Compare an original OET referral letter for suspected schizophrenia with an improved version and learn how clearer purpose, stronger organisation and more natural clinical language make the letter easier for the receiving specialist to act on.
A doctor is referring Mrs Alison Martin, a 28-year-old teacher, for specialist psychiatric assessment after a progressive deterioration in her mental state.
The main challenge is to make the referral purpose clear immediately, prioritise the current psychiatric presentation and avoid opening the letter with lower-priority biographical details.
The opening paragraph should tell the receiving specialist why the patient is being referred before moving into personal background or earlier consultations.
I am writing to refer Mrs Alison Martin, a 28 years old female, married with two children. She works as a teacher and lives with her husband's parents. She has a positive family history for schizophrenia.
I am writing to refer Mrs Alison Martin, a 28-year-old teacher, for urgent specialist assessment and management due to a recent deterioration in her mental state, including reduced speech, poor eye contact, disorganised speech, bizarre behaviour and possible visual hallucinations and delusions.
This version keeps the original clinical meaning while improving the referral purpose, organisation, professional register and sentence control.
Dr Peta Cassimatis
1414 Logan Road
Mt Gravatt 4222
6 February 2026
Dear Dr Cassimatis,
Re: Mrs Alison Martin, 28 years old
I am writing to refer Mrs Alison Martin, a 28-year-old teacher, for urgent specialist assessment and management due to a recent deterioration in her mental state, including reduced speech, poor eye contact, disorganised speech, bizarre behaviour and possible visual hallucinations and delusions.
Mrs Martin first attended the clinic on 1 September with tiredness, low-grade fever, reduced motivation at work, stress, poor appetite and weight loss. Her vital signs and physical examination were normal. She was advised to use relaxation techniques, exercise regularly, maintain a temperature chart and return if her symptoms did not improve.
Less than two weeks later, she returned with persistent symptoms, poor concentration and difficulty coping with household problems. She was anxious and experiencing frequent headaches. Early depression or schizophrenia was considered, and diazepam 10 mg at night and paracetamol as required were commenced, with a review planned in two weeks.
At her most recent appointment, Mrs Martin attended with her husband, who reported that she had been avoiding eye contact, speaking less, planning poorly and showing signs suggestive of visual hallucinations and delusions. On examination, she had a depressed mood, poor eye contact, disorganised speech and bizarre behaviour, although her vital signs remained within normal limits.
Given these findings and her positive family history of schizophrenia, I would appreciate your urgent assessment and ongoing management.
Please do not hesitate to contact me if you require any further information.
Yours sincerely,
Doctor
Both versions describe the same patient. The difference is how quickly and clearly the receiving specialist can understand the clinical concern, the reason for referral and the action being requested.
The student version begins with biographical details before explaining the current psychiatric concern.
The corrected version opens with the reason for referral: urgent specialist assessment and management due to a recent deterioration in mental state.
In a psychiatric referral, the receiving clinician should understand the current risk and clinical concern before reading background details.
Details such as marital status, children and living arrangements may be relevant later, but they should not delay the main reason for writing.
The corrected opening prioritises symptoms, deterioration and the need for assessment.
The recipient can quickly identify why the patient needs specialist input and how urgent the situation appears.
The original letter moves through several appointments but does not always highlight the progression clearly.
The corrected version shows how the patient’s symptoms developed from nonspecific complaints to signs suggestive of a significant psychiatric condition.
The revised version replaces awkward wording with professional healthcare English, such as “recent deterioration in her mental state” and “urgent specialist assessment and management.”
A strong referral letter does not simply list symptoms. It guides the specialist toward the clinical reason for referral.
The opening paragraph should make the referral purpose obvious before providing lower-priority background information.
I am writing to refer Mrs Alison Martin, a 28 years old female, married with two children. She works as a teacher and lives with her husband's parents. She has a positive family history for schizophrenia.
