How to refer to the patient in an OET letter: name, title and pronouns without repetition
In an OET Nursing letter, introduce an adult patient with their title and full name in the Re: line, then use their title and surname ('Mrs Patel') at the start of the letter and at the start of new paragraphs, and 'he' or 'she' in between, following the case notes. Avoid starting every sentence with the name, avoid first names for adults, and repeat the name only where a pronoun could be unclear.
Why this matters
How you refer to the patient affects three criteria at once:
- Genre & Style: a first name or "the patient" in every line can sound informal or cold. See formal tone and Genre & Style.
- Conciseness & Clarity: an unclear "he" or "she" makes the reader stop and check.
- Organisation & Layout and Language: starting every sentence with "Mr Okafor..." makes the letter read like a list rather than connected text. See linking words and cohesion.
A simple pattern
| Where | What to write (invented patient) |
|---|---|
| Re: line | "Re: Mr Daniel Okafor, aged 58" (follow the details the notes and task give) |
| First sentence | "I am writing to refer Mr Okafor, who..." |
| Rest of the paragraph | "he", "his", "him" |
| Start of a new paragraph | "Mr Okafor" again, so each paragraph is clear on its own |
| Where two people could be "he" | the name or a noun ("his son", "Mr Okafor") |
For the layout of the Re: line and salutation, see OET letter format: Re line and salutation.
Titles: Mr, Mrs, Ms, Miss and others
Use the title that appears in the case notes. If the notes give an adult woman no title, "Ms" is neutral and does not assume marital status. If the notes give another title, such as "Dr", use it. Do not change "Mrs" to "Ms" or the other way round when the notes are clear.
For children, the full name usually appears in the Re: line, and the first name may then be natural in the letter body ("Lily has been..."), or you can use pronouns. See letters about a child patient.
Avoiding repetition
Repeating the name in every sentence is one of the most common style problems in practice letters. Here is an invented example.
Repetitive:
Mr Okafor was admitted on 3 June with chest pain. Mr Okafor had an angiogram on 4 June. Mr Okafor had a stent inserted. Mr Okafor is now pain-free. Mr Okafor will be discharged on 6 June.
Better:
Mr Okafor was admitted on 3 June with chest pain. The following day, he had an angiogram, and a stent was inserted. He is now pain-free and will be discharged on 6 June.
Techniques used:
- Pronouns after the first mention.
- Combining sentences that share the same subject; see sentence length and combining sentences.
- Passive voice where the action matters more than the person; see passive voice in an OET letter.
- Time phrases ("The following day") at the start of a sentence instead of the name.
Avoiding unclear pronouns
The opposite problem is using a pronoun when the reader cannot tell who it means. This happens most often with family members, carers and other health professionals.
| Unclear | Clear |
|---|---|
| "Mr Okafor's brother drives him to appointments, but he has recently had cataract surgery." | "Mr Okafor's brother drives him to appointments but has recently had cataract surgery." |
| "The physiotherapist reviewed her, and she said she can walk with a frame." | "The physiotherapist reviewed Mrs Lin and reported that she can walk with a frame." |
| "He was seen by Dr Rao, and he started him on furosemide." | "Dr Rao reviewed him and started furosemide." |
Rule of thumb: if a sentence contains two people who could share the same pronoun, name one of them. For more on family members, see how to write about family and carers.
Pronouns and the case notes
Use the pronoun that matches the information in the case notes. If the notes do not make it clear, use the title and surname more often, or restructure sentences so they do not need a pronoun ("Mx Taylor was admitted...; the wound was dressed daily"). Never guess.
Quick checklist before you finish
- The Re: line has the full name and the details the task requires.
- The first sentence uses the title and surname.
- No two sentences in a row start with the patient's name.
- Every "he", "she" or "they" clearly points to one person.
- No first name alone for an adult.
- "The patient" is used rarely, if at all.
Practise and check
Write a timed practice letter, then read it once just for names and pronouns. You can also check a letter you have written to get corrections marked on your own sentences and a mark for each of the six criteria. medEmu is an independent practice tool for OET Writing for Nursing; its grades are estimates, and it is not affiliated with OET.
Sources
This guide is medEmu's writing advice, not official OET guidance; all patients are invented. The network used for this run could not reach oet.com, so no OET test facts are stated beyond the criterion names. For OET's official Writing information, see oet.com.