OET Writing practice · Medicine
Changing pigmented lesion – dermatologist (urgent)
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.
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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: 10/09/2026 You are a GP at Greenacre Medical Practice, 14 Linden Avenue, Holmfield. Patient: Mr Brendan O'Callaghan, DOB 30/06/1977 (49 yrs) Social background: - Self-employed landscape gardener; works outdoors; rarely uses sunscreen - Lived and worked outdoors in Australia 2001–2008; several blistering sunburns - Married; wife (Siobhan) noticed the lesion - Non-smoker. Alcohol approx. 14 units/week. Plays golf weekly Family history: - Sister: melanoma excised age 44 (2021) - Father: basal cell carcinoma of nose Medical history: - Paroxysmal atrial fibrillation (2023): apixaban 5 mg BD, bisoprolol 2.5 mg daily - Actinic keratoses on scalp: cryotherapy 03/2025 - Lumbar back strain (2022) - Skin type I–II, red hair, >50 naevi on trunk - NKDA Consultation notes: 22/07/2026 - AF review: asymptomatic. HR 66 reg, BP 128/78 - U&E normal (eGFR 88 mL/min); apixaban continued - Sun protection advice re actinic keratoses 09/09/2026 - Wife concerned about mole on L upper back, "getting bigger" since June (holiday photos: approx. 4 mm, uniformly brown) - Occasionally itchy; bled once after rubbing on shirt 2 weeks ago - No weight loss, no new lumps noticed - O/E: L scapular region: pigmented lesion 9 × 7 mm, asymmetrical, irregular notched border, variegated colour (light brown, dark brown, black), slightly raised at one edge - Dermoscopy: atypical pigment network, irregular dots/globules, blue-white veil - Weighted 7-point checklist score: 7 - Several seborrhoeic keratoses on trunk, typical appearance - No palpable cervical, axillary or supraclavicular lymphadenopathy. No hepatomegaly - Clinical and dermoscopic photographs uploaded to referral system - Pt anxious; asks whether he can keep working outdoors 10/09/2026 (telephone) - Lesion bled again overnight, small amount, stopped with pressure after 10 min - Asks whether to stop apixaban → advised to continue unless instructed by specialist team - Also c/o R shoulder pain after hedge trimming; advised rest and paracetamol Assessment: - Changing pigmented lesion, suspicious for melanoma Plan: - Urgent suspected cancer referral to dermatology (appointment within 2 weeks) - Continue apixaban; dermatology to advise before excision - Sun protection: SPF 50+, hat, protective clothing - Self-examination advice; report any new lumps in armpits or neck Writing Task: Using the information in the case notes, write a letter to Dr Meera Kapoor, Consultant Dermatologist, Pigmented Lesion Clinic, Holmfield General Hospital, 23 Victoria Road, Holmfield, referring Mr O'Callaghan for urgent assessment. 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.