Including articles: How to write more accurately for the OET

In relation to grammatical errors, the most common omission students make relates to two of the most popular, and yet often overlooked, words in the English language “a/an” and “the”. Despite the popularity of the aforementioned words in regular writing, they are almost never actually included in the case notes that candidates must use in order to write their referral/discharge letters, this is because the case notes are written in note form where it is common to omit articles. However, if candidates do not correctly use them in their letters, they will find their scores negatively affected, so let’s have a look at some ways we can ensure we are using them and are using them correctly.

Step 1: Check your nouns

We only ever use articles with a noun or noun phrase, so when you’re asking yourself “Do I need to use a or the here?” You should be asking yourself that question in relation to some sort of noun. For example, if you have the sentence: “Patient presented with severe bruises.” You can see that there are two nouns involved: “patient” and the noun phrase “severe bruises”. Only with these sorts of words will you need to use an article. Which do you think might require an article in this case? Why? (Answers given in Step 2).

-Are they singular or plural?

“A/An” can only be used with singular nouns, such as “doctor” or “disease”, so if a noun is in its plural form, “doctors” or “diseases”, it cannot be used. “The” can be used with both singular and plural nouns. So, if a noun is plural or uncountable, it will take either the or no article.

-Are they countable or uncountable?

“A/An” can only be used with countable nouns; namely, nouns which can be counted (e.g: One doctor, two doctors; one disease, two diseases). “A/an” cannot be used with uncountable nouns, nouns which can’t be counted, such as information or anxiety (you can’t say one information, two informations or one anxiety, two anxieties for example, as to do so would be grammatically incorrect). Again “the” can be used with both countable and uncountable nouns. So, if a noun is uncountable, it will take either the or no article.

 

Step 2: Are we being general or specific?

This is an important question because using the indicates that we are referring to something specific, whereas using a or no article at all indicates a focus on something more general. Let’s go back to the previous sentence: “Patient presented with severe bruises.” Are we writing about a specific patient here? Clearly the answer is yes. We are not just writing about any patient, we’re referring to the patient who presented with severe bruises, so we should use the in order to show that we’re being specific. But what about severe bruises, are we being specific here? At this stage, no. We don’t know exactly where the bruises are or anything else about them, as a result we do not use an article with this phrase. The correct sentence would therefore be: “The patient presented with severe bruises.” Correctly indicating what is specific: the patient, and what is general: severe bruises.

Join one of our OET course packages (starting at just $49)in order to get high quality practice and feedback from one of our OET UK teachers by clicking here:

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Step 3: Are we mentioning something for the first or second time?

This is another important question for articles because if we’re mentioning something for the first time we are unlikely to use “the”. For example with the noun phrase staph infection in the following sentence: “The patient is presenting with a staph infection” a is used because it’s the first time the infection has been mentioned. However, later on in the letter is written: “the infection is now showing signs of healing.” in this case the is used because it’s the second time the infection is being referred to. This is a key distinction between a and the and, logically, it means that you should expect to use more “a”s and the beginning of your letter and more “the”s as your letter progresses. The same is true of course for when you use a plural or uncountable noun, such as in bruises back to our old sentence: “The patient presented with severe bruises.” In this case “bruises” is being mentioned for the first time and is plural so takes no article. However, later on, would be written: “The bruises have begun to show signs of healing.” with the being used because the bruises are being mentioned a second time.

 

Summary:

So, here are the general guidelines in table form:

Article type 

Can be used when… 

Is not usually used when… 

a/an 

noun is singular and countable and when the noun has a general reference and/or is being referred to for the first time 

noun is plural or uncountable or is being referred to for a 2nd time (or more) 

no article 

noun is plural and uncountable and when the noun has a general reference and/or is being referred to for the first time. 

noun is singular and countable and/or is being referred to for a 2nd time (or more) 

the 

noun is singular or plural and countable or uncountable and has a specific reference and/or is being referred to for a 2nd time (or more) 

noun has a general reference and/or is being referred to for the first time 

 

Practice

1. Correct the following article errors.  Why are they errors? 

The patient’s arm was placed in sling. 

