Occupational English Test

WRITING SUB-TEST: MEDICINE

TIME ALLOWED: READING TIME: 5 MINUTES
WRITING TIME: 40 MINUTES

Read the case notes and complete the writing task which follows.

Notes:

Assume that today’s date is 15 May 2021. You have been Ms Bennet’s GP for two years and have been treating her
recently following her hospitalisation for cardiac problems.

PATIENT DETAILS:
Name: Eleanor Bennet
DOB: 06 Dec 1975 (45 y.o.)
Address: 32 Station Road, Oakville

Social background:
Commercial lawyer – frequent international travel
Divorced – 2 daughters (18 & 16 y.o.)
Children live mainly with children’s father (custody currently contested) – Pt reports extreme
stress re worries about quality of father’s childcare
Since 2019 Óalcohol intake from 10 Ò 40 units/wk; smokes 20 cigs/day
BMI 29 (overweight) – little exercise (gym x1/mth)

Family history: Father died 53 y.o. – heart disease

Older brother – mental health problems (2 suicide attempts in last 12 mths)

Medical history:
08 Feb 2021, 0800 hrs
Heart attack at airport after long-haul flight (pain in jaw, nausea, SOB)
Defibrillator applied by first-aider

08 Feb 2021, 0915 hrs

Emergency hospital admission (Oakville General Hospital)
Balloon-expandable stent applied via groin (arm tried initially, artery too small)

15 Feb 2021 Discharged, 4 weeks off work Ò gradual return to work

Mother moved in to give care. Pt reports Óstress (poor relationship)
Medications/treatment on discharge:
Captopril 50mg 2x/day
Atorvastatin 80mg daily
Referral for cardiac rehabilitation sessions – non-attendance
Counselling given re lifestyle changes

Presenting complaint:
15 May 2021 Side effects of captopril – dizziness and light-headedness, headaches, episodes of diarrhoea
Pt reports stress from side effects
Pt requests captopril discontinuation (side effects) – reluctant to start new meds

Plan: Referral to cardiologist re review of meds and ways to encourage lifestyle changes

Writing Task:

Using the information given in the case notes, write a letter of referral to Dr Banerjee, consultant cardiologist.
In your letter, briefly outline Ms Bennet’s history and treatment so far, requesting advice and a review of her
medication. Address your letter to Dr James Banerjee, Consultant Cardiologist, Sanditon City Hospital, Sanditon.
In your answer:
● Expand the relevant notes into complete sentences
● Do not use note form
● Use letter format
The body of the letter should be approximately 180–200 words.
Dr James Banerjee

Consultant Cardiologist

Sanditan City Hospital,

Sanditan

15 May 2021

Dear Dr Banerjee

Re: Eleanor Bennet, DOB: 06.12.1973

I am writing regarding Mrs Bennet, who has been treated in our clinic due to cardiac problems for
two years. She is being referred to you today and requires your advice about lifestyle changes and a
review of her medications.

On the 8th February, Mrs Bennet was admitted to emergency department after having had a heart
attack due to a long-haul flight. Firstly, a defibrillator was applied and then balloon-expandable stent
was placed. One week later, she was discharged and advised to return to work gradually after four
weeks of recovery time. She was commenced on captopril, 50 mg, twice a day and atorvastatin, 80
mg, daily. She was referred to cardiac rehabilitation sessions, which she did not attend, and informed
regarding lifestyle changes.

Today, Mrs Bennet visited our clinic with signs and symptoms related to side effects of captopril. In
addition to feeling dizzy and light-headed, she had headaches and episodes of diarrhoea. She
reported having increased stress level due to side effects, and as a result, she requested to stop the
captopril. Please note, she is reluctant to a new medication.

Regarding her social background, Mrs Bennet is a lawyer, due to which she travels frequently. As a
result of having a poor relationship with her mother, who is her caregiver, and having worries
regarding her children, she is feeling extremly stressfull. Her alcohol intake has increased from 10 to
40 units per week in the last two year and she smokes 20 cigarettes per day. Please be aware of the
fact that her father died due to a heart disease.

In view of the above, it would be greatly appriciated if you could review Mrs Bennet’s medications
and encourage her regarding her lifestyle changes.
Please do not hesitate to contact me, if you have any queries.

Yours sincerely

Doctor
Dr. James Banerjee

Consultant Cardiologist

Sanditon City Hospital, Sanditon

15 May 2021

Dear Dr. Banerjee,

Re: Eleanor Bennet, DOB: 06.12.1975

I am writing to seek your expertise on the case of Mrs. Eleanor Bennet, whom we've been treating
for cardiac issues for two years. Mrs. Bennet is experiencing side effects from captopril, including
dizziness, light-headedness, headaches, and diarrhea. These side effects have elevated her stress
levels, and she is reluctant to initiate a new medication.

On 8th February, Mrs. Bennet suffered a heart attack following a long-haul flight, leading to
defibrillator use and a subsequent balloon-expandable stent placement. She was prescribed captopril
(50 mg, twice daily) and atorvastatin (80 mg, daily) upon discharge, with a referral to cardiac
rehabilitation, which she did not attend.

It is essential to note her stressful social background as a commercial lawyer with frequent
international travel, her strained relationship with her caregiver mother, and concerns regarding her
children. She also faces challenges like increased alcohol intake and smoking habits. Her father's
history of heart disease is significant.

Given these circumstances, we kindly request a review of Mrs. Bennet's medications and your
guidance on lifestyle changes to better address her current condition.

Please feel free to contact me should you require further details.

Yours sincerely,

[Your Name]