I am writing to refer Mrs Alison Martin, a 28-year-old teacher, for urgent specialist assessment and management due to a recent deterioration in her mental state, including reduced speech, poor eye contact, disorganised speech, bizarre behaviour and possible visual hallucinations and delusions.
A referral letter should begin with the clinical reason for referral, not with general background. Once the receiving specialist understands the current concern, supporting details become much easier to interpret.
Small changes in wording, sentence control and clinical emphasis can make a referral letter much easier for the receiving specialist to read.
Mrs Alison Martin, a 28 years old female, married with two children.
Mrs Alison Martin, a 28-year-old teacher.
On september first, she came to the clinic with a complaint of tiredness, low grade temperature, lack of motivation at work, stress, loss of appetite and weight.
Mrs Martin first attended the clinic on 1 September with tiredness, low-grade fever, reduced motivation at work, stress, poor appetite and weight loss.
On the hypothesis of early depression or schizophrenia, treatment with Diazepam 10mg/nocte and paracetamol as required was commenced, with a review in two weeks.
Early depression or schizophrenia was considered, and diazepam 10 mg at night and paracetamol as required were commenced, with a review planned in two weeks.
According to him, she avoids eye contact with other people, is presenting with reduced speech output, impaired planning and indications of visual hallucinations and delusions.
Her husband reported that she had been avoiding eye contact, speaking less, planning poorly and showing signs suggestive of visual hallucinations and delusions.
Given these clinical findings, she needs a specialist evaluation and management.
Given these findings and her positive family history of schizophrenia, I would appreciate your urgent assessment and ongoing management.
The corrected version does not add unnecessary medical detail. It improves how the information is prioritised, phrased and connected to the referral purpose.
One of the biggest differences between average and high-scoring OET referral letters is information selection. Strong letters focus on what the receiving specialist needs to know first rather than simply following the order of the case notes.
The original draft follows each consultation chronologically. Although the information is generally accurate, the psychiatrist must read several background details before understanding the patient's current mental state.
Personal information, early symptoms and treatment are introduced before the referral purpose is fully developed.
The psychiatrist has to determine why the referral has been made while simultaneously processing information that is not immediately relevant to today's assessment.
The corrected version establishes the patient's current psychiatric deterioration immediately. Earlier consultations are then presented only to explain how the condition progressed.
Every paragraph supports the referral rather than competing with it.
The patient's history explains the referral. It should not delay the referral purpose.
An effective referral answers the recipient's questions in a logical sequence.
Reason for referral
1Current mental state
2Clinical progression
3Previous management
4Relevant history
5Specialist request
6Mrs Martin's occupation, family circumstances and previous consultations provide useful context. However, they become much more meaningful after the psychiatrist already understands the patient's current presentation and the reason specialist assessment is required.
Organising the information around today's clinical problem reduces reader effort and improves communication throughout the letter.
Each paragraph should answer one clinical question. Mixing unrelated information forces the receiving specialist to work harder than necessary.
The first paragraph explains why urgent psychiatric assessment is required.
The first consultation explains the initial symptoms without overwhelming the reader.
The second consultation demonstrates that the symptoms continued despite initial management.
The latest appointment provides the information that justifies specialist referral.
The psychiatrist is asked clearly to provide assessment and ongoing management.
The letter ends with an invitation to request further information if needed.
Even when grammar is accurate, poor organisation increases reader effort. Structuring information according to the recipient's priorities helps the communication feel much more natural and professional.
One of the biggest differences between average and high-scoring OET referral letters is the use of natural healthcare English. Grammar is important, but examiners also assess whether the language sounds appropriate for communication between healthcare professionals.
Several expressions in the original letter communicate the correct idea but sound unnatural in professional correspondence.
| Student wording | Why it weakens the letter |
|---|---|
| a 28 years old female | Not natural professional English. |
| On the hypothesis of... | Uncommon clinical wording. |
| Giving these clinical findings... | Incorrect grammar. |
| is presenting with... | Awkward tense choice. |
| came to the clinic | Less professional than standard medical wording. |
The corrected version replaces these expressions with wording commonly used in psychiatric referral letters.
| Improved wording | Benefit |
|---|---|
| a 28-year-old teacher | Natural professional description. |
| schizophrenia was considered | Standard clinical phrasing. |
| Given these findings... | Correct grammar. |
| had been avoiding eye contact... | Clearer clinical description. |
| first attended the clinic | Professional healthcare English. |
Learning complete medical expressions helps your writing sound much more natural than memorising isolated vocabulary.
