Grammar

Grammar Lecture 1
Lecture 1 Booklet
OET ONLINE
Table of Contents
GRAMMAR OVERVIEW 1
TIPS AND HINTS IMPROVING ENGLISH 1
KEY AREAS TO FOCUS ON TO IMPROVE YOUR WRITING 1
VERB TENSES 4
THE PRESENT TENSE 5
THE PAST TENSE 6
THE FUTURE TENSE 7
TASK ONE 8
CONTINUOUS AND PERFECT TENSE 9

TASK TWO 11
ACTIVE VS. PASSIVE TENSE 12

TASK THREE 13
VERB TENSE AND CASE NOTES 14
TIME MARKERS AND TENSE 15

TASK FOUR 16
APPENDICES 17
This resource was developed by OET Online and is subject to copyright © 2

Website: http://oetonline.net.au Email: info@oetonline.net.au
Tips and Hints for Improving English
✓ Learning and improving a language is not the same as studying to be a health

professional. Improving a language, and the different parts of a language, is
more like learning a musical instrument.
✓ You learn and improve language by using it NOT studying it, so start using
it today.
✓ Read a little every day. Reading helps with all aspects of language, especially
with reading and writing.
✓ Write for at least 1 hour, 3 to 5 times a week. Then, read what you have
written and try identify any errors. If you can’t find your errors, try reading your
writing aloud. Sometimes you can hear what you can’t see.
✓ Whenever you write anything, including a text message or an email, READ
IT BEFORE you send it, and get into the habit of self-correction.
✓ Be patient with yourself and remember that improving your grammar and
vocabulary (and other language areas) is a marathon not a sprint. It takes time
and daily practice. Slow and steady wins the race!
Key Areas to Focus on to Improve Your Writing
Makes sure you focus on these 4 areas first:
Verb Tense
Articles & Vocabulary

Prepositions and Phrasing
Sentence
Construction

Verb Tenses
The tense of a verb tells you when a person did something or when something
existed or happened. In English, there are three main tenses: the present, the past,
and the future.
Being able to express yourself correctly means being able to use these accurately.
BEWARE!
More than 4 or 5 verb errors in the writing sub-tests will usually result in a grade
lower than B!

The present – subject + present verb + object
The present tense: also called the present simple, or simple present.
Please refer to the following examples to see how it is mainly used:
To describe things that are currently happening, or that are currently or

always the case
o Mark is allergic to peanuts.

o She has low energy because she is anaemic.
o High blood pressure puts you at risk of having a heart attack.
To talk about something that exists or happens regularly
o The patient uses a steroid inhaler to manage her asthma.

o Mr Jones smokes 2 packets of cigarettes per day.
To refer to a future situation in certain cases, and in some subordinate

clauses
o Discharge is on 01/06/2018.
o I will send you the patient’s test results when they are available.

The past – subject + past verb + object
The past tense: also called the past simple or simple past. It is used to talk about
things or situations which happened in the past, that is, before the present time of
speaking or writing.
To refer to an event or situation which happened once and is now finished
o We transferred the patient to our Rehabilitation Ward for ongoing care.

o I extracted tooth 65 due to decay.
To describe a situation that lasted for a longer time in the past but is now
finished
o The patient suffered from back pain in 2015.

o He stayed in the intensive care unit for 6 days.
To talk about an event that happened regularly or repeatedly but is now

over
o I gave the patient analgesics every four hours for 3 days.

The future – subject + ‘will’ + verb + object
The future tense is used to refer to things that haven’t yet happened at the present
time of speaking/writing, but which are due, expected, or likely to occur in the
future.
To give or ask information about the future
o You will need to visit your doctor to get another prescription.
To refer to conditional situations, namely things that will or may happen

if something else occurs
o If you continue with the exercise program, you’ll soon see some benefits.
To make promises, or to state decisions at the time of speaking
o I will send you the pathology report as soon as it is ready.

Task One
Correct the following sentences:
1. His supportive family help with his cooking, cleaning and laundry after his
discharge.
________________________________________________________
2. On 14/07/2018, she do not want to eat as her pain is increased.
________________________________________________________
3. She is happy to keep her baby, but she is still anxious about her future and
refuse to contact her family about her situation.
_______________________________________________________
4. On examination, the patient’s blood pressure is 145/80 and pulse is 88.
_______________________________________________________
5. In terms of her past medical history, she has had a benign lesion in her right
breast, which was treated by lumpectomy five years ago.
_______________________________________________________

Continuous and Perfect Tense
There are two further types of tense: the continuous and the perfect.
Continuous
These tenses (also called progressive tenses) are used to talk about actions that
continue for a period of time. They are formed with the relevant tense of the
auxiliary verb to be and the present participle of the main verb.
The present Mr Smith is making steady progress.

continuous Mr Smith was making steady progress before submitting to
The past continuous a hospital acquired infection.
I am confident Mr Smith will be making steady progress
The future once he overcomes the infection.
continuous
Perfect
Perfect tenses are typically used to talk about actions that are completed by the
present or a particular point in the past or future.
They are formed with the relevant tense of the auxiliary verb to have and the past
participle of the main verb.
The present perfect I have lost 5 kg of weight over the past 3 months.
The past perfect I had lost 5 kg of weight prior to admission to hospital.
The future perfect I will have lost 5 kg of weight by the end of the year.

Perfect Continuous
There is a final set of tenses, which combine features of the perfect and continuous
tenses.
The present Used to talk about how long something has continued up till
perfect continuous now.
Example: I have been smoking for 20 years.
The past perfect Used to talk about something which continued up to a
continuous particular moment in the past but is now completed.
Example: I had been smoking for 20 years before I quit.
Past Perfect represents an action which happened before
another action in the past.
I will have lost 5 kg of weight by the end of the year.
The future perfect Used to talk about something which is expected to end by a
continuous particular time in the future.
Example: By the time I am 50, I will have been smoking for
30 years unless I quit.

Task Two
1. The patient is experiencing left pain for 2 months.
_________________________________________________________
2. John’s condition has deteriorating over the past 3 weeks.
________________________________________________________
3. When the patient presented to me 2 days ago, he already lost his appetite.
________________________________________________________
4. Mrs. Bartley shows limitations in eating, showering and mobilisation and she
is having a speech impairment.
________________________________________________________
5. After two weeks, Mr Taylor has make good progress and now breathing
well on room air.
________________________________________________________

Active vs. Passive Tense
In most contexts you can decide whether you want the subject in the sentence to be
active or passive.
To check your active/passive tense is correct, ask yourself, is the subject doing the
action (active), or are they having the action done to them or for them (passive).
Compare the following active and passive sentences:
1. The doctor prescribed the medication to be taken once daily.

2. The patient was prescribed the medication to be taken once daily.
Simple passive form = ‘be’ verb (in the correct tense) + past participle
Continuous passive form = ‘be verb’ (in the correct tense) + being + past participle
Present perfect form = have/has + been + past participle
Past perfect passive form = has been + past participle

Task Three
1. I am writing this letter regarding your patient, Mr. Caveros, who has been
moved from Melbourne to Sydney.
_________________________________________________________
2. She was informed about the choices of treatment and core biopsy
performed.
_________________________________________________________
3. She will be discharge on 30/05/2017.
_________________________________________________________
4. Over the past 3 weeks, Mr Glum’s mood has been improved.
_________________________________________________________
5. Regular appointments with a GP is organised for her pregnancy checks and

monitoring of her health status.
_________________________________________________________

Verb Tense and Case Notes
Which sentence is correct? Sentence 1 or Sentence 2?

What are the errors in the incorrect sentence?
Case Notes Sentence 1 Sentence 2
Today’s examination: The bald area is 4 cm in The bald area was 4 cm in

Bald area 4 cm in diameter and is located in a diameter and located in a
diameter, left temporal visible area above her left ear. visible area above her left
region. temporal region.
Today’s Plan I suggest a Feliway Plug In to I suggested a Feliway Plug In

Recommend Feliway Plug reduce any stress he may be to reduce any stress he may
In to reduce cat stress suffering. have suffered from.
Today patient temp. Today, the patient’s Today, the patient’s

38.8 C temperature is temperature was 38.8 C.
38.8 C.
Discharge plan Meals on Wheels and a home The social worker is going to
Social Worker to organise physiotherapist visit are being organise Meals on Wheels
Meals on Wheels and organised by a social worker. and a home physiotherapist
physiotherapy. visit.

