OET Writing samples: Band A vs Band B letters

The fastest way to internalise what good OET Writing looks like is to read it. This guide gives two complete referral letters in response to the same scenario — one Band A, one Band B — with the examiner reasoning that explains the difference.

For the structure these letters follow, see our OET Writing format guide.

The scenario

You are a community nurse in the UK. Your patient:

• Ms Maria Patel, 67, retired teacher, lives alone
• History: hypertension on amlodipine 5mg, type 2 diabetes on metformin
• Current: 3 weeks of progressive postural dizziness, two recent falls, last fall caused a bruised hip
• On exam: postural BP drop 25mmHg systolic
• Action taken: stopped amlodipine, started fluid replacement, marginal improvement

Write a referral to Dr Smith, the GP, requesting further assessment.

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Sample 1 — Band B

Dear Dr Smith,

I am writing to refer Ms Maria Patel, a 67-year-old retired teacher, for further assessment of her progressive postural dizziness. She has been under our care for a number of conditions and has recently had two falls.

Ms Patel has a history of hypertension, managed with amlodipine 5mg daily, and type 2 diabetes on metformin. She lives independently and has had no previous falls until this episode.

Over the past three weeks, Ms Patel has reported worsening dizziness on standing. She has had two falls — the most recent last Thursday, resulting in a bruised hip. There is no associated chest pain or loss of consciousness.

On examination, her postural blood pressure showed a significant drop of 25mmHg systolic. I have stopped her amlodipine and started oral fluid replacement, and her dizziness has improved marginally. I would appreciate your urgent assessment to investigate the cause and to optimise her cardiovascular medications.

Please do not hesitate to contact me for further information.

Yours sincerely,

Sarah Chen, Community Nurse

Word count: ~190.

Examiner reasoning (Band B)

• Purpose: clear in paragraph 1 ("refer for further assessment of progressive postural dizziness"). ✓
• Content: includes the relevant history (hypertension, diabetes), the chronology, the specific findings (25mmHg drop), and what's been done. Omits irrelevant case-note items (the grommet surgery, hobbies). ✓
• Conciseness and clarity: paragraphs are well-bounded, chronology is in order. Slight redundancy ("She has been under our care" + "She has had two falls" is recap, not new info). −
• Genre and style: formal register maintained, appropriate professional courtesy. ✓

Score: roughly 5/7 on average across criteria → Band B.

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Sample 2 — Band A

Dear Dr Smith,

I am writing to refer Ms Maria Patel, a 67-year-old retired teacher, for urgent assessment of progressive postural dizziness which has caused two falls in the past three weeks and now compromises her independence.

Ms Patel has a background of hypertension on amlodipine 5mg daily and type 2 diabetes on metformin. She lives alone and was previously independent in all activities of daily living.

Her dizziness began three weeks ago, predominantly on standing, and has progressively worsened. She has fallen twice — most recently last Thursday, sustaining a bruised hip — without loss of consciousness or chest pain.

Examination revealed a significant postural systolic drop of 25mmHg. I have discontinued the amlodipine and commenced oral fluid replacement, with marginal symptomatic improvement. Given the severity of her falls and the ongoing risk to her independence, I would appreciate your urgent review for further investigation into orthostatic causes and optimisation of her cardiovascular regimen.

Please do not hesitate to contact me should you require further information.

Yours sincerely,

Sarah Chen, Community Nurse

Word count: ~190.

Examiner reasoning (Band A)

• Purpose: clear, framed with stakes ("compromises her independence") that justify urgency. ✓✓
• Content: every sentence carries clinical information. Negatives are explicit ("without loss of consciousness or chest pain"). Specific request ("investigation into orthostatic causes") not generic. ✓✓
• Conciseness and clarity: tight prose, no recap. Use of "Examination revealed" and "I have discontinued" keeps the chronology crisp. ✓
• Genre and style: precise clinical vocabulary ("orthostatic causes", "cardiovascular regimen") without being inaccessible. Professional courtesy. ✓✓

Score: roughly 7/7 across criteria → Band A.

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The differences that move bands

Reading the two side by side, the Band A improvements are:

1. Stakes are framed in paragraph 1 — "compromises her independence" gives the reader a reason to prioritise.
2. Negatives are explicit — Band B has "There is no associated chest pain or loss of consciousness". Band A integrates these into the chronology more efficiently.
3. Specific clinical language — "orthostatic causes" vs "the cause"; "optimisation of her cardiovascular regimen" vs "optimise her cardiovascular medications".
4. Less recap — Band B has a half-sentence summary in para 1 that the rest of the letter repeats; Band A doesn't.

A second exemplar (Band B → Band A diff)

If you want a second case to compare, the most common Band B → Band A delta is paragraph 1. A typical Band B opening:

I am writing to refer Mr John Lee, a 58-year-old man, regarding his diabetes.

Band A version:

I am writing to refer Mr John Lee, a 58-year-old man with poorly controlled type 2 diabetes, for urgent specialist input given his recent HbA1c of 11.2% and recurrent hypoglycaemic episodes despite multiple medication adjustments.

The Band A opening has the clinical context the recipient needs to triage before they even reach paragraph 2.

Next steps

• Read the structure guide: OET Writing format
• Foundation: What is OET?
• Plan: How to prepare for OET

When Writing is at Band B and Speaking is the bottleneck, join the waitlist.