1. Punctuating your first paragraph:
The first paragraph, as I’m sure many of you will know, ought to focus directly and immediately on the reason your letter is being written. For example, you’re writing to a surgeon due to a worsening case of arthritis. The error I often see here, however, is with punctuation. Consider the following response, what is the punctuation error?
I am writing to refer the above-mentioned patient who has worsening osteoarthritis for a possible knee-joint replacement.
Did you get it? In order to answer the question, you need to first recognise the fact that this sentence includes a lot of information, so much so that we need punctuation to establish which part of it is the main focus of the sentence and which part of it is additional, albeit important, information. We can establish this via the use of commas, like so:
I am writing to refer the above-mentioned patient, who has worsening osteoarthritis, for a possible knee-joint replacement.
Now you can see that the information highlighted in commas is the additional part of the sentence. It could be removed and the sentence would still make sense and contain its main idea, it would just lack the extra information, which the use of commas allows us to provide. Another way the sentence could have been written is like so:
I am writing to refer the above-mentioned patient for a possible knee-joint replacement. She has a worsening case of osteoarthritis.
These two sentences would be grammatically correct but they have the disadvantage of requiring two sentences to say what it is possible to say in just one. So, by using our commas correctly, we can link ideas and still maintain clarity.
2. Errors using small numbers:
Another common error in OET writing comes with the use of small numbers. Let’s take another example, see if, this time, you can spot two errors:
The patient presented with a 2 weeks history of migraines.
How did we do? Well, the first and most obvious error here is with the use of the number “2” rather than the word “two”. In formal writing, we ought to use words rather than numbers when the numbers are small, so, basically, any number from one to ninety-nine ought to be written as a word. Numbers from 100 and above can be written as a number.
This is a convention you ought to follow in your OET letters. The second error comes with the use of “weeks” rather than what it should be: “week”. This is because “two-week” should be linked as an adjectival phrase rather than being seen as two separate words.
As an adjectival phrase, they have the function of qualifying the noun “history” and when a number is being used as an adjective, it should be directly linked to the adjective which follows. Since “week” is also an adjective in this sentence, it should not be pluralised; so, our sentence ought to look like this:
The patient presented with a two-week history of migraines.
The small number has now been correctly written as a word and it has been linked to the following adjective.
3. Ending your letter with the second conditional:
A final bit of medical English grammar to finish here. It is very often the case that students will end their OET letters using a second conditional structure. This is a very good idea but the issue is that they often use the second conditional incorrectly. Let’s look at a final example:
I would be grateful if you advise her on her diet and help her with her activities of daily living.
So, what’s the problem here? Well, let’s look at the structure. So we have a “would” clause at the beginning of the sentence and we have an “if” clause following it. “Would” + “if” = a second conditional sentence and, in a second conditional sentence, we should be using the past tense forms of the verbs. So, it should look like this:
I would be grateful if you advised her on her diet and helped her with her activities of daily living.
Now, you don’t have to be a grammar expert, necessarily, to get this right. Just remember that “would” + “if” = past tense verb forms, and you will be fine. The second conditional is a very common way of making a polite request, so it is worth getting it right.
4. Correct use of grammar:
Please read the Grammar, Spelling & Punctuation guide from the University of Kent.
Are there any sentences where you have punctuated incorrectly?