Time Markers and Tense
There are many time expressions in English and if you get good at noticing them and
using them, they will help you use the correct verb tense.
Overview
Present simple tense • Usually, never, generally,

always, seldom, often
Present continuous tense • At present, now, at the

moment
Present perfect tense • Already, just, yet, never,

recently
Present perfect or present • Since, for

continuous tense
Past simple • Yesterday, last week, two hours
ago, in 2014, on 11/04/2018
Past Continuous • At 10pm, while, yesterday,

when
Past perfect • Before, after

Future simple • Tomorrow, next week, next
year

Task Four
Fill in the gaps for the following sentences:
1. Initially, she _____ to see me _____ 27/12/17, complaining of constipation, and

requesting strong laxatives for her problem. Her weight _____ 54 kg and her vital
signs and physical examination _____ normal. Her diet included 2 spoons of bran
_____ morning.
2. Over the _____ few weeks, Mrs. Olsen _______ unsettled and shown signs and
symptoms of indigestion, tiredness and disturbed sleep. She was given Normison, but
_____ 10.45 pm, her condition had deteriorated.
3. Regarding his social history, he stopped _______ university _____ early 2016. He
is the only child of his parents, who divorced 2 years _____, and now _____ with his
mother.
4. Mark Hanlon should have had an urgent abdomen ultrasound because he was
scheduled to _____ an operation _____ 21/03/18. He _____ sent to our
department _____ 12:55, but unfortunately a patient _____ a cardiac arrest in the
radiology department ____ that moment. Therefore, the procedure______ not
____ completed.

Appendices

Grammar Lecture 2
Lecture 2 Booklet
OET ONLINE
Overview
✓ Sentence Structure
o Simple sentences
o Compound sentences
o Complex sentences
✓ Dependent and Independent Clauses
✓ Relative clauses and relative pronouns
✓ Common sentence construction errors
This resource was developed by OET Online and is subject to copyright  2

Sentence Structure
A complete sentence in English =
subject + verb + it expresses a complete thought.
Simple
Sentences
3 Types of
Sentences
Compound Complex
Sentences Sentences
IMPORTANT! Please note:
• In the OET exam you must use all 3 • There is another sentence type in
of the sentence types above to give English called a compound-complex
yourself the best chance of getting a B sentence, but you don’t need to use
grade. those to get a B grade in the OET
exam.

Simple Sentences
Example: Karen takes Microgynon 30.
• Contain only one independent clause

- this can stand alone because it expresses a complete thought, and it contains a
subject and a verb
• Express only one main idea
• May contain compound (more than one) words or phrases, not additional clauses
BEWARE: Don’t get tricked by sentences like the one below!
Example: Karen takes Microgynon 30 and daily folic acid 400 mcg.
o This is also a simple sentence

o The example above is not a compound sentence because it contains only
one clause, not two clauses.
o Therefore, it is a simple sentence, but it lists more than one object. It
contains compound elements, like ‘and’, which is a coordinating (FANBOYS)
conjunction.

Compound Sentences
Example:
Karen takes Microgynon 30 for contraception, and she has never been pregnant.
• Contain at least two independent clauses

• Express at least two main ideas
• When we join two or more independent clauses (simple sentences) we call
the new sentence a compound sentence
Notice the two clauses:
1. Karen takes Microgynon 30 for contraception.

2. She has never been pregnant.
You could also write the independent clauses like this to show the relationship
between the two sentences:
1. Karen takes Microgynon 30 for contraception.

2. In addition, she has never been pregnant.
Please note:
•The sentences above are simple sentences, not compound sentences.

How do we join independent clauses to form a compound sentence?
We get some glue!
There is only one type of glue that you can use to form compound sentences:
coordinating conjunctions (FANBOYS).
Example:
or
Karen takes Microgynon 30 for contraception, and she
nd has never been pregnant, but she hopes to be one day.
or
ut
How many clauses does the sentence
r above contain?
et

What about ‘However’, ‘In addition’, and ‘Therefore’?
Aren’t they conjunctions?
The simple answer is NO. As shown earlier, these are sentence connectors, so they
should only be used to show the relationship between ideas at the sentence level.
For example: Karen has never been pregnant. However, she hopes to be one day.
BEWARE: Don’t forget the punctuation!
✓ The job of correctly applied punctuation is to make your writing easier to

read, and to make the meaning clearer.
✓ In compound sentences, you should place a comma BEFORE the
conjunction. It is incorrect to place it after the conjunction.
✓ In certain situations it is okay to exclude the comma. For example, if the
compound sentence is short enough that there will no confusion for the
reader. If in doubt, include it!

Compound Sentences: Error Correction
1. The size of the lesion was 10mm x 10mm x 5mm, which had an even border,
and brown base.
_________________________________________________________
2. The patient was complaining of lack of appetite and general fatigue, his
physical examination was normal.
_________________________________________________________
3. Mrs. Martin does not drink alcohol and smokes cigarettes.

_________________________________________________________
4. The patient regularly attends the dentist also cleaning and scaling were
performed every 6 months.
_________________________________________________________
5. On examination, her blood pressure was 110/70, and was making good
progress.
_________________________________________________________
6. In term of Mary’s rehabilitation, dressing of wound is required for the
following month and should not do impact activities.
_________________________________________________________
7. Her appetite has increased and usually eats 3 full meals per day.
_________________________________________________________

Complex Sentences
Complex Contain at least one independent clause and one dependent

Sentences (subordinate) clause.
Both clauses should contain a subject and a verb, even the dependent
clause.
When we join one independent clause and one dependent clause, we

call the new sentence a complex sentence.
Example: Although Karen discontinued her use of Microgynon 30, she still had
trouble falling pregnant.
Notice the two clauses:
1. Although Karen discontinued her use of Microgynon 30.

Incomplete dependant clause
2. She still had trouble falling pregnant.

Complete independent clause.
Please note:
•Subordinate means that something is not equal to something else, which is an easy way
to remember that the dependent clause can’t stand on it’s own because it isn’t a
complete sentence. It isn’t complete because it doesn’t express a complete thought.

We use a different type of glue to join clauses in complex sentences. In complex
sentences we use: subordinating conjunctions NOT coordinating (fanboys)
conjunctions.
Here is a list of common subordinating conjunctions for you to use in your writing.
after, although, as, because, before, even though, if, since, that, though, unless,
until, when, where, who, whenever, whereas, wherever, which, while
•Using another type of conjunction won’t create a

complex sentence. You may end up changing the
meaning of your sentence, or making it difficult for the
BEWARE reader to understand, which will result in your
sentence being incorrectly constructed and you losing
marks. Oh no! 
•You can tell if a sentence is a compound sentence or a

complex sentence by looking at the glue. Coordinating
(fanboys) conjunction = compound sentence.
TIP Subordinating conjunction = complex sentence. So
remember FANBOYS = compound and you won’t go
wrong! ☺

Clauses: Linking Words
Medical conditions are complex and progress is not on always routine and straight
forward. Hence, a referral is often required so another health professional can take
over the care. You will need to demonstrate the ability to summarise this complexity
clearly through the use of complex sentences with dependent and independent
Dependent clauses are introduced with subordinating conjunctions. Common
examples in medical writing include:
despite, is spite of, in order to, due to, as well as, because of, although, even
though,
Please note:
•You can always change the order of clauses in this type of complex sentence. If the
dependent clause comes first, make sure you use a comma to separate the clauses!
Grammar Rules
due to/in spite of/because of + noun
despite//as well as + gerund
Example 1 : Due to the possibility of pain, a local anaesthetic was used to numb
the region. (Reason)
Example 2: Despite using a local anaesthetic, the patient complained of pain.
(Contrast)
Example 3: In order to numb the region prior to treatment, a local anaesthetic

was used. (Purpose)
although/ even though + dependent clause
because
Example 4 : Although a local anaesthetic was used, the patient complained of

pain. (Contrast)

Clauses: Error Correction
1. Despite of the treatment he had intermittent pain and also had swollen joint
_________________________________________________________
2. Recently, James stopped exercising because muscle soreness.
_________________________________________________________
3. John is suffering from depression due to his wife passed away.
_________________________________________________________
4. Although, he was in considerable pain he refused to take analgesics.

_________________________________________________________
5. She is being discharged to a Woman’s Shelter due to her conditions are

stable.
6. Since the stroke, Mr Grant’s condition has been progressing slowly. He has
mild depression and is reluctant to mobilise as well as he requires full
assistance with activities of daily living.
_________________________________________________________
_________________________________________________________
_________________________________________________________

Relative (Adjective) Clauses
These are dependent clauses where the entire clause performs the job of an
adjective. They modify (describe) nouns and pronouns.
They are divided into two types:
• defining relative clauses
• non-defining relative clauses
Adjective clauses are usually introduced by words known as relative pronouns and
relative adverbs. These types of pronouns and adverbs are referred to as relative
because they relate the clauses to the words they modify.
Relative Pronouns: that, who, whom, whose, which
Relative adverbs: where, when, why
Example 1: Example 2:
I am writing to refer this patient who She grazed both palms of her hands
recently tested positive for chlamydia. which were cleansed with antiseptic.
TIPS
✓ Relative pronouns and relative adverbs differ slightly from conjunctions. They
not only connect the clauses, but also act as the subject or object of the verb in
the relative clause.
✓ The main ones in use in a referral letter are who to refer to a person, i.e the
patient, and which to refer to an object such as a procedure or a medical
condition.
✓ Keep the relative pronoun close to the noun it represents.

