This psychiatric referral is already a strong OET Writing response. Compare the original letter with expert observations and discover the language and communication improvements that can help move your writing closer to Band A.
This is not a basic correction of a weak letter. The original referral is already clear, professional and logically organised.
The purpose of this review is to show how a strong Band B letter can be refined through more precise clinical wording, sharper information selection and slightly stronger psychiatric communication.
This referral would likely sit within the Band B to B+ range. The purpose is clear, the organisation is logical, the tone is appropriate and the clinical information is relevant. Only minor precision issues prevent it from feeling closer to a Band A response.
The opening immediately explains that the patient requires specialist psychiatric assessment and further management.
The letter includes the patient's mental state deterioration, family history and relevant symptoms without overwhelming the recipient.
A few expressions could be made more precise, including “conservative measures”, “mood disorder” and the diagnostic wording in the opening.
This is the original letter being reviewed. It is already a strong response, so the focus is on refinement rather than major correction.
Dr Peta Cassimatis
Psychiatrist
1414 Logan Road
Mt Gravatt 4222
6 February 2026
Dear Dr Cassimatis,
Re: Mrs Alison Martin, DOB: ————
I am writing to refer Mrs Alison Martin, a 28-year-old teacher, for your specialist psychiatric assessment and further management due to features suggestive of a psychotic disorder.
Mrs Martin is married with two children and lives with her husband and his parents. She has a significant family history of schizophrenia but no history of substance use.
On 1 September, she presented with fatigue, low-grade fever, reduced motivation, stress, poor appetite, and weight loss. Physical examination and vital signs were normal, and she was advised on conservative measures, including relaxation strategies and regular exercise.
She re-presented less than two weeks later with persistent symptoms, alongside poor concentration, difficulty managing household responsibilities, anxiety, and frequent headaches. Given concern for a mood disorder, diazepam 10 mg nocte and paracetamol as required were commenced, with follow-up arranged.
At her most recent review, she attended with her husband, who reported progressive social withdrawal, poor eye contact, reduced speech output, impaired planning, and emerging visual hallucinations and delusional beliefs. On examination, she appeared depressed, with disorganised speech and bizarre behaviour, although her vital signs remained stable.
Given the progression of symptoms and family history, I would appreciate your assessment to confirm the diagnosis and guide ongoing management.
Yours sincerely,
Doctor
Unlike weaker referral letters, this case requires only minor refinements. The overall organisation, tone and clinical reasoning are already strong. The suggested improvements simply make the language more precise and the communication even easier for the receiving psychiatrist.
...features suggestive of a psychotic disorder.
...for assessment and management of suspected schizophrenia.
If the clinical information clearly supports schizophrenia as the working diagnosis, naming it directly gives the psychiatrist a clearer understanding of the referral purpose. If diagnostic uncertainty remains, the original wording is still entirely appropriate.
Conservative measures.
Supportive measures including reassurance, relaxation techniques and regular exercise.
Specific descriptions provide a clearer picture of previous management than broader terms such as conservative measures.
Given concern for a mood disorder...
As early depressive symptoms were initially suspected...
The revised wording explains why treatment was started at that stage without suggesting diagnostic certainty before psychotic symptoms became apparent.
...although her vital signs remained stable.
This detail could be omitted to maintain focus on the psychiatric presentation.
Removing information that does not influence psychiatric assessment helps maintain a sharper referral focus.
Many candidates focus only on mistakes. Reviewing strong letters is equally valuable because it demonstrates what examiners expect from effective professional communication.
The letter gradually builds the clinical picture by combining family history, progressive behavioural change, psychotic symptoms and mental state examination findings before requesting specialist assessment.
The vocabulary is natural, objective and appropriate for communication between healthcare professionals. Only a handful of expressions could be made slightly more precise.
The referral avoids unnecessary laboratory data or unrelated history, allowing the psychiatrist to focus immediately on the patient's mental health presentation.
The difference is rarely the amount of clinical information. Instead, Band A letters typically demonstrate greater precision, smoother sentence construction and consistently natural medical English.
In this referral, only a few refinements are needed. More specific diagnostic wording, slightly stronger clinical terminology and the removal of less relevant information would make the communication even more concise while preserving the same clinical message.
For many candidates, learning how to refine an already strong letter is one of the most effective ways to progress from Band B towards Band A performance.
Studying stronger referral letters helps candidates understand not only how to avoid mistakes but also how to polish their professional writing. Below are some common questions raised after reviewing this case.
The referral purpose is immediately clear, the chronology is logical, clinically relevant information has been selected appropriately and the tone remains professional throughout. Most of the language is natural, with only a few expressions that could be made more precise.
Not necessarily. If the clinical evidence clearly supports schizophrenia as the working diagnosis, naming it directly can strengthen the referral. However, if diagnostic uncertainty remains, using broader wording such as features suggestive of a psychotic disorder is entirely appropriate.
Stable observations are reassuring, but they contribute very little to the psychiatrist's assessment in this particular referral. Removing unnecessary information improves conciseness without affecting clinical understanding.
Its logical progression. The patient's deterioration unfolds naturally across each consultation, allowing the receiving psychiatrist to understand why specialist assessment has become necessary.
The biggest improvements usually come from refining language rather than adding information. More precise medical terminology, smoother sentence construction and careful editing help create referral letters that read naturally to healthcare professionals.
One of the most valuable lessons from this case is that higher-scoring referral letters rarely contain more information than average ones. Instead, they communicate the same clinical picture with greater precision, stronger organisation and language that feels effortless to read.
As you compare referral letters across different specialties, you will begin to recognise the communication patterns that consistently produce clear, professional correspondence in the OET Writing exam.
Receive detailed examiner-style feedback explaining how to strengthen your referral purpose, improve clinical communication, refine your language and maximise your OET Writing score before test day.