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11

Conclusions: Must,
Have (got) to, May,
Might, Could, Cant

A Visit to the
Doctor
Focus on Grammar 3
Part VIII, Unit 37
By Ruth Luman, Gabriele Steiner, and BJ Wells
Copyright 2006. Pearson Education, Inc. All rights reserved.

Am
Am II OK?
OK?
Well, I have
What could
terrible pain
the problem
in my
be?
stomach.

So, what
There
are
seems
to be
several
the
problem?
Well
need to
possibilities.
take some
X-rays and
do some
tests to find
out.

Meaning
Meaning
We often make guesses and draw conclusions about
present situations using the information we have.

Positive

100% Certain

must
have (got) to
may

Negative

cant, couldnt
We use modals to show how
must not
certain or uncertain we are
aboutmay
our conclusions.
not

might, could

might not
0% Certain

Affirmative
Affirmative Conclusions
Conclusions
When we are almost 100% certain, we use must, have
to, or have got to to state affirmative conclusions.

Mr. Jones
must
have
I looked
at all
the test
anI ulcer.
results, and
talked to the
patient. I believe that
He has to be in pain.
Hes got to be very
uncomfortable.

Possibilities
Possibilities
When we are less certain about our conclusion, we use may,
might, or could to express that something is possible.

I see something
unusual.

Mr. Jones could


have an ulcer.
He may have an
infection.
He might be very
sick.

Practice 1
100% Certain
must
have (got) to
may
might, could
0% Certain
An X-ray of the heart
and lungs.

Look at each part of the photograph one


at a time. Try to guess what it is.
Increase the certainty of your guesses by
using the appropriate modals.

This might be

Negative
Negative Conclusions
Conclusions 11
Use cant and couldnt when you are almost 100% certain
that something is impossible. Use must not when you are
slightly less certain.

It cant be an
The X-rays
infection.
look good.
The patient couldnt
have heartburn.
It must not be
serious.

Negative
Negative Conclusions
Conclusions 22
Use may not and might not when you are
even less certain.
Your illness might
not be serious.

You may not need to


stay in the hospital.

Questions
Questions
Use can and could in questions.

What can the


The test results
problem be?
are not clear.

Could the patient


need surgery?

Look at the objects under a


microscope. Ask and answer
questions about possibility. Use
positive and negative modals.

Practice 2
Example:
1.
It may be a
Itfeather.
must be
cotton fibers.
3.

2.
5.
It cant be
What
could
skin.
it be?
4.

stomach of a spider (#5)

eye of an insect (#2)

a feather (#3)

cotton fibers (Example)

tongue of a snail (#4)

skin (#1)

Short
Short Answers
Answers
In short answers, use a modal alone.

He may not.
not
The surgeon
He has to.
to
might
He was in a
operate first.
serious
accident.

Does
Does the
he
patient
need a
have
cast?a
broken
bone?

Be
Be Careful!
Careful!
Use be in short answers to questions that
include be.

Could that
be an image
of my brain?

Im
sure.
Ohnot
wait.
It
It might
be.
has
to be.
I see the
brain stem.

Ask and answer questions


about the X-rays. Use
short answers.

Practice 3
Possible Questions

Possible Answers

Could X-ray # ___ be a ___?

It has to be./Its
got to
be.
It might
be.

Can X-ray #___ be a ___?

It may/might/could be.

1.

2.

Could that X-ray


be a knee?

Example:

knee

shoulder

brain

References
References
Copyright 2006 Pearson Education and
its licensors. All rights reserved.