GRAMMAR:

How to Use the Right Tense?

When discussing ‘today’s visit’, you are reporting on a completed past event.
However, you may not necessarily report all details from the visit using the past
tense.
While this may sound confusing, there are some tips you can follow to help. Here are
some that can help you decide which tense is the right one:
1. Past tense
For details such as test results or vital signs, which were accurate at the time of the
visit, the past tense is usually appropriate.
Example:
 On examination, the abdomen was tender on palpation.
Examples in OET Writing:
 ‘On examination, her abdomen was tender on palpation.’
 ‘She reported a sharp pain in her abdomen yesterday.’
 ‘He presented at the clinic with shortness of breath and a persistent cough.’
 'Her blood pressure was elevated at 140/90.'

2. Present tense
For details such as lifestyle choices, the present tense (simple or continuous) is
usually appropriate
Example:
 Despite previous advice, Mr Hoskings is still smoking 20 cigarettes a day.
Examples in OET Writing:
 ‘Mr Smith has chronic asthma.’
 ‘Ms Fedele lives alone and uses a wheelchair.’
 ‘She has a history of severe chest pain.’

3. Present perfect
For details which describe unresolved situations such as improvement or
deterioration in the patient’s condition, the present perfect tense is usually
appropriate.
Example:
 Since her last visit, Mrs Baxter’s pain levels have reduced from an 8 to a 4.
Examples in OET Writing:
 ‘Since her last visit, Mrs Baxter’s pain levels have reduced from an 8 to a 4.’
 ‘Mrs. Green has shown significant improvement since starting the treatment.’
  ‘She has expressed concerns about potential side effects.
4. Present Continuous
Usage: The present continuous tense is employed to describe actions that are
ongoing at or around the moment of speaking or writing. It can also be used to
indicate future plans or arrangements.
Examples in OET Writing:
 ‘Mrs. Jones is experiencing severe back pain.’
 ‘She is currently taking two tablets daily.’
 ‘Ms Klim is responding well to the new treatment regimen.’

Present perfect is often combined with for OR since OR over.

 For is used to describe an amount of time (eg: for one week).
 Since is used to refer to the start of a period of time (eg: since September
2018).
 Over is used to express a change in condition, or to describe a repeated
event. Examples:
The patient's condition has deteriorated over the past 3 months. (change in
condition)
The patient has presented several times over the last year. (repeated event)
Handy tip:
When using time markers such as:
 For the last...
 For the past...
 Over the last...
 For the next...
ALWAYS use the article ‘the’, with these expressions.

Now try this quiz to check your understanding:

Some of these sentences use incorrect verb tenses. Can you spot them?
Mr X has had hypothyroidism since 2007.
Mr X is smoking two packs of cigarettes a day for the past 25 years.
Over the past week, she remains free from pain.
The ulcer under her tongue has been present for more than one year.
Mr X has had type 2 diabetes for 10 years
Mr is a patient of mine since 2013.
Why is a strong grasp of tenses important in OET writing?
For instance, writing, ‘The patient experiences chest pain’ (present simple) instead
of, ‘The patient experienced chest pain’ (past simple) can change the entire context
of the situation. The first sentence suggests an ongoing issue, while the second
sentence indicates a past event.

Test yourself with our quiz

Complete the sentences with the correct form of the verb in brackets. Answers
are at the bottom of the page.
1. Martinez ________ in the Radiology Department since 2015. (work)
2. The patient ________ a severe headache when he arrived at the hospital
yesterday. (have)
3. Nurses ________ vitals every four hours as a standard procedure. (check)
4. Currently, the research team ________ on a new vaccine for the flu. (work)
5. Last year, she ________ a groundbreaking paper on genetic mutations.
(publish)
6. The patient ________ any allergic reactions to medications in the past. (not
have)
7. The physiotherapist ________ with Mr. Brown's rehabilitation plan next week.
(start)
8. The hospital ________ a new wing to accommodate more patients. (build)

Answers
1. has worked
2. had
3. check
4. is working
5. published
6. has not had / hasn't had
7. is starting
8. is building
Connectors:
Phrase: A group of words that lacks both a subject and a verb. It acts as a single
component of a sentence, such as a noun or an adjective.
- Example: "on the table," "running quickly," or "the big clock".

Clause: A group of words that contains both a subject and a verb.

Types:

1. Independent Clause: Can stand alone as a complete sentence.

2. Dependent (or Subordinate) Clause: Cannot stand alone and must be

attached to an independent clause.

- Example: "she ate breakfast" (independent) or "before she left" (dependent).

Sentence: A complete thought that contains at least one independent clause. It

starts with a capital letter and ends with a punctuation mark like a period, question
mark, or exclamation point.
- Example: "She ate breakfast before she left for work."

