OET GUIDES · LAST REVIEWED 9 JULY 2026
OET Speaking tips: the habits that move the grade, by criterion
By the MedEngly clinical team, led by a UK based IMG doctor who came through this pathway.
OET Speaking is scored against two families of criteria: the linguistic ones, intelligibility, fluency, appropriateness of language, and grammar and expression, and the clinical communication ones, relationship building, understanding the patient's perspective, structure, and information gathering. Generic speaking advice ignores the second family, which is where most role plays are won or lost.
These tips are grouped by the family they act on, so you can work on the part that is actually costing you.
Intelligibility: be followed first time, not native
Assessors score whether a stressed patient can follow you first time, not your accent. Slowing slightly, finishing your sentences, and replacing clinical shorthand with everyday words raise intelligibility faster than any attempt to sound native. If the interlocutor has to ask you to repeat, the recording shows it.
Fluency: flow beats perfection
Fluency is about continuity, not speed or flawless grammar. Long silences and repeated reformulations cost more than a small grammatical slip you carry on past. Practise keeping going: a clear, slightly plainer sentence delivered smoothly scores better than an ambitious one you abandon halfway.
Clinical communication: ask before you tell
The highest-value habit in the whole test is eliciting before explaining. Open by orienting the patient to the purpose of the conversation, then ask what they already understand and what worries them most, before you deliver information. A role play where you talk at the patient without finding out their perspective loses clinical communication marks no matter how good your English is.
Deliver information in short chunks and check understanding after each one, rather than in one long block.
Respond to emotion before returning to the task
If the patient says they are frightened or upset and you continue your explanation, the recording shows a clinician who did not listen. Acknowledge the emotion in a sentence, then return to your tasks. This single move separates many grade B role plays from C+ ones.
Use the three minutes on tasks, not a script
Spend preparation time deciding the order of your tasks, the plain-language version of any clinical terms, and your opening sentence. Do not script whole paragraphs: candidates who do tend to deliver them regardless of what the patient says, which is exactly what the clinical communication criteria penalise.
Practise by recording yourself
Recording a role play against a card and reviewing it is the single highest-value practice habit: most candidates immediately hear the interruptions, jargon, and missing check-ins they never noticed while speaking. Rotate cards so your structure survives unfamiliar content, which is what exam day tests.
COMMON QUESTIONS
How can I improve my OET Speaking score?
Work on the clinical communication criteria, not just your English. Open by orienting the patient, ask what they understand and worry about before explaining, deliver information in short chunks with check-ins, and respond to emotion when it appears. Recording yourself against role play cards exposes what to fix.
Does my accent affect my OET Speaking score?
No. Assessors score intelligibility, whether a patient can follow you first time, not accent. Speed, unfinished sentences, and jargon lower intelligibility; a clear, slightly slower delivery from any accent scores well.
What is the most common OET Speaking mistake?
Explaining before eliciting: talking at the patient without first finding out what they understand and what worries them. It costs marks across the clinical communication criteria even when the English is strong.
How should I use the three minutes of preparation?
On the tasks, not a script. Decide the order you will address them, the plain-language version of clinical terms, and your opening sentence. Scripting whole answers tends to make you deliver them regardless of what the patient actually says.
PUT IT INTO PRACTICE
Reading about the criteria is the start; seeing them applied to your own letter is what moves the grade. Get one letter marked against all six criteria, free, no signup.
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Independent preparation guidance based on publicly available OET materials; not affiliated with, or endorsed by, OET or Cambridge Boxhill Language Assessment. Regulator requirements change: confirm current scores with the regulator you are registering with.