Program for Medical Translators in Japan

The Japanese and the English Language / Creating healthy dialogue Hiroko Ihara / Daily Yomiuri Staff Writer OSAKA--As anyone who has found themselves acting as interpreter between a non-Japanese friend and a Japanese doctor well knows, good intentions and daily conversation ability alone are not enough to deal with such complex communication. To accurately translate a patient's symptoms or a doctor's instructions, specialized training is required. With more than 2 million foreigners registered as residents in Japan and the number of foreign visitors to the country now in excess of 8 million a year, the demand for trained medical interpreters is rising rapidly. In this nation, English-Japanese medical interpreting in particular has a crucial role, not only because English is the most familiar foreign language among Japanese, but also because large numbers of foreigners living here learned English as a second language in their own nation. These crucial workers negotiate the language barrier for people throughout the medical process, from dealing with reception to paying fees and everything in between--consultations, prescriptions, treatment plans and even surgery. Responding to a growing need, interpreting services firm Inter Group is to run a yearlong training course for English-Japanese medical interpreters from May. Such an expert role requires a high level of bilingual proficiency, and among Japanese people, there are many more who have this level of skill in English than there are who have this level of skill in other languages. It is much more feasible, then, to provide medical institutions with trained English-Japanese interpreters than it is for Japanese to any other language. "As English is taught as part of the Japanese school system, many people can use the language well. We believe we can train good Japanese-English medical interpreters, because students will enter our course already having high English proficiency and the ability to deal with difficult language concepts," said an Inter Group spokesman. "Our firm was founded in 1966 and has a great deal of accumulated knowhow with regard to training English-Japanese interpreters," the spokesman said. Based in Kita Ward, Osaka, the firm will offer the course at its Osaka, Tokyo, Nagoya, Hiroshima and Fukuoka schools. The course plans to bolster the medical interpreting service currently provided by affiliates of local governments and nongovernmental organizations, which sees volunteer interpreters dispatched on request. These interpreters--who offer their services purely because they feel it is important for foreigners to have access to such assistance--usually take part in intensive training before their first assignment and take follow-up seminars about once a month, but Inter Group plans to offer more thorough preparation. The yearlong, 40-lesson course is a joint project with the Rinku General Medical Center in Izumisano, Osaka Prefecture. In April 2006, rather than rely on temporary volunteers, the center set up its own medical interpreter system, which is very rare for a medical facility in Japan. According to Mamoru Ito, vice director general of the center, it now has a pool of about 50 trained volunteer interpreters skilled in English, Chinese, Spanish and Portuguese to help outpatients at the three hospitals managed by the center. About 30 percent of the patients require Japanese-English interpreting. Ito, who supervises the system, will also oversee the curriculum of the new course. "Medical interpreting requires expertise that can't be obtained without training," he said. "There's nowhere in Japan where people can learn these skills efficiently, so we decided to share the knowledge and expertise we've built up." "The curriculum is based on actual situations and problems known to occur at the center, so students will be able to use what they learn at work immediately," Ito said. Students will be required to have English-language ability at least equivalent to a score of 730 in the Test of English for International Communication (TOEIC). According to Ito, the course is intended to cover the four main facets of being a medical interpreter--language skills, basic medical knowledge, intercultural communication, and appropriate professional behavior. Each 105-minute lesson will feature a 30-minute TV lecture given by Ito on the functions of different organs. Inter Group instructors who have worked as interpreters at medical conferences will instruct students in essential vocabulary, such as disease names, descriptive terms for explaining symptoms, and procedural language for medication instructions. "Learning drug terms is important, as it is said 20 percent of medical errors involve incorrect drug administration," Ito said. Role-playing sessions using texts jointly prepared by Inter Group and the center will focus on acquiring practical skills. The curriculum will also cover the workings of the medical insurance system, ethical issues, and possible culture-gap problems that may arise. Cultural misunderstandings can lead to frustration and, for the patient, a loss of confidence in the medical staff, Ito said. He offered the example of a Chinese woman who, after giving birth at the center, asked to take the placenta home to eat it, as is common in her culture. The doctor refused her request as he was worried about the risk of infection. "The patient was extremely unhappy about it until an interpreter explained why the doctor had refused. We were also very surprised to hear from the interpreter that the woman had misunderstood the doctor completely--she thought that the hospital staff wanted to eat the placenta," Ito said. Sample lessons already given by Inter Group have been well attended. Among the prospective students was Mamie Yamada of Neyagawa, Osaka Prefecture, who teaches English to company workers and university students. She first considered undergoing this kind of training after volunteering as an interpreter for a foreign government official at an international conference in Kyoto last year. The official was diabetic but forgot to bring insulin, so Yamada accompanied him to a local hospital to help him acquire the medicine. "Although it was volunteer work, I felt really rewarded. I also realized I needed some training, though," Yamada said. "This kind of work shouldn't rely on volunteers alone, because it requires a lot of expertise," said Prof. Yasuhide Nakamura of the Department of International Collaboration at Osaka University's Graduate School of Human Sciences. "Medical interpreters also deserve to receive proper payment." There is currently no system of formal qualifications or certificate recognition for medical interpreting in Japan. To help improve the role's professional status, the Japan Association of Medical Interpreters was founded in February by nongovernmental organization workers, medical interpreters, doctors, and researchers. Nakamura, a pediatrician, chairs the the association and said he realized the importance of medical interpreting when he treated foreign patients at Tokyo University Hospital's international outpatient clinic in the 1990s. According to Nakamura, the association will learn from precedents set by similar organizations overseas, such as the U.S.-based International Medical Interpreters Association. Founded in 1986, that association intends to launch a national certificate test this year, a big step forward for the profession. Australia also has an advanced system, under which community interpreters take a national accreditation test. Nakamura said: "The Inter Group course indicates the business sector is interested in this field. So many people would be able to work as medical interpreters--foreign residents who speak Japanese, for example. They also sometimes have medical qualifications from their countries. Japanese doctors and nurses who speak foreign languages could also do this work." === Bilingual access benefits all parties Medical interpreting is provided free of charge to patients at the Rinku General Medical Center, located near Kansai Airport. The advantages of the free service occurred to Ito, a neurologist, after he treated a Filipino woman who gave birth to a premature baby at the center after suffering a brain hemorrhage on her flight to Japan. Both mother and child survived, but they returned home leaving their medical bills unpaid. The center had been unable to discuss payment with her due to the language barrier. "At the time, it seemed to me that a medical center so close to an international airport should be well-equipped to overcome language-related obstacles," Ito said. The center now has English interpreters available four days a week, meaning patients needing their help can usually get it even without a reservation. Spanish and Portuguese interpreters are available two days a week, and Chinese interpreters one. According to Ito, the number of patients using the service has increased as awareness of it has grown. While 88 people took advantage of the system in fiscal 2006, the number soared to 427 in fiscal 2008. Interpreters at the center are paid 5,000 yen plus transportation costs for a 9 a.m.-3 p.m. shift. "That is much less than an ordinary interpreter would be paid, however," said Dr. Kaori Minamitani, who interprets for Portuguese-speaking patients at the center in addition to her work as a practitioner. Nevertheless, the number of people applying for positions as interpreters at the center is steadily rising, Ito said. Stressful moments do arise, and the center has a number of support measures in place for interpreters. Computer records of patients' symptoms can be accessed before consultations, enabling interpreters to prepare for likely scenarios. Some long-term interpreters have been hired as part-time staff, and it is common for them to mentor junior members of the team by working together in pairs. Minamitani herself is also available to address concerns and questions as they come up. "That support system is necessary," Minamitani said. (Apr. 28, 2009)