Medicine — Discharge to the GP after a Heart Attack
A doctor discharges a 59-year-old man to his GP after a non-ST-elevation myocardial infarction. The skill being tested is hand-over completeness without over-writing: the new medications, the follow-up actions, and the safety net must all survive, while the minute-by-minute inpatient course is summarised, not transcribed.
Letter type
Discharge
Write to
General Practitioner
Target length
180–200 words
The case notes
Patient: Mr Raymond Okafor, 59 years old, taxi driver
Admission: 5-day admission with central chest pain; diagnosed non-ST-elevation myocardial infarction (NSTEMI)
Procedure: Coronary angiogram + drug-eluting stent to right coronary artery, day 2; uncomplicated
Progress: Pain-free since day 2; mobilising fully; echocardiogram — preserved LV function
Discharge medication: Aspirin 75 mg OD, ticagrelor 90 mg BD (12 months), atorvastatin 80 mg ON, bisoprolol 2.5 mg OD, ramipril 2.5 mg OD
Medical history: Hypertension, ex-smoker (quit on admission), BMI 29
Follow-up: Cardiac rehabilitation referred; cardiology review in 6 weeks; GP to check renal function/BP in 2 weeks
Advice given: Not to drive for 4 weeks (DVLA); dual antiplatelet importance explained
Task: Write a discharge letter to the patient's GP, Dr Helen Pryce, summarising the admission and the ongoing management required in primary care.
Writing task
Write a discharge letter to the patient's GP, Dr Helen Pryce, summarising the admission and the ongoing management required in primary care.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
-
Diagnosis (NSTEMI) and the stent procedure
The GP needs the headline event and what was done to manage future care and medication.
-
The full discharge medication list, especially dual antiplatelet duration
Ticagrelor for 12 months is the single most safety-critical hand-over item — stopping it early risks stent thrombosis.
-
The two follow-up actions for the GP: renal/BP check in 2 weeks
A discharge letter must make the recipient's required actions explicit and time-bound.
-
Driving restriction and cardiac rehab referral
Decision-relevant for the GP and the patient's safety; both belong in the closing.
Leave out
-
Day-by-day inpatient observations
Summarise the course in one line. Transcribing it wastes words and weakens Conciseness & Clarity.
-
Occupation as a stand-alone fact
Only mention the taxi driving if you tie it to the driving restriction; otherwise it is filler.
Criterion in focus · Content
Discharge letters are graded heavily on whether the recipient could safely continue care from your letter alone. Omitting the antiplatelet duration or the follow-up timeframe is a Content failure even if the prose is flawless.
Now write the letter — and find out what is blocking your Grade B
Write a 180–200 words discharge letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.