Recent deterioration in mental state
Disorganised speech
Bizarre behaviour
Urgent specialist assessment
Ongoing management
Psychiatric evaluation
Poor concentration
Reduced speech
Visual hallucinations
Higher-scoring OET letters usually rely on familiar medical collocations rather than complex vocabulary. Using language that healthcare professionals expect to read improves both clarity and professionalism.
Most grammar mistakes in OET Writing do not completely change the meaning, but they increase reader effort. Correcting these small issues produces smoother and more professional communication.
Most high-scoring OET referral letters are not dramatically different from average ones. They simply avoid the small grammar, organisation and language issues that gradually increase reader effort throughout the letter.
OET Writing is assessed on more than grammar. A strong referral letter must communicate the clinical purpose clearly, select relevant information and guide the receiving specialist efficiently.
The corrected version immediately explains that urgent specialist assessment and management are required because of a recent deterioration in Mrs Martin’s mental state.
The strongest clinical details are kept: symptom progression, mental state changes, previous management, family history and the need for psychiatric input.
Lower-priority biographical details no longer delay the main clinical message, and the patient’s deterioration is easier to follow.
The corrected version uses clinical language suitable for communication between healthcare professionals.
The structure moves from referral purpose to early symptoms, progression, current mental state and the specialist request.
Unnatural expressions are replaced with clearer medical English, improving fluency and professional credibility.
This case shows several issues that appear frequently in OET referral letters, especially when candidates try to include every case-note detail before establishing the main clinical concern.
Age, marital status and family situation should not delay the current psychiatric concern.
The receiving specialist needs to understand the most recent mental state findings early.
Phrases translated directly from another language often sound awkward in professional healthcare correspondence.
The final paragraph should clearly request assessment, management or ongoing care.
Following the timeline too closely can hide the reason why the referral is being made now.
The first paragraph should immediately prepare the specialist for the rest of the letter.
A strong psychiatric referral letter does not simply describe symptoms. It explains why those symptoms now require specialist assessment and management.
Candidates often ask why information was reorganised even though the original clinical facts remained the same. The answers below explain the communication principles behind this correction.
The psychiatrist first needs to understand why the patient is being referred now. Beginning with the current deterioration in Mrs Martin's mental state immediately establishes the purpose of the referral. The remaining clinical history then explains how the patient reached that point.
Information such as marital status, children and living arrangements may still be relevant, but it is usually less important than the patient's current presentation. These details should not delay the referral purpose unless they directly influence clinical management.
If the suspected diagnosis is one of the main reasons for referral, introducing it early helps the receiving psychiatrist immediately understand the clinical concern. However, the diagnosis should be supported by the patient's presentation rather than replacing it.
Yes. OET Writing rewards effective information selection rather than copying every case note. Earlier consultations should be summarised when they explain the patient's clinical progression and support the referral.
No model letter can guarantee a particular score because every script is assessed as a whole against the official OET Writing criteria. However, this version demonstrates communication principles that are commonly associated with stronger referral letters, including a clear purpose, logical organisation, relevant information selection and natural professional language.
Although this case focuses on suspected schizophrenia, the communication principles extend far beyond mental health. Every effective referral letter begins with a clear purpose, presents clinically relevant information in a logical order and helps the receiving healthcare professional understand exactly why further assessment is required.
As you compare referral letters from different specialties, these communication patterns become easier to recognise and apply independently during your own OET Writing exam.
Detailed personalised feedback shows exactly why a referral letter loses marks and how to improve your purpose, organisation, language, clinical relevance and professional communication before your next OET Writing test.