Few grammar topics cause more confusion in OET Writing preparation than passive voice. Candidates arrive with two contradictory pieces of advice lodged in their heads simultaneously: “Use passive voice — it sounds more professional” and “Avoid passive voice — it’s wordy and weak.”
Both pieces of advice are partially right, and the contradiction is resolved once you understand that clinical writing has specific conventions for when passive voice is appropriate — and when active voice is better.
This post gives you a clear framework for passive voice in OET Writing, with before/after examples across the contexts that appear most frequently in exam tasks.
What Passive Voice Actually Is
Before applying rules, make sure the definition is solid.
Active voice: The subject performs the action.
The nurse administered the medication.
Passive voice: The subject receives the action. The agent (who performed the action) is either moved to a “by” phrase or omitted entirely.
The medication was administered by the nurse. The medication was administered. (agent omitted)
In clinical writing, the agent-omitted form of passive is extremely common — and deliberately so. When documenting that a chest X-ray was performed, the emphasis belongs on the investigation and its result, not on which staff member ordered it.
When Passive Voice Is Correct and Expected in OET Writing
There are specific clinical contexts where passive voice is the standard convention. Using active voice in these contexts can actually sound non-clinical or inappropriate.
1. Clinical procedures and investigations
| ✅ Passive (correct clinical convention) | ❌ Active (sounds non-clinical in this context) |
|---|---|
| “A chest X-ray was performed." | "We performed a chest X-ray." |
| "Blood cultures were taken." | "The nurse took blood cultures." |
| "An ECG was recorded." | "I recorded an ECG." |
| "A CT abdomen was requested." | "I requested a CT abdomen." |
| "Oxygen was commenced at 4L/min." | "I commenced oxygen at 4L/min.” |
The passive voice depersonalises clinical actions — which is appropriate when the focus is on what was done, not who did it. OET Writing rewards this convention under Genre & Style.
2. Medication management
| ✅ Passive (correct) | Active (acceptable but less clinical) |
|---|---|
| “Metformin 500mg was commenced." | "We commenced metformin 500mg." |
| "Furosemide was withheld." | "I withheld furosemide." |
| "IV antibiotics were prescribed." | "The doctor prescribed IV antibiotics." |
| "Analgesia was administered." | "The nurse administered analgesia.” |
3. Referrals, consults, and notifications
| ✅ Passive (correct) | Active alternative |
|---|---|
| ”A referral was made to cardiology." | "I referred the patient to cardiology." |
| "The surgical team was consulted." | "We consulted the surgical team." |
| "The patient’s family was notified." | "I notified the patient’s family.” |
Both active and passive are often acceptable in these contexts. The passive form is more conventional in formal written clinical English.
4. Diagnoses and findings (when confirmed)
| ✅ Passive (correct) |
|---|
| “A diagnosis of Type 2 diabetes was confirmed." |
| "Bilateral pleural effusions were identified on chest X-ray." |
| "A fracture of the right femur was diagnosed.” |
Scope of practice note: When the diagnosis has NOT been confirmed by a doctor, use hedging language regardless of voice: “X-ray findings are consistent with bilateral pleural effusions.” The passive/active distinction is secondary to the hedging requirement.
When Active Voice Is Better in OET Writing
Active voice is preferred in specific sections of the OET letter — particularly where clarity, directness, and reader action are the priority.
1. The Purpose sentence (opening)
The opening sentence must communicate the reason for writing clearly and efficiently. Active voice does this more directly.
| ✅ Active (preferred) | ❌ Passive (weaker for opening) |
|---|---|
| “I am writing to refer Mrs. Santos for urgent respiratory review." | "Mrs. Santos is being referred for urgent respiratory review." |
| "I am referring Mr. Hassan to your care following discharge." | "Mr. Hassan has been referred to your care following discharge.” |
The passive version of the Purpose sentence removes the writer’s agency — which can make the opening feel less grounded and purposeful. Examiners expect the first sentence to be clear and assertive.
2. The closing request
The closing paragraph requests specific action from the recipient. Active voice is more direct and appropriate.
| ✅ Active (preferred) | ❌ Passive (weaker) |
|---|---|
| “I would be grateful if you could review Mrs. Lee at your earliest convenience." | "It is requested that Mrs. Lee be reviewed." |
| "Please do not hesitate to contact me should you require further information." | "Further information can be provided if required.” |
3. Reporting what the patient said or did
When attributing information to the patient directly, active voice is cleaner.
| ✅ Active (preferred) | ❌ Passive (wordy) |
|---|---|
| “The patient reported chest pain on exertion." | "Chest pain on exertion was reported by the patient." |
| "She described the pain as sharp and constant." | "The pain was described by her as sharp and constant." |
| "He denied any history of cardiac disease." | "Any history of cardiac disease was denied by him.” |
The “by the patient” construction is grammatically correct but unnecessarily wordy. In a 180–200 word letter, this wordiness costs Conciseness & Clarity marks.
