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If I use a very idiomatic language in speaking test, I gain point or lose point? For example suppose instead of saying:

Medical graduates are considered the best in our university.

I say:

Medical graduates are considered as cream of the crop in our university.

Which one is better in IELTS speaking exam?

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    I have no idea, but I expect it's more important to use idiomatic grammar. Neither of your sentences is 100% correct. Moreover I'm confused by "medical graduates". Do you mean "medical students"? "Graduates" are no longer in the university, you see. Plus various other errors. – Andrew Oct 29 '18 at 15:44
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    I'm voting to close this question as off-topic because it is not about learning English but about how a certain test is graded. Not even sure why there's an ielts tag in the first place. – Tᴚoɯɐuo Oct 29 '18 at 15:58
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    cream of the crop is a perfectly respectable cliché. – Lambie Oct 29 '18 at 17:00
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Students who earn a medical degree are considered to be the cream of crop of all the graduates at our university.

It is a good idea to write and speak idiomatically. They are many ways to express the sentence above, I provided one possibility.

cream of the crop is a cliché and an idiom.

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