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How comfortable are you with using the past perfect?

The past perfect is useful for putting past events in order.

To form the past perfect you use had + past participle. For example:

  • Stephanie had told her mother she felt sick the morning she fainted.
  • Mrs Le had taken the medication as prescribed but it did not alleviate her pain.

When you’re referring to some point in the past and want to reference an event that happened even earlier, using the past perfect allows you to convey the sequence of the events.

You are most likely to use it in your letter to explain previous medical or social history. When describing two events which are both in the past compared to the time of speaking or writing, then the event furthest in the past is described using the past perfect. The event more recently in the past is described using simple past.

Some candidates choose not to use this verb tense, either because it isn’t a feature in their language, or because they are unsure about how to apply it correctly to the sentence.


How to use past perfect accurately

Past perfect is not usually used on its own in a sentence. You will often find it with the past simple. Let's look at some examples:

Example 1: ‘She had taken her medication this morning.’ 

The sentence above is wrong because the verb does not relate to another event which took place later.

Example 2: 'Before she visited the clinic this morning, she had taken her medication.’

This sentence is correct because a sequence of events is being described.


Order of Information

Note that the order of events in the sentence doesn’t matter, as the use of past perfect clearly indicates which event happened first. So you can choose which event to describe first.

Eg:  She had taken her medication before she visited the clinic.


       She visited the clinic after she had taken her medication.

How do I write a negative sentence using past perfect?
Example: ‘Before she visited the clinic this morning, she had not taken her medication.’
*The word ‘not’ should be placed between had + past participle of the verb. 


Reported speech and past perfect

There are some other sentence types which require the use of past perfect too, such as reported speech. You may also use this kind of sentence in your OET letter.


  • Mrs Singh reported that she had experienced two episodes of nausea and dizziness that morning.
  • He claimed that he had lost 10 kg of weight in the last 6 months.


Test your knowledge!

Now try these quizzes to practise the correct use of past perfect verbs in your OET letter.

1) Which box (A or B) contains the past perfect verb in these sentences.

1Before he arrived at the Emergency Department,he had consumed a bottle of whiskey.
2The home nurse had just arrived to check on Mrs Smithwhen she collapsed in the bathroom.
3Mr Black decided to seek medical assistancetwo hours after he had suffered an episode of severe chest pain.
4Twenty-four hours after she had been involved in a car accident,she began to experience neck pain.
5Mr Anderson could not self-treat his asthmabecause he had not brought his Ventolin with him.

Mr Smith claimed that

(*reported speech)

he had had asthma in the past.

She complained that

(*reported speech)

she had felt depressed for the last 3 months.

2) Change these verbs to form the past perfect verb tense.

  1. She _______ surgery twice before she was discharged from hospital. (undergo)
  2. She sustained a whiplash injury after she ________ her car two days earlier. (crash)
  3. He claimed that he________ the lesion on his leg before. (not notice)
  4. Mr Smith_________ the medication 2 hours before he vomited. (take)
  5. She claimed that her diabetes_________ well-controlled by the medication until recently. (be)


  1. 1B  2A  3B  4A  5B  6B  7B
  2. a) had undergone b) had crashed c) had not noticed d) had taken e) had been