The Wordiness Trap: Passive Constructions to Avoid
Some passive constructions are not just stylistically weak — they are genuinely wordy and will cost Conciseness marks.
| ❌ Wordy passive | ✅ Concise alternative |
|---|---|
| ”It was found that the patient had a temperature of 38.9°C." | "The patient had a temperature of 38.9°C." |
| "It is noted that she has a history of hypertension." | "She has a history of hypertension." |
| "It can be seen that his condition has deteriorated." | "His condition has deteriorated." |
| "It is hoped that a full recovery will be made." | "Full recovery is anticipated." |
| "It has been brought to our attention that…" | "We have been informed that…” / Just state the fact directly |
| ”Pain was experienced by the patient in the lower back region." | "The patient reported lower back pain.” |
The “It was found that / It is noted that / It can be seen that” constructions are among the most common Conciseness errors in OET Writing. They add 5–7 words to every sentence that uses them — in a 180–200 word letter, this is significant.
Before and After: A Full Paragraph Using Passive Voice Correctly
Scenario: Nurse writing a discharge letter to the patient’s GP following hospitalisation for a COPD exacerbation.
❌ Version with passive voice errors (overuse + wordiness):
It was noted that Mr. O’Brien was admitted on 14 April with a severe exacerbation of his COPD. It was found that his oxygen saturation was 84% on room air on admission. Nebulised salbutamol and ipratropium were administered by the nursing staff. Oral prednisolone was commenced by the doctor. It can be seen that improvement was made by the patient over the subsequent 48 hours. He is now being discharged by us to your care.
Problems:
- “It was noted that” / “It was found that” / “It can be seen that” — all wordy introductory constructions, cost Conciseness marks
- “were administered by the nursing staff” / “was commenced by the doctor” — the “by” agents are unnecessary; the focus should be on the action
- “improvement was made by the patient” — the patient is the subject; use active voice here
- “is now being discharged by us” — awkward; passive with unnecessary agent
✅ Corrected version (appropriate passive use):
Mr. O’Brien was admitted on 14 April with a severe COPD exacerbation, presenting with oxygen saturation of 84% on room air. Nebulised salbutamol and ipratropium were commenced, alongside oral prednisolone. His condition improved significantly over 48 hours, and he is now medically fit for discharge. I am writing to request continuation of his COPD management in the community setting.
What changed:
- Removed all “It was noted/found/seen that” constructions
- Retained passive for clinical actions (nebulised salbutamol were commenced, oral prednisolone) — correct convention
- Switched to active for patient improvement (“His condition improved”) — patient as subject, active voice is cleaner
- Switched to active for Purpose/closing (“I am writing to request”) — direct and clear
- Word count: 93 words → 68 words for the same clinical information
Quick Reference: Passive vs. Active in OET Writing
| Context | Recommended Voice | Example |
|---|---|---|
| Purpose sentence | Active | ”I am writing to refer…” |
| Clinical procedures | Passive | ”A chest X-ray was performed.” |
| Medication management | Passive | ”IV fluids were commenced.” |
| Patient-reported symptoms | Active | ”The patient reported pain.” |
| Clinical findings | Passive | ”Consolidation was identified.” |
| Referrals / consults made | Either | ”A referral was made to…” / “I referred…” |
| Closing request | Active | ”I would be grateful if you could…" |
| "It was noted that…” constructions | Avoid | Rewrite directly |
Passive Voice and the Criteria It Affects
Understanding which OET criteria passive voice decisions affect helps you prioritise:
| Criterion | How Passive Voice Affects It |
|---|---|
| Genre & Style /7 | Incorrect avoidance of passive in clinical action contexts sounds non-clinical; penalised |
| Conciseness & Clarity /7 | Wordy passive constructions (“it was noted that”, “by the patient”) cost marks |
| Language /7 | Grammatically incorrect passive formation (e.g., wrong auxiliary verb) costs marks |
| Content /7 | Indirect effect — wordiness from passive can push the letter over 200 words, forcing you to cut content |
The highest-priority criterion for passive voice decisions is Conciseness & Clarity. Wordy passive constructions are the most common way candidates lose marks in this criterion beyond content selection issues.
The Simple Test for Every Passive Construction
Before using a passive construction, ask two questions:
-
Is the agent (the person doing the action) important to state? If yes, use active voice or passive with “by [agent]”. If no, use agentless passive.
-
Is this construction adding words without adding meaning? “It was noted that the patient had a fever” adds five words and no meaning compared to “The patient had a fever.” Delete it.
If a passive construction fails either test, rewrite it.
Practice: Identify the Passive Voice Error
Here is a practice sentence. Identify the problem and write the correction before reading the answer.
“It was observed by the attending nurse that the patient’s wound had become infected, and it was decided that antibiotics would be prescribed.”
Problems: “It was observed by the attending nurse” — wordy passive with unnecessary agent. “It was decided that antibiotics would be prescribed” — double passive construction, imprecise.
Correction: “The nurse observed signs of wound infection. IV antibiotics were prescribed.” — 10 words instead of 28, same clinical information, cleaner structure.
Passive voice is not a problem to eliminate — it’s a tool to use deliberately. Clinical letters use it correctly for procedures, medications, and investigations. They use active voice for Purpose, patient reporting, and closing requests. They avoid it when it creates wordiness without clinical precision.
Getting this right is part of what makes an OET letter read like a genuine clinical document — and that’s exactly what the Genre & Style and Conciseness criteria are looking for.
Practice with criterion-specific feedback to find out if passive voice is affecting your score at /blog/oet-writing-practice-test-free.
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