OET Writing practice · Medicine
Iron-deficiency anaemia and positive FIT – gastroenterologist
An original practice task written by LetterScore AI. Read the case notes in 5 minutes, then write your referral letter in 40 minutes, about 180–200 words in the body.
Write this letter and get feedback
Case notes
MEDICINE — WRITING TASK (practice) Time allowed: Reading time 5 minutes, Writing time 40 minutes Read the case notes below and complete the writing task which follows. Notes: Today's date: 08/09/2026 You are a GP at Fernhill Health Centre, 27 Quarry Street, Dunmore. Patient: Mrs Ingrid Solberg, DOB 19/11/1963 (62 yrs) Social background: - Retired pharmacist. Widowed 2022; lives alone. Daughter lives nearby - Vegetarian for 30 years (eats eggs and dairy) - Never smoked. Alcohol 1–2 glasses of wine/week - Volunteers at a charity shop 3 days/week; walks dog daily Family history: - Mother: breast cancer, age 70 - No known family history of bowel cancer Medical history: - Transient ischaemic attack (2024): clopidogrel 75 mg daily, simvastatin 40 mg nocte - Hypothyroidism (2015): levothyroxine 100 mcg daily - Total abdominal hysterectomy for fibroids (2009) - Osteoarthritis both hands: paracetamol PRN - Allergy: penicillin (rash) Consultation notes: 14/07/2026 - c/o tiredness × 4 months; breathless walking dog uphill; hair thinning - No abdominal pain, no change in bowel habit, no rectal bleeding, no melaena, no haematuria - No NSAID use - Wt 63 kg (March 2026: 66 kg); reports eating normally - O/E: pale. BP 118/72, HR 88 reg. Abdo soft, non-tender, no masses. PR declined - Plan: FBC, ferritin, B12, folate, U&E, LFT, TFT, coeliac serology 21/07/2026 (results) - Hb 94 g/L (115–165), MCV 72 fL (low), ferritin 5 µg/L (low) - B12, folate normal. U&E, LFT normal. TSH 2.1 mU/L (normal) - Coeliac serology (tTG IgA) negative; total IgA normal - Urine dipstick: no blood - Plan: FIT. Ferrous fumarate 210 mg BD commenced - Diet discussed; vegetarian diet unlikely to explain severity of anaemia 04/08/2026 (results) - FIT 18 µg Hb/g faeces (positive; threshold ≥10) - Pt informed by phone; anxious, agreed to referral 08/09/2026 - Still tired; breathlessness slightly improved - Nausea with iron → ferrous fumarate reduced to 210 mg once daily - Stools dark since starting iron; formed, frequency unchanged - Epigastric discomfort after meals × 2 weeks - Wt 62 kg. Repeat Hb 101 g/L - Pain at base of L thumb, consistent with OA - Worried about having to stop clopidogrel for procedures Plan: - Urgent referral to gastroenterology (suspected cancer pathway) for colonoscopy and OGD - Continue ferrous fumarate; repeat FBC in 6 weeks - Do not stop clopidogrel without specialist advice - Safety-netting: seek urgent help if black tarry stools with dizziness, vomiting blood or severe abdominal pain Writing Task: Using the information in the case notes, write a letter to Dr Samuel Okafor, Consultant Gastroenterologist, Lakeside General Hospital, 88 Canal Road, Dunmore, referring Mrs Solberg for urgent investigation. In your answer: - Expand the relevant notes into complete sentences - Do not use note form - Use letter format The body of the letter should be approximately 180–200 words.
How to approach this referral letter
- The reader has never met the patient. State the reason for referral, and how urgent it is, in the first paragraph.
- Select the history, findings and investigation results that support the referral, and group them by topic rather than by date.
- End with what you are asking the reader to do, and any action you have already taken.
Members also get the model answer, the note-selection table and task-specific tips for this task.