Formal and Lexical Aspects

Formal and lexical aspects cover the structural backbone of English grammar tested in MDCAT 2026 — voice, speech, tenses, prepositions, pronoun reference, punctuation, sentence types, inversion, and high-yield synonyms. The PMDC syllabus draws roughly 4–5 of the 9 English MCQs from this section. Master the rules, then drill the traps below.

PMC Table of Specifications. This chapter covers fourteen PMDC subtopics — from Active/Passive Voice to Transitional Devices. Skim the headings below to confirm full coverage before sitting any practice paper.

Active and Passive Voice

In the active voice the subject performs the action; in the passive voice the subject receives it. The passive is formed using a form of be + past participle (V3), with the original doer optionally introduced by the preposition by.

Core conversion rule

Object of the active sentence becomes the subject of the passive. The verb shifts to be + V3, matching the tense of the original verb. The original subject becomes the agent introduced by by, and is dropped when unknown or unimportant.

Tense-by-tense conversion

Present Simple: Active: She writes the letter. → Passive: The letter is written by her.
Present Continuous: Active: She is writing the letter. → Passive: The letter is being written by her.
Present Perfect: Active: She has written the letter. → Passive: The letter has been written by her.
Past Simple: Active: He broke the window. → Passive: The window was broken by him.
Past Continuous: Active: They were repairing the road. → Passive: The road was being repaired by them.
Future Simple: Active: He will deliver the parcel. → Passive: The parcel will be delivered by him.
Modal verbs: Active: You must finish the work. → Passive: The work must be finished (by you). Pattern: modal + be + V3.

When to prefer the passive

The doer is unknown: My wallet was stolen.
The doer is obvious or unimportant: The patient was admitted at 9 p.m.
To emphasise the receiver of the action: Penicillin was discovered by Fleming.
Scientific or formal writing: The samples were heated to 80°C.

Common trap. Intransitive verbs (sleep, arrive, die, happen) cannot be made passive — they take no object. "An accident was happened" is wrong; it must be "An accident happened".

Adverbs

An adverb modifies a verb, an adjective, another adverb, or a whole sentence. It answers how, where, when, how often, or to what degree an action happened.

Five major types

Manner: How? — quickly, carefully, well, badly. "She sings beautifully."
Place: Where? — here, there, upstairs, abroad. "Come here."
Time: When? — now, yesterday, soon, already. "I will leave tomorrow."
Frequency: How often? — always, often, sometimes, rarely, never. "He always arrives early."
Degree: How much? — very, quite, almost, extremely. "The test was extremely difficult."

Position rules

Adverbs of frequency usually go before the main verb but after be: She often visits us. / She is often late.
Adverbs of manner normally follow the main verb or the object: He drove carelessly.
Adverbs of time often appear at the end: I met him yesterday.
An adverb is not placed between a verb and its direct object: Wrong: She speaks fluently English. → Right: She speaks English fluently.

Comparative and superlative forms

One-syllable: fast → faster → fastest; hard → harder → hardest.
Most -ly adverbs: use more / most: carefully → more carefully → most carefully.
Irregular: well → better → best; badly → worse → worst; far → farther/further → farthest/furthest.

Contextual Clues and Vocabulary

Contextual clues are signals inside a sentence that help you deduce the meaning of an unfamiliar word without a dictionary — the most-tested skill in MDCAT vocabulary items.

Five clue types

Definition: The meaning is given directly. "An ophthalmologist, a doctor who treats eye diseases, examined her." → eye doctor.
Synonym / restatement: Linkers like that is, in other words, or introduce a synonym. "He was indolent, in other words lazy."
Antonym / contrast: Linkers like but, however, unlike, on the contrary. "Unlike his frugal brother, Ali spent freely." → frugal = thrifty.
Example: "Citrus fruits such as oranges, lemons and limes are rich in vitamin C." → citrus = a class of fruit.
Inference: Logic + tone. "After the long hike the trekkers were parched and gulped down two bottles of water." → parched = very thirsty.

Common Pakistani-English MDCAT vocab traps

cope up with → correct form is cope with (no "up").
discuss about → discuss (no "about"). Same for describe, request, order, mention.
good in / weak in (a subject) → good at / weak at.
marry with → marry (transitive). "She married him."
do mistake → make a mistake.
open / close the light → switch on / switch off the light.
back side / front side → usually just back / front.