Defining relative clauses:
These are used to add important information. The sentence would have a different
meaning without the defining relative clause. We don’t use commas in defining relative
clauses.
Example 1: I’m going to attend to the patient who needs a right-knee x-ray.
Non-defining relative clauses:
These add extra information to the sentence. If we take the clause out of the
sentence, the sentence still has the same meaning.
Example 1:
The patient, who was referred by Doctor Ho, needs a right knee x-ray.
TIPS
Non-defining relative clauses are usually used in written English NOT in spoken English.
You can tell that a clause is non-defining because it is separated by commas at each
end of the clause
John, that had a right knee x-ray, is a regular at this clinic. ✗
John, who had a right knee x-ray, is a regular at this clinic. ✓
Non-defining relative clauses can use most relative pronouns (which, whose etc,) but
they CAN’T use ‘that’, and the relative pronoun can never be omitted

Relative Clauses: Error Correction
1. Socially, her son is her next of kin who is very supportive.
_________________________________________________________
2. She grazed both palms of her hands for which were cleansed with antiseptic.
________________________________________________________
3. His wound was reviewed by the wound nurse and recommended for a
dressing change twice weekly.
_________________________________________________________
4. I am writing to refer this 85-year-old widow with good physical health and
living alone who is presenting with symptoms suggestive of dementia possibly
due to early Alzheimer's disease for your full memory assessment to confirm
the diagnosis.
_________________________________________________________
_________________________________________________________
_________________________________________________________
5. Based on patient log, he was late 42 minutes late, which we had to cancel his
appointment
_________________________________________________________

Common Sentence Construction Errors
Trying to do too much (Overwriting)
Remember, don’t fall into the mistake of trying to write overly long, incredibly
complicated sentences to demonstrate this fact to the OET Centre because it isn’t
required in order for you to achieve a B grade in the exam, and what might happen is
that the reader gets lost trying to follow everything that you want to say and in the end
they lose the entire point of the sentence you’ve written, and maybe you do to.
Clarity is the key. Clear communication written using a variety of sentence structures. Got
it? Good! ☺

Sentence Fragments
These are groups of words missing important information, which means they no longer
express a complete thought.
They may be okay to use in spoken language, but they are definitely not okay in formal
medical writing.
Note: To get a B grade in the exam, you must write in complete sentences.
There are 4 possible reasons why your group of words is a fragment and not a sentence:
1. It is missing a subject.
Subjects tell whom or what sentences (or clauses) are about. If the subject is missing, the
reader is left wondering who or what performed the action.
Is now suffering from liver abscess. ✗
The patient is now suffering from liver abscess. ✓
2. It is missing a verb.
Verbs tell what the subject did or is. If the verb is missing, the reader is left wondering
what the subject did or what the subject is.
Another point to consider that the government encourages doctors to prescribe

generic brands. ✗
Another point to consider is that the government encourages doctors to

prescribe generic brands. ✓

3. It is missing a subject and a verb.
If both the subject and verb are missing, then the reader doesn’t know whom the
sentence is about or what they did or what they are.
I consulted Kate on 10/06/15 after referred by her general practitioner. ✗
I consulted Kate on 10/06/15 after she was referred by her general practitioner.
4. It is missing verb (subordinate) clause.
Remember, dependent clauses contain a subject and a verb, but they don’t express
complete thoughts, so you can’t use them on their own. They must be added to
independent clauses.
Where he demonstrated good oral hygiene. ✗
Nathan’s first appointment was last month, where he demonstrated good

oral hygiene.✓

Run-On Sentences
These are sentences that contain two or more independent clauses that are not
separated with a comma and coordinating (fanboys) conjunction, or a full stop.
Example:
Mr. Thurlow is an 18-year-old young man with features of autism he attends a

special needs school where I regularly see him. ✗
Mr. Thurlow is an 18-year-old young man with features of autism. He attends a

special needs school where I regularly see him. ✓
Mr. Thurlow is an 18-year-old young man with features of autism, and he

attends a special needs school where I regularly see him. ✓
Comma Splices
When independent clauses are joined by only a comma, we call them comma splices.
Example:
His speaking abilities are very good but he does not really listen, you may not
receive an answer to your question. ✗
His speaking abilities are very good but he does not really listen, so you may
not receive an answer to your question. ✓
His speaking abilities are very good but he does not really listen. Therefore, you
may not receive an answer to your question. ✓
His speaking abilities are very good but he does not really listen. You may not
receive an answer to your question. ✓

Notes

Grammar Lecture 3
Lecture 3 Booklet
OET ONLINE
Pluralisation
Making a mistake with noun pluralisation will result in a singular/plural error.

There are three main types:
Types of noun pluralisation

• Attributive nouns
• Uncountable nouns
• Countable noun in general terms
Attributive nouns
Incorrect Correct
While wearing the cast, please encourage

toes movement.
I have attached a medications list with

this letter.
John lives in a 3 bedrooms house.
I am writing to refer Mr Thompson, a

34-years-old man who presented to the
hospital with a 3 days history of chest
pain.
This resource was developed by OET Online and is subject to copyright Ó 2

Uncountable nouns
Incorrect Correct
I provided the patient with some advices.
If you require further informations,

please do not hesitate to contact me
Educations on a healthy diet and lifestyle

modifications were provided.
The treatment was delayed due to lack

of staffs.
Countable noun in general terms
Incorrect Correct
These days, less money is spent on the

development of new drug.
A baby requires adequate nutrition in

order to meet the developmental
guideline.
A wound will heal more quickly if proper

hygiene practice is followed.
These days, less money is spent on the

development of new drug.
A doctor is encouraged to prescribe

generic brand because of the reduced
cost.

Word Order
When we make a sentence in English, we normally follow this order:

Subject + Verb + Object + Adverb of Place + Adverb of Time + Adverb of
reason.
Or in short:
Who + What + Where + When + Why
Example
The patient was admitted to hospital on 15/03/18 due to head trauma.
Important The verb and the object of the verb normally go together. We do
Notes not usually put other words between them.
We usually say the place before the time.
We can put the time at the beginning of the sentence.
When there is more than one verb, we usually put an adverb

after the first verb. i.e The patient was recently admitted to
hospital due to head trauma.
BEWARE OF EXCEPTIONS
A lot of adverbs are put before main verbs: always, also, sometimes, possibly, probably,
often, seldom, never, hardly ever, almost, still, definitely, certainly, even, only.

Task 1: Word Order Sentence Correction
1. I would be grateful if you could assess urgently condition Mr. Moustafawy’s.
______________________________________________
2. The patient was recently admitted to hospital on 15/03/18 due to head trauma.
______________________________________________________________
3. Also, I advised the patient to take his medication regularly.
______________________________________________________________
4. Jack Smith is due to discharge on 03/08/18 from hospital.
______________________________________________________________
5. The patient also has been advised on the importance of regular check ups.
______________________________________________________________

Determiners
(a/the/an/his/my/your/all/both)
Determiner Adjective Noun modifier Head noun

Her left foot
All compound fractures
All her injuries
Both her legs
1. My all friends live in Australia.
______________________________________________________
2. He attempted suicide with deep cuts to his both wrists.
______________________________________________________
3. The patient presented with ulcers on his both feet.
_________________________________________________________
4. We treated the his infection with antibiotics.
______________________________________________________

Adverbial Phrases
What is a phrase?
A phrase is a group of words, without a subject and verb, that when put together
function as a particular part of speech. It is not a complete sentence and it is not a
complete thought.
The Adverbial Phrase
The adverbial phrase can be used in referral letters to provide information such as a
time, place, context, emphasis or mood in the sentence which is to follow and it is
commonly separated by a comma.
Context On examination, there was slight tenderness in the right fornix.
Date On today’s visit, the patient was pale and sweaty.
Emphasis Please note, the patient is allergic to penicillin.
Mood Unfortunately, the patient’s condition has worsened.
Note, mood or comment adverbs, such as unfortunately or regrettably convey

the health professionals concern toward the patient’s condition and are
therefore effective ways of displaying empathy.

They are mostly commonly places at the beginning or end of the sentence. A comma is
required if the adverbial phrase is at the beginning of the sentence.
Purpose Adverbial Subject Verb Object/compliment Adverbial

Phrase Phrase
Context During the made steady progress
hospitalization patient
Date On review there was no improvement in
today, her condition
Frequency She attends physiotherapy on a
regular
basis.
Emphasis Please note, the is allergic to penicillin.
patient
Mood Unfortunately, the has deteriorated over the
patient’s past 3
condition weeks.

