What is the OET Exam for IMGs?

OET Exam Basics

The OET – Occupational English Test, that has now replaced the STEP 2 CS, assesses the health care-specific English language competency and communication skills of physicians. It is more than a test of English language proficiency, emphasizing the type of language physicians will need to communicate effectively in a clinical setting with peers and patients. All ECFMG pathway applicants, regardless of citizenship, native language, or medical school language of instruction, must satisfy this requirement.

Passing Requirement

Applicants who pursue one of the pathways are required to attain a satisfactory score on the OET Medicine to satisfy the communication skills requirement for ECFMG Certification.

To meet ECFMG’s requirements:

  • Applicants who take OET Medicine on or after April 1, 2022 must attain a minimum score of 350 on the Listening, Reading, and Speaking sub-tests, and a minimum score of 300 on the Writing sub-test, in one test administration.

Applicants who do not attain the minimum score on one or more of the measured sub-tests must retake all OET Medicine sub-tests (Listening, Reading, Writing, and Speaking) and achieve the minimum score on all sub-tests in a single test administration.

To be eligible for 2024 Pathways, applicants must attain a satisfactory score, as described above, on or after January 1, 2022.

Applicants will need to ensure that their test results are released to ECFMG. There is no limit on the number of times you can retake OET Medicine, subject to scheduling availability.

Booking OET Medicine

OET on paper and OET on computer are currently available at test venues around the world, including the United States.

OET@Home, a version of the test that can be taken at home through remote proctoring, is also available to certain applicants. OET@Home is available only to applicants who do not have a physical test venue (for paper-based or computer-based testing) in their country. Applicants with a test venue in their country should plan to take OET on paper or OET on computer at a physical test center to ensure that they test in time to meet Pathways requirements for participation in the 2024 Match.

You should take OET Medicine on or before the last scheduled test date in December 2023 to help ensure that your test score is reported to ECFMG in enough time for ECFMG to determine the status of your Pathways application and to report that status to the National Resident Matching Program® (NRMP®) by the NRMP’s Rank Order List Certification deadline. If you test after December 2023, ECFMG will continue to process OET results as they become available, but may not receive your results in time to determine the outcome of your Pathways application in time for you to participate in the 2024 Match.

Release of Test Results

OET Medicine results will be released to you typically 14 business days after you take the test.

The test results are valid only for 2 years.


Now, let’s learn about the exam from IMGs who have taken it! The following information has been written by our Match A Resident Ambassadors.

Listening Section 

PART A has TWO sets of audio recordings, with 12 questions designated to each audio. It is usually a recording between a doctor and a patient. You get 30 seconds to take a look at the conversational text before the audio starts; utilize THESE 30 seconds to have an idea what the audio might be about. Then, while you are listening to the audio, keep filling in the blanks simultaneously. You CANNOT replay the audio.

PART B consists of SIX short recordings of approximately 1 minute each. There is ONE question per recording, so in total there are SIX questions. These recordings are conversations/short voice presentations. The examinee gets 15 seconds to focus on the questions and then listen to the audio.

*TIP – Do not look at the options during the 15 seconds you get, rather focus on understanding the question.

PART C – In this part, there are two separate long recordings followed by SIX questions for EACH recording. They are either a conversation between two health professionals or a presentation, the latter being more common. The recordings are five minutes long, and you will get 90 seconds to look at the set of questions along with the options.

*TIP – Understand the question. Underline keywords of the question.

Reading Section 

PART A consists of small texts (3-4) based on topics related to medicine and there are 20 QUESTIONS which need to be answered in the following formats:

One format of question is that we need to just specify, in which paragraph, the author writes about a particular topic. The second format of question is where we need to write short answers.

PART B consists of SIX paragraphs unrelated to each other, followed by ONE question for each paragraph.

*TIP: Read the question first to know where you should concentrate within the paragraph.

PART C consists of TEXT A and TEXT B; each consisting of 5-6 paragraphs followed by EIGHT questions each.

*TIP: The paragraphs are in chronological order. Read the questions first.

Writing Section 

Here, you will get case notes to review in order to write a referral letter. Make sure to be clear on the following:

  • Whom should the letter be addressed to?
  • About whom to write?
  • What is the purpose of the letter?

Then, write the letter in 5 paragraphs that focus on and include the following:

Introduction – Start with the salutation, diagnosis of the patient if any, and present an outline of what you might be talking about in the letter, in two lines.

1st body paragraph – Discuss what the patient initially presented with. If it’s an urgent scenario, then start with today’s history.

2nd body paragraph – Include the initial history, if any.

3rd body paragraph – If any relevant social history is present, it can be mentioned here.

Conclusion – Mention the scenario that was asked and end with closing statements.

Speaking Section 

The speaking section is divided into two separate role-plays. The role-plays will be between the examinee (role playing as a health professional) and an interlocutor (role playing as a patient). There is a warm-up session to get the examinee oriented and is not assessed. The examinee gets 2-3 minutes after being assigned the role play cards (TWO) to pre-meditate the structure of the conversation.

*TIP – Remember to greet the patient, introduce yourself and also be empathetic throughout the whole conversation!


Now that we’ve talked about the format of the exam in detail, let’s review some resources and tips from another Ambassador that can help you prepare.

“There is about a 60-70% failure rate on the exam for English native speakers.  I honestly would’ve rather taken the Step 2 CS. The hardest portion for me was reading. However, the hardest part to prepare for is the writing portion because it is completely different from what you learned about how to write for a regular progress note or H&P on your clinical rotations. I studied for the exam for about 30 days, Aug 25th-September 24th.” – MAR Ambassador

Resources for study guides, practice tests, etc.

E2 Language: https://www.e2language.com/Course/OET/NursesAndDoctors

  • When you sign in you will see the main login, the live lectures, and registration.
  • OET courses have writing, reading, speaking, and listening.
    • Writing: They have practice tests (around 6-12) in each section.  Even for the writing section, they have a real scenario where you write for 45 minutes, with feedback.
    • Speaking: Role play cards are available, and they also have 1 on 1 practice live speaking with patients (where you are the physician and the actor is the patient).
    • Free assessment OET
  • OET Free Assessments: https://www.occupationalenglishtest.org/preparation-portal/free-sample-tests/

Feel free to reach out to our Ambassador with any OET related questions!


The NATIONAL RESIDENT MATCHING PROGRAM®, The NRMP®, SUPPLEMENTAL OFFER AND ACCEPTANCE PROGRAM®, and SOAP® are registered trademarks of National Resident Matching Program. THE MATCH™ is a trademark of National Resident Matching Program. ResidencyPrep, LLC and this page are not sponsored by, endorsed by, or affiliated with National Resident Matching Program.

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1 Comment

  1. Tahereh Rezaei

    Does Nevo Scotia’s College accept OET exam for GP? I do have PR cart and I am a general practitioner from IRAN ,60 years old woman.Am I eligible to apply job for NS?

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