Direct and Indirect Speech

Direct speech reports the exact words inside quotation marks. Indirect (reported) speech paraphrases them without quotes, usually after a reporting verb in the past.

Backshift of tenses

Present Simple → Past Simple: Direct: She said, "I play tennis." → Indirect: She said that she played tennis.
Present Continuous → Past Continuous: "I am studying." → He said he was studying.
Present Perfect → Past Perfect: "She has left." → He said she had left.
Past Simple → Past Perfect: "I saw him." → He said he had seen him.
Will → Would: "I will help." → He said he would help.
Can → Could; May → Might; Must → Had to: "I can swim." → She said she could swim.

Pronouns, time and place

Pronouns shift to match the new speaker: I → he/she; we → they; you → I/he/she/they.
now → then; today → that day; tomorrow → the next day; yesterday → the previous day; here → there; this → that; these → those; ago → before.

Reporting different sentence types

Statements: use said that. "I am tired." → He said that he was tired.
Yes/No questions: use asked if/whether + statement word order. "Are you ready?" → She asked if I was ready.
Wh-questions: keep the wh-word + statement word order. "Where do you live?" → He asked where I lived.
Commands / requests: use told / ordered / requested + to-infinitive. "Open the door." → He told me to open the door.
Negative commands: use not to. "Don't be late." → She told me not to be late.

Universal-truth exception. If the reported clause states a permanent fact or universal truth, the present tense is kept even after a past reporting verb. "The teacher said that water boils at 100°C."

Gerund and Gerund Phrases

A gerund is the -ing form of a verb used as a noun. A gerund phrase is the gerund plus its objects and modifiers, functioning as a single noun unit.

Gerund vs present participle

Both end in -ing, but a gerund acts as a noun while a present participle acts as an adjective or part of a continuous verb. Test: replace the -ing word with "it/this" — if the sentence still works, it is a gerund. "Smoking is harmful." (Gerund — subject) vs "He is smoking." (Participle — verb).

Functions of a gerund

Subject: Swimming keeps you fit.
Object of a verb: She enjoys reading.
Object of a preposition: He is fond of painting.
Subject complement: Her hobby is baking cakes.

Verbs that take a gerund (not infinitive)

enjoy, avoid, finish, mind, suggest, admit, deny, consider, postpone, practise, risk, recommend, miss, keep (= continue), give up, look forward to, be used to, object to.

Correct: I enjoy swimming. — Wrong: I enjoy to swim.
Correct: She avoided meeting him. — Wrong: She avoided to meet him.
Correct: He looks forward to seeing you. — Wrong: He looks forward to see you. (the to here is a preposition, not the to-infinitive marker).

Infinitives and Infinitive Phrases

An infinitive is the base form of a verb, usually preceded by to (to-infinitive: to write) or used without it (bare infinitive: write). An infinitive phrase = infinitive + objects/modifiers.

To-infinitive uses

Subject: To err is human.
Object: She wants to leave.
Purpose: He worked hard to pass the exam.
After certain adjectives: happy to help, ready to go, easy to learn.

Bare infinitive (no to)

After modal verbs: can, could, will, would, may, might, must, shall, should. "You must leave now."
After let, make, see, hear, watch, feel + object. "She made me laugh." / "I heard him sing."
After had better, would rather. "You had better go."

Verbs that take a to-infinitive (not gerund)

want, hope, plan, decide, agree, refuse, promise, expect, learn, manage, offer, pretend, choose, fail, deserve, intend, seem, tend, threaten.

Split infinitive

A split infinitive places an adverb between to and the verb: "to boldly go". Old prescriptive grammars banned it, but modern usage accepts it when it improves clarity. MDCAT examiners usually do not penalise split infinitives unless an option without splitting reads better.

Mnemonic for gerund verbs. "EARS-DAMP" → Enjoy, Avoid, Recommend, Suggest, Deny, Admit, Mind, Postpone — all take -ing. Memorise this list and you will clear most gerund/infinitive MCQs.

