Introducing medical translation

Medical translation has become an increasingly rich and varied field of working interest, offering a broad spectrum of opportunities ranging from patient education material to trial drug testing. As per other LSP (language for special purposes) contexts, it is not merely a matter of replacing terms and phrases from one language to another by following a set of grammatical and stylistic rules. Prospective medical translators should be entirely proficient in two languages, possess in-depth LSP (scientific, medical and technical) knowledge and fully understand the nature and purpose of the text in question. Dosage information of any given drug or the assembly instructions of an electromedical device for domestic use are text types which have a decisive impact on the health and life quality of patients and require responsible translation. Likewise, the description of symptoms, laboratory findings, diagnosis, treatment and follow-up in medical case reports aimed at a professional audience should be reflected accurately in translation according to standards relating to grammar, syntax, structure and register widely endorsed by a more expert community. Medical translators are also required to be conversant with a plethora of country-specific regulatory aspects, pharmacovigilance guidance, EU and FDA guidelines, inter/national legislation frameworks and restrictions pertaining to linguistic validation, harmonisation procedures and official readability and usability criteria.

The medical translator: approaching the industry

There is a need for further guidance as to where such resources may be retrieved and some sort of indication of their extent, both in literature and online. A list of existing research resources is compiled both in Italian and English comprising four sections: ‘glossaries and dictionaries’, ‘EU and international guidelines’, ‘useful papers and links relating to the medical field’ and ‘blogs and articles on medical translation’ (See Appendix A). The need for more updated and user-friendly dictionaries and glossaries is suggested, as well as clearer directions regarding what resources may be employed to fulfil the precise commission and brief of any medical sub-genre, be it a PIL or a scientific monograph for publication.

On the basis of these observations, it may be argued that medical language is ever-changing and tends to follow new trends such as anglicisation or loaning, especially with the advent of English as the lingua franca of scientific language. Medical perception and approaches are also rapidly undergoing change, therefore joining medical societies and networks, subscribing to medical journals, attending seminars and workshops as well as reading about all things scientific and medical on diverse topics are a step in the right direction. In addition, over the past years, there has been a growing tendency for medical translators to branch out and create professional networks, by consulting online blogs and fora in which they may come together, share information and useful translation tips on bio/medical translation and writing, translation websites bridging the gap between outsourcers and translators bidding for projects (many specialising in life science only), translator organisations also offering more general features such as crowdsourcing, blacklisted customers, panel and group discussions, webinars and virtual translation events. Even the most popular social networks represent a set of potential resources which, if used appropriately, may also contribute to increasing the visibility of prospective medical translators interested in creating a virtual window for themselves, marketing their professional competencies, advertising their profile in a manner of ways including blog writing, uploading and tagging a list of functional links and resources to be shared with other colleagues and taking part in subject-specific polls, contests and competitions. Incidentally, many medical translation agencies also have their own blogs with an interesting selection of blog posts which are truly insightful in order to get a glimpse into the world of biomedical writing and translation. Nevertheless, approaching medical translation may be daunting to begin with due to the intrinsic burden of responsibilities and risks it inevitably carries, therefore some light should be shed on several field-specific requirements and the research process involved in this domain.

General industry requirements:

• Academic qualification and/or formal certification (e.g. sworn translator in the country of residence)
• membership or affiliation with national or international linguist or translator associations
• 5+ years’ experience in translation or ± 250,000 translated words, ideally in the bio/medical or scientific sectors
• verifiable credentials such as a list of references (usually at least 2, with complete contact details), a portfolio of anonymised translation samples and any other evidence of substantial past experience in the medical/scientific/pharmaceutical fields
• CAT tools or any other translation software used
• willingness to undergo a short bio/medical translation test (between 200 and 400 words, generally unpaid)
• willingness to endorse ISO quality procedures and standards or any other internal company policies
• willingness to sign an NDA (non-disclosure agreement) in order to ensure the protection of sensitive and confidential information. The translator may also be required to sign a declaration whereby s/he commits to refraining from the use of unsecure email accounts such as hotmail or yahoo and TM tools such as Google Translate
• agreement to third-party review, proofreading and post-editing procedures.

