Writing strategy

** First 5 minutes :
 Read the task to know the following :

(a) Purpose + type of the letter + urgent or not .

(b) Whether the recipient knows the patient or not ?

(c) To whom and to where ?

__________________________________________________________________________________________________

(a) types of letters (urgent or not )

*) Referral : Pure referral >>> referral letter >>> 1) urgent : - Emergency
- Recently diagnosed malignancy
- psycho harming himself or
harming others
>>> 2) non urgent: others .

+ Discharge ( recovered ) >>> discharge letter .

+ Transfer ( worsened ) >>> transfer letter .

*) Update letter >>> update on the current situation.

*) Request letter >>> Requesting something from non-medical staff.

(1) Referral letter (95 %) : referred from you to another doctor .

N.B. : The word refer may be mentioned with the other types of letter .
.‫ ألن الكلمة دي ممكن تذكر مع األنواع الثانية‬refer ‫( ال يعني قطعا إن الخطاب‬refer ) ‫**من اآلخر وجود كلمة‬
. ‫ البد أن يخلو من أي أنواع تانية من الخطابات‬refer ‫** عشان أقول إن الخطاب ده‬
( Write to refer MR X for further management …etc. >>> Pure referral letter .

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 ‫‪(2) Discharge letter (4 %) : the patient is being discharged and you are referring him back‬‬
‫‪to his GP .‬‬
‫كما ذكرنا سابقا ‪ :‬هيذكر في التاسك ‪ refer‬و ‪ discharge‬سنتجاهل األولى والنوع هيكون الثانية ‪.‬‬

‫‪** Write letter to Dr X to refer MR X who is ready to be Discharged‬‬

‫‪today : (discharge letter) .‬‬

‫‪(3) Update letter (1 %) :‬‬

‫** مريض تحول لك وأنت عالجته لكن لسه ما خرجش من المستشفى وبتبعت خطاب للممارس العام أو الدكتور‬
‫األصلي بتاع المريض وتحكيله آخر التطورات فى الحالة <<<<<< ‪.update‬‬

‫‪** Write a letter to update DR X on the latest changes of MR X condition >>> Update letter .‬‬

‫** ملحوظة ‪ : 1‬دايما المستقبل بيكون عارف المريض قبل كده‬

‫** ملحوظة ‪ : 2‬الفرق بينه وبين ال ‪ discharge‬إن المريض لسه ما خرجش من المستشفى ولذلك لو ذكرت كلمة‬
‫‪ discharge‬أصبح ‪. discharge letter‬‬

‫‪** Write a letter to update DR X on the latest changes of MR X condition who is ready to be‬‬
‫‪discharged today >>> discharge letter‬‬

‫دول األنواع الخاصة باألطباء ‪...‬‬

‫لسه نوعين مش هيجوا إن شاء هللا بس هناخد عنهم فكرة سريعة وهم ‪:‬‬

‫‪(4) Transfer letter :‬‬

‫** نقل المريض من قسم لقسم آخر أو من مستشفى إلى ‪ ICU‬أو إلي مستشفى أخري أكثر تجهيزا ‪.‬‬
‫** شبيه جدا بال ‪ discharge‬لكن الفرق إن حالة العيان غالبا بتكون تدهورت وبنقله لمكان آخر أكثر تجهيزا‬
‫لعالجه ‪ +‬المستقبل مش هيكون عارف العيان غالبا ‪.‬‬
‫‪** Write a letter to transfer MR X to the ICU …etc. : Transfer letter .‬‬

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 (5) Request letter :
.. ‫** طلب من شخص مش دكتور‬
. ‫ خطاب إلي مدير الشركة لطلب إجازة مرضية للمريض‬: ‫** مثال‬
** Write letter to general manager regarding MR X to request a medical leave of absence
: Request letter .

(b) Does the recipient know the patient or not ?!

(1) Referred letter : - not knowing If from GP >>> specialist.

GP >>>another GP in Emergency Department

specialist >>> another specialist

Knowing >>> specialist >>> GP .

(2) Discharge letter : usually knowing the patient .

(3) Update letter : Always knowing the patient .

(4) Transfer letter : usually not knowing the patient .

(5) Request letter : usually not knowing the patient .

** N.B. : ’s = knowing him

e.g. Write a letter to Mr Mark ’s cardiologist : knowing him .

e.g. Write a letter to Dr X , cardiologist : Not knowing him .