Task 2: Adverbial Phrases Sentence Correction
1. Initial examination revealed, severe tendonitis in the left elbow.
________________________________________________________
2. Please note that, this medication must be taken once daily in the morning.
(Advice to patient)
________________________________________________________
3. Unfortunately, this couple have no children and require a personal carer for
support.
_______________________________________________________
4. On examination revealed a 2 X 2cm non-tender hard lump with ill defined

margins.
_______________________________________________________
5. It is important to note that this patient is allergic to penicillin. (Information to

another health professional)
_______________________________________________________

Task 3: Adverbial Sentences Gap Fill
Word Bank
unfortunately, based on the information above, initially, on the next visit, at night,
furthermore, for the last five days, however
Dr. Peta Cassimatis

1414 Logan Road
Mt Gravatt, 4222
Dear Dr. Cassimatis,
Re: Mrs. Alison Martin
Thank you for seeing Mrs. Martin, a 28-year-old married teacher who has been
presenting with a clinical picture consistent with schizophrenia.
Mrs. Martin has an unremarkable medical history and she denies any substance
abuse. ________, she has a family history of schizophrenia controlled by
Rispirodene. She is a mother of 2 children and lives with her husband’s family.
________, I saw Mrs. Martin 4 weeks ago when she complained of poor health,
tiredness and lack of motivation at work. ________, she reported worsening of her
symptoms and her situation at work and family was causing her stress and frequent
headaches. Due to a provisional diagnosis of depression and/or schizophrenia,
diazepam 10 mg ________ was prescribed. ________, on today’s visit, her
symptoms have not improved. ________, her husband reported that she has had
hallucinations and delusions ________.
________, I believe Mrs. Martin is experiencing schizophrenia for which she

requires specialist care. I would be happy to share her clinical management and
please do no hesitate to contact me if you require any additional information.
Yours sincerely,
Dr Ivan Henjak

Vocabulary Building & Collocation
What is collocation?
Collocation is the way two or more words fit together naturally to native speakers
of English. The best way to increase your range of expression and to improve your
collocation is to read widely.
Strategies for successful word choice
Be careful when using words you are unfamiliar with.

Look at how they are used in context and check their dictionary definitions.
Be careful when using the thesaurus.

Each word listed as a synonym for the word you’re looking up may have its own
unique associations or shades of meaning. Use a dictionary to be sure the synonym
you are considering really fits what you are trying to say.
Always read your own writing.

Getting into the habit of reading your own writing and checking for mistakes or for
phrases that don’t sound right is one of the best ways to improve.
If you have trouble finding errors on the page, try reading your writing out
loud at…a…slow…pace.
You can do this alone or with a friend, colleague, etc. When read out loud, your
written words should make sense to both you and other listeners. If a sentence
seems confusing to you, or to them, rewrite it to make the meaning clearer.

Important questions to ask yourself:
• Am I sure what each word I use really means? Am I positive, or should I look
it up?
• Have I found the best word or just settled for the most obvious, or the
easiest, one?
• Am I trying too hard to impress my reader?
• What’s the easiest way to write this sentence? (It may be easier to answer
this question by trying it out loud. How would you actually say it to someone
when speaking?)
Correct the following sentence:
He needs your assist on the issues of his accommodation, visa renew, a letter for
his university as well as referring to programs for stop smoking and weigh loss.
___________________________________________________________

Online Learning Tools
You can speed up the process with some useful online learning tools.
Collocations
Free Online English Collocation Dictionary
Collocations are word combinations that tend to occur together. Using common
collocations helps your English sound more natural. You can look up medical English
words and see their common collocations on the free Ozdic.com site.
Examples
Foboko example sentence dictionary
When you are learning new words, it’s helpful to see many example sentences of the
word to put it into some kind of context. Foboko lets you type in a word and see
many example sentences. It even has informal words and slang. You don’t get
definitions or explanations of the word, but if you are looking for example sentences
it’s a great place to check.
Dictionaries
Cambridge Learner’s Dictionary,

A great English learner’s dictionary. The language is simplified for intermediate level
learners. You can search for idioms and phrasal verbs too. Just type the phrasal verb
or idiom in the search box and the results pop right up for you.
Longman dictionary of contemporary English online.

Features: British and American English, collocations, phrases, and a wealth of other
useful information. There are also clickable pronunciation links so you can hear what
the words sound like.
Oxford Learner’s dictionaries online.

Features: British and American English, synonyms, grammar, and many other
resources. You can click to hear the pronunciation of words too.

Translations
Reverso
Reverso is an incredibly powerful tool you can use to learn English. You can
get definitions and example sentences of English words and phrases. Reverso does
translation too, currently between Dutch, English, French, Spanish, German, Italian,
Russian, Portuguese, Chinese, Arabic, Hebrew, and Japanese.
Collins English Dictionary

On the Collins dictionary main page you can look up words and get translations in
many languages. There is also a thesaurus to help you build your vocabulary and find
just the right word you are looking for. There are audio examples of many of the
words so you can hear the pronunciation.

Register
Formal, Informal and Neutral Language
Register often refers to the degree of formality of language, but more generally, it
refers to language used by a group of people who share similar work or interests,
such as health professionals.
Informal Register:
I will appreciate it if you can give more care…
Formal Register
I would appreciate if you could provide ongoing care…
Key points for the OET Exam:
• Make sure to use a relatively formal tone because medical correspondence is

considered to be a professional style of letter.
• Informal language such as that used in an email, spoken language and SMS
texting style is not appropriate.
• Show awareness of your audience by choosing appropriate
words and phrases. For example, if you are writing to
another health professional, technical terms and, possibly,
common abbreviations may be appropriate. However, if you
are writing to a parent or a group of non-health professionals, use non-
technical terms and explain things carefully

Examples:
Casual Formal Casual Formal
asks for requests think believe
say state get receive
said stated got received
like including like such as
get become so very
got became about regarding
so therefore a bit slightly
don’t do not thanks thank-you
but however told reported
really greatly sad depressed
kid child till until
kids children lots a lot of

Task 4: Register Sentence Correction
1. I will really appreciate it if you can take over the care of Bailey ASAP.
_________________________________________________________
2. There was evidence of poor oral hygiene, carious lesions and active
periodontal disease too.
_________________________________________________________
3. I have requested some more blood tests.
_________________________________________________________
4. The patient hasn’t eaten anything since they came to hospital.
_________________________________________________________
5. I’m writing to refer this patient, a 42-year-old man who……..
_________________________________________________________
6. She was given general advise for softening her stool, like changing her dietary
habit but she was non compliance.
_________________________________________________________

7. There are several things which can be done to reduce the risk of infection
like taking a shower in the morning, using separate towels and washing hands
thoroughly before and after meals.
_________________________________________________________
8. Today, Mrs Jones told me she had experienced nausea and headaches for the
last 3 days.
_________________________________________________________
9. I am writing to request a follow-up for this patient.
_________________________________________________________
10. Examination revealed that his vitals were normal.
_________________________________________________________
11. Her BMI was 28 and all the rest of the examinations were normal.
_________________________________________________________
12. She had had termination of pregnancy 10 years back.
_________________________________________________________

KISS method: Keep It Simple Stupid!
What?
What that means is don’t be a risk taker and to aim to be clear and direct and
remember
§ Avoid informal expression
§ Be objective and factual
§ Avoid repetition
§ Avoid too much detail
§ Focus on the forest, not the trees
§ The outcome is more important than the journey
See overleaf for a case notes example.

Case Notes
Recent Nursing Notes (Nina Sharman)

15/02/18
• Chest infection. Keflex 500mg QID x 7 days
26/02/18
• Occasional cough & episodes of SOB with ↑RR
27/02/18
• Sporadic throat clearing after eating yoghurt
20/03/18
1700 hrs
• Episode of choking on a piece of food (? food not chewed properly). She
suddenly turned blue, grabbed the throat with both hands and coughed. The
piece of solid food was removed.
1710 hrs
• Nursing assessment after treatment
o Pulse 110 BPM
o BP 120/70 mmHg
o RR – 22/min
o T– 37.1° C
o BSL – 6.0 mmol/L
1800 hrs
• No complaints
o Pulse – 88 BPM
o BP – 115/70 mmHg
o RR – 16/min
o T- 37.0 °C
o Skin: normal colour.
o Hospital visit not required

Example Summary
Weak Summarising Technique
Yesterday, Nina had episode of choking on a piece of food, and most probably it was
not chewed properly. She suddenly turned blue. I immediately grabbed her throat with
my both hands and let her cough it out. Eventually, piece of solid food was taken out.
Vital signs were taken after she had rested, and everything was fine with blood
pressure 115/70, pulse 88 BPM and temperature 37° C. Her skin colour was normal.
82 words
• Too long
• Resembles spoken English
• Content errors
• Missing articles
Good Summarising Technique
Nina had an episode of choking on a piece of food yesterday, which was possibly due
to not chewing her food properly. Fortunately, after removing the piece of solid food,
her vital signs returned to normal and a hospital visit was not required.
43 words
• Clear & concise
• All relevant details stated in summary form
• Uses complex sentences to summarise in original language
• Correct use of articles

Phrasal Verbs
A phrasal verb is a phrase that’s made up of a main verb and usually a preposition but
sometimes an adverb, and sometimes both.
Phrasal verbs change the meaning of the original verb. Typically, their meaning is not
obvious from the meanings of the individual words themselves.
Example: His lung cancer was brought on by years of smoking.
The example above has nothing to do with bringing anything to anywhere or anything
being on any surface. It actually means to cause something to happen. So in the example
above, he caused his lung cancer by smoking for many years.
Example: She has broken out in a rash.
In this example nothing has been broken. It means that the rash appeared suddenly.
If you’re not sure whether a phrase is a phrasal verb or just a verb used with a
preposition, try looking it up. Most dictionaries have entries for phrasal verbs, so look
the phrase up to be sure. It might seem difficult to learn them all, but many of these
phrases become natural with repetition and practice.