What connectors should I avoid?

Remember, writing a healthcare care letter to another healthcare professional is not

the same as writing an essay task or academic report. Some candidates make the
mistake of using the same connectors as they did for academic tasks at school or
university. These may be less appropriate in the context of OET.

Some connectors are less suitable for healthcare letter writing. These include:

 Academic connectors: furthermore, moreover

 Informal connectors: besides, meanwhile, apart from that, later on

 Outdated connectors: hence, thus, thereafter

Tip: Don’t use a connector if it doesn’t add any value to the sentence.

If you can remove the connector and the sentence still makes sense, then you
are using a connector when one isn’t needed. Avoid this in OET when it is
important to write efficiently without words the reader does not need.
For example:
 Considering the above/Given the above/In light of the situation, Mrs
Jones will need to attend a follow-up appointment in 3 days’ time.
Instead, you could simply write:
 Mrs Jones will need to attend a follow-up appointment in 3 days’ time.
1. Mrs Smith was admitted to hospital because she fell down the stairs at
home.
2. Mr X has been diagnosed with hypertension. Hence, he has been
prescribed Metformin, 500 mg daily.
 3. On review today, his blood pressure was slightly elevated. Apart from
that, his other vital signs were normal.
4. Mr X was treated with pain relief and discharged home. Later on, he
was re-admitted to hospital complaining
of a severe headache and nausea.
5. He requires a wheelie-walker for support. As well as this, please
provide daily visits from a home care nurse.
Answers:
1. Mrs Smith was admitted to hospital due to a fall down the stairs at home.
2. Mr X has been diagnosed with hypertension. Therefore, he has been
prescribed Metformin, 500 mg daily.
3. On review today, his blood pressure was slightly elevated. Otherwise, his
other vital signs were normal.
4. Mr X was treated with pain relief and discharged home. Subsequently, he
was re-admitted to hospital complaining of a severe headache and nausea.
5. He requires a wheelie-walker for support. In addition, please provide daily
visits from a home care nurse.
You can use 'since' or ‘as’ when it is appropriate for the sentence you are
writing. There may also be other more formal and concise alternatives to
consider.
In these two sentences, you could change the connector to improve the
formal writing style. For example:
1. Mrs Thompson will require assistance with personal care since she does
not have full range of motion in her shoulder yet.
= Mrs Thompson will require assistance with personal care due to the limited
range of movement in her shoulder.
2. She was brought to the hospital by ambulance as she fell off her bicycle in
the street.
= She was brought to hospital by ambulance following a fall from her bicycle.

Linking/Transition Words
When the transition word is at the beginning of the sentence, it should be followed by
a comma:
How to use transition words

 At the beginning of a sentence: This is the most common placement

and works well to connect paragraphs or new sentences.

o Example: "He is a talented musician. Furthermore, he is also a

great writer."

 In the middle of a sentence: You can place a transition word or

phrase within a sentence to provide a similar connecting effect.

o Example: "He is a talented musician. He is, however, a great

writer."

 After a semicolon: Use a semicolon to join two related independent

clauses, followed by the transition word and a comma.
 o Example: "He is a talented musician; consequently, he is also a
great writer."

LOGICAL TRANSITIONAL EXPRESSION

RELATIONSHIP
Similarity also, in the same way, just as … so too, likewise,
similarly
Exception/Contrast but, however, in spite of, on the one hand … on the other
hand, nevertheless, nonetheless, notwithstanding, in
contrast, on the contrary, still, yet
Sequence/Order first, second, third, … next, then, finally
Time after, afterward, at last, before, currently, during, earlier,
immediately, later, meanwhile, now, recently,
simultaneously, subsequently, then
Example for example, for instance, namely, specifically, to
illustrate
Emphasis even, indeed, in fact, of course, truly
Place/Position above, adjacent, below, beyond, here, in front, in back,
nearby, there
Cause and Effect accordingly, consequently, hence, so, therefore, thus
Additional Support or additionally, again, also, and, as well, besides, equally
Evidence important, further, furthermore, in addition, moreover,
then
Conclusion/Summary finally, in a word, in brief, briefly, in conclusion, in the
end, in the final analysis, on the whole, thus, to conclude,
to summarize, in sum, to sum up, in summary

Examples:
As a result/Consequently/Furthermore
 The company is growing. Consequently, there will be more jobs on offer.
Besides/Furthermore/In addition/More over
 The holiday is too expensive. Besides, I don’t really want to go.
However/Nevertheless/Nonetheless
 The shop was open. However, nobody came to the kiosk.
In the same way/ Likewise/ Similarly
 I believe that teenagers are respectful. Similarly, research has shown this.
- On the one hand, I'd like to go to the party, but on the other hand, I need to get up
early for work
- In addition to Japanese and English, I also speak French n addition to Japanese
and English, I also speak French
- Gardening can improve fitness. In addition, gardeners report better self-esteem

Linking words: conjunctions

Linking words within a sentence are referred to as coordinating conjunctions. The
word fanboys is an acronym formed from the first letters of the seven
conjunctions: for, and, nor, but, or, yet, so.
Punctuation: when two independent clauses (sentences) are joined with a coordinating
conjunction, a comma is usually needed before the conjunction:
 I found John reading in the living room, and we left for the party in one car.

