After working with internationally trained nurses preparing for OET Writing, the same patterns come up time and again. The nurses sitting this test are not struggling because their English is weak. They are struggling because OET Writing requires a specific set of skills – professional letter writing, clinical information selection, register control, time management – that most nurses have never had cause to develop in a formal way.
In our work, we have identified four writing mistakes that account for the majority of Band C results in OET Writing. We have also given them names, because naming a problem is the first step to solving it. We call them the four nurse writing archetypes: the Purpose Loser, the Conciseness Killer, the Tone Drifter, and the Time Crasher.
Read through all four. Most nurses recognise themselves most strongly in one or two archetypes, but elements of all four can appear in a single letter. Knowing which patterns apply to you is what allows you to focus your preparation where it will make the biggest difference.
Archetype 1: The Purpose Loser
The Purpose Loser writes letters that take too long to get to the point. The opening paragraph contains the patient’s name, age, date of birth, and a summary of their entire medical history. By the time the reader reaches the reason for the letter, they have already had to piece together the purpose themselves.
This is one of the most common and most penalised patterns in OET Writing. The Genre and Text Organisation criterion specifically assesses whether your letter follows the conventions of its type – and professional healthcare letters establish their purpose in the opening line.
How to fix it
Train yourself to write the purpose in your first sentence, every time. If you are writing a referral letter, your opening sentence should say so: why you are writing, who you are referring, and the primary reason for the referral. If you are writing a discharge letter, the opening should state that the patient has been discharged and from where.
Practice opening sentences until stating the purpose first becomes automatic. It sounds simple but it requires retraining if you have developed a habit of opening with background information.
Archetype 2: The Conciseness Killer
The Conciseness Killer includes everything. They read the case notes thoroughly and then write it all down, in order, because they are not sure what to leave out and they do not want to omit something important.
The result is a letter that is too long, poorly prioritised, and difficult for the reader to use. A specialist receiving a referral letter does not need a complete social history. A GP receiving a discharge summary does not need a full account of every day of the hospital admission. OET Writing assesses your ability to select what is clinically relevant to the specific reader and purpose – and Conciseness and Clarity is a separate marking criterion, not a bonus.
How to fix it
Before you write, read the task instruction carefully and ask: who is this letter going to, and what do they need from it? A cardiologist receiving a referral needs cardiac-relevant history, current presentation, relevant medications and your specific request. They do not need the patient’s full surgical history from twenty years ago unless it is directly relevant.
Practice making deliberate selection decisions as part of your planning time. Identify which information in the case notes is essential, which is potentially relevant, and which is not needed. Then write from your selection rather than from the full notes.
Archetype 3: The Tone Drifter
The Tone Drifter starts well but loses control of register – the level of formality and professional tone appropriate to a healthcare letter – as the letter progresses. They might use contractions (‘she doesn’t’ instead of ‘she does not’), slip into note form in the middle section, use informal expressions from spoken clinical English, or over-rely on abbreviations that may not be clear to the reader.
Register drift happens most often when nurses are writing quickly and under pressure. The formal conventions of the letter opening feel deliberate, but midway through a busy paragraph about medication history, the phrasing becomes more casual. Assessors notice this and it affects Language scores.
How to fix it
The best approach is to review your practice letters specifically for register. After writing a letter, read it back asking: does every sentence sound like a professional healthcare letter? Check for contractions, informal expressions, over-abbreviated language, and note-form sentences that should be full sentences. Mark them and rewrite them.
Over time, consistent register becomes habitual. But it requires deliberate attention in the early stages of preparation – especially in the middle sections of the letter where the clinical detail is densest.
Archetype 4: The Time Crasher
The Time Crasher runs out of time. Their letter is strong – good purpose statement, well-selected information, appropriate register – and then it stops. The conclusion is missing, or present but rushed. A recommendation for ongoing care is absent. The letter ends mid-thought.
An incomplete letter cannot be fully assessed on Genre and Organisation. The assessor cannot award marks for a structure they cannot see. And the absent conclusion often means the action required of the reader is also absent, which affects Content.
How to fix it
Time management in OET Writing is a skill that must be practised, not assumed. 45 minutes is enough time to write a complete, well-structured letter – but not if you spend 20 minutes writing the patient history and leave 25 minutes for everything else.
Use a deliberate structure: five minutes reading and planning, 33-35 minutes writing, five minutes reviewing. Stick to your plan. If you are running long on a section, make a deliberate decision to move on. An adequate conclusion is better than a perfect opening followed by nothing.
Which archetype are you?
Most nurses recognise themselves primarily in one or two of these patterns. The Conciseness Killer and the Purpose Loser often appear together. The Time Crasher can be a consequence of the Conciseness Killer – when you include too much in the early sections, you run out of time to finish.
The fastest way to identify your specific pattern is to write a practice letter under timed conditions and have it reviewed with detailed feedback. That feedback will tell you precisely which of these mistakes is most affecting your score – and what to work on first.
Head to FunctifyLearning.co.uk/oet-writing to take our nurse writing archetype quiz and find out which pattern most closely matches your OET Writing results.
Find out which part of OET Writing is holding you back.
Take the free nurse writing archetype quiz and get a personalised result in under two minutes – showing exactly which of the four nurse writing patterns applies to you and what to work on first.
Take the free OET Writing quiz at FunctifyLearning.co.uk/oet-writing
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