Four types of phrasal verbs:
1. Some phrasal verbs are intransitive. An intransitive verb cannot be followed

by an object. For example: She passed away last night.
2. Some phrasal verbs are transitive. A transitive verb can be followed by an

object. For example: He got over his cold in a few days.
3. Some transitive phrasal verbs are separable. The object is placed between the
verb and the preposition.
Correct: The cause of his condition can be traced back to his poor diet. (not
separated and used in monologues)
Also correct: We can trace it back to his poor diet. (separated and used in
dialogues)
Correct: I would appreciate it if you could take over the care of this patient.
(not separated and used in monologues)
Also correct: I would appreciate it if you could take it over. (separated and
used in dialogues)
Incorrect: We can trace back it to his poor diet. TIP: You must put the object
between the verb and the preposition if the object is a pronoun.
4. Some transitive phrasal verbs are inseparable. The object is placed after the
preposition.
Correct: We have run out of medical wipes.

Incorrect: We have run medical wipes out of.

Task 5: Phrasal Verbs Gap Fill
Complete the sentences using the phrasal verbs below.You will have to change the
forms of some of the verbs to make the grammar of the sentence correct.
1. The nurses are _______________her very well.
2. He was _______________ mucus last night.
3. Since she had the accident she _______________ using crutches.
4. She was advised to _______________ smoking.
5. The swelling has started to _______________.
6. She became worried when the girl started _______________blood.
7. He was _______________ by a blow to the head.
Phrasal Verbs Word Bank

bring up, cough up, knock out, get around, give up, go down, look after
Visit this page for a range of useful phrasal verbs and useful expressions:
https://oetonline.net.au/mod/page/view.php?id=529

Final Tips and Hints
ü Read as many examples as you can find of formal medical correspondence as

it will contain a rich source of suitable language for your referral letters.
Keep a list of preferred expressions handy so you can use them at the
appropriate times. This will help with preposition use with phrasal verbs as
well.
ü Be realistic and try not to be in a hurry. Remember, learning and improving

language is not like studying for your health profession. It is more like learning
a musical instrument, like the piano! J You learn by using a little every day
for prolonged period of time, not by studying a lot at once, or cramming.
ü Get into the habit of self-correction. Write for at least 10 minutes a day 5
days a week, and read what you have written. If you can’t see your errors, try
reading your writing aloud. Sometimes you can hear what you can’t see.
ü Remember that you are writing for a reader, not for you. Whenever you write
anything, READ IT BEFORE you send it or let anyone else read it.
ü When submitting writing tasks for correction, at the beginning, focus on

accuracy rather than time limits and write to the best of your ability, double-
checking each sentence before submitting. As you learn the patterns and
progress, you can focus on writing within the time limits as well.
ü Finally, be patient with yourself and remember that improving your grammar
(and other language areas) is a marathon, not a sprint. It takes daily practice
and usually time.
J Good Luck!
OET Online
Grammar Lecture 1
Virtual
Classroom
1
Grammar Booklet: Virtual Classroom Lecture 1
Verb Tenses
In English, there are 12 different verb tenses that we use to express actions
happening at different times. Being able to express yourself correctly means
being able to use these accurately.
Beware!
More than 4 or 5 verb errors in either the writing or speaking OET sub-tests will
usually result in a C grade!
Study Hint
Review the worksheets and complete the
quizzes found in the Grammar and Vocabulary Clinic.
This resource was developed by OET Online and is subject to copyright 

Website: http://oetonline.net.au Email: steve@oetonline.net.au
2

3
Time Markers
For (present Since (Present Ago (Simple In/on (simple

perfect) perfect) Past) past)
 The patient  The patient  The patient  The patient was
has had has had had a stroke diagnosed with
hypertension hypertension 10 years ago. hypertension in
for 10 years. since 2004. 2004.
 The patient was

diagnosed with
hypertension on
12/7/14.
Handy Hint: Do not use “from” as a time marker.

i.e “The patient has had hypertension from 2010”. (Incorrect)
Verb Tense – Error Correction
1. The patient was diagnosed hypothyroidism since 2010.
 ________________________________________________________
2. He is smoking 2 packs of cigarettes a day for past 25 – 30 years.
 ________________________________________________________
3. She has underwent triple coronary bypass surgery on 10/08/14.
 ________________________________________________________
4. Paul has been having cystic fibrosis since birth.
 ________________________________________________________

4
Signal Words with Verb Tense
Tense Signal Words

Present Simple always, every …, never,
normally, often, seldom,
sometimes, usually
Present Continuous at the moment, just, just now,
now, right now
Past Simple yesterday, … minutes ago, in
1990, the other day, last …
Past Continuous when, while, as long as
Present Perfect Simple already, ever, just, never, not

yet, so far, until now
Present Perfect Continuous all day, for 4 years, since 1993
Past Perfect Simple already, just, never, not yet,

once
Past Perfect Continuous for, since, the whole day, all day

5
Passive Vs Active
Form: be verb + past participle
Active Passive (Focus Passive (Focus on the subject)

on Person)
 The patient took  The patient was  Oxycontine was given to control the
oxycontine to given oxycontine pain.
control the pain. to control the
pain.
 The patient had  The patient was

arthritis in diagnosed with  Arthritis was diagnosed in 2002.
2002. arthritis in 2002.
 The patient has

an appointment  An appointment with Dr Smith has been
with Dr Smith  The patient will scheduled for 10am tomorrow.
at 10am be seen by Dr
tomorrow. Smith at 10am
tomorrow.
Passive Vs Active – Error Correction
1. Mrs. Heart had the flu vaccination on 16/05/14 and Mylanta prescribed
for her.
 ________________________________________________________
2. The patient was presented to hospital on 12/03/16.
 ________________________________________________________
3. A liver scan was confirmed a 10 cm liver abscess.
 ________________________________________________________
4. The patient admitted to hospital yesterday.
 ________________________________________________________

6
Transferring from Case Notes Error Correction
Case Notes Incorrect Sentence Correct Sentence

Medical History Regarding her medical history, she
COPD since 2002 has been diagnosed with COPD in
2002.
Lost 5kg after operation. Poor She also has a poor appetite and
appetite. has been losing 5kg after the
operation.
…petit mal epileptic seizure Noah had an episode of petit mal
(trigger hyperventilation?...) epileptic seizure, which may be
triggered by hyperventilation
during the dental procedure.
10/06/15 On 20/06/2013, her trunk joint
Rotation: <¼ of normal range range motion reduced and the
Pain at end of the ROM of range is similar to the first visit.
flexion, right side flexion, right
rotation, and extension
20/06/15
Same as in the first visit

7
What is a Sentence?
• Has a minimum of one main clause (a subject and verb).

• Expresses a complete thought.
• Three types: simple, compound and complex sentences.
• Begins with a capital letter, ends with a full stop, or (?) or (!).
IMPORTANT INFORMATION: In the OET exam you must use all 3 sentence
types to give yourself the best chance of getting a B grade.
Simple Sentences (subject + verb minimum)
• Use a simple sentence when you want to be clear and direct.

• If you have an important point, using a simple sentence amongst
other sentences can be very effective.
• Notice how there is only one main verb group.
Example: Mr Rash has red spots.
A simple sentence can also be referred to as an independent clause. It is

referred to as "independent" because, while it might be part of a compound or
complex sentence, it can also stand by itself as a complete sentence.

8
Subject-Verb Agreement 1
Singular and plural nouns as subjects
• Nouns are divided into countable and uncountable nouns.

