. Daniel is transferred to your facility for regular pulmonary rehabilitation sessions and continuation of his physiotherapy and speech therapy. Additionally, ensure his compliance with his medications and smoking cessation regime.
However, in some cases, the purpose is in brief form and requires no explanation in the conclusion. In such cases, paraphrasing is advisable instead of repeating the sentence.
Example
Introduction:
I am writing to refer Mrs. Liza Jones, a 45-year-old type 2 diabetic who has poorly controlled blood sugar levels, for appropriate management.
Conclusion:
In light of the above, it would be appreciated if you could manage Mrs. Jones’ suboptimal blood sugar levels.
3. How is this criterion scored?
The criterion ‘Purpose’ is scored 3, 2, 1 or 0.
As per the ‘OET WRITING Assessment Criteria and Level Descriptors’, it is graded as follows.
| Band 3 | The purpose of the letter should be immediately apparent/easily noticeable and sufficiently expanded as per the case notes. |
|---|---|
| To secure grade A, the band for purpose should be 3.
| |
| The following tips will help you to secure this. 1. Use the appropriate keyword to indicate the purpose. 2. Compose the introduction succinctly with (only) the necessary information. 3. Convey the purpose of the document generally in the introduction. 4. Explain the expected care/action by the reader in detail in the conclusion (as per the case notes). 5. Write introduction and conclusion in separate paragraphs so that they stand out making the purpose immediately apparent to the reader. | |
| Band 2 | The purpose of the letter is apparent but not sufficiently highlighted or expanded. |
| To secure grade B, it is important to achieve a score of at least 2 out of 3 for ‘Purpose’. | |
| The possible reasons are as follows. 1. Relevant information in the introduction may be obscured by secondary/unnecessary details or wordy expressions. 2. The expected care/action by the reader is not conveyed generally in the introduction. 3. The expected care/action by the reader is not explained completely/clearly/specifically in the conclusion/at the end. | |
| Band 1 | The purpose of the document is not immediately apparent and may show very limited expansion. |
| The possible reasons can be any or a combination of the following. 1. ‘Key word’ that indicates the purpose is missing. 2. The introduction does not have all the required information (medical reason/expected care or action). 3. Medical reason is not clear. For example, writing the presenting complaint(s) instead of the final assessment/opinion by the writer. 4. The introduction includes too wordy sentences or secondary/irrelevant information. 5. The expected care/action by the reader is not explained clearly/specifically at the end or anywhere in the letter. Introduction and conclusion are not written in separate paragraphs so that they are not immediately visible to the reader. | |
| This score can result in grades lower than B (C+ or C). | |
| Band 0 | The purpose of the document is partially obscured/unclear and/or misunderstood. |
| The possible reasons can be any or a combination of the following. 1. The letter does not have an introduction. 2. The introduction is poorly developed or structured. 3. The introduction includes a lot of secondary/irrelevant information. 4. The introduction misleads the reader regarding further care/action. 5. No sufficient information related to the expected care/action by the reader. 6. Misinterpreted information related to the expected care/action by the reader This score can result in lower grades. |