Prepositions

Prepositions show the relationship between a noun/pronoun and another word in the sentence — relations of time, place, direction, or manner. They are nearly always tested in MDCAT through fixed collocations.

Time prepositions

at: Specific clock time / point. at 5 p.m., at noon, at sunrise.
on: Days and dates. on Monday, on 14th August, on my birthday.
in: Months, years, centuries, longer periods. in May, in 2026, in winter, in the morning.
by / until: by = not later than (deadline); until = up to that time. "Finish by 5." vs "Wait until 5."

Place and movement prepositions

at = a point: at the door, at the bus stop.
in = enclosed space: in Lahore, in the room.
on = surface: on the table, on the wall.
into / out of = movement inward / outward.
across = from one side to the other; through = inside something.
between = two; among = three or more.

High-yield collocations

depend: depend on someone/something. "Success depends on hard work."
agree: agree with a person; agree to a proposal; agree on a decision. "I agree with you." / "He agreed to the plan."
different: different from (British/American standard). Avoid different than/to in formal MDCAT writing.
consist: consist of (active, no passive). "Water consists of hydrogen and oxygen."
compare: compare with (to find similarities/differences); compare to (to liken).
responsible: responsible for (a task) / to (a person). "She is responsible for sales to the manager."
capable / incapable: capable of, never "to". "He is capable of doing it."
familiar: familiar with a thing; familiar to a person.

Pronoun-Antecedent Agreement

A pronoun must agree with its antecedent (the noun it replaces) in number, gender, and person. Failure to agree is one of the most common MDCAT error-identification trap.

Three rules of agreement

Number: Singular antecedent → singular pronoun; plural → plural. "Every student must bring his or her book." (not their in strict formal writing, though increasingly accepted).
Gender: Match masculine, feminine, or neuter. "The doctor said she would call later" (if doctor is female).
Person: Stay in the same person throughout the sentence. "If one works hard, one succeeds" — not "...you succeed."

Indefinite pronouns — singular vs plural

Always singular: each, either, neither, everyone, everybody, someone, anybody, no one, nothing. "Everyone raised his or her hand."
Always plural: both, few, several, many. "Both have submitted their reports."
Either / Neither / Or / Nor → pronoun agrees with the nearer noun. "Neither the boys nor the teacher remembered his umbrella."

Ambiguous antecedent — fix it

Wrong/unclear: Sara told Maryam that she had won. (Who won?)
Right: Sara told Maryam, "You have won." or rewrite to name the winner.

Punctuation

Punctuation marks structure meaning. MDCAT examiners commonly test the comma, semicolon, apostrophe, and quotation marks.

Core marks at a glance

Comma ( , ): Separates items in a list, clauses joined by coordinating conjunctions, and introductory phrases. "After dinner, we went home."
Semicolon ( ; ): Joins two independent clauses without a conjunction, or separates list items containing internal commas. "It was raining; I stayed home."
Colon ( : ): Introduces a list, explanation, or quotation. "You will need three things: a pen, paper, and patience."
Dash ( — ): Marks a sudden break or strong parenthesis. "He answered — after a long pause — honestly."
Apostrophe ( ’ ): Shows possession (Ali's book) or contraction (don't). Plural possessive: students' results (after the s).
Quotation marks ( "…" ): Enclose direct speech, titles of short works, or technical terms used in a special sense.

The Oxford (serial) comma

The Oxford comma is the comma placed before and / or in a list of three or more items: "red, white, and blue." It removes ambiguity and is preferred in formal academic writing — the style most MDCAT papers follow.

Without Oxford comma (ambiguous): I dedicate this book to my parents, Atif Aslam and Madonna. (Are parents = Atif and Madonna?)
With Oxford comma: I dedicate this book to my parents, Atif Aslam, and Madonna.

Sentence Classes and Phrases

English sentences fall into four classes by structure, and phrases are grouped by the part of speech they head.

The four sentence classes

Simple: One independent clause. "The patient recovered."
Compound: Two or more independent clauses joined by a coordinating conjunction (FANBOYS: for, and, nor, but, or, yet, so) or a semicolon. "The patient recovered, and he went home."
Complex: One independent clause + one or more dependent clauses (introduced by because, although, when, if, that, etc.). "Although he was tired, he kept working."
Compound-Complex: Two or more independent clauses + at least one dependent clause. "Although it was late, I finished the report, and I emailed it to my boss."