• Uncountable nouns are always treated as singular (e.g., advice,
information, blood…).
• Countable nouns can be singular (e.g., a suture, a threadworm, a
tooth...) or plural (e.g., the sutures, threadworms, teeth…).
• Whether a subject is singular or plural will affect the choice of
verb.
Subject-verb agreement: Basic Rule
• Subject–verb agreement means that the subject (noun) of a clause

and the verb of the same clause go together.
• The main verb of a clause is not affected by the object.
• The basic rule states that a singular subject takes a singular
verb, while a plural subject takes a plural verb.
• Verbs do not form their plurals by adding an ‘s’ as nouns do.
TIP: In order to determine which verb is singular and which one is plural, think
of which verb you would use with he or she (singular verb) and which verb you
would use with they (plural verb).
Another hint is that you can only ever have one ‘s’, not two.
Example verb: look and looks. Which one is the singular form? Ask yourself
which one you would use with she? “She looks”. Therefore, looks is singular.
“They look” – look is plural.
SO: Threadworms look like fine pieces of cotton thread…

(Plural subject = plural verb)
BUT: A threadworm looks like a fine piece of cotton thread…

(Singular subject = singular verb)

9
Compound Sentences (subject + verb (+ object);

FANBOYS, subject + verb (+ object))
• Use compound sentences when the ideas in both clauses have equal
importance.
• The subject for each clause is different and each clause can function
as a complete sentence.
• Notice how there are two main verb groups because there are two
clauses.
• The independent clauses in a compound sentence are separated by a
comma. The comma precedes the coordinating conjunction. A
common error is to place the comma after the conjunction.
Linking words: (coordinating conjunctions) ‘FANBOYS’ = for, and, nor, but, or,
yet, so
A compound sentence refers to a sentence made up of two independent clauses

(or complete sentences) connected to one another with a coordinating
conjunction. Conjunctions show the relationship between the two ideas.
• Example: Mr Rash has red spots, so he was advised to apply

calamine lotion.
IMPORTANT TIP: Never start a sentence with And, But or So in writing – this
is a grammatical mistake. Use In addition, However, and Therefore, instead.

10
Compound Sentences – Error Correction
1. Mrs. Black is a widow and a resident at Golden Pond Retirement Village,

has a son in Warwick.
 ________________________________________________________
2. The parents say that immunizations were given at birth to both their
children, but no records to prove that.
 ________________________________________________________
3. Mrs. Martin does not drink alcohol and smokes cigarettes.
 ________________________________________________________
4. Her blood pressure was 175/95 and took Normison 1 tablet and 2
Panadol at 10 pm.
 ________________________________________________________

11
Tips and Hints
• When choosing correct verb tense always ask yourself: When is the action
(or effect of the action) taking place?
• Always base your verb tense usage from the perspective of NOW. For
example, anything that started and finished before now requires you to
use past tense.
• Whenever you write anything, including a text message or an email, READ
• Write for at least 10 minutes a day 5 days a week, and read what you have
written. If you can’t find your errors, try reading your writing aloud.
Sometimes you can hear what you can’t see.
• Read a little every day. Reading helps with writing.
• Be patient with yourself and remember that improving your grammar (and
other language areas) is a marathon not a sprint. It takes time and daily
practice.
• You learn and improve language by using it NOT studying it, so start using
it today.
• If you follow this advice you won’t get worse, so why not try it?
• Good luck!!!

OET Online
Grammar Lecture 2
Virtual
Classroom
1
• Subject-verb agreement is most important with the present tenses –
simple, continuous and perfect (e.g., go/goes, is/are/am).
• It happens with some verbs in the future tenses (is going/are going).
• These rules do not apply to the past tenses. The verbs are the same for
all subjects in the past except for the be-verb (was/were).
See if you can complete the following sentences with the correct verb
forms and singular or plural nouns:
Neither the patient nor the doctor _____ prepared for the tumour found in the
patient's brain on MRI last Tuesday.
There _____ wounds found on both legs on physical assessment when he went
to the emergency room.
Physical therapy, as well as acupuncture, ____ recommended.
Diverticulosis, otherwise known as "diverticular disease," ____ the condition of

having diverticula in the intestines.

2
Common types of errors:
MISTAKEN SUBJECT
Words and phrases between the subject and verb distract from the real subject
of the sentence.
Example: I am writing to refer this patient who I suspect is suffering from

rheumatic fever and need urgent admission. INCORRECT The correct verb is
needs as the real subject here is patient.
MULTIPLE SUBJECTS JOINED BY ‘EITHER … OR’/’NEITHER … NOR’

The verb agrees with the subject nearest it (ie, the noun after ‘or/‘nor’).
Example: Neither the patient’s husband nor her family members were informed
about the diagnosis. = The verb agrees with the subject nearest it.
BUT
Example: Neither the patient’s family members nor her husband was informed
about the diagnosis. = The verb agrees with the subject nearest it.
MEASURED ITEMS
Example: 100g of X was administered = The verb is singular because the
measured item was administered as a
single unit.
TIP: There are also words that may be mistaken to be plural because they end
in ‘s’ in the singular form. For example: measles; mumps

3
Subject-Verb Agreement – Error Correction
1. Measles are spread through transmission from the nose, throat, and
mouth of someone who is infected with the virus.
 ________________________________________________________
2. 50g of glucose were given orally and blood was collected 1 hour later for
glucose estimation.
 ________________________________________________________
3. I believe that teeth 65 and 54 needs to be extracted.
 ________________________________________________________
4. Studies has shown that Lovan works as well as Prozac does.
 ________________________________________________________

4
Gerunds and Infinitives

• A gerund is the –ing form of a verb that functions the same as a noun
and so can be the subject or object of a verb.
For example: “Studying is fun.” In this sentence, “studying” is the

gerund. It acts just like a noun.
• The infinitive form of a verb appears either as the basic form or with the
word “to.”
For example, you can say “I might study tonight” or “I like to study.” In
this sentence, “to study” is the infinitive.
• It can be difficult for English learners to know whether to use a gerund or

an infinitive after a verb.
• Unfortunately, there are no real rules for you to follow for this grammar.
• You need to read a lot in order to practice this grammar point.
Look at the example sentences below and decide which one is correct?
Sentence One: I suggested seeing the physio.
Sentence Two: I suggested to see the physio.
ANSWER: Sentence One, with the gerund, is correct. “I suggested seeing the
physio.” Why? You can only use a gerund after the verb “suggest.”
Look at the word “like.” You can say “I like studying” or “I like to study.” Both
sentences have the same meaning, and you can use either a gerund or an
infinitive after “like.”
However, what about the word “enjoy.” We can say, “I enjoy studying.” But
we cannot say, “I enjoy to study.” Why? Only a gerund can follow the verb
“enjoy.”
Therefore, some verbs are followed by gerunds, some verbs are followed by
infinitives, and some verbs can be followed by gerunds or infinitives. That’s why
you have to memorise them.

5
Gerunds and Infinitives

Tip 1: You almost always find a gerund after a preposition. For example, “He is
afraid of going to the dentist.” In this sentence “of” is the preposition and
“going” is the gerund. You cannot say “He is afraid of to go.” An infinitive
cannot be the object of a preposition, only a gerund can. You could say, “He is
afraid to go,” but in this sentence, the preposition “of” is gone.
Tip 2: When you are talking about an activity, you usually use a gerund. For
example, “I stopped smoking 3 years ago.”
Only a gerund can follow these verbs:

admit, appreciate, avoid, be used to, can’t help, can’t stand, complete,
confident, consider, delay, deny, discuss, dislike, end up, enjoy, feel like,
finish, get used to, give up, go on, have, difficulty, have problems, have
trouble, imagine, it’s no use, it’s worthwhile, keep, look forward to, mention,
mind, miss, postpone, practice, recall, report, recommend, resist, resume, risk,
quit, stop, suggest, understand, work at
Either a gerund or an infinitive can follow these verbs, and there is no

change in meaning
advise (requires object with infinitive), begin, continue, hate, intend, like, love,
prefer, start
Either a gerund or an infinitive can follow these verbs, but the meaning
may change:
forget, remember, stop
An infinitive follows these verbs:

afford, agree, aim, appear, arrange, ask, attempt, be able, care, choose, dare,
decide, deserve, demand, expect, fail, happen, have, hesitate, hope, hurry,
learn, manage, mean, offer, plan, prepare, pretend, promise, refuse,
remember, seem, stop, volunteer, wait, want, write
A noun or pronoun and an infinitive follow these verbs

advise, allow, ask, cause, challenge, command, convince, expect, forbid, force,
hire, instruct, invite, order, pay, permit, program, remind, teach, tell, urge,
want, warn

6
See if you can complete the following sentences with the correct verb
forms:
I have advised the patient _________ the prescribed medication twice a day.
(take)
I recommended _______ the entire course of antibiotics to increase their

effectiveness. (finish)
Mrs. Spleen is confident ______ her own medication at home after discharging
from hospital. (take)
I am writing ________ information about Mr. Morris, a 45-year-old carpenter,

who requires ongoing care from a dietician regarding his diet and lifestyle.
(provide)
Betty was sick for years until one day she decided _________ smoking. (stop)
Now she feels so much better. I'm so glad that she has chosen ________ that
terrible habit. (give up)

7
Complex Sentences
• Use complex sentences when you want to express complex information

and relationships between ideas.
• A complex sentence is made up of an independent clause and one or
more dependent clauses.
• A dependent clause is similar to an independent clause, or complete
sentence, but it lacks one of the essential elements that would make it a
complete sentence. Therefore, dependent clauses cannot stand alone as
a sentence; they must be added to an independent clause to form a
complex sentence.
• Notice below how there are two main verb groups because there are at
least two clauses.
Dependent clauses begin with subordinating conjunctions. Some of the most

common subordinating conjunctions are: after, although, as, because, before,
even though, if, since, that, though, unless, until, when, where, who,
whenever, whereas, wherever, which, while
Example 1: Unless she follows the recommended physiotherapy program.