    1. I advised the patient that I couldn’t provide a further information on his condition. 
        1. The patient returned to my surgery with further complaint. 
        1. I addressed complaint but the patient was not satisfied. 
        1. I suggest that the patient be referred to psychologist. 

      2. Complete the following referral letter by filling in the missing articles with a/an, no article (-) or the: 

    Re: Ms Anne Hall, DOB 19.9.1965 

    Thank you for seeing Ms Hall, 1.______ 44-year-old secondary school teacher, who is presenting with 2.______two-week history of symptoms of dysphagia for solids, epigastric pain radiating posteriorly to T12 level, and concomitant weight loss. 3._____symptoms follow 4.________ constant course. 

    Ms Hall believes 5.______problem commenced after 6.______ upper respiratory tract infection two weeks ago for which she self-prescribed 7._______ over-the-counter Chinese herbal product with 8._______unknown ingredients. However, she has also recently increased her coffee consumption and takes 9.______aspirin 2-3 times a month. She has a history of dyspepsia (2004), and dermatitis for which she was prescribed oral and topical cortisone. There are no apparent signs of anxiety. She has not smoked for the last 15 years. She drinks socially (mainly spirits), has 10._____ family history of peptic ulcer disease and is allergic to codeine. Her BMI is currently 28.2. 

    My provisional diagnosis at this point is gastro-oesophageal reflux with possible stricture. I am therefore referring Ms Hall to you for further investigation.  

    Thank you for the assessment and ongoing management of this woman. If you require any further information, please do not hesitate to contact me. 

    Yours sincerely 

    Doctor 

     3. Write your own referral letter using case notes from the Swoosh OET VIP group.  Check your use of articles, can you justify them in each case using the rules above? 

    Answers: 

    1. The patient’s arm was placed in a sling. (singular/countable noun) 
    1. The patient returned to my surgery with a further complaint. (singular/countable noun) 
    1. I addressed the complaint but the patient was not satisfied. (2nd reference to “complaint”) 
    1. I suggest that the patient be referred to psychologist. (singular/countable noun) 
    1. I advised the patient that I couldn’t provide (-) further information on his condition (uncountable noun) 

    Re: Ms Anne Hall, DOB 19.9.1965 

    Thank you for seeing Ms Hall, 1.___a___ 44-year-old secondary school teacher, who is presenting with 2.__a____two-week history of symptoms of dysphagia for solids, epigastric pain radiating posteriorly to T12 level, and concomitant weight loss. 3.__the___symptoms follow 4.____a____ constant course. 

    Ms Hall believes 5.__the____problem commenced after 6.__an____ upper respiratory tract infection two weeks ago for which she self-prescribed 7.__an_____ over-the-counter Chinese herbal product with 8.____-___unknown ingredients. However, she has also recently increased her coffee consumption and takes 9.___-___aspirin 2-3 times a month. She has a history of dyspepsia (2004), and dermatitis for which she was prescribed oral and topical cortisone. There are no apparent signs of anxiety. She has not smoked for the last 15 years. She drinks socially (mainly spirits), has 10.___a__ family history of peptic ulcer disease and is allergic to codeine. Her BMI is currently 28.2. 

    My provisional diagnosis at this point is gastro-oesophageal reflux with possible stricture. I am therefore referring Ms Hall to you for further investigation.  

    Thank you for the assessment and ongoing management of this woman. If you require any further information, please do not hesitate to contact me. 

    Yours sincerely 

    Doctor 

    Join one of our OET course packages (starting at just $49)in order to get high quality practice and feedback from one of our OET UK teachers by clicking here:

    For doctors: https://www.swooshenglish.com/oet-packages-doctors
    For nurses: https://www.swooshenglish.com/oet-packages-nurses

     

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