Research process: resources and tools

Since medical translation is entirely knowledge-based it is crucial for medical translators to feed this knowledge in a manner of ways, many of which have been listed previously, in order to remain updated and abreast of their profession. Besides, research into the medical translation process is pivotal for preserving a high translation standard and level of competence. A list of research resources and tools ranging from the more traditional to the most contemporary is illustrated below, encompassing the most vital aids for the acquisition and further broadening of medical knowledge (see Appendix A):

• paper-based aids including specialised books, magazines, journals, encyclopedias, leaflets and brochures, monolingual and bilingual dictionaries, vade mecums
• electronic aids such as specialised online dictionaries, lists and dictionaries of medical acronyms and abbreviations, online libraries, style guides, translation blogs, references and glossaries, thesauri, web term resources, EU and international regulatory guidelines
• human aids such as healthcare professionals, clinical trial investigators, medical students and researchers, scientific journal editors, life science experts, medical writers, fellow-colleagues in the biomedical translation domain, and essentially anyone able to enhance pre-exsisting medical knowledge.

Naturally, all the research resources and tools mentioned above may be used separately or combined according to genre-specific and end-user requirements, thus optimising the analysis and use of all collected data and encouraging the development of a more accomplished research method while refining a variety of research skills.

Specialising as a medical translator

It is also worth dwelling on a gamut of other equally crucial aspects for those translators intending to pursue a career in medical translation. For instance, should medical translators have a medical or healthcare-related background? Is an MD with linguistic experience better equipped for medical translation than a linguist with a smattering of medical knowledge? Who should specialise as a medical translator? How and when is is possible to claim specialised knowledge in the field of medical translation? These aspects revolving around the issue of specialisation have been discussed at length by translators and medical experts alike (particularly in a range of blog topics and online discussions) and the ensuing debate still raises a number of points that deserve to be addressed in detail.

Many would say that a qualified MD is able to perform better in medical translation than a linguist, due to a pre-existing medical background. This may well be true, as an MD is endowed with the technical expertise acquired through higher medical education and by working in the healthcare industry. However, specialising as an MD does not exempt prospective medical translators from investing in refreshers courses or from constantly being up to date with the latest developments and discoveries in the scientific world through in-depth research and extensive reading. An MD also requires strong linguistic skills as well as a sound grasp of the internal mechanisms of translation, in order to transfer medical content with absolute accuracy. On the other hand, more effort is required from linguists intending to specialise in medical translation, as they are faced with an array of diverse specialistic topics ranging from technical equipment to rare medical conditions and regulatory provisions. Ideally, after attaining any formal academic qualification and/or accreditation, the budding translator should invest in a medical writing and/or translation course in order to refine a set of skills relating to the medical domain and ultimately try for a diploma or certificate in medical translation and/or interpreting. Later, when attempting to carve a niche for him/herself in the medical translation industry, the focus should be on a clearly restricted scope in order to become familiar with specific medical content. For instance, s/he may wish to concentrate on a more generic healthcare area involving the translation of correspondence, questionnaires, surveys or information packs. Along these lines, another valid option is to translate on a pro bono basis for non-profit organisations, public health authorities, research foundations and associations dealing with sensitive and humanitarian issues. Alternatively, it is possible to seek employment as a freelance medical translator with translation agencies running on a limited budget frequently looking to expand their database due to an increased workload. In such cases, it goes without saying, priority should be given to the building up of professional experience in medical translation rather than to monetary gratification. Once suitably acquainted with any given medical specialty/ies, translators should feel prepared to broaden their medical horizons and engage in more advanced project ventures. However, it is not easy to understand when exactly it is acceptable to claim specialistic proficiency or to fully comprehend the boundaries of personal expertise. Professional choices are subjective and should be made individually as well as undertaken responsibly.

Key challenges

The main problematic aspects faced by linguists aspiring to specialise in the translation of biomedical and pharmaceutical texts are clearly connected to the lack of academic medical background and hands-on experience. This gap may be bridged only through a keen passion for any particular medical field/s, and compensated by the willingness to read extensively around the subject/s and the desire to overcome a multitude of potential drawbacks. Below is a list of the most notable pitfalls in biomedical translation that may be encountered as freelancers:

• omissions
• vagueness
• mistranslation due to misinterpretation of content
• unusual acronyms and abbreviations
• over-technical lexis
• medical jargon
• formulaic language
• successful deciphering of handwritten reports and documents
• compact style.