Incorrect.
Example 2: The patient will continue to experience lower back pain unless
she follows the recommended physiotherapy program. Correct.
The 3 types of dependent clause:
Noun Clause – usually placed after a verb, but sometimes an adjective
• A dependent clause that functions as a noun in a sentence is called a

noun clause.
• A noun clause performs the same function as a noun in a sentence.
Example: The patient was advised that they should quit smoking and improve
their diet.
The patient was advised to quit smoking and improve their diet.

8
Complex Sentences
Adjective Clause (Relative Clause)
• A dependent clause that functions as an adjective in a sentence is called

an adjective clause.
• An adjective clause works like adjective an in a sentence.
• The function of an adjective is to modify (describe) a noun or a pronoun.
Similarly, an adjective clause modifies a noun or a pronoun.
Example: I am writing to refer this patient, who is due to be discharged today.
Adverb Clause
• A dependent clause that functions as an adverb in a sentence is called an

adverb clause.
• An adverb clause, like an adverb, modifies a verb, adjective clause or
other adverb clause in a sentence.
• It modifies (describes) the situation in the main clause in terms of time,
frequency (how often), cause and effect, contrast, condition, intensity (to
what extent).
The subordinating conjunctions used for adverb clauses are:
Time: when, whenever, since, until, before, after, while, as, by the time, as
soon as
Cause and effect: because, since, now that, as long as, so, so that,
Contrast: although, even, whereas, while, though
Condition: if, unless, only if, whether or not, even if, providing or provided
that, in case
Example: Although her condition has improved, she is still very weak.

9
Complex Sentences – Error Correction
1. I first saw Mrs. Gumm at my clinic last week, she urgently needed a new
partial denture.
 ________________________________________________________
2. Socially, her son is her next of kin who is very supportive.
 ________________________________________________________
3. He can become aggressive when his needs are not met that is a real
concern due to his size and strength.
 ________________________________________________________

10
Common Sentence Errors

Common errors that are frequently found in students’ writing are:
• sentence fragments
• run-on sentences
• lack of meaning
Sentence Fragments
A sentence fragment is missing some of its parts. There are three main reasons
why a sentence may be incomplete.
1. Missing subject
Incorrect: Presented with a complaint of smaller sized first lower incisors.
Correct: The patient presented with a complaint of smaller sized first lower
incisors.
2. Missing verb
Incorrect: She needs to be monitored for oxygen usage and dressing change for
her abdominal wound three times a week.
Correct: She needs to be monitored for oxygen usage and requires a dressing
change for her abdominal wound three times a week.
3. Incomplete thought
Incorrect: As a result of the information mentioned above.

Correct: As a result of the information mentioned above, she requires urgent
admission to your hospital.
Sentences beginning with words like so, as, because, who, which, that, are
often incomplete.

11
Run-on sentences
A run-on sentence occurs when two simple sentences are incorrectly joined:
The results of all investigations were within the normal range she received
Augmentin 500mg.
TIP: There are two ways to fix a run-on sentence:
1. Use a joining or linking word such as and, but, or, nor, for, so, yet.
Example: The results of all investigations were within the normal range, and
she received Augmentin 500mg.
2. Make two separate sentences.
Example: The results of all investigations were within the normal range. She
received Augmentin 500mg.
OR
Example: The results of all investigations were within the normal range. In
addition, she received Augmentin 500mg.
Lack of Meaning
• Ensure that each sentence you write has clear meaning in English. It must
be fully understandable when read.
• If you are not sure if your sentence has clear meaning in English, think
about re-writing it in a simpler and clearer way that you (and the reader)
can fully understand.

12
Useful Websites
https://courses.oetonline.net.au/course/view.php?id=22
http://www.studyandexam.com/learn-english.html
http://www.english-grammar-revolution.com/sentence-structure.html
http://web2.uvcs.uvic.ca/elc/studyzone/330/grammar/index.htm
http://a4esl.org/q/h/9901/cw-svagreement.html
http://a4esl.org/q/f/z/zy57mbw.htm
http://tls.vu.edu.au/sls/slu/FOR_STUDENTS/CALM%20Resources/Resources_
Health_Engineering_and_Science/PBL%20Engineering/webbja/

OET Online
Grammar Lecture 3
Virtual
Classroom
1
Articles
The articles in English are: a/an/the and zero. The main things to consider
when choosing an article are whether or not the noun is countable or
uncountable and whether it is definite or indefinite.
• Countability means that the noun can be made plural, e.g.

smoker/smokers.
• Whether a noun is definite or indefinite depends on whether you and
your reader or listener both know what you are referring to.
Indefinite article: a/an (singular only)

1. To introduce a singular, usually unknown, countable noun.
Example: A patient walked into the room. (I don’t know this patient.)
2. One of many, no one in particular.
Example: Can you open a window? (There are 4 windows.)
Example: Would you like an apple? (I have many apples. Would you like
one?)
3. For measurements and rates.
Example: She requires physiotherapy treatment three times a week.
(3 times during 1 week)
Example: Four times an hour. (4 times during 1 hour)
4. To say what a thing or person is.
Example: Measles is a contagious disease. (Defines measles as contagious)
Example: She is a dentist. (Defines the woman’s job)
TIP: Using ‘an’ depends on the pronunciation of the first letter of the noun, not
the spelling.

2
Articles
Definite article: the (either singular or plural)
1. Use ‘the’ when it is clear which thing we mean.
Example: The patient is due to be discharged today.
(We know the patient we are referring to)
Example: The wound on his left foot is healing well.
(It is a specific wound in a specific location)
2. When there is only one.
Example: The nursing director will address your complaint.
(There are no other nursing directors at the hospital)
Example: She is currently the only doctor on duty.
(There are no other doctors on duty)
3. To refer to a specific organisation or location
Example: The World Health Organisation has a detailed definition of health.
(Specifies the organisation)
Example: He has been transferred to the intensive care unit.
(Specifies the location)
Zero article (no article)
1. Before abstract nouns used in a general sense.

Example: Health is of paramount importance.
(health in general)
Example: Medical science is progressing at an astonishing rate.
(Some specific branches of medical science may not be
progressing quickly, but overall, it is.)
2. With most proper nouns.
Example: Bart’s Hospital is almost 900 years old.
Example: Ritalin can cause anxiety and insomnia.
Example: GlaxoSmithKline’s headquarters are at 980 Great West Road,
Brentford, Middlesex.
3. With bed, institutions (e.g. hospital, university, court, prison), & places of
worship when these are used for their primary purpose.
Example: The patient is in hospital.
cf. The journalist is at the hospital to interview her.
Example: The patient is in bed.
cf. The patient sat on the bed to put his socks on.
Example: He goes to mosque every day.
cf. He went to the mosque to find his friend.

3
Articles
With diseases or medical conditions

Example: The patient is suffering from depression.
Example: Hypertension increases the risk of heart disease, stroke and death.
5. With possessives (my, your, his, her, its, our, their, whose) or
demonstratives (this that, these, those).
Example: The next appointment has just called to cancel, but your 10:15
appointment is in the waiting room. Shall I show this patient in?
The next patient after that is not until 11:00.
TIPS:
• If you have a singular countable noun, then you must use an article in
almost every case.; sometimes a/an, and sometimes the.
• We do not need an article if a noun is plural or uncountable and it is not
definite.
Example: Women generally live longer than men.
• If you don’t know whether a noun is countable or not, check in an English
dictionary.
Complete the following paragraphs with the correct article or NO

article:
_____ above named patient presented at my clinic today with _____ complaint
of spontaneous pain, localised swelling around _____ right third molar,
drainage, _____ foul taste and _____ difficulty swallowing.
_____ initial examination on 10/10/14 revealed that he was undergoing _____
orthodontic treatment. In _____ following years, cleaning and fluoridation have
been done on _____ regular basis. _____ consultation with _____ Dr. Perl
about his wisdom teeth was done on 13/12/17. He recommended that _____
extractions be postponed due to _____ proximity of _____ nerve to _____ root
formation. Please note, _____ patient experienced vasovagal syncope during
_____ first administration of _____ local anaesthetic.