When a coordinating conjunction is used between any two words, phrases or dependent
clauses, a comma is not ordinarily used before the conjunction:
 small yet strong

Commas are optional EXCEPT for and & but.

Conjunctio
Function
n

for connects a reason to a result

and connects equal and similar ideas

nor connects two negative ideas

but connects equal but different ideas

or connects two equal choices

yet connects equal and contrasting ideas

so connects a result to a reason

Correlative Conjunction Definition

these pairs must be used together.

 Both…and (combining or addition)

 Not only…but also (combining or addition)

 Either…or (binary choice)

 Whether…or not (binary choice)

 Neither…nor (negative)

The first word of the conjunction must go directly before the first subject or clause;
the second word of the conjunction must go directly before the second.

both…and can only be used with simple subjects. However, not only…but also
can be used with simple subjects and clauses:

o The paper’s results were both impressive and innovative.

 o I will not only grow the cells for the assay, but also interpret the
results.

o The daughter bought not only a designer purse, but also a custom
wallet.

o I neither want to clean my room nor desire to go caroling.

o Jill neither wanted nor needed singing bass novelty.

o The child both ate an entire cake and drank a liter of soda; she soon
vomited.

o Mark wanted either Cheerios or Raisin Bran.

Subordinating Conjunction:
These linking words are often used to expand or further describe the main
clause/element (the explanation clause is subordinate).
• as, because, since (cause)
• so, so that (purpose)
• although, though (contrastive)
• after, before, until, while (temporal)
• if, unless, provided, whichever, whenever (conditional)
The conjunction must go before the subordinating clause (the explanation clause)
Commas must go at the end of the first clause, which can be either the
subordinating or main clause
Examples:
- Before going to the game (subordinate), we often eat at the pub (main).
- Although very cute (sub), pandas are not suitable pets (main).
- Peanut butter is delicious (main), provided you don’t have a nut allergy (sub)
- Although she is old, she can still run far.
- She is pretty and single, but even if she wasn’t pretty, she would still be
single.
- You might want to take flat shoes; in case you want to dance later.
- In spite of/despite the fact she was busy, she still made time to volunteer.
- He took a large umbrella so that if it rained, he wouldn’t get wet.
- You can rely on me whatever happens.
- Samantha has a dog, whereas Billy does not
- I would lend money to you whenever you need it.
- I will still care for you wherever you go.

Test:
1. Many species of wildlife are becoming extinct __________ the
rainforests are being destroyed.

A. ? therefore
B. ? since
C. ? so
D. ? consequently
 2. __________ logging provides jobs and profits, the government is
reluctant to control it.

A. ? So
B. ? Consequently
C. ? Due to
D. ? Since
3. Hemp can be used to make paper, __________ it could reduce the
need for logging.

A. ? therefore
B. ? so
C. ? due to
D. ? because
4. Hemp was grown throughout history __________ its versatility; it can
be used to make many different things.

A. ? due to
B. ? because
C. ? since
D. ? as a result
5. Hemp is related to the marijuana plant; __________, it is illegal in
many countries.

A. ? so
B. ? because
C. ? due to
D. ? as a result
6. Hemp cannot be used to produce marijuana __________ its low THC
content.

A. ? because
B. ? as
C. ? because of
D. ? consequently
7. Marijuana is less toxic than alcohol or tobacco. __________, some
people believe it should be legalized.

A. ? So
B. ? Therefore
C. ? Due to
D. ? Because
8. __________ Canada has legalized hemp farming, we can expect to
see pulp and paper produced from hemp very soon.

