OET SAMPLE UPDATE LETTER

OET letter writing is categorised in 3 types mainly. These are

  • Referral
  • Discharge
  • Transfer

It’s important to note that regardless of the type of letter, the approach to writing an OET letter is the same. Source

In some case notes scenarios, you may be required to give an update on the patient’s condition or expected care to his/her GP, relative/care giver, or reporting authority/administrative officer.

NOTE: As mentioned above, there are only three OET letter types: referral, discharge, and transfer. Writing a letter to update a patient’s condition is not considered a separate type of OET letter. Source

Please note, in this scenario, the addressee has an existing relation with the patient, which means the intended reader already knows the patient. Therefore, selection of case notes is critical and you need to be careful about deciding not only which information to choose, but also which one to EXCLUDE.

The content can be based on hospitalization details, progress of a patient’s condition, drug interaction, requirement for monitoring/attention/supervision, etc.

The sample update letter given below will help you understand how to select case notes for this specific scenario, present them appropriately using good vocabulary and organize them logically.

It’s worth reading the entire article as the tips given are universal and easily apply to any type of OET case notes scenario. Last but not least, don’t forget to take the mock test and quiz given at the end.

OET Case Notes (Medicine)
Note:
You are a paediatrician at Brookdale Hospital. Alan Brown is a teenager admitted to your floor for severe abdominal pain.

PATIENT DETAILS:

Name: Alan Brown

DOB: 13 y.o.

Address: 5884 W Isle Rd, Lunenburg

Social Background:

  • Middle school student
  • Live with parents, they work
  • Non-smoker, no alcohol

Family History:

  • Father (diabetes since age 53)
  • Mother (depression since age 35)

Past Medical History:

  • Childhood asthma till 5 yrs
  • ORIF for Fx R thigh bone in 2004

Presenting Complaint: Severe abdominal pain

TREATMENT SUMMARY:

05/10/2021     

  • Presented with mother to ED with severe abdominal pain for 2 days
  • Generalized dull pain on palpation
  • Unsure of any triggers; was playing video games at home with sister
  • Labs showed mildly high WBC
  • Admitted to in-patient paediatric floor

06/10/2021

  • Pt started on Ibuprofen, still moderate pain
  • Started Zosyn for suspected appendicitis
  • Mother remains at bedside

10/10/2021     

  • Pt’s pain subsiding, better mood
  • Pt’s father visited, ward nurse mentioned loud arguments
  • Patient agitated, later claimed pain worsened, teary-eyed

13/10/2021

  • Pain decreased, pt in better spirits
  • Discussed possible discharge with mom, pt cried claiming pain was worse
  • Spoke to pt directly about going home, pt admitted to troubled relationship with father
  • Mother confirmed relationship strained – Pt’s father unhappy about son’s poor grades at school, punishes regularly
  • Assessment – Abdominal pain, a somatic symptom of depression?
  • Psych consult requested

14/10/2021

  • Psychiatrist saw pt,
  • Assessment – ?depression
  • Recommends admission to peds psych ward for assessment
  • Plan
  • Admission later in day
  • Update pt.’s primary paediatrician

Writing Task

Using the information given in the case notes, write a letter to Dr. Silvia, the patient’s primary paediatrician. In your letter, briefly outline Alan Brown’s history and current condition. Address your letter to Dr. Richard Silvia, Paediatrician, Advocate Medical Centre, Layman Road, Lunenburg.

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Let us structure the first part of the letter and see what information should be included there.

Date & Recipient Details
Date (Relevant date as per the case notes or Date of Examination)

Full name of the recipient with title

Designation/job title

Address

Greeting (Dear ……. ) (Second name of the recipient with appropriate title)

Reference line (Re: the patient’s full name & age if DOB is not given)

Tip 1: ‘14 October 2021’ is the preferred date format at the start. In real exam, it is generally the examination date that should be written at the top.

