Key Takeaways
- The OET Speaking assessment criteria cover four linguistic and five clinical communication areas.
- Assessors consider how clearly and appropriately you communicate, not whether you have a native accent.
- Clinical communication includes relationship-building, exploring the patient’s perspective and organising the conversation.
- Candidates need to gather and provide information in a patient-centred way.
- Medical knowledge is not directly assessed in the Speaking sub-test.
- High-scoring performances sound responsive and natural rather than memorised.
Introduction
What do OET (Occupational English Test) Speaking assessors actually expect?
Many candidates focus heavily on grammar, vocabulary and completing every task on the role-play card. These areas matter, but they do not represent the whole assessment.
OET Speaking uses two groups of criteria:
- Four linguistic criteria
- Five clinical communication criteria
Each role-play is recorded and assessed against these criteria. According to OET’s official guidance, the clinical communication criteria are language-based; candidates are not being assessed on their medical knowledge (OET, n.d.-a).
However, you must still demonstrate that you can use English effectively in a realistic healthcare conversation. This means using English to conduct a patient-centred clinical conversation—listening, responding, explaining and involving the patient rather than simply speaking accurately.
Understanding the OET Speaking Assessment Criteria
The four linguistic criteria are scored from 0 to 6, while the five clinical communication criteria are scored from 0 to 3.
OET advises that candidates achieving Grade B, equivalent to 350, will typically have achieved predominantly 5 out of 6 across the linguistic criteria and 2 out of 3 across the clinical communication criteria (OET, n.d.-b).
This does not mean that one strong area automatically compensates for every weakness. Assessors consider how effectively your linguistic and communication skills work together throughout both role-plays.
The Four Linguistic Criteria
1. Intelligibility
Intelligibility means how easily the listener can understand you.
Assessors consider:
- Pronunciation
- Word stress
- Sentence stress
- Rhythm
- Intonation
- The effect of your first-language accent
You do not need to lose your accent. OET’s official descriptors recognise that even a strong candidate may have a noticeable first-language accent, provided it does not make communication difficult.
Focus on pronouncing important information clearly, particularly:
- Medication names
- Dosages
- Numbers
- Dates and times
- Symptoms
- Medical instructions
Speaking loudly does not necessarily make you more intelligible. A comfortable pace, appropriate pauses and clear emphasis are usually more helpful.
2. Fluency
Fluency refers to the rate and flow of your speech.
Assessors are not expecting you to speak continuously without pausing. Natural speakers pause to think, respond to emotion and organise information.
Problems arise when speech contains:
- Frequent hesitation while searching for words
- Repeated false starts
- Excessive fillers
- Unnecessary repetition
- A pace that is too fast or too slow
- Long pauses caused by constructing complicated sentences
Instead of trying to produce an impressive sentence, use language you can control confidently.
For example:
“I would recommend that you should perhaps consider reducing your consumption of cigarettes.”
A more fluent version is:
“I recommend cutting down on smoking. How would you feel about getting some support with that?”
The second version is shorter, clearer and easier to deliver naturally.
3. Appropriateness of Language
Appropriateness means choosing language, register and tone that suit the patient and situation.
A phrase that sounds appropriate during a routine consultation may be unsuitable when discussing a serious diagnosis.
Assessors consider whether you can:
- Use patient-friendly language
- Explain technical information in everyday terms
- Maintain a professional but conversational tone
- Adapt your language to the patient’s emotions and understanding
- Avoid sounding judgmental or dismissive
Instead of:
“Your symptoms are suggestive of hypertension.”
Try:
“Your blood pressure is higher than it should be.”
Using plain English does not make your performance less professional. It shows that you can adapt your language for a patient.
4. Resources of Grammar and Expression
This criterion considers the range and accuracy of your grammar and vocabulary.
Assessors look at whether you can:
- Express ideas clearly and unambiguously
- Use an adequate range of grammatical structures
- Select appropriate vocabulary
- Paraphrase when the patient does not understand
- Connect ideas logically
- Maintain longer explanations when necessary
You do not need to use advanced words in every sentence.
Effective language may be simple:
“The medication should reduce the pain, but it may take a few days to work.”
If the patient does not understand, rephrase rather than repeating exactly the same words:
“In other words, you may not notice an improvement immediately.”
Accuracy matters, but communication should remain the priority. A complex sentence is not useful if it becomes difficult for either you or the patient to follow.
The Five Clinical Communication Criteria
5. Relationship-Building
Assessors consider how effectively you establish and maintain a professional relationship with the patient or relative.
This includes:
- Beginning the interaction appropriately
- Introducing yourself when needed
- Showing attentiveness and respect
- Remaining non-judgmental
- Responding with empathy
The opening should suit the setting. A cheerful introduction may work in a routine clinic but feel inappropriate in a distressing situation.
Useful phrases include:
- “Good morning. My name is Dr Patel, and I’m one of the doctors in the clinic.”
- “I understand you’ve been experiencing some back pain. Could you tell me what has been happening?”
- “I’m sorry you’ve had such a difficult time.”
- “Thank you for explaining that.”
To build rapport, respond to what the patient says rather than relying on the same prepared empathy phrase in every situation.
6. Understanding and Incorporating the Patient’s Perspective
This criterion examines how well you involve the patient in the conversation.
Assessors look for your ability to:
- Explore the patient’s ideas
- Identify concerns and expectations
- Notice verbal cues
- Respond to emotions
- Connect your explanations to what the patient has told you
For example:
Patient:
“My father had similar symptoms before he was diagnosed with cancer.”