Phrase types

Noun phrase: The bright red car caught my eye.
Verb phrase: She has been studying all night.
Adjective phrase: The book full of pictures is mine.
Adverb phrase: He spoke in a low voice.
Prepositional phrase: The cat sat under the table.

Sentence Inversion

Inversion is reversing the normal subject-verb order, usually for emphasis or formality. MDCAT often tests inversion after negative adverbs and in conditional sentences.

Inversion triggers

Negative / restrictive adverbs at the start: never, seldom, rarely, hardly, scarcely, no sooner, little, nowhere, not only. "Never have I seen such beauty." (not "Never I have seen…")
"Only" expressions at the start: only then, only after, only if, only by. "Only after the bell rang did the students leave."
"So / Such" + adjective at the start: "So loud was the noise that we couldn't hear ourselves." / "Such was his anger that he left the room."
Conditional inversion (formal "if"): drop if and invert. "Had I known, I would have helped." (= If I had known…) / "Were I in your place, I would refuse."
"Hardly…when / No sooner…than": "Hardly had he arrived when the phone rang." / "No sooner had I sat down than the doorbell rang."

Common error

Wrong: Never I had seen such a sight.
Right: Never had I seen such a sight.
Wrong: Only when he left, I realised the truth.
Right: Only when he left did I realise the truth.

Synonyms (Irony, Parody, Satire)

Irony, parody and satire are often confused. They overlap but each has a distinct flavour.

Distinguishing the trio

Irony: A contrast between expectation and reality, or saying the opposite of what is meant. Example: a fire station burns down. Verbal irony: "What a beautiful day!" said during a thunderstorm.
Parody: An imitation of a specific work or style for comic effect. Parodies copy the form to mock the original. Example: Weird Al Yankovic's song parodies.
Satire: The use of humour, irony, exaggeration, or ridicule to criticise vices — usually political or social. Example: Jonathan Swift's A Modest Proposal.

High-frequency MDCAT synonym pairs

Abundant — plentiful, copious, ample. (Antonym: scarce.)
Benevolent — kind, generous, charitable. (Antonym: malevolent.)
Candid — frank, straightforward, honest. (Antonym: evasive.)
Diligent — hardworking, industrious. (Antonym: lazy / indolent.)
Enigma — mystery, puzzle, riddle.
Frugal — thrifty, economical. (Antonym: extravagant.)
Lucid — clear, intelligible. (Antonym: obscure.)
Mitigate — alleviate, ease, lessen. (Antonym: aggravate.)
Pragmatic — practical, sensible. (Antonym: idealistic.)
Reluctant — unwilling, hesitant. (Antonym: eager.)
Tedious — boring, monotonous, dull.
Vivid — lively, bright, graphic. (Antonym: dull.)

Tenses

English has 12 tense forms generated by combining 3 times (past, present, future) with 4 aspects (simple, continuous, perfect, perfect continuous).

The 12 English tenses — structure + signal words + example (verb: to write)
Tense	Structure (positive)	Use / signal words	Example
Present Simple	S + V₁ / V₁+s	Habits, facts; always, daily, often	She writes daily.
Present Continuous	S + am/is/are + V₁+ing	Now; at the moment, currently	She is writing a letter.
Present Perfect	S + has/have + V₃	Past with present relevance; just, already, yet, ever	She has written three books.
Present Perfect Continuous	S + has/have been + V₁+ing	Started in past, ongoing; since, for	She has been writing since morning.
Past Simple	S + V₂	Completed past; yesterday, ago, last	She wrote a letter yesterday.
Past Continuous	S + was/were + V₁+ing	In progress at past time; while, when	She was writing at 8 p.m.
Past Perfect	S + had + V₃	Before another past action; before, by the time	She had written the report before the meeting.
Past Perfect Continuous	S + had been + V₁+ing	Continuing up to a past point	She had been writing for two hours when I arrived.
Future Simple	S + will + V₁	Promise, prediction; tomorrow, next	She will write tomorrow.
Future Continuous	S + will be + V₁+ing	In progress at future time	She will be writing at noon.
Future Perfect	S + will have + V₃	Completed before a future point; by + future time	She will have written ten pages by Friday.
Future Perfect Continuous	S + will have been + V₁+ing	Continuing up to a future point	By next month, she will have been writing for a year.

