British or American spelling in OET Writing? Keeping spelling consistent in your letter
Choose one spelling system, British or American, and use it consistently throughout your OET letter; mixing 'haemoglobin' with 'anemia' or 'organise' with 'organization' looks careless. Check with OET's official guidance for its current position on accepted spellings, and learn the clinical words where the two systems differ, such as oedema/edema, paediatric/pediatric and anaesthetic/anesthetic.
The short answer: pick one and stay with it
The most important spelling rule in an OET letter is consistency. A letter that uses "haemoglobin" in one paragraph and "anemia" in the next mixes British and American spelling. A reader notices, and it makes the writing look less careful.
The network used for this run could not reach oet.com, so this guide does not state OET's position on spelling; check oet.com for its current guidance before your test.
Clinical words that differ
These differences come up often in nursing letters.
| British | American |
|---|---|
| oedema | edema |
| haemoglobin | hemoglobin |
| anaemia | anemia |
| haemorrhage | hemorrhage |
| paediatric | pediatric |
| anaesthetic | anesthetic |
| oesophagus | esophagus |
| diarrhoea | diarrhea |
| faeces / faecal | feces / fecal |
| orthopaedic | orthopedic |
| gynaecology | gynecology |
| tumour | tumor |
| catheterise | catheterize |
| haematoma | hematoma |
Notice the patterns: British often uses ae or oe where American uses e.
Everyday words that differ
| Pattern | British | American |
|---|---|---|
| -our / -or | behaviour, colour, favour | behavior, color, favor |
| -ise / -ize | organise, mobilise, recognise | organize, mobilize, recognize |
| -yse / -yze | analyse, paralyse | analyze, paralyze |
| -tre / -ter | centre, litre, metre | center, liter, meter |
| -ll / -l | travelled, labelled, counselling | traveled, labeled, counseling |
| -ence / -ense | licence (noun), defence | license, defense |
| other | programme, practise (verb), grey | program, practice (verb), gray |
British English also accepts "-ize" in some styles ("organize"), but within one letter, keep the same choice every time.
In British English, "practice" is the noun and "practise" is the verb: "Her GP practice is nearby." / "She should practise her exercises daily." In American English, "practice" is both.
Names and medicines: copy exactly
Some words should not change, whatever system you use:
- people's names and titles as given in the task;
- names of hospitals, clinics and care homes;
- medicine names, as written in the case notes.
Changing "Riverside Medical Centre" to "Center" changes a proper name. Copy it.
Worked example (invented case)
Mixed spelling:
Mrs Nakamura was admitted with a lower gastrointestinal hemorrhage and anaemia. Her haemoglobin has since stabilized, and her ankle edema has improved. She is mobilising with a frame and will attend the colorectal center for review.
Mixed: "hemorrhage", "stabilized", "edema", "center" (American) alongside "anaemia", "haemoglobin", "mobilising" (British).
Consistent British version:
Mrs Nakamura was admitted with a lower gastrointestinal haemorrhage and anaemia. Her haemoglobin has since stabilised, and her ankle oedema has improved. She is mobilising with a frame and will attend the colorectal centre for review.
Consistent American version:
Mrs. Nakamura was admitted with a lower gastrointestinal hemorrhage and anemia. Her hemoglobin has since stabilized, and her ankle edema has improved. She is mobilizing with a walker and will attend the colorectal center for review.
The American version also shows a vocabulary difference ("frame" vs "walker") and the full stop after "Mrs" that is common in American style. Keep titles consistent too.
A two-minute spelling check
At the end of your writing time, scan your letter for:
- ae / oe words: oedema, haemoglobin, paediatric, diarrhoea — all one system?
- -ise / -ize verbs: mobilise, organise, stabilise — all one system?
- -our / -re words: behaviour, centre — all one system?
- Doubled letters: labelled, travelled, referral (double r in both), referred.
- Commonly misspelt clinical words: "dependent" (adjective), "occasionally", "recommend", "necessary", "separate", "independently".
The word "referral" and "referred" have a double r in both systems, and "referring" too. This is one of the most common spelling slips in nurse letters.
For other frequent errors, see common OET Writing mistakes, and for grammar in general, see the Language criterion. Dates are a related issue: see dates and times in OET letters.
Words that sound alike
Spell-checkers often miss these because both words exist. Read for them separately.
| Pair | Example in a letter (invented) |
|---|---|
| affect / effect | "The fall did not affect her mobility." / "The side effect resolved." |
| complement / compliment | "Physiotherapy will complement her exercise plan." |
| principal / principle | "Her principal carer is her husband." |
| advice / advise | "She was given advice." / "Please advise her..." |
| dose / doze | "The evening dose was omitted." |
| breath / breathe | "She was short of breath." / "He can breathe comfortably." |
In a timed test there is no spell-checker, so a short list of your own repeated errors, learnt before the test, is more useful than a long list of rare words.
Practise and check
Practise a timed letter at /writing/, or check a letter you have written to see spelling and grammar corrections with the reason for each. medEmu covers OET Writing for Nursing only; 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 and details are invented for practice. The network used for this run could not reach oet.com, so OET's own position on spelling is not stated here: check OET's official Writing information at oet.com before your test.