Tip 2:  Interchanging the order of Date & Recipient’s Details is acceptable.

Tip 3:  Interchanging the order of Greeting & Reference Line is acceptable.

Tip 4:  If date of birth (DOB) is given, write that in the reference line.

Tip 5:  Title, such as Mr or Ms, is not required when referring to a patient aged 16 or below

14 October 2021

Dr. Richard Silvia

Paediatrician

Advocate Medical Centre

Layman Road

Lunenburg

Dear Dr. Silvia

RE: Alan Brown, 13 years old

Now, let us take a stepwise approach to composing each paragraph.

Introduction
Patient, Medical Issue & Purpose
Writing ‘introduction’ of an update OET letter is not much different from a discharge or referral letter. It includes the name of the patient, introduces the medical complaint and discusses the reason for writing the letter.

Tip 6:  Keep in mind that excluding the purpose would affect your score negatively.

Tip 7:  Read the ‘Notes’ & ‘Writing Task’ given at the start and end of the case notes respectively to identify the purpose.

Tip 8:  You may use key words ‘update/inform/outline/regarding to indicate the purpose as you are writing to update the addressee on the patient.

Tip 9:  You can use ‘your patient as you are writing to the patient’s primary paediatrician. However, this is applicable only in case of update scenarios as in referral or emergency scenarios, the recipient may be seeing the patient for the first time.

Tip 10:  Avoid using ‘a/the/this/my patient’ to refer to the patient in the letter as it is considered less polite.

Tip 11:  Write full name without title as the patient is a child aged below 16.

Tip 12: In this case, the addressee should be informed about the reason for the patient’s admission and the newly developed condition while in the hospital.

Introduce the patient. Refer PATIENT DETAILS

Alan Brown, a middle school student

Medical complaint(s): Refer Notes, Presenting Complaint & Latest information dated 14/10/2021

Admitted to Brookdale Hospital for severe abdominal pain

Suspected depression (while in hospital)

Reason for writing the letter: Refer Writing Task.

Write a letter to Dr. Silvia, the patient’s primary paediatrician. In your letter, briefly outline Alan Brown’s history and current condition
The introduction of your OET letter would be

I am writing to update you on your patient, Alan Brown, a middle school student who has recently been admitted to Brookdale Hospital for abdominal pain and is now in need of psychiatric assessment for suspected depression.

Body Paragraph 1
Hospitalization & Management
Tip 13:  You can exclude the patient’s social/medical/family background as the patient’s primary paediatrician is already aware of that. As mentioned previously, writing information already known to the recipient is of no use and may even be counter-productive for it may increase the length of your letter and even confuse the intended reader.Tip 14:  dd/mm/yy is the preferred date format in the body of the letter

Tip 15:  Use first name (without title) when referring to the patient

aged 16 or below initially in a paragraph.

Tip 16:  Avoid using pronouns to refer to the patient at the first occurrence in a paragraph.

Tip 17: Brand name of drugs (Zosyn) should be capitalized but generic (ibuprofen) should not be capitalized.

Refer ‘TREATMENT SUMMARY’ dated 05/10/2021 & 06/10/2021.

Tip 18: Irrelevant information should be ignored

05/10/2021

  • Presented with mother to ED with severe abdominal pain for 2 days
  • Generalized dull pain on palpation
  • Unsure of any triggers; was playing video games at home with sister
  • Labs showed mildly high WBC
  • Admitted to in-patient paediatric floor

 

06/10/2021

  • Pt started on ibuprofen, still moderate pain
  • Started Zosyn for suspected appendicitis
  • Mother remains at bedside

Let’s compile relevant information and compose the body paragraph 1 as follows.

On 05/10/2021, Alan was brought to ED by his mother with a 2-day history of severe abdominal pain without any known trigger. When examined, he had dull pain, and investigations showed mildly elevated WBC. Following admission, he was managed with ibuprofen and *Zosyn.

