When an action is the "main character" of a sentence — what the sentence is about — we turn the verb into a noun by adding -ing. This is the gerund used as the subject.
Structure: [Verb + -ing] + verb phrase.
Example: "Smoking is harmful to your lungs."
⚠️ Common mistake (Bulgarian learners): In Bulgarian, we often use a noun or a different construction. In English, the verb must be in the -ing form when used as subject.
After any preposition, we always use the -ing form, never the infinitive. This is one of the most commonly tested gerund rules.
Common prepositions: about, of, for, in, on, without, after, before, instead of, by, responsible for.
"You should wash your hands before eating."
"The doctor is famous for treating rare diseases."
"He left the hospital without paying the bill."
Certain verbs are always followed by the -ing form. These must be memorised. They appear frequently in medical advice and instructions.
Key verbs: suggest, recommend, avoid, finish, stop, keep, mind, consider, enjoy, admit, deny, miss, practise, risk, can't help, can't stand.
"I recommend taking these vitamins with your main meal."
"You must avoid lifting heavy objects for two weeks after surgery."
"Have you considered seeing a specialist?"
Some expressions look as though they might take an infinitive — especially those ending in to — but they always require the gerund. These must be learned as fixed phrases.
| Expression | Example | Note |
|---|---|---|
| look forward to + -ing | "I'm looking forward to feeling better." | "to" is a preposition here, not part of an infinitive |
| get used to + -ing | "She is getting used to taking insulin daily." | Describes adapting to a new routine |
| be used to + -ing | "He is used to working night shifts." | Describes an established habit |
| it's (not) worth + -ing | "It's worth getting a second opinion." | Is the effort justified? |
| it's no use + -ing | "It's no use worrying about the results." | The action has no benefit |
| no point in + -ing | "There's no point in skipping the medication." | The action is pointless |
| no good at + -ing | "He's no good at describing his symptoms." | Lack of skill |
| have difficulty (in) + -ing | "She has difficulty breathing at night." | Common medical phrase |
| can't help + -ing | "She can't help sneezing — it's her allergy." | An uncontrollable action |
| object to + -ing | "He objects to being kept waiting." | "to" is a preposition |
With some verbs, the choice between gerund and infinitive changes the meaning of the sentence. The most tested pairs in medical English are stop, try, remember, and forget.
| Verb | + Gerund | + To-Infinitive |
|---|---|---|
| stop | "Stop smoking." You quit the action itself. |
"He stopped to smoke." He paused what he was doing in order to smoke. |
| try | "Try taking a warm bath to relax." Experiment — see if it helps. |
"Try to breathe slowly." Make an effort — it is difficult. |
| remember | "I remember taking that medicine as a child." A memory of a past action. |
"Remember to take your tablets." Don't forget — a future task. |
| forget | "I'll never forget hearing the diagnosis." A memory of a past event. |
"Don't forget to book your appointment." A task you must do in the future. |
Many adjectives are followed by a specific preposition. When a verb comes after that preposition, it must be in the -ing form. This structure is very common when describing a patient's feelings or a doctor's qualities.
"The patient is afraid of undergoing surgery."
"She is good at explaining symptoms clearly."
"Are you tired of taking these pills every day?"
We use for + gerund to explain what something is used for or what its purpose is. This is especially useful for describing medical instruments and equipment.
"A stethoscope is used for listening to the heart."
"This ointment is for treating minor burns."
"A thermometer is a tool for measuring body temperature."
⚠️ Do not confuse this with purpose (why you do something), which uses to + infinitive: "She went to the clinic to see the doctor."
To make a gerund negative, place not before the -ing form. This is used frequently in medical instructions and advice.
"Not skipping breakfast is important for energy levels."
"The doctor insisted on not missing any follow-up appointments."
"Not exercising can lead to serious heart problems over time."
My name is Sofia, and last year I went through something that completely changed how I think about my health. It started with a symptom I kept ignoring — a persistent tiredness that I put down to working too hard. My husband insisted on me seeing a doctor, and I'm so glad he did. After examining me, the GP suggested running a few blood tests. She was very good at explaining what each test was for without causing unnecessary alarm. I remember feeling relieved after talking to her — she had a way of making everything seem manageable. A week later, the results came back with an unexpected finding. My iron levels were dangerously low, and avoiding the problem any longer would have risked serious complications. The doctor recommended taking iron supplements and changing my diet — she specifically warned me about not skipping meals, which had become a bad habit of mine. Getting used to a new routine was hard at first. I had difficulty remembering to take the supplements at the right time, and I kept forgetting to eat breakfast. But after a month of sticking to the plan, I started feeling better. I stopped being tired all the time, and I actually looked forward to waking up in the morning. The experience taught me that not listening to your body is one of the biggest mistakes you can make. It's worth getting a check-up regularly, even when you feel fine.
1. Why did Sofia initially ignore her symptom?
2. What did the doctor recommend to treat Sofia's condition?
3. What does "getting used to a new routine was hard" suggest? (Inference)
4. What is the main lesson Sofia takes from her experience?
I have been a GP for over fifteen years, and the most rewarding part of my job is helping patients understand their own health. But I must admit — the most frustrating part is watching people avoid coming in until things have already become serious. Smoking is the most common risk factor I see in patients with lung and heart problems. Stopping smoking is difficult, I understand that. But it is also the single most effective thing a person can do for their long-term health. I always suggest trying nicotine patches before jumping straight to prescription medication. One thing I am particularly keen on encouraging is regular preventive check-ups. Many diseases — including diabetes and high blood pressure — show very few symptoms in the early stages. Not catching them early makes treatment far more complicated. I am also concerned about the growing habit of self-diagnosing using the internet. There is no point in spending two hours on a website reading about every possible condition when a fifteen-minute appointment could give you a proper answer. I'm not against using the internet for general health information — but using it instead of seeing a professional can lead to serious mistakes. My advice to every patient is this: don't wait until you're too ill to ignore it. Getting checked early, even when you feel fine, is always worth doing.
1. What does the doctor find most frustrating about his patients?
2. What does the doctor suggest as a first step for patients who want to stop smoking?
3. What is the doctor's main concern about patients self-diagnosing online? (Inference)
4. Which of the following best summarises the doctor's overall advice?
Text 1 — A Reluctant Patient
My colleague had been (1) going to the doctor for months. She kept (2) she was too busy, but in reality she was afraid (3) bad news. After a while, I stopped (4) to convince her and instead suggested (5) the appointment myself. She finally agreed, and on the day she ended up (6) she had been dizzy for weeks. The GP was very good (7) patients at ease.
Text 2 — After the Diagnosis
After the appointment, the doctor recommended (8) a blood test. She also reminded my colleague about (9) meals — low blood sugar was contributing to the dizziness. She prescribed a glucose monitor, a small device (10) blood sugar levels throughout the day. She went (11) her prescription from the pharmacy the same afternoon. The doctor had also suggested making dietary changes (12) the risk of future episodes. My colleague is now looking forward (13) better, and she has (14) her annual check-ups altogether.