A. ? Therefore
B. ? Due to
C. ? So
D. ? As

-Re-write the sentence with the appropriate punctuation and linking word. (There
are multiple correct answers)

1. She is afraid of dogs | She was bitten by her neighbors’ Chihuahua as a child
2. Tsunamis are highly destructive events | They are rare and often unpredictable

3. Chickens have wings | They cannot fly

4. Penny did not pass the class | She never did her homework

5. The Mayans were one of the most academically advanced cultures in pre-
Colombian North America | The cause for the collapse of their civilization is still
unknown

UNDERSTANDING TYPES OF PREPOSITIONS

 Time Prepositions: These indicate when something happens.
o Examples include: "at" 3 p.m., "on" Wednesday, "in" February”, "during" the
patient's visit, and "until" the medication finishes.
 Place Prepositions: These indicate where something is or where something
happens.
o Examples include: "at" the clinic, "in" the operating room, "on" the third floor,
"between" the radiology and pathology departments, and "under" the
microscope.
 Direction Prepositions: These show movement from one place to another.
o Examples include: "to" the pharmacy, "from" the laboratory, "over" to the next
ward, "under" the surgical light, and "through" the hospital corridor.
 Manner Prepositions: These describe how something is done.
o Examples include: "by" injection, "on" an empty stomach, "in" a sterile
manner, "with" care.
 Cause or Reason Prepositions: These explain why something happens.
o Examples include: "due to" a viral infection, "because of" low blood sugar,
"from" lack of exercise.

 Prepositions for time: days, weeks, months

On:
Days of the week:
 Example: The patient has an appointment on Friday.
 On holidays. Weekends.
In:
Use "in" for general times of the day, like morning, afternoon, and evening.
 Example: The surgery is scheduled in the morning.
Use "in" for months
 Example: Flu vaccinations are usually available in August.
Use "in" for specific years
 Example: The hospital was established in 1999.
Use "in" for seasons.
 Example: Allergy symptoms often worsen in spring.
centuries and historical periods
 Ex: in the 19th century
after a certain period of time
 ex: the Market closes in two hours.

At:
At (to refer a time) — Meet me at 5 p.m. tomorrow.
Use "at" for noon, night, and midnight.
 Example: The patient usually takes the medication at night.
With “names of mealtime”:
 Ex: at breakfast
with “age”:
 ex: I learned how to use a computer at 12.
Until
with a period of time up to a specific point in time:
 Ex: I cannot go dancing until I finish reading this chapter
By
 with in the sense of ''at the latest''; ex: You must return your book by April 21st
 with due date: ex: My essay is due by the end of the week.

Prepositions of place:
In
We use in to talk about a place that is inside a bigger space, such as a box, a house,
a city or a country. (or we say when something is in a place, it is inside it (enclosed
within limits))
The clothes are in the wardrobe.
The children are playing in the park.
There's a bookshop in the shopping centre.
My grandmother was born in Sweden.
We also use in with other physical locations such as:
in the world
in water / the sea / a river / a lake / a pool
in the mountains / the countryside / a valley / the forest
in a car / a taxi
In (used while doing something) — The tagline should be catchy in marketing a
product.
In (to indicate color, shape and size) — This dress comes in four sizes.
On
We use on to talk about location on a surface.
The books are on the desk.
We live on the fifth floor.
There are pictures on the wall.
She likes to sit on the floor.
We also use on for some types of public transport.
He's on the bus now.
You can't make phone calls on a plane.
They go to school on the train.
We also use on for lines (including rivers, borders, streets, etc.) and islands.
London is on the River Thames.
The Pyrenees are on the border of Spain and France.
There's a market on James Street.
I'd love to live on the Isle of Wight.
On (refers TV or other devices)- She is on the phone.
On (refers the parts of the body) — I keep wearing my wedding ring on my finger.
On (to refer a state)- The products available in the store are on sale.
for a certain side (left, right) – turn on the left.
for a floor in a building – on the second floor.

At
We use at in many common phrases, especially when we are talking about a place
for a specific activity.
I'm at work.
She's working at home today.
The children are at school.
See you at the train station!
They're at the supermarket.
I met him at a party.
We also use at for addresses or exact positions.
I live at 15 Craig Street.
She's sitting at a desk.
He's waiting at the entrance.
Please sit at the back of the room.
For events
Ex: at a concert/at a party
Place where you are to do something typical (watch a movie, study, work)
Ex: at the cinema/at school/at work
To :
To (to indicate the direction, place)- The friends went to the restaurant.
I am heading to my college.
To (to indicate relationship) — Do not respond to the annoying persons.
Your answer is important to me.
To (to indicate a limit) — The old newspapers were piled up to the roof.
To (to refer a period) — I am here from 10 to 5.
Of :
Of (to indicate relating to, belonging to) — I always dreamed of being famous.
Of (to indicate reference) — This is a picture of my last birthday.
Of (to specify the number or an amount) — A good number of people understand
Hindi.
For :
For (to indicate the reason or because of) — I am really happy for you.
For (to indicate the duration or time) — I attended the session for one year only.
For (specify the use of something) — She is preparing for her final exam.

