USING ALTHOUGH & EVEN THOUGH

Some problems with this paragraph starting with a word like Although is problematic because
nd
although sets up the sentence to be a 2 conditional one.
st
nd
This is the 1 condition
This is the 2 condition

E.g. Although it is cold I am going for a walk.

Although I dont like hot spicy food, I will eat some anyway just to please you. Although the house
was very untidy with small rooms, I decided to rent it anyway.
So, the use of although in your writing is not appropriate not the right starting word because
what follows is not a condition, but a statement: they have different reasons such as new
experience, career preparation . You have 3 options: (1) Start this sentence with some other
word, (2) fix up the second part of the sentence, or (3) delete the but (line 5)
And!! I personally have a problem with your use of every individual - this is just nonsense - not all
of us go to college or university - some dont even go to TAFE some just finish their high school and
get a job. What about - - - Although some individuals attend college or university to gain new experiences, some go for career
preparation, increasing their knowledge, and so on.
OR
Individuals attend college or university for different reasons such as gaining new experiences, career
preparation, increasing knowledge and so on.
OR
Although some individuals attend college or university, they have different reasons for doing so such as
.. and so on.
[No but]

Paragraphs re live animals/experiments

Para 1 / Line 3 : Even though
- this is like the word although - sets you up at the start of a
nd
2 conditional sentence. Lets see:
Even though we cannot use all the medicines directly for humans, due to risk of side effects in newly
invented medicines, [now I need the second condition to marry up with the even though at the
start.]
Even though we cannot use all the medicines directly for humans, due to risk of side effects in newly
invented medicines, animals still continue to die in research experiments.

USING RAISE & RISE

raise: v. elevate, lift; excite, arouse; cause, bring about; grow, cultivate
rise: v. stand up, get into an upright position; get out of bed; climb, ascend, move upward; rebel, revolt;
, grow; appear over the horizon; come back to life, return from the dead; puff up, swell; originate in,
begin in
increase: v. enlarge, add to, augment; multiply, heighten, intensify
another difference is that rise is an intranstive verb while raise is a transitive one. increase can be
transitive and intransitive according to the context
from: http://www.usingenglish.com/forum/ask-teacher/73125-raise-rise-increase.html

Lack of articles / lack of noun word / pluralisation of noun / preposition with

continuous tense / using obesity rather than overweight
th

Date: 10 June 2011

I am referring the above patient who is suffering from Cushings syndrome , for assessment and
ongoing management.
The patient is married and has a history of hay fever and colds. She has been attending this clinic for
various ailments since July 2003. She was prescribed vitamin B12 injection for low Hb level due to a
strict vegetarian diet. Two weeks later, her symptoms were unchanged and work-related stress was
suspected. In addition, she was treated with Ventolin for mild asthma.
On review five months later, Serevent and Pulmicort turbuator were commenced as had due to the
side effects of Ventolin.
After returning from overseas in October 2007 she experienced features of allergic rhinitis which was
aggravated by close contact with domestic cats. Subsequently, she was prescribed Zyrtex and also
referred to an Allergy specialist. Two weeks later, she was commenced on a course of
Immunotherapy for her allergic reaction to cat fur.
Four months ago, she complained of failed immunotherapy. Her symptoms have not been recovered
resolved even through they she followed strict hygiene and avoidance of trigger factors for allergy.
Moreover, Stilnox was trialled to help her sleep. for one month s duration.
Today, her sleeping problem, poor wound healing, obesity and depressive mood change are
suggestive of Cushings syndrome.
I would be grateful if you take over further management of Ms Agnostolli.
Yours truly,
th

th

COMMENTS: The letter is dated 10 June 2009 that is the reference point. If the 10 June 2009
is today (last paragraph) what date would you put on ..two weeks later in paragraph 2 /
five months later paragraph 3 /
In Paragraph 4: October 2007 is the reference point so what date is two weeks later ?
Final paragraph: Four months ago would this be March 2009 ???
I think it is really very very very very important that you SPECIFY the PRECISE DATE if it is in the case
study. Dont be vague about it quote the exact date.