4
Prepositions
• Prepositions are short words that usually stand in front of nouns or

pronouns and sometimes in front of gerunds. They are never used in
front of verbs but can be used after verbs to make phrasal verbs (e.g.,
The patient passed out).
• A preposition is used to show direction, location, or time, or to introduce
an object.
• They are never used in front of verbs but can be used after verbs to
make phrasal verbs (e.g., The patient passed out).
• Some verbs, adjectives and nouns have particular prepositions with
them; dependent prepositions
• Prepositions are a difficult area of language to fully master because there
are hardly any rules for choosing a preposition.
• The best ways to learn prepositions are by looking them up in
a dictionary, reading a lot in English and memorising useful phrases.
TIP: One simple rule to remember is for + noun, and to + verb.
Here are some commonly used prepositions with their uses and some examples:
On
Used to express the surface of something. Example: He has a rash on his arm.
Used to specify days and dates. Example: She was admitted to hospital on 12/05/18.
Used to indicate a part of the body. Example: She has a wound infection on her leg.
At
Used to point out specific time. Example: Two Panadol tablets were given at 10pm.
Used to indicate a place. Example: He was first seen at my clinic two years ago.
In
Used for unspecific times during a day, month, season, year. Example: She will be
discharged in 1 week.
Used to indicate a location or place. Example: He has no family in the UK.
Used to indicate a shape, colour, or size:

Example: Examination revealed a considerable increase in the swelling.
Used to indicate a belief, opinion, interest, or feeling:

Example: In my opinion, he will need ultrasound-guided drainage.
Used to express while doing something:

Example: She participated in our physiotherapy program.
5
Here are some other commonly used prepositions:
For- Used to indicate the use of something or giving a reason
From- Used to show the origin or direction of something
Of- Used for belonging to, relating to, or connected with
To- Used to indicate the place, person, or thing that someone or something
moves toward, or the direction of something
With- connected to something and near something; using something
Prepositions – Error Correction
1. He has 2 standard drinks each on a night.
• ________________________________________________________
2. She had tenderness over the spine and the muscles her right side.
• ________________________________________________________
3. Mrs. Watego was alert but complaining of pain on her feet.
• ________________________________________________________
4. She insisted on more medications being prescribed to her mother.
• ________________________________________________________
5. He has been referred the doctor as the physiotherapist.
• ________________________________________________________
6. She has been my patient of 5 years.
• ________________________________________________________
6
Vocabulary, Phrases and Expressions
LEARNING VOCABULARY
• English has the largest vocabulary of any language. Depending on counting

methods, it has nearly one million words. The reason it has so many words
is due to words from Latin and Greek, from French, and from languages of
countries colonised by England.
• An educated native speaker of English knows around 20,000 word families.
The average English language learner knows less than 5,000 word families.
It is very important, therefore, for you to build your vocabulary using
proven methods.
• It is vital that you:

o Read. Reading is one of the best ways to learn new vocabulary because it
exposes you to a variety of language.
o Review newly recorded vocabulary at least 4-5 times (e.g., within 24
hours, the next day, 2 days later, 1 week later).
o Test out new words and phrases in speaking and writing. Get a native
speaker to check and correct you whenever possible.
o Use an English dictionary to help you, but also make sure that you learn
common collocations.
COLLOCATIONS
When words are used together regularly, rules are formed about their use, not
only for grammatical reasons, but because of the association. ‘Signs and
symptoms' appear in that order because of collocation. They are always in that
order and to put them the other way around seems wrong.
Other examples of collocation:

X make research √ conduct research
X large medical history √ significant medical history
X hard pain √ sharp pain
Whenever you learn vocabulary, make sure to learn words in their common
groups. A dictionary is a good source for collocations.
For example, you know the word health, but perhaps you are not exactly sure
what words go with it, or how to use it in a sentence. It’s a noun, but you want
to know what adjectives go with it. Did you know it can also be an adjective
itself?

7
Vocabulary, Phrases and Expressions

COLLOCATIONS
Let’s have a look in the Cambridge Online dictionary and see what help we can get:
You can also go to other dictionaries or go to an English passage about health (a

health-related journal article) and see what collocations there are, and build your
vocabulary that way. You could also use a resource devoted to collocations, like FLAX.
PHRASES
A phrase is a group of words that belong together by meaning and does not
contain a subject + verb combination. A phrase cannot stand alone – it needs
to be part of a sentence. You can learn phrases by reading and memorising
them, and then by adding them to your writing.
Vocabulary, Phrases and Expressions – Error Correction
1. With regards to his medical history,
• ________________________________________________________
2. I would be greatly appreciate if you could review this patient.
• ________________________________________________________
3. She has a definite family history of breast cancer.
• ________________________________________________________
4. He has sign and symptoms suggesting of schizophrenia.
• ________________________________________________________
5. Mrs. Moan presenting with complain of lower back pain.
• ________________________________________________________

8
Useful Websites
Articles
http://www.flinders.edu.au/slc_files/Documents/Yellow%20Guides/Articles.pdf
Prepositions
http://proeurasiamedwriter.com/Writing_Resources/pickingproperprepositions.html
Dependent prepositions
https://courses.oetonline.net.au/mod/page/view.php?id=529
Grammar & Vocabulary Clinic

https://courses.oetonline.net.au/course/view.php?id=22&section=3
Learners’ dictionaries
http://dictionary.cambridge.org/
http://oxforddictionary.so8848.com/
Collocations
http://flax.nzdl.org/greenstone3/flax?a=fp&sa=collAbout&c=collocations&if=flax
http://www.ozdic.com/
http://www.just-the-word.com/
Final Tips and Hints

• Learning and improving language is not like studying for your health
profession. It is more like learning a musical instrument. You learn by using
a little every day, not by studying a lot at once.
• Whenever you write anything, including a text message or an email, READ

• Write for at least 10 minutes a day 5 days a week, and read what you have
written. If you can’t find your errors, try reading your writing aloud.
Sometimes you can hear what you can’t see.
• Read a little every day. Reading helps with writing and speaking.
• Be patient with yourself and remember that improving your grammar (and
other language areas) is a marathon not a sprint. It takes time and daily
practice.
Good luck!!!

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Grammar Lecture 1

CONTINUOUS AND PERFECT TENSE 9

ACTIVE VS. PASSIVE TENSE 12

TIME MARKERS AND TENSE 15

This resource was developed by OET Online and is subject to copyright © 2

✓ Learning and improving a language is not the same as studying to be a health

Key Areas to Focus on to Improve Your Writing

Makes sure you focus on these 4 areas first:

Articles & Vocabulary

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This resource was developed by OET Online and is subject to copyright © 4

Please refer to the following examples to see how it is mainly used:

To describe things that are currently happening, or that are currently or

o Mark is allergic to peanuts.

To talk about something that exists or happens regularly

o The patient uses a steroid inhaler to manage her asthma.

To refer to a future situation in certain cases, and in some subordinate

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Please refer to the following examples to see how it is mainly used:

To refer to an event or situation which happened once and is now finished

o We transferred the patient to our Rehabilitation Ward for ongoing care.

o The patient suffered from back pain in 2015.

To talk about an event that happened regularly or repeatedly but is now

o I gave the patient analgesics every four hours for 3 days.

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Please refer to the following examples to see how it is mainly used:

To give or ask information about the future

o You will need to visit your doctor to get another prescription.

To refer to conditional situations, namely things that will or may happen

To make promises, or to state decisions at the time of speaking

o I will send you the pathology report as soon as it is ready.

This resource was developed by OET Online and is subject to copyright © 7

Correct the following sentences:

2. On 14/07/2018, she do not want to eat as her pain is increased.

4. On examination, the patient’s blood pressure is 145/80 and pulse is 88.

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The present Mr Smith is making steady progress.

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This resource was developed by OET Online and is subject to copyright © 10

Correct the following sentences:

1. The patient is experiencing left pain for 2 months.

2. John’s condition has deteriorating over the past 3 weeks.

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Compare the following active and passive sentences:

1. The doctor prescribed the medication to be taken once daily.

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Correct the following sentences:

3. She will be discharge on 30/05/2017.

4. Over the past 3 weeks, Mr Glum’s mood has been improved.

5. Regular appointments with a GP is organised for her pregnancy checks and

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Which sentence is correct? Sentence 1 or Sentence 2?

Case Notes Sentence 1 Sentence 2

Today’s examination: The bald area is 4 cm in The bald area was 4 cm in

Today’s Plan I suggest a Feliway Plug In to I suggested a Feliway Plug In

Today patient temp. Today, the patient’s Today, the patient’s

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Present simple tense • Usually, never, generally,

Present continuous tense • At present, now, at the

Present perfect tense • Already, just, yet, never,

Present perfect or present • Since, for

Past Continuous • At 10pm, while, yesterday,

Past perfect • Before, after

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1. Initially, she _ to see me _ 27/12/17, complaining of constipation, and