Body Paragraph 2
Assessment of Depression
Refer ‘TREATMENT SUMMARY’ dated 10/10/2021. 10/10/2021

  • Pt’s pain subsiding, better mood
  • Pt’s father visited, ward nurse mentioned loud arguments
  • Patient agitated, later claimed pain worsened, teary-eyed

Tip 19:  Writing status of symptoms in detail is not highly important considering the scenario requires focus on the other two points. Therefore, ‘reported improvement’ is sufficient.

Tip 20:   Synonyms for ‘teary-eyed’ – teary, tearful, visibly upset

Tip 21:  Use appropriate connector to introduce the change in the patient’s condition.
This paragraph can be written as below.

On 10/10/2021, Alan reported improvement; however, following his father’s visit, he was agitated and tearful. He later stated that his pain had worsened. Please note, the ward nurse reported witnessing loud arguments between them.

Body Paragraph 3
Psychiatric referral
Refer ‘TREATMENT SUMMARY’ dated 13/10/2021.

13/10/2021

  • Pain decreased, pt in better spirits
  • Discussed possible discharge with mom, pt cried claiming pain was worse
  • Spoke to pt directly about going home, pt admitted to troubled relationship with father
  • Mother confirmed relationship strainedPt’s father unhappy about son’s poor grades at school, punishes regularly
  • Assessment – Abdominal pain, a somatic symptom of depression?
  • Psych consult requested

Tip 22:  As mentioned in Tip 19, pay attention to the other points than writing about symptoms in detail. Therefore, ‘Alan’s condition improved’ is fine and it avoids repetition also.

Tip 23:  Choose words wisely to avoid repetition of information.

  • Spoke to pt directly about going home, pt admitted to troubled relationship with father
  • Mother confirmed relationship strained

On further discussion, he admitted to having a strained relationship with his father, which was confirmed by his mother.

Tip 24:  Use ‘poor academic performance’ for ‘poor grades at school’. It’s a good idea to paraphrase or use appropriate synonyms.

Tip 25: Connectors for empathy, such as unfortunately, regrettably can be used when there is a negative prognosis or significant change in the patient’s condition, but avoid their overuse.

Tip 26:  ‘?’ indicates it is not a definitive diagnosis; therefore, suspected/possible can be used.
Compile the above information to form this paragraph.

Three days later, Alan’s condition improved. Unfortunately, upon discussing discharge plan, he started crying, claiming that his pain had become worse. On further discussion, he admitted to having a strained relationship with his father, which was confirmed by his mother. According to her, Alan’s father is unhappy about his son’s poor academic performance, which often led to punishments. Consequently, his abdominal pain was assessed as a somatic symptom of possible depression.

Body Paragraph 4
Patient Information (Latest)
Refer ‘TREATMENT SUMMARY’ dated 14/10/2021.

14/10/2021

  • Psychiatrist saw pt,
  • Assessment – ? depression
  • Recommends admission to peds psych ward for assessment
  • Plan
  • Admission later in day
  • Update pt.’s primary paediatrician

Tip 27:  The last point can be excluded in this paragraph as the letter is written to the primary paediatrician and it need not be repeated in the content written to him.

Tip 28:  Mention ‘Today’ as the letter is dated today as per case notes.

Combine relevant information from the content given above as follows.

Today, Alan was seen by a psychiatrist, who suspected him to have depression and recommended his hospitalization.

Conclusion
Reason
After discussing the details related to the patient’s admission, progress and need for further referral, it is time to conclude the letter emphasising the purpose of the letter.

Refer ‘Plan’ dated 14/10/2021 in ‘TREATMENT SUMMARY’ and ‘Writing Task’.

  • Plan
  • Admission later in day

In your letter, briefly outline Alan Brown’s history and current condition. Address your letter to Dr. Richard Silvia, Paediatrician, Advocate Medical Centre, Layman Road, Lunenburg.

