A good OET letter does more than list facts. It helps the reader understand how those facts relate to one another. Did a symptom appear before or after treatment? Has the patient improved but still needs support? Is a follow-up action necessary because of a current risk?
Connectors help you express those relationships. The key is to choose them for their meaning, rather than adding them to make your letter sound more formal.
The most useful connectors for OET Writing
| Relationship | Connectors to practise | Example |
|---|---|---|
| Sequence | initially, subsequently, following, after | Following assessment, Ms Lee was admitted for observation. |
| Current status | currently, at present, as of discharge | At present, she is mobilising independently. |
| Contrast | although, however, despite | Although her pain has improved, she still requires assistance with dressing. |
| Cause | because, due to | Her medication was changed because she experienced nausea. |
| Result | therefore, as a result | Her blood glucose remains unstable; therefore, regular monitoring is required. |
| Addition | also, in addition | She also has a history of hypertension. |
| Condition | if, should | If her symptoms worsen, please arrange an urgent medical review. |
| Purpose | to, in order to | She was referred to physiotherapy to improve her mobility. |
You do not need to use every connector in one letter. A small group used accurately is much more effective than a long list used mechanically.
See the difference in a clinical example
Consider these notes:
Pain improved. Patient still needs assistance with washing. Community nurse to review after discharge.
A letter that simply repeats the notes may feel disconnected:
Her pain has improved. She needs assistance with washing. The community nurse will review her.
A clearer version shows the contrast and the next step:
Although her pain has improved, she still requires assistance with washing. A community nursing review is planned after discharge.
The connector although makes an important point clear: improvement in pain does not mean the patient is fully independent.
Three connector mistakes to avoid
1. Suggesting a cause that the notes do not establish
Her blood pressure improved; therefore, her medication was stopped.
This sentence says that the improvement caused the medication to be stopped. Use therefore only if the case notes support that relationship. If they do not, report the two facts without inventing a reason.
2. Starting every sentence with a connector
Firstly… Moreover… Furthermore… Finally…
This style can make a clinical letter sound like an essay. In OET Writing, relevant information arranged in clear paragraphs often needs very few visible linking words.
3. Confusing although and however
Both can show contrast, but their sentence structures differ:
Although her wound is healing, she still needs daily dressings.
Her wound is healing. However, she still needs daily dressings.
Choose the structure you can use accurately and naturally.
A simple check before you submit
When reviewing your letter, look at each connector and ask:
What relationship am I expressing? Sequence, contrast, cause, result or condition?
Do the case notes support that relationship?
Does this word help the reader understand the patient’s situation or the requested care?
If the answer to the last question is no, you may be able to remove it.
Remember: OET Writing is a clinical communication task. Your goal is to give the reader an accurate, concise account of the patient’s situation and make the required action clear. Use connectors to support that goal—never to decorate the letter.
Teacher Aracelis | Oxford English Center
