OET Case Notes: Physiotherapy Post-Stroke Rehab Referral (Beginner)
A community physiotherapist writes to a GP following the initial assessment of a 66-year-old one month after ischaemic stroke. A clean beginner referral: a clear functional baseline, a single ongoing concern (mild left-sided weakness with foot-drop risk), and two specific requests. A practical first case before moving to complex neurological letters.
Letter type
Referral
Write to
General Practitioner (GP)
Target length
180–200 words
The case notes
Patient: Mrs Rita Osei, 66 years old
Background: Ischaemic stroke (right MCA territory) 4 weeks ago; discharged home with community physiotherapy
Mobility: Ambulant independently indoors; single-point stick outdoors; manages stairs with one rail
Left-sided weakness: Mild residual left upper and lower limb weakness; gait mildly unsteady at pace
Upper limb: Left hand grip reduced; handwriting slower but functional; no neglect
Ongoing concern: Mild ankle dorsiflexion weakness — foot-drop risk with fatigue; possible orthotic assessment indicated
Home exercise programme: Issued and demonstrated; patient engaged and motivated
Patient goals: Return to driving; resume twice-weekly yoga
OT plan: Requesting GP review for orthotic referral and fitness-to-drive assessment guidance
Writing task
Write a referral letter to Mrs Osei's GP, Dr Paul Mackay, summarising the physiotherapy assessment and requesting review regarding orthotic referral and guidance on return to driving.
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
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The functional baseline — what she can do independently and what she cannot
The GP needs a functional picture to decide on onward referral. 'Mild left-sided weakness' alone is too vague; describe the actual impact on mobility and daily activities.
-
The two specific requests: orthotic assessment and fitness-to-drive guidance
A referral letter must state what action is required. Both requests must be explicit so the GP can act on them independently.
-
The ankle dorsiflexion finding and foot-drop risk
This is the clinical justification for the orthotic referral. Without it, the request appears arbitrary.
Leave out
-
The stroke diagnosis in detail (MCA territory, ischaemic type)
The GP ordered the community physiotherapy — they know the diagnosis. A brief mention for context is fine; a stroke overview is not.
-
The patient's yoga and driving goals as clinical concerns
Goals are useful context for motivation and urgency, but they do not require clinical action from the GP. Include them briefly; do not make them the letter's focus.
Criterion in focus · Content
For a beginner referral, the Content mark comes from selecting the two or three clinical details that justify each request. What does the GP need to grant the orthotic referral? The ankle weakness and foot-drop risk. What do they need to advise on driving? The functional picture and the patient's readiness to ask. Everything else is background.
Now write the letter — and find out what is blocking your Grade B
Write a 180–200 words referral 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.