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Grammar Rules Articles: a/an/the

Rule 1: Countable & Uncountable Nouns
Whether an article is required or not depends on the noun that follows. For this purpose nouns can be classified into three types: singular
nouns, plural nouns, uncountable nouns.
 Singular nouns: Usually an article is used before a singular noun. Example: The doctor received a complaint from her patient.
 Plural Nouns: Articles can be left out before plural nouns. Example: The doctor received complaints from her patients.
 Uncountable nouns: Some nouns cannot take a plural form such as: cancer, anaesthesia and information. For these words no article is
required.
NB. Exceptions: The article can be left out if it is replaced with another determiner such as his/her or this /that or
any/each/every
i.e Each complaint was recorded; Her complaint was recorded.

Incorrect Correct
Example 1: The patient presented with complaint of lower left 1. The patient presented with a complaint of lower left
abdominal pain. abdominal pain.
This is incorrect The basic rule is complaint is a singular countable 2. She has a family history of deep vein thrombosis, otherwise
noun (i.e there are many kinds of complaints. Eg: a complaint of she is a healthy woman.
lower back pain, a complaint of stomach cramp, a complaint of 3. Her blood result showed a positive pregnancy test.
migraine) and with singular countable nouns an article must be used, 4. Thank you for seeing Mr Eddy who presents today with a
either a or the. Use a for the first time you mention it and the for complaint of broken back teeth
subsequent times. 5. After being discharged from the hospital, Mr. Riley needs to
Example 2: She has family history of deep vein thrombosis otherwise go for a follow- up visit to a local general practitioner and to
she is healthy woman. continue rehabilitation exercise program.
History & woman are both singular forms of countable nouns so they 6. He has been receiving attention from a social worker.
require must be preceded by an article. 7. The patient had surgery 3 times in 2007.
Example 3: Her blood result showed positive pregnancy test.
Test is a singular countable noun so requires an article.
Example 4: Thank you for seeing Mr Eddy who presents today with a
complaint of a broken back teeth

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Teeth is a plural form of a countable noun so no article is required.

Example 5: After being discharged from the hospital, Mr. Riley
needs to go for follow- up visit to local general practitioner and to
continue rehabilitation exercise program.
Both visit and practitioner are countable nouns so an article is
required.
NB. If you use the plural form, visits or practitioners, no article is
required.
Example 6: He has been receiving an attention from a social worker.
Attention is an uncountable noun so no article required. i.e. There is
no word: attentions
Example 7: The patient had three surgeries in 2007.
Surgery is generally used as an uncountable noun so should not be
used in the plural forms.

Rule 2: Introducing new information Vs Previously mentioned information

When you mention something for the first time the indefinite article a/an is required. This signifies to the reader that it hasn’t been
mentioned before. However the second and subsequent times that we mention it definite article the is required because it is referring a
specific thing.
 Initially, she came to me on 03/07/06 for a blood test. The results of the blood test were negative.

Incorrect Correct
1. The patient has the family history of diabetes. (first time to 1. The patient has a family history of diabetes.
give this information) 2. Today, the patient reported back with the above mentioned
2. Today, the patient reported back with above mentioned pain pain and symptoms.
and symptoms. (second time to give this information)
Rule 3: Use “the” for parts of the body.
1. Pain in left groin. 1. Pain in the left groin.

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2. Pain in right iliac fossa. 2. Pain in the right iliac fossa.

3. I suspect it to be adenoma of parotid gland. 3. I suspect it to be adenoma of the parotid gland.
4. Mr. Smith had an operation on a left knee. 4. Mr. Smith had an operation on the left knee.
Rule 4: Do not use an article for names of diseases.
Incorrect Correct
1. The patient is suffering from the high blood pressure. 1. The patient is suffering from high blood pressure.
2. Recently, the patient has complained of the headache. 2. Recently, the patient has complained of headaches.
3. The patient was diagnosed with having the arthritis. 3. The patient was diagnosed with having arthritis.
4. The patient has had the influenza for three days. 4. The patient has had influenza for three days
Exceptions to rule 4: For some common illnesses the definite article “ the” is used.
Incorrect Correct
1. The patient has had flu for three days. 1. The patient has had the flu for three days.
2. Parents have been advised to immunise their children to 2. Parents have been advised to immunise their children to
reduce the possibility of contracting measles reduce the possibility of contracting the measles.
3. Mumps is still a common childhood disease in Australia 3. The mumps is still a common childhood disease in Australia.

Rule 5: Use of articles with gerunds.

A gerund is the …ing form of a verb which takes on the grammatical function of a noun. It can be the subject or object in a sentence.
Usually no article is required with gerunds.
Exception to this rule is when However, he is complaining of discomfort during the passing of urine.
Incorrect Correct
1. On review today, Mr Walker has reduced the smoking from 1. On review today, Mr Walker has reduced smoking from 20
20 to 10 per day to 10 per day
2. The patient was advised to stop the drinking. 2. The patient was advised to stop drinking.
Rule 6: Use of articles with a noun phrase that contains a noun phrase with the preposition “of”:
Often in medical English it necessary to use a noun phrase such as : The excessive drinking of alcohol will adversely affect your health. The
reduction of weight has led to improved health. It is common in these cases to use an article before the noun phrase.

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Incorrect Correct
1. The patient is complaining of discomfort during passing of 1. The patient is complaining of discomfort during the passing of
the urine. urine.
2. In addition he had a habit of thumb sucking till age of 5 2. In addition he had a habit of thumb sucking until the age of
years five.
Rule 7: Use of articles when indicating one particular thing.

Incorrect Correct
1. The patient works in machinery industry 1. The patient works in the machinery industry
In this case, while there are many kinds of industry, there is 2. An interpreter may be required as the mother has limited
only one machinery industry so the article “the” is used. understanding of English
2. Interpreter may be required as mother has limited
understanding of English
In this case interpreter needs the article “a” because it is the
first time to mention the word. Mother needs the article “the”
because the writer is referring a particular mother which has
been mentioned previously in the letter.

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