Test yourself with our quiz

Fill in the blanks with the appropriate preposition:
The clinic has seen a significant reduction ___ cases of chickenpox due to
vaccinations.
The patient was concerned ___ the long-term effects of the medication.
The research indicates a potential risk ___ heart disease in individuals with a
sedentary lifestyle.
The child had a severe reaction ___ the new dietary supplement.
Many individuals benefit ___ regular check-ups to monitor their health.
The patient was diagnosed ___ a rare genetic disorder after extensive testing.
The community has seen an increase ___ awareness about mental health issues.
The doctor advised the patient to adhere ___ the prescribed medication schedule for
best results.
The patient prefers to take his blood pressure medication ___ the evening.
The health fair will take place ___ December 15th.
New medical interns usually start their training ___ January.
The research facility was inaugurated ___ 2010.
The patient has been on this specific medication ___ three weeks.
She has been seeing her therapist ___ the incident last month.
1. Nouns + prepositions
Certain nouns are commonly paired with specific prepositions. Here are some
examples:
Risk of
 Example: The patient is at a high risk of developing diabetes.
Symptoms of
 Example: She presented with the classic symptoms of influenza during the
winter season.
Treatment for
 Example: The doctor recommended a new treatment for her condition at the
clinic.
Reaction to
 Example: The patient had an allergic reaction to the medication.
Increase in
 Example: There has been a significant increase in cases of measles this year.
Reduction in
 Example: A healthy diet can lead to a reduction in cholesterol levels.
Exposure to
 Example: Prolonged exposure to the sun can increase the risk of skin cancer.

2. Verbs + Prepositions
Many verbs that you will encounter in healthcare also use specific prepositions:
Admit to
 Example: He was admitted to the paediatric department.
Diagnose with
 Example: He was diagnosed with pneumonia last week.
Recover from/after
 Example: It took her three months to fully recover from/after the operation.
Protect against
 Example: Vaccines help to protect against many infectious diseases.
Adhere to
 Example: It's essential for patients to adhere to their medication schedule for
optimal results.
Benefit from
 Example: Patients with respiratory issues often benefit from physiotherapy.

3. Adjectives + prepositions
Notice how adjectives are often linked to specific prepositions as well:
Prone to
 Example: Elderly patients are often more prone to fractures.
Immune to
 Example: After vaccination, the body becomes immune to certain diseases.
Satisfied with
 Example: The patient was satisfied with the care he received during his
hospital stay.
Aware of
  Example: Medical professionals should be aware of the latest research in
their field.
Susceptible to
 Example: Children and the elderly are often more susceptible to flu
complications.
Concerned about
 Example: The patient was concerned about the potential side effects of the
treatment.
Resistant to
 Example: Some bacteria have become resistant to standard antibiotics.

COUNTABLE AND NONCOUNTABLE NOUNS:

To use articles correctly, you need to understand nouns.
Countable nouns: These can be singular (one) or plural (more than one) and can be
counted.
Example: "A patient was admitted." (Singular) vs. "Three patients were admitted."
(Plural)

Uncountable nouns: These can't be counted as they represent a mass, concept, or

quantity.
Example: "She gave advice on post-operative care." (Not "an advice" because advice
is uncountable

INTRODUCTION TO ARTICLES
Articles are words that accompany and give context to nouns. They can be:
 Definite article: 'the'
 Indefinite articles: 'a' and 'an'
 Zero article: no article

A / An
Explanation Example When we use it

“Movie” is a noun. Let's see a movie. We use “a” and “an” for
singular, countable nouns
It's singular (one movie). when the listener doesn't
know which one we're
It's countable. talking about yet.
 Explanation Example When we use it

It's the first time we talk about the

movie, so the listener doesn't know
which movie yet — at this point, it might
be any movie.

The
Explanation Example When we use it

It's a specific book — both the I love the book We use “the” for a specific noun —
speaker and the listener know which you gave me. both the speaker and the listener
book we're talking about. know which one we're talking about.
We can use it for any noun —
singular or plural, countable or
Specific students. “Students” is I explained it uncountable.
plural in this case. to the students in
my class.

Specific information. She gave

me the informatio
“Information” is uncountable. n I wanted.

Zero Article
Explanation Example When we use it

This means I love all cats; I I love cats. Zero article means no article
love cats in general. at all. We use zero article
when we're speaking or
writing about something in
general, about all the
members of that group.

Additional Information Regarding the Use of Articles

 When indicating an unspecified, limited amount of a count or noncount noun,

use some.
1. My cousin was seeking some advice from a counselor (not advice in general
or advice about everything, but a limited amount of advice).
2. I would love some coffee right now (not coffee in general, but a limited
amount of coffee).
 3. We might get rain tomorrow. Some rain would be good for the crops (a certain
amount of rain, as opposed to rain in general).
4. There are some drops of water on the table (a limited number, but more than
one drop).