USING PARTICIPLE HAD OR HAS / THE ARTICLE THE

I am pleased to refer the above patient, with multiple myloma, for monitoring of her diet plan and
medication.
The patient is a 65 year old retired teacher , divorced with no children. She first attended my clinic on
12.2.2009 complaining of generalised muscle aches and pain for six weeks. She was given
Ibuprofen t.i.d and advised to stop taking Simvastatin.
On review one week later , her pain was persistent all the time, especially at night, however, it resolves
by warm bath. In addition , she had reported loss of
6 kg over two months and was depressed about life. [reported is already past tense so do not need
to double-up by using the past-participle had ]
On review today, Mrs. ____________ is suffering from severe pain and reports that she is drinking
more alcohol. On examination, her BP was 155/90 and her pulse was 88. Skeletal survey and
urinanalysis test were ordered and these confirmed the diagnosis of multiple myloma.

As a divorced elderly lady , who lives alone with no one to take care after her, I believe that she needs
to be visited two times a week to monitor her compliance with the diet plan and medication (
Amitriptyline 25 mg t.i.d). Therefore , I would be grateful if you could visit her at home to
monitor her compliance with the diet plan and medication.
Please do not hesitate to contact me for any further information.
Yours truly,
COMMENTS Overall an excellent letter.
1. Make sure you put in a date
2. Take care not to put past-participles together with a past-tense verb no need for this over kill !
3. Events that are happening here and now On review today and she is drinking more
alcohol. need to be all in the continuous tense. Mrs V____ is suffering from
4. Skeletal is the adjective describing the noun survey - however - urinanalysis is a kind of
what? - a test - so you need to put in that noun word.
Your letter is 18-19 lines long. It is tightly written just the facts which is what the OET Center
want. Well done. Is certainly not too long. If anything its a bit short!
Marg

THIS LETTER HAD MANY PROBLEMS: No date / no specific recipient just the Nursing Centre /
Continuous form of to be / preposition with / singular verb form missing (para 3) /
Adverb and pronoun missing near her / noun form treatment / last sentence was not a
sentence as it lacked subject me
11 March 2011

[Always put in a date]

Palliative Care Nurse

District Nursing Centre
COBURG Victoria 3058
Dear Nurse,
Re: M_______ S ________, 58 year old
I am referring Mrs S______ who will be discharged home after being diagnosed with terminal cancer.
Her cancer is already at the end stage.
Mrs S________ was diagnosed with left breast cancer in 1997. She had a mastectomy in 2004 after
radiotherapy. The patient was in remission from 2004 to 2008 until a carcinoma in her right breast was
detected. This latest cancer has pulmonary secondaries.
Mrs S ________ wishes to die at home with her husband, children and near her eight grandchildren
who also live in Coburg.
Upon discharge Mrs S_______ and her family need your help in four-hourly pressure-area care, daily
sponging, assistance with care and application of Duoderm dressings to a small pressure sore on the
right buttock. Morphine 10mg is required as pain relief. The family needs your help in explaining
preparation of food that Mrs S______ can tolerate (mashed, with fluids).
As you know, in her case the most important treatment is psychological support for her and her family,
and pastoral care from her local parish priest, as she has strong links with her local Catholic Church.
Please do not hesitate to contact me if you require any further information.

AN ALMOST NEAR-PERFECT LETTER FROM SOMEONE WHO THOUGHT THEIR WRITING WAS VERY
SUBSTANDARD. THIS CANDIDATE PASSED THE FEBRUARY 2010 OET TEST !
230 instead of 220 words is not a problem. Anyway this is only 21 lines long. You have written an
excellent letter - clearly worth a B - however, you do occasionally leave out the article a an or
the. Subjects / nouns usually have an article before them . unless they are the generic form ..
otherwise you would be getting an A for a letter like this. I am confident you are going to pass.
rd
23 January 2010
Dear Dr. Smith
th

Re: Mrs L_____ C________ D.O.B 18 April 1955.

Bank Manager

I am writing to refer Mrs C________ ,who is suffering from a Barettes oesphagus and needs a
gastrointestinal assessment for further management (fundoplication).
She initially presented to me on 18.08.2009, complaining of difficulty in swallowing of solid foods.
She also reported discomfort and a burning sensation in the upper abdomen since her early 20s. The
clinical examination was unremarkable except for an increased blood pressure (135/85 mmHg).She
seemed to have dysphagia,due to either hiatus hernia or other organic lesions. She has been smoking
20 cigarettes daily for the past 30 years. She was advised to quit smoking and some life style
1
modifications. Her past medical history includes mild hypertension.
She re-presented on 20.11.2009 with complaints of persistent worsening of her symptoms along
with regurgitation of undigested solid foodstuffs. She was concerned about her weight loss (5 kgs in
2
three months). At her review on 25.11.20009 she reported cough production of clear sputum at
night. At that time, certain investigations were done which were unremarkable except for a biopsy and
3
an endoscopy indicating an oesphagitis and a stricture at 56 cm from incisor teeth showing a small
hiatus hernia. She was diagnosed to have a Barettes oesophagus and was commenced on Gavison
and Omperazole. She was also advised regarding the possibility of an operation if the repeat
endoscopy suggested malignancy. She is an occasional alcohol drinker.
Today, she is asymptomatic and wishes to stop her medications. In my opinion, she needs a further
assessment for an operation.