Rather than moving immediately to the next question, respond to the concern:
“It sounds as though you’re worried that this could also be cancer. Is that right?”
Once the concern is clear, you can address it directly:
“I understand why your father’s experience has worried you. At present, your symptoms do not necessarily mean cancer, but I’d like to explain which tests we can arrange.”
This demonstrates that you have listened and adapted your explanation to the patient’s perspective.
7. Providing Structure
A well-structured conversation helps the patient understand where the consultation is going.
Assessors consider whether you:
- Organise the interaction logically
- Signpost changes of topic
- Introduce new information clearly
- Summarise important points
- Keep the conversation focused
Useful signposting phrases include:
- “First, I’d like to ask a few questions about your symptoms.”
- “Now, let’s discuss the treatment options.”
- “Before we finish, I’d like to explain when you should seek further help.”
- “So, to summarise what we’ve discussed…”
Structure does not mean following a rigid script. You may need to change direction when the patient raises a concern or provides unexpected information.
The conversation should feel organised but responsive.
8. Information-Gathering
Assessors look at how effectively you obtain relevant information from the patient.
This includes:
- Beginning with appropriate open questions
- Moving to focused questions when needed
- Avoiding unnecessary interruption
- Clarifying vague information
- Summarising to confirm accuracy
- Allowing the patient to add relevant details
Begin broadly:
“Could you tell me what has been happening?”
Then clarify:
“When did the pain begin?”
If the patient gives an unclear answer, explore it:
“When you say you feel dizzy, could you describe what that feels like?”
Summarising also demonstrates active listening:
“So, the dizziness started three days ago and is worse when you stand up. Have I understood that correctly?”
The role-play card may tell you what information to obtain, but it should not turn the interaction into a rapid series of questions.
9. Information-Giving
Information-giving involves more than delivering medically accurate facts.
Assessors consider whether you:
- Establish what the patient already knows
- Give information in manageable sections
- Use patient-friendly language
- Encourage questions and reactions
- Check understanding
- Discover what further information the patient needs
Before explaining, ask:
“What have you been told about the condition so far?”
Give information in small sections:
“The test shows that you have a stomach ulcer. This is a sore in the lining of the stomach.”
Then pause and check:
“Does that make sense so far?”
A stronger check of understanding might be:
“Just so I know I’ve explained it clearly, could you tell me how you’ll take the medication?”
The purpose is not to test the patient. It is to check whether your explanation was effective.
What a High-Scoring Performance Feels Like
A high-scoring role-play does not need to sound perfect.
It should feel like a professional conversation in which the candidate:
- Is easy to understand
- Speaks at a natural pace
- Uses appropriate language
- Listens and responds
- Explores the patient’s concerns
- Organises the interaction clearly
- Gathers relevant information
- Explains information effectively
- Checks understanding
These skills should work together.
For example, an empathetic phrase may support relationship-building, but if you immediately ignore the patient’s concern, it will not demonstrate strong patient-centred communication.
Similarly, a clear explanation may support information-giving, but it will be less effective if it contains unexplained medical jargon or does not address what the patient wants to know.
How to Use the Criteria During Preparation
Do not try to practise all nine criteria simultaneously from the beginning.
Choose one or two areas for each practice session.
For example:
- Practise identifying and responding to patient cues.
- Record yourself explaining a condition in plain English.
- Focus on signposting and summarising.
- Practise asking open questions without interrupting.
- Review your pace, pronunciation and hesitation.
- Check whether your empathy responds to the specific situation.
After each role-play, ask:
- Was I easy to understand?
- Did my speech flow naturally?
- Was my language appropriate for the patient?
- Did I explore the patient’s perspective?
- Did the conversation have a clear structure?
- Did I gather the necessary information?
- Did I check that the patient understood?
General feedback such as “Your English is good” is not enough. Useful feedback should identify the relevant criterion, explain what happened and suggest a specific improvement.
Final Thoughts
Understanding what OET Speaking assessors look for can make your preparation more focused and effective.
The assessment is not based only on grammar, pronunciation or how many tasks you complete. It examines whether you can use English to conduct a clear, respectful and patient-centred clinical conversation.
Learn the criteria, but do not turn them into another rigid checklist. The strongest performances integrate the skills naturally: listening informs your questions, patient concerns shape your explanations, and clear structure supports understanding.
With realistic practice and criterion-based feedback, you can develop a performance that is both exam-ready and relevant to real clinical work.
Book a consultation to discuss your goals and see how I can help.
References
Occupational English Test (OET) (n.d.-a) The ultimate guide to the OET Speaking sub-test: Clinical communication criteria. Available at: https://cdn-aus.aglty.io/oet/pdf-files/OET%20Speaking%20Guide%20Part%202%20Clinical%20Communication.pdf (Accessed: 2 August 2026).
Occupational English Test (OET) (n.d.-b) The ultimate guide to the OET Speaking sub-test: Linguistic criteria. Available at: https://cdn-aus.aglty.io/oet/pdf-files/OET%20Speaking%20Guide%20Part%201%20Linguistics.pdf (Accessed: 2 August 2026).
Occupational English Test (OET) (n.d.-c) Speaking sub-test: Assessment criteria and level descriptors. Available at: https://cdn-aus.aglty.io/oet/pdf-files/Speaking%20assessment%20criteria%20and%20level%20descriptors.pdf (Accessed: 2 August 2026).