Understanding when to use active and passive voice is one of the most practical grammar skills for OET and IELTS. In clinical writing, the wrong choice can make your letter unclear or unprofessional. In speaking, overusing passive constructions makes you sound hesitant. This guide explains both voices with healthcare-specific examples and shows you exactly when to use each one.
What Is Active Voice?
In active voice, the subject performs the action. The sentence follows the pattern: subject + verb + object.
Active: The nurse administered the medication at 08:00.
Active: Dr. Singh referred the patient to a cardiologist.
Active: The patient reported chest pain on exertion.
Active voice is direct, clear, and concise. It tells the reader who did what.
What Is Passive Voice?
In passive voice, the subject receives the action. The sentence follows the pattern: object + was/were + past participle (+ by agent).
Passive: The medication was administered at 08:00.
Passive: The patient was referred to a cardiologist.
Passive: Chest pain on exertion was reported.
Passive voice shifts focus from the person performing the action to the action itself or the person receiving it.
When to Use Active Voice in OET
In Speaking Role-Plays
Always use active voice when speaking to patients. It is clearer and more direct:
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Active (correct): 'I am going to check your blood pressure now.'
Passive (awkward): 'Your blood pressure is going to be checked now.'
Active voice sounds confident and professional. Passive voice in patient consultations sounds evasive or impersonal — both of which lower your OET Speaking score.
In Writing: When Stating Your Purpose
The opening of every OET referral letter should use active voice:
Active (correct): 'I am writing to refer Mr. Kumar for cardiac assessment.'
Passive (weak): 'This letter is being written to refer Mr. Kumar for cardiac assessment.'
When to Use Passive Voice in OET
In Writing: When the Agent Is Obvious or Unimportant
Clinical letters often use passive voice when describing investigations and treatments where the performer is assumed:
'A chest X-ray was performed on admission.' (We do not need to say who performed it.)
'The patient was commenced on metformin 500mg twice daily.'
'Blood cultures were taken and are currently pending.'
In these cases, the passive is appropriate because the focus is on what was done, not who did it.
In Writing: When Describing the Patient's Experience
'Mrs. Chen was diagnosed with Type 2 diabetes on 15 May.'
'He was discharged in stable condition on Day 5.'
The Golden Rule
Use active voice by default. Switch to passive only when the performer of the action is unknown, obvious, or less important than the action itself. If in doubt, choose active — it is always clearer.
Common Mistakes in OET Writing
1. Overusing Passive in the Opening
Wrong: 'This letter is written regarding the patient Mrs. Ali who was seen in the clinic.'
Right: 'I am writing to refer Mrs. Ali for further management of her chronic kidney disease.'
2. Mixing Voices Awkwardly
Wrong: 'The patient was examined and I noted bilateral ankle oedema.'
Right: 'On examination, bilateral ankle oedema was noted.' (consistent passive)
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Or: 'I examined the patient and noted bilateral ankle oedema.' (consistent active)
3. Using Passive in Speaking
Wrong: 'It has been decided that a blood test will be done.'
Right: 'I would like to do a blood test to check your cholesterol levels.'
Practice Exercise
Rewrite these passive sentences in active voice:
- 'The wound was cleaned and redressed by the nurse.' → 'The nurse cleaned and redressed the wound.'
- 'Antibiotics were prescribed for seven days.' → 'I prescribed antibiotics for seven days.'
- 'The patient was advised to reduce salt intake.' → 'I advised the patient to reduce salt intake.'
Now rewrite these active sentences in appropriate passive voice:
- 'The lab processed the blood samples.' → 'Blood samples were processed.'
- 'Someone performed an ECG on admission.' → 'An ECG was performed on admission.'
Practise this transformation regularly. In OET Writing, you will naturally use a mix of both voices — the skill is choosing the right one for each sentence. In Speaking, default to active voice for clarity and confidence.