OET Grammar Book

A, an and the are articles. A and an are used for indicating a singular noun which is mentioned in the letter for the first time. However, "the" is used to refer to something that is already mentioned.

A / An

• An automobile engineer, Mr Parker lives with a friend.

The

• The friend that Mr Parker lived with is shifting to another house.

The is also used before body parts:

• Error: She had pain in abdomen.
• Correct: She had pain in the abdomen.
• Reason: Use "the" before body parts.

An / A?

Examples for “an”

• An MRI (em-aar-ai)
• An admission (ad…)
• An outpatient admission (aut…)
• An eight-year-old child
• An eighty-year-old…
• ____ one-eyed patient. 

Examples for “a”

• A university (yoo-ni) student…
• A one-pound (van- pound) reduction
• A one-eyed man…
• A youth festival …

Important: It is not AEIOU, but the first sound of the word!

The + “Anything already mentioned”

• When you mention something for the first time in the letter, like, “pain in the chest,” do not write “the” before it. 
• However, do not miss “the” when you refer to the same chest pain the second, third, fourth, fifth times.
• First Time: She was brought to the clinic with chest pain. (No “the”)
• After the First Time: “It was found that the pain was radiating to the right side. (“the pain” refers to the chest pain mentioned before)

The + Body Parts

• Do not miss the article “the” before all body parts – internal or external.
• However, if it is a disease condition like “hip-fracture”, we do not write “the” before hip fracture. You can write, fracture of the hip.

Examples

• He is not able to lift the left hand.
• She cut the right ear lobe in an accident.
• An immediate extraction of the tooth is advised.
• At the end, two of the extremities were amputated.

There are a large number of nouns we have to be careful with:

History

• Error: She had a history of Appendectomy.
• Correct: She has a history of appendectomy.
• Reason: History is always present; only the event can be in the past.

Adjective vs Nouns

• Error: He has allergic for penicillin.
• Correct: He is allergic to penicillin.
• Reason: Use is before an adjective form.
• Other forms: He has allergy to penicillin.

There are some words we shouldn't use in OET letters. Here are some of the:

Patient

• Error: The patient is not suffering from any other condition.
• Correct: Mr Parker does not have any other condition.
• Reason: We cannot use words like "suffer", "patient", etc.
• Other words to avoid: Obese, greatly, overweight.

Suffer

• Error: Mr Parker is suffering from diabetes.
• Correct: Mr Parker has had diabetes.
• Reason: We avoid "suffer" and its forms.

Also avoid:

• Obese / overweight.
• Unfortunately.
• Regretfully.

And / But / However / Also

• We use “but” if the information on its both sides are opposite:

Examples

• She was admitted on 22nd March and was diagnosed with…
• Her dietitian made her shift to a Mediterranean diet plan; however, she did not show any progress.
• Although her dietitian had made her shift to a Mediterranean diet plan, she did not show any progress.

Additionally (In addition to this)

Use “additionally” to begin a sentence only if the previous sentence has a similar information

• Ms Renuka recommended homeopathy for her colleagues. Additionally, one day, she introduced them to Dr Siva, a homeopath.

Look at these two sentences:

• She has been able to tolerate light meals at present… (progress).
• In addition to this, she can walk short distances… (progress).

You can see that the first sentence is about a patient’s progress. What about the second sentence? That is progress, too!

Also / In addition to this, +

You cannot use “Also” to start a new sentence. However, it is a good practice to start a sentence with “In addition to this, …”

• Incorrect: Also, his haemoglobin level has dropped to 71.
• Correct: In addition to this, his haemoglobin level has dropped to 71.

And / along with / As well as …

• “And” and “along with” are not the same. They are slightly different!
• And is used to connect A and B (two pieces of information of the same type).
• Along with is used to connect A and 2 (two information of the same category but slightly different).
• Medication and diet change are part of management (same) but they are slightly different.

Examples

• She was thereafter treated with metformin and amoxicillin.
• She requires medication along with a meal programme.
• She was managed thereafter with medication along with diet change.

For which / for this

• “For which” is used to connect two parts of a sentence. However, “For this” is used to start a new sentence.
• Important – Do not use a comma before or after for which.
• Do not miss the comma (,) after “For this,”

Examples

• She exhibited symptoms of myocardial infarction at 11 pm for which she was transferred to …
• She exhibited symptoms of myocardial infarction after the evening meal. For this, she was transferred to ….

