OET Writing Past Perfect: How to Use It to Clarify Medical Timelines

Download the companion PDF with drills on the past perfect for OET Writing: Past Perfect: Mini Guide + Exercises

OET Writing Past Perfect: Why It Matters...

The past perfect helps you show the sequence of events in the past (what happened before something else). In OET Writing, this is invaluable for summarising medical histories and case timelines without listing every date. Use it to keep your letter concise, logical, and easy to assess.

Quick Definition (Zero Jargon)

Form: had + past participle (e.g., had discovered, had been confirmed).
Use: To refer back to an earlier past event while you’re already talking about a past time.

When to Use Past Perfect in OET Writing

• Summarising early history: “Mr Smith had noticed a lesion two weeks earlier…”
  
• Referring back while starting later: Begin at a clinically important point, then step back once: “On 30 June, biopsy confirmed BCC; he had first noticed the lesion in mid-June.”
  
• Clarifying sequence without dates: “Antibiotics were commenced after cultures had been taken.”

Past Perfect vs Past Simple (At a Glance)

• Past simple = a past event (“The dermatologist removed the carcinoma on 5 July”).
  
• Past perfect = an earlier past event relative to that past point (“…after it had been confirmed by biopsy”).

Mini Timeline Example (OET Style)

Events: 13 Jun lesion found → 14 Jun GP referred → 28 Jun biopsy → 30 Jun results confirmed BCC → 5 Jul removal.

Chronological (okay but repetitive):
“On 13 Jun the patient found… On 14 Jun he visited… On 28 Jun… On 30 Jun… On 5 Jul…”

Improved with past perfect (concise, clinical):
“On 30 June, biopsy confirmed basal cell carcinoma on the dorsum of the right hand. The patient had first noticed the lesion approximately two weeks earlier. Subsequently, on 5 July, the lesion was removed.”

Sentence Patterns You Can Reuse

• “On [date], [key past simple action]. The patient had [past participle] [time reference] earlier.”
  
• “[Intervention] was initiated after [tests] had been completed.”
  
• “Symptoms resolved following treatment that had been prescribed by the GP.”

Common Pitfalls (and Fixes)

• Overusing dates: Replace repeated timestamps with one anchor date + past perfect for the earlier step.
  
• Overusing past perfect: Usually one step back is enough. Anchor → step back → continue with past simple.
  
• Form errors: Remember had + past participle (not “was had did”). E.g., “had been confirmed,” not “had confirmed” (unless active voice fits).

Quick Practice (Transform to Past Perfect)

1. “On 12 Apr, IV antibiotics were started. Blood cultures (take) earlier that morning.” → “…after blood cultures had been taken earlier that morning.”
   
2. “CT confirmed appendicitis. The patient (present) with 24h abdominal pain.” → “CT confirmed appendicitis; the patient had presented with 24-hour abdominal pain.”
   
3. “Surgery proceeded. Informed consent (obtain).” → “Surgery proceeded after informed consent had been obtained.”

FAQs: OET Writing Past Perfect

Do I need dates if I use past perfect? Not always. Use one anchor date (or timeframe) and the past perfect to refer to earlier steps.

Can I mix active and passive? Yes. Choose what’s clinically foregrounded. Passive often works for tests/procedures (e.g., “had been confirmed”).

How many times should I use past perfect? Usually once per timeline paragraph to step back; then return to past simple.

Key Takeaways

• Anchor your paragraph at the most relevant past point.
  
• Use had + past participle once to refer to the earlier action.
  
• Keep the rest in past simple for clarity and flow.

Related: How to Pass OET: a Nurses Journey · Why Vocabulary Matters in OET · How OET Reading Works...