ARTICLES A AND THE WERE LACKING

I'm writing to refer the above patient, a 35 year old male, who presented today to my surgery with a
large and hard swelling on the right cheek.
The patient has visited me four times, and all were emergency situations. On his first visit, he
complained of pain associated with tooth 46: my radiograph showed periapical infection. I arranged an
appointment with the patient to start root canal therapy but he didn't attend.
On 15.05.08, the above patient presented with pain on the same tooth (46). I wrote a course of
antibiotics for the patient, and arranged another appointment with the patient, but he didn't attend.
Today the patient presented with a large hard swelling on the right cheek. My clinical examination
showed a fistula in the lower right vestibule with pus discharge. The radiograph shows a well-defined
radiolucent area that includes apices of the teeth 45,46 and 47. The pus has been drained using a
1

She was advised to

- quit smoking
and
- some lifestyle modifications
Does this sound right to you? The connecting word
and separates 2 clauses: quit smoking and some lifestyle modifications. If you took out the first clause and this
sentence was She was advised to some lifestyle modificiations what would you have to ADD in this second
clause to make it grammatically correct ??? [I will put MY answer on the next page see if you can work
this out yourselfdont look just yet .]
2
You need production because you are talking about something a noun cough-production
3
The incisor teeth because you have two of them - teeth is already the plural form of one tooth.

needle aspirating syringe.

I'm referring the above patient for curettage of the cyst wall and bone augmentation. Please note that,
the remaining mandible bone needs support and it's currently high risk of mandibular fracture.
and it currently has a high risk of
I have to mention, the patient was recently diagnosed with diabetes.
If you need more information, please do not hesitate to contact me.
Your truly

30 July 2010

Dr Nathan Helliwell
Mental Health Unit
Alice Springs Hospital
NT 0870

Dear Dr. Helliwell,

Re Barbara Marika, 22 years old.
I am writing to refer Mrs. Marika, a patient of mine,
association with domestic violence.

to you. She is having a conversion disorder in

Mrs. Marika is 22 years old, recently married, a smoker (4-5 cigarettes per day), and drinks alcohol (45 beers per day). Her previous medical history is significant for chronic otitis media (4 years old) and
pneumonia (6 years old). She also has a mild degree of deafness. 2 months ago she underwent wound
debridement and skin grafting for an infected wound on her right foot. Both her parents have diabetes
and hypertension. She has no allergies. Please note that Mrs. Marika is not fluent in English.
th

I have seen her on the 12 of July. She was brought in by a community health worker chiefly
complaining of numbness and tingling in her feet of 1 months duration, severe headaches and nausea.
Nothing remarkable was found on examination. The community health worker reported that she Mrs
Marika has a poor home situation and an aggressive husband who bullies her. She was diagnosed to
have tension headache and prescribed mild painkillers. An Advice about healthy life style was also
given.
th

On the 19 of July she came back for a follow up. She was still complaining of the same symptoms plus
a colicky abdominal pain. She also had an attack of chest pain that was associated with shortness of
breath. She admitted inability to do household chores due to lack of concentration. Nothing remarkable
was found on examination. Anxiety disorder was suspected and the plan was family counseling, life
style education and social support.
Today she was brought in by her sister who reports that the patient had a 5 minutes fit (jerky
movement in all limbs, no incontinence, no tongue biting) after a quarrel with her husband. On
examination I found that she had bruises and scratch marks on her face and forearms. However, her
neurological exam was normal. She was given painkillers and advised to use ice compressions. I also
contacted the social worker to arrange for a safe sheltered accommodation.
I think she is having a conversion disorder associated with domestic violence, and I believe she needs
further psychological assessment and psychotherapy.
Please do not hesitate to contact me if you require any further information.
Yours truly,
DOCTOR
*

Not necessary to say a patient of mine as this is self-evident