Noncount nouns are those which usually cannot be counted. Following are some
common examples:

◊ Certain food and drink items: bacon, beef, bread, broccoli, butter, cabbage,
candy, cauliflower, celery, cereal, cheese, chicken, chocolate, coffee, corn,
cream, fish, flour, fruit, ice cream, lettuce, meat, milk, oil, pasta, rice, salt, spinach,
sugar, tea, water, wine, yogurt

◊ Certain nonfood substances: air, cement, coal, dirt, gasoline, gold, paper,
petroleum, plastic, rain, silver, snow, soap, steel, wood, wool

◊ Most abstract nouns: advice, anger, beauty, confidence, courage,

employment, fun, happiness, health, honesty, information, intelligence,
knowledge, love, poverty, satisfaction, truth, wealth

◊ Areas of study: history, math, biology, etc.

◊ Sports: soccer, football, baseball, hockey, etc.

◊ Languages: Chinese, Spanish, Russian, English, etc.

◊ Other: clothing, equipment, furniture, homework, jewelry, luggage, lumber,

machinery, mail, money, news, poetry, pollution, research, scenery, traffic,
transportation, violence, weather, work

 Geographical names are confusing because some require the and some do
not.

Use the with: united countries, large regions, deserts, peninsulas, oceans, seas,
gulfs, canals, rivers, mountain ranges, groups of islands
the Gobi Desert
the United Arab Emirates
the Sacramento River
the Aleutians

Do not use the with: streets, parks, cities, states, counties, most countries,
continents, bays, single lakes, single mountains, islands

Japan
Chico
 Mt. Everest
San Francisco Bay

Healthcare examples:
 The definite article: 'the'
Healthcare examples:
Singular, countable: "The patient in room 12 needs attention."
Plural, countable: "The patients in the ICU are critical."
Uncountable: "The equipment has been delivered."

 The indefinite articles: 'a' and 'an'

Note: the choice between ‘a’ and ‘an depends on the following vowel sound, not just
the vowel. E.g. We say, ‘an MRI’ because of the pronunciation of m (“Em”). And we
say, ‘a urologist’ because of the pronunciation of start of the word (“You”).
Healthcare examples:
"A nurse is required in the ER."
“She presented with a persistent cough.”
“He was treated for a fever and complained of a headache.”
"An ultrasound revealed the issue."
“He requires an X-ray of the area.”

 The zero article

Healthcare examples:
Plural, countable:
"Doctors need to be vigilant during operations."
“She was prescribed antibiotics.”
“Investigations revealed a previously undiagnosed heart condition in the patient.”
“She complained of headaches and stomach cramps.”

 Uncountable - Healthcare:
"She presented to the Emergency Department with nausea and dizziness."
“Physiotherapy will help Mr X to regain mobility.”
“High blood pressure can result from stress.”
“Care must be taken when sterilising equipment before surgery.”

Remember, the zero article is used when speaking about things in general, not
specific instances. So, "doctors" refers to the profession as a whole, not a specific
group of doctors. Similarly, "equipment" refers to the concept in general, not a
specific piece of equipment.

Advanced Tips for OET Candidates

Context is Key: In healthcare, the context often determines the article. “The
operation” refers to a specific operation, while “an operation” could refer to any
operation.
Consistent Practice: Engage in reading medical journals, writing mock reports, and
participating in medical discussions. As you do, notice how articles are used or
omitted and consider why.

Common OET questions: Articles with symptoms and conditions

Symptoms:
Many common symptoms are countable, so you use an indefinite article in the
singular. E.g.,
 a cough
 a runny nose
 a headache
 a swollen ankle
 a fever
 a sore throat
 a muscle cramp
 a migraine
However, note that some are uncountable, so usually do not need an article:
 nausea
 vomiting
 dizziness
 hearing loss
 constipation
 breathlessness
 amnesia
 diarrhoea

Conditions:
All of these common conditions do not usually take an article:
 cancer
 hypertension
  Parkinson’s disease
 dementia
 Crohn’s disease
 diabetes
 jaundice
 eczema
 hay fever
 depression
 epilepsy

Common mistakes and corrections

Overusing 'the': Avoid using 'the' unnecessarily. For instance, "She has diabetes" is
correct, not "She has the diabetes."
Misunderstanding uncountable nouns: Words like 'equipment' and 'advice' are
uncountable. So, it's "Give some advice" not "Give an advice."
Not using an article with singular countable nouns: A singular countable noun
always needs an article (a, an, the) or a determiner (e.g. his, her, that, this). So, “She
received treatment for sprained wrist” should be, “She received treatment
for a sprained wrist,’ or “She received treatment for her sprained wrist.”