**N.B. : Write a letter to DR X , physiotherapist who :

- Is responsible for MR X case  knowing

- Will be responsible for MR X case  Not knowing .

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 (c)To whom & to where

(1) To whom : this will be mentioned as :

- Name + specialty : Dr smith , cardiologist .
- Specialtly only : Gastroentrologist .
- Name only : Dr Smith .

(2) To where: will be clearly mentioned at the end of the task .

N.B. : in some case note your own address may be mentioned at the beginning of the note .
This Address will not be used at all .We write the address of the recepient not your address (the
sender)

_____________________________________________________________________________

(a) urgent or not ?

- Emergency & Nearly detected malignancy & Psycho with suicidal thoughts or harming
others  Urgent

- Others : Non urgent .

N.B. :patient who have established diagnosis of malignancy and coming for follow up  NOT
urgent .
While patient who have been recently diagnosed with malignancy and have not received the
treatment yet  Urgent

N.B. : If you are not sure whether the letter is urgent or not  consider it as an urgent letter .
====================================================================
 Read the case note :
‫ تن تن‬: ‫** حتي اآلن بدون استخدام األقالم‬
End of the first 5 minutes…………
Still Time ??  Repeat Reading and try to classify the notes into : Relavant &
Irrelevant & Semi-relevant

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 The next 40 minutes :

(1) Read the case note again with highlighting of the relevant and the semi relevant
information by your pencil OR different colored highlighters .

(2) Connect the related information by arrows .

(3) Write the uppermost part of the letter :

Dr Wiliam Smith  full name of the recipient( 1st mention ) / ( may be absent )
Cardiologist / Admitting Officer / General Director specialty of the doctor or the job title if
non-medical
Emergency Department / London Hospital
150 Falcon St. / 150 Falcon Street Address
Mansoura +/- , post code
** Blank line
Date of the last visit = Date of the exam  case note ‫اكتبه زي ما هو في‬
** Blank line
Dear Dr Smith , ( family name only-2nd mention) /// Dear Doctor, (if name not mentioned ) ///
Dear Mr Anderson, (if non-medical) /// Dear Sir / Madam, (if name not mentioned)
** Blank line
Re : Mr Jack George ( full name-1st mention), aged 35 /// DOB : 10/12/1980.
** Blank line
I am writing to refer …

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 Important notes regarding the uppermost part of the letter

(1) Regarding the capitalization : the first letter of each word is capitalized except :
- aged 35 .
- DOB  All capital .

(2) Regarding the punctuation : No punctuation except :

- ( . ) in St.
- ( , ) in address before the post code if present .
- ( : ) before DOB and Re .
- ( , ) before aged .
- ( , ) After Dear Doctor , ( as well as after your sincerely , )
-
(3) Regarding the titles : > 18 years  use title
< 18 years  no titles .

(4)Regarding the names : > 18 years  1st mention  full name

 2nd mention  family name .
...............
: < 18 years  1st mention  full name
 2nd mention 1st name .

N.B. : No abbreviation of the title if the name is absent:

e.g. Dear Dr ,  ( wrong !!!)
Dear Doctor,  ( correct )
Dear Dr Smith  ( correct ) .

(4) Regarding the address : Address in the case note  (1) , (2) , (3) +/- , postcode .
: post code ‫ بأخذه في سطر لوحده عدا ال‬comma 2 ‫كل ما هو بين‬

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 (1)
(2)
(3) +-, post code

(5) Regarding different writing styles : you must be consistent in your spelling throughout
the whole letter. You cannot mix the British and the America styles .
British America

DOB : 01/12/1993 D.O.B. 12/01/1993

Dr Smith (No (.) except the title which is Dr. smith

spoken as an incomplete word as Prof.)

Any long formula of the word Anemia / edema / esophagus

( anaemia/ oedema / oesophagus )

. ‫كلمات اإلنجليز طويلة ومش منقطة‬ ‫كلمات األمريكان منقطة وقصيرة‬

N.B. : If the title isn’t spoken as a complete word  it must be followed by a dot (.)
e.g. Prof. Smith ( correct ) Prof Smith  ( wrong !!!)

N.B : If spoken as a complete word  No ( . ) in British .

e.g. Dr smith ( correct ) Mr Ahmed ( correct )

N.B. : ** Mr + man single or married .

** Ms + woman single or married .

** Mrs +married including the widows .

** Miss + young unmarried woman > 18 years .

N.B. : The name of the doctor or the specialty may be absent but NOT both .
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