Pakistani-typical tense mistakes

Wrong: I am working here since 2020. → Right: I have been working here since 2020.
Wrong: When I reached, the train already left. → Right: When I reached, the train had already left.
Wrong: She is having two cars. → Right: She has two cars. (have = possess is not used in continuous).
Wrong: I am studying in this college since two years. → Right: I have been studying in this college for two years.

Transitional Devices

Transitional devices (linkers / connectors) signal the relationship between sentences and ideas. They create cohesion in writing and are often tested in MDCAT cloze items.

Linkers grouped by function

Addition: moreover, furthermore, in addition, besides, also, what is more.
Contrast: however, nevertheless, on the other hand, in contrast, conversely, yet, still.
Cause / reason: because, since, as, due to, owing to.
Effect / consequence: therefore, consequently, thus, hence, as a result, accordingly.
Example: for example, for instance, namely, such as, in particular.
Sequence: first, second, then, next, finally, subsequently, meanwhile.
Conclusion: in conclusion, to sum up, in short, overall, all in all.

Quick usage examples

"He studied hard; however, he failed the test." (contrast)
"She was late; therefore, she missed the lecture." (effect)
"Smoking is harmful; moreover, it is expensive." (addition)
"Although he was tired, he finished the work." (contrast, subordinator)
"Consequently, the team lost the match." (consequence)

Worked MCQs

Five MCQs that capture the high-yield testing patterns for this chapter. Read the explanation even when you get the answer right — it's where the deeper concept lives.

Q1. Choose the correct passive form: "They are repairing the road."

The road is repaired by them.
The road has been repaired by them.
The road is being repaired by them.
The road was being repaired by them.

The active is in the present continuous tense (are + V-ing). Its passive equivalent uses is/are + being + V3: "The road is being repaired by them."

Q2. Choose the correctly reported sentence: She said, "I will help you tomorrow."

She said that she will help me tomorrow.
She said that she would help me the next day.
She said that she would help me tomorrow.
She said that she helped me the next day.

Two changes are required: will shifts to would after a past reporting verb, and tomorrow shifts to the next day. Pronouns adjust to the listener's perspective (you → me).

Q3. Fill in the blank: Success depends ____ hard work and consistency.

upon
on
at
in

The fixed collocation is "depend on". Although upon is occasionally seen in older formal English, MDCAT keys "on" as the standard preposition for this verb.

Q4. Identify the error: "Each of the boys have submitted their assignment."

Each of the boys
have submitted their
submitted
their assignment

Each is singular, so the verb must be has submitted, and the pronoun must be singular his. Correct version: "Each of the boys has submitted his assignment."

Q5. Choose the closest synonym for mitigate:

aggravate
alleviate
celebrate
imitate

Mitigate means to make less severe; the closest synonym is alleviate (to ease). Aggravate is its antonym — a classic distractor.

Quick Recap

Passive = subject receives action; structure = be + V3; intransitive verbs cannot be passive.
Adverbs of frequency go before the main verb but after be; never insert an adverb between verb and direct object.
Indirect speech: backshift tenses one step into the past; shift time/place words; pronouns follow the new speaker.
Gerund verbs (enjoy, avoid, mind, suggest, finish) take -ing; infinitive verbs (want, hope, decide, agree, refuse) take to + V1.
Fixed collocations: depend on, agree with/to/on, different from, consist of, capable of.
Singular indefinite pronouns (each, every, none, anyone) take singular verb + singular possessive pronoun.
Negative adverb at sentence start → auxiliary inversion (Never have I seen…).
Irony = expectation vs reality; parody = imitative mockery; satire = ridicule of vice.
"Since" needs a perfect tense; possessive have/has is never continuous.
Linkers: however = contrast; moreover = addition; therefore = effect; nevertheless = strong contrast.

Test yourself. Take a timed practice test or browse topic-wise MCQs to lock these concepts in.