Tip 29:  In this case, there is no specific request related to expected care/action. The purpose of the letter is only to update the addressee on his patient, who is under another medical professional’s care.
Therefore, the letter can be concluded as below.

I would like to inform you that Alan is being admitted to the paediatric psychiatry ward today for further assessment.

Closing Sentence
Not included in Word Count
Tip 30:  You can be relieved that the closing sentence is not considered for ‘word count’.

Tip 31:  A typical polite closing sentence can be written as the addressee can get back to the writer if he needs more information about the patient.

For any further information regarding Alan in this regard, please contact me.

Complementary Close
Yours…..
Use appropriate salutations in the letter.

Tip 32:  Yours sincerely (If the name of the recipient is given.)

Tip 33:  Yours faithfully (If the name of the recipient is NOT given.)

Tip 34  Write the name of the profession/designation indicated in the case notes. Give the name of the hospital or organization if given.

In this case,

Yours sincerely,
Paediatrician
Brookdale Hospital

Mock Test
Test Your Writing Skills

Dr. Richard Silvia
Paediatrician
Advocate Medical Centre
Layman Road
Lunenburg

Dear

RE: Alan Brown, 13 years old

I am writing to patient, Alan Brown, who has recently been admitted Brookdale Hospital for abdominal pain and is now in need of psychiatric assessment for depression.

On 05/10/2021, Alan was brought to ED by his mother with a 2-day history of severe pain without any known trigger. When examined, he had dull pain, and investigations showed mildly elevated WBC. Following admission, he was managed with ibuprofen and Zosyn.

On 10/10/2021, reported improvement; , following his father’s visit, he was agitated and tearful. He later stated that his pain had worsened. Please note, the ward nurse reported loud arguments between them.

Three days later, Alan’s condition improved. , upon discussing discharge plan, he started crying, claiming that his pain had become worse. On further discussion, he admitted a strained relationship with his father, which was confirmed by his mother. According to her, Alan’s father is unhappy about his son’s poor academic performance, which often led to punishments. Consequently, his abdominal pain was assessed as a somatic symptom of possible depression.

Today, Alan was seen by a psychiatrist, who depression and recommended his hospitalization.

I would like to inform you that Alan is being admitted to the paediatric psychiatry ward today for further assessment.

For any further information regarding Alan this regard, please contact me.

Yours
Paediatrician
Brookdale Hospital

/ 16
 
Example Letter

14 October 2021

Dr. Richard Silvia
Paediatrician
Advocate Medical Centre
Layman Road
Lunenburg

Dear Dr. Silvia

RE: Alan Brown, 13 years old

I am writing to update you on your patient, Alan Brown, who has recently been admitted to Brookdale Hospital for abdominal pain and is now in need of psychiatric assessment for suspected depression.

On 05/10/2021, Alan was brought to ED by his mother with a 2-day history of severe abdominal pain without any known trigger. When examined, he had dull pain, and investigations showed mildly elevated WBC. Following admission, he was managed with ibuprofen and Zosyn.

On 10/10/2021, Alan reported improvement; however, following his father’s visit, he was agitated and tearful. He later stated that his pain had worsened. Please note, the ward nurse reported witnessing loud arguments between them.

Three days later, Alan’s condition improved. Unfortunately, upon discussing discharge plan, he started crying, claiming that his pain had become worse. On further discussion, he admitted to having a strained relationship with his father, which was confirmed by his mother. According to her, Alan’s father is unhappy about his son’s poor academic performance, which often led to punishments. Consequently, his abdominal pain was assessed as a somatic symptom of possible depression.

Today, Alan was seen by a psychiatrist, who suspected him to have depression and recommended his hospitalization.

I would like to inform you that Alan is being admitted to the paediatric psychiatry ward today for further assessment.

For any further information regarding Alan in this regard, please contact me.

Yours sincerely
Paediatrician
Brookdale Hospital

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