Test yourself with our quiz

Fill the gaps with a, an, the, or no article.
Following ___ diagnosis, Mr Singh was advised to reduce his meal sizes.
He needs ___ MRI scan to assess the extent of the injury.
She was prescribed ___ painkillers for her infection.
I have referred Ms Kim to ___ podiatrist for further treatment.
Nurses give ___ advice to patients daily.
It is widely known that ___ sleep is essential for recovery.
Patients with ___ irregular heartbeat should avoid caffeine.
Mr Leong underwent ___ left knee replacement.

Answers:
the / 2. an / 3. no article / 4. a / 5. no article / 6. no article / 7. an / a

PUNCTUATION MARKS
Five comma rules
 Rule 1: use a comma to separate independent clauses
Commas are used to separate two independent clauses* when they are joined by
coordinating conjunctions like 'and', 'but', 'or', 'so'. There are only seven coordinating
conjunctions (for, and, nor, but, or, yet, so) and you can remember them with this
acronym: FANBOYS. The most commonly used ones are ‘and’, ‘but’ and ‘so’.
*An independent clause is a group of words that can stand alone as a sentence as it
expresses a full thought.
Example: "Mr Kymont was recommended physiotherapy, and he will begin his
sessions next week."

Rule 2: use a comma after an introductory element

Often, a sentence will begin with an introductory word, phrase, or clause. In such
cases, use a comma after the introductory element to set it off from the rest of the
sentence.
Example: "During his last consultation, Mr Smith reported improved mobility after his
knee replacement surgery."

Rule 3: use commas to separate elements in a series

When listing three or more items, use commas to separate each item. The final
comma before the conjunction (usually 'and' or 'or') is known as the Oxford comma.
Example: "I have advised Ms Davis to eat a balanced diet, increase her physical
activity, and attend regular check-ups for monitoring her diabetes."

Rule 4: use a comma to set off non-essential information

A non-essential element is a word, phrase, or clause that is not essential to the
meaning of the sentence. Commas are used to set off non-essential elements.
Example: "Ms Ferrago, despite experiencing mild discomfort post-surgery, is
recovering well and eager to return home."

Rule 5: use a comma after a dependent clause that begins a sentence

A dependent clause at the beginning of a sentence is often followed by a comma.
This is to indicate the end of the dependent clause and the start of the independent
clause, which is the main point of the sentence. You will often see this comma when
a sentence starts with a subordinating conjunction such as ‘although’, ‘if’, ‘when’,
‘while’, ‘after’, ‘until’ and ‘because’.
Example: "Although Mr Johnson has made some improvement in his health, he still
requires ongoing monitoring of his blood pressure."
Three common errors
Here are some of the most common errors people make with commas (and the
corrected sentences).
Error 1: joining two sentences with a comma only (aka a ‘comma splice’)
When two sentences are joined with only a comma, it's wrong. We can use 'and', a
semicolon, or make two sentences.
Incorrect: "Dr Lee checked the patient's lab results, he didn't find anything wrong."
Correct: "Dr Lee checked the patient's lab results and didn't find anything wrong."

Error 2: Using a comma with a defining relative clause

A defining relative clause is a clause that you can't get rid of because it specifically
defines some part of the sentence. Don't separate a defining relative clause from the
rest of the sentence with commas.
Incorrect: "The patient who has type 2 diabetes, should continue taking his insulin
medication."
Correct: "The patient who has type 2 diabetes should continue taking his insulin
medication."

Error 3: Using an unnecessary comma with two actions

When the same person or thing is doing two things, you don't need a comma.*
Incorrect: "Mrs Brown has a check-up next week, and also needs more tests."
Correct: "Mrs Brown has a check-up next week and also needs more tests."

*As in Rule #1 above, if you have two complete sentences and a coordinating
conjunction, you should use a comma.
Correct: “Mrs Brown has a check-up next week, and she also needs more tests.”
Remember, correct comma usage makes your writing clearer and easier to read. It
also shows a high level of English proficiency, which can help boost your OET writing
score. Keep practising, look for how commas are used in expert writing, and avoid
the common errors above for a successful OET experience.

The semi-colon (;) contains a comma and a full stop.

To link sentences that are closely related:
 The night sky was the deepest sapphire; Claire realised that she had not
observed its beauty until now.
To link sentences that are in opposition to each other:
  His research methods were fundamentally flawed; nonetheless, he collected
the data.
To separate items in a list:
 Mrs Brown was assisted by other members of staff: Dr Benham from Animal
Husbandry; Mr Gleeson from Botany; and Dr Chalk from Soil Science.