Though / Although / even though: However,

• These two have almost the same meaning.
• If the first part of the sentence is over 20 words, you can full-stop and start the next sentence with However:

Examples

• Currently, he ambulates short distances with the help of a wheelie walker; however, he needs assistance with activities of daily living.
• Although he currently ambulates short distances with the help of a wheelie walker, he needs assistance with activities of daily living.
• Currently he ambulates short distances with the help of a wheelie walker for long distances, or a stick, for shorter distances. However, he needs assistance with activities of daily living.

Unless (If + not)

• Please do not take this medicine unless indicated.
• You can’t pass this exam unless you work hard.
• I will not admit Ms Lee unless (if + not) she is in critical condition.

Please note / Please note,

You can use “please note” followed by a comma or a “that” as a connective when the current sentence is not well connected to the previous sentence. Suppose the previous sentence is about the discharge medication but the current sentence is about a drug allergy.

• Mr Pious has recently recovered from an acute episode of coronary artery disease. Please note that he consumes alcohol in excess.

NB: Do not use a comma and “that” together. You need only one of them:

• Incorrect: Please note that, he consumes alcohol in excess.
• Correct: Please note, he consumes alcohol in excess.
• Correct: Please note that he consumes alcohol in excess.

Banned Connectors: So, besides, further more, moreover. Instead, you can use the following connectors:

What connectors should I avoid?

• Furthermore
• Moreover,
• Besides, 
• Meanwhile, 
• Apart from that, 
• Later on,
• Hence,
• So,
• Thus,
• Thereafter
• So

Don'ts

• So, Mr Parker underwent surgery on the same day.
• Besides, he was advised to take a break from his job.
• Moreover, she was shifted to the ward on the same day.

Dos.

• Therefore, Mr Parker underwent surgery on the same day.
• Additionally, he was advised to take a break from his job.
• In addition to this, she was shifted to the ward on the same day.

Here is a list of a few prepositions that should be carefully used.

On

• Error: She is undergoing for surgery.
• Correct: She is undergoing surgery.
• Reason: No need for "for."

By or With

• Error: He was treated with a physiotherapist.
• Correct: He was treated by a physiotherapist.
• Reason: By is used before people; with is used before things.
• Examples: Treated by a doctor. Treated with antacids.

Since vs For

• Error: She is a diabetic since 10 years.
• Correct: She has been a diabetic for 10 years.
• Reason: Use "for" with durations.

Of / About

• Error: He was complaining about headache.
• Correct: He was complaining of a headache.
• Reason: Use "of" with complaints.

For

• Error: He was advised for surgery.
• Correct: She was advised to undergo surgery.
• Reason: Use "to + undergo" for advice.

On

• Error: M Reeta was admitted on yesterday.
• Correct: Ms Reeta was admitted yesterday.
• Reason: We do not use "on" with "today, yesterday, tomorrow."
• Similar Errors: On today. On tomorrow.

On assessment / Admission + Past medical condition

Rules:

• Always use past tense after “on assessment” and “upon admission.”
• Do not forget the comma (,) before the patient’s name.

Examples:

• On admission, Ms Reeta had high blood pressure and symptoms of myocardial infarction.

Following / Followed by 

The more you think of “following” and “followed by,” your confusion increases. So, before you cannot deal with it, “he was admitted following a fall” means fall happened first.

• Incorrect: Mrs Price was admitted 2 days ago with mild concussion followed by a fall.
• Correct: Mrs Price was admitted 2 days ago with mild concussion following a fall.
• The first is incorrect because fall happened first! Following a fall = Fall happened first!

Be careful with verbs and tenses.

Undergo, Underwent, Undergone

• Error: She was undergone an MRI.
• Correct: She underwent an MRI.
• Reason: "Undergone" is used with "has, have or had."

Completed / Incomplete Actions

If an action started but not yet completed, use "have" or "has" forms. For completed actions, use simple past (was, did).

Incomplete Actions

• She has commenced medication.
• He has been advised not to lift heavy weights.

Completed Actions

• She commenced medication.
• He was advised not to lift heavy weights.

Refused vs Denied

• Error: Mr Parker refused any history of hypertension.
• Correct: The patient denied any history of hypertension.
• Reason: Refuse and deny are not the same.