Colons (:) are used in the following ways:

To introduce a list:
 The results of the indoor team games were as follows: Wessex came first,
Bridges and Wantage were joint second, and Sibly came last.
To link two sentences thematically:
 Psychological studies into domestic violence are usually centred on an idea of
the nuclear family: Henry Davis decided that he should undertake a more
radical approach to research in this area.
To draw out a conclusion:
 Language acquisition is a difficult but immensely rewarding task: without it,
there is little hope for global communication.

The apostrophe (‘) has two functions:

1. To show that letters are missing. This is known as contraction.
2. To indicate ownership. This is known as possession.
Contractions
When letters are missing in a word, and the word becomes shorter, the apostrophe is
used to show where the missing letters belonged.
For example:
 I am becomes I'm
 You will becomes you'll
 They would becomes they'd
Contractions are used in informal writing. Essays and reports should not contain
informal writing.
Possession
Apostrophes are also used to show that something belongs to something else.
For example:
 The girl's hat - means that the hat is owned by the girl.
 The girl's hats - means that the girl owns more than one hat.
 The girls' hat - means that the girls all share ownership of one hat.
 The girls' hats - means that the girls own several hats (or one each).
With the words ending in (s) like Socrates, Venus, Jesus, etc..For example:
There is no additional 's' and the apostrophe goes after the final 's' in Socrates.
 Ex: Socrates’ wife.
Its/it's
 The cat licked its paws.
There is no need for an apostrophe, because 'its' is a pronoun in its own right which
stands in for 'the cat's' and indicates ownership.
 It's an amazing idea.
A missing letter has been replaced by the apostrophe, so it really means 'it is':
Whose/who's
 Whose shoes are they?
Here whose is a special kind of pronoun (like its) which indicates ownership already,
so there is no apostrophe.
 Who's coming to dinner?
A missing letter has been replaced by the apostrophe, so it really means, 'who is'.
Dates
The 1960s were a period of radical changes in morality. (is a plural referring to all the
years between 1960 and 1969, so there is no apostrophe.)
In the '60s, public morality underwent radical changes. (there is a contraction with
'19' missed off. The apostrophe replaces the missing numbers.)
1960s' morality was quite different to that which had gone before. (what is being
referred to is the morality of the 1960s, so the apostrophe indicates possession)

Active & Passive voice:

Active voice:
In active sentences, the person or thing doing the action comes first.
Examples
 The nurse checked the patient.
 Vaccines stop many diseases.
 Lab workers test blood samples.
Passive voice:
In passive sentences, the action or result is more important than who did it, so it
comes first in the sentence. Sometimes, we don’t know who did the action.
Examples:
 Active: The nurse checked the patient.
  Passive: The patient was checked (by the nurse).

How to make passive sentence:

Object + to be + past participle (e.g., 'given' or 'checked')
Examples
 The report has been read.
 The patient will be seen by the doctor.
 The medicine was taken.

Relative pronouns:
Relative pronouns introduce a clause that adds extra information about a noun, with
common examples being who, which, that, whose, whom, when, where, and why.

What are closed and open questions?

Notice the difference between the open question:
 How are you feeling today?
And the closed question:
 Are you feeling unwell today?
Open questions are broad and allow patients to express themselves freely,
providing more comprehensive information.
Examples:
 What symptoms have you been experiencing recently?
 How has this condition affected your daily life?
 Can you describe the nature of the pain you're feeling?*
 What concerns do you have about your health?
*Note that open questioning techniques include indirect questions (e.g. '"Can you tell
me more about that?" "Could you explain that a bit more?".)

Closed questions seek specific answers, often limiting the patient's response to a
predetermined set of options (e.g., yes or no).
Examples:
 Do you have any allergies?
 Have you been taking your medication regularly?
 Are you experiencing any side effects?
 Did the symptoms start after a particular event?
How to form open questions
1- Start with "wh-" words like "what", "how", "why", "where", "when"
2- Encourage elaboration by keeping the question broad
3- Avoid leading the patient to a specific answer
4- Use verbs that prompt detailed responses, such as "describe", "tell",
"explain".
Examples:
 How did you feel when the symptoms first started?
 What measures have you taken to address the issue?
 Can you describe the progression of your condition?
How to form closed questions
1. Begin with auxiliary verbs like "is", "are", "do", "did", "have"
2. Keep the question concise and to the point
3. Ensure the question is seeking a specific piece of information
Examples:
 Have you been to a doctor about this issue before?
 Did the symptoms start suddenly?
 Are you currently on any medication?