Naturally, the learning process is long and may take time. Eventually, issues pertaining to medical terminology and style will become less elusive, also thanks to an improved and regular consultation of the most functional research tools and resources available. Experience will lead the medical translator to stay away from omissions or vagueness, as approximation may lead to textual distortion and an unacceptable end-result. Although unravelling the meaning of quasi-illegible handwriting or tackling unheard-of medical acronyms may prove exacting tasks, at times it may be advisable (and by no means should be viewed as demeaning) to open a communication channel with the commissioning party/customer or translation agency, demanding further clarifications or assistance whenever unavoidable.

Core requirements in medical translation

In order to remain versed in the translation profession a few core requirements should be committed to mind:

• full understanding of the content, for accurate con/textual rendering
• appropriate definition and transfer of abbreviations and acronyms
• command of widely accepted and endorsed terminology
• stylistic consistency, uniformity and precision
• drafting, editing, formatting and proofreading skills.

Concluding remarks

Lastly, and as already mentioned above, it is crucial that medical translators stay current as to the latest developments in medical and pharmaceutical research, scientific news and clinical issues, ever mindful of the implications, constraints and consequences inherent in their profession.
The aim of this article has been to provide prospective medical translators with a number of helpful suggestions by reflecting on the principal industry pre-requisites, the resources available and the potential specialisation-related issues which might be of interest when approaching the field of bio/medical translation.










Appendix 1

Glossaries and Dictionaries:

ACKR.- Dictionary of initialisms and acronyms. (n.d.). Retrieved October 3, 2012 from http://en.hades-presse.com/ackr/

Acronime Demonstration. (2012). Retrieved October 2, 2012 from http://www.nactem.ac.uk/software/acromine/

Acronimi (italiani e anglosassoni) usati in medicina. (n.d.). Retrieved September 25, 2012 from http://www.gilbertolacchia.it/acromed.pdf

Aetna – InteliHealth The Trusted Source. (2012). Retrieved September 28, 2012 from http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/9339.html

Armenian Medical Network – Dictionary of Medical Acronyms and Abbreviations. (2006). Retrieved October 2, 2012 from http://www.health.am/acronyms/a/

Biomedical Sciences Acronym and Abbreviation.(2004). Retrieved October 1, 2012 from http://www.changbioscience.com/abbr/a0f.htm

Dica 33 – Glossario medico. (2012). Retrieved September 27, 2012 from http://www.dica33.it/servizi/glossario/glossario-medico.asp

Dorland’s. (2012). Retrieved October 2, 2012 from http://www.dorlands.com/wsearch.jsp

English to Italian glossary of translations – Medical:Health Care terms. (n.d.). Retrieved September 25, 2012, from http://www.proz.com/glossary-translations/english-to-italian-translations/94

Eurodicautom. (n.d.). Retrieved September 26, 2012, from http://iate.europa.eu/iatediff/SearchByQueryLoad.do?method=load

The Free Dictionary by Farlex.(2012). Retrieved October 1, 2012 from http://medical-dictionary.thefreedictionary.com/

Glossario Medico. (n.d.). Retrieved September 29, 2012 from http://www.glossariomedico.it/

Glossary of MHRA terms. (2010). Retrieved September 26, 2012, from http://www.mhra.gov.uk/SearchHelp/Glossary/GlossaryA

HCV Advocate – Medical Glossary – Glossary of Medical Terms. (2011). Retrieved October 4, 2012 from http://www.hcvadvocate.org/library/glossary.asp

ICD-10. (n.d.). Retrieved October 2, 2012 from http://apps.who.int/classifications/icd10/browse/2010/en

Lexicool – dizionari medicina. (2012). Retrieved September 25, 2012 from http://www.lexicool.com/dizionario-online.asp?FKW=medicina

MedDRA MSSO. (2012). Retrieved September 30, 2012, from http://www.meddramsso.com/

Medical Dictionary by Stedman’s. (n.d.). Retrived October 1, 2012 from http://www.drugs.com/medical_dictionary.html#a2z

Medilexicon – Medical Dictionaries, Drugs & Medical Searches. (2012). Retrieved October 1, 2012 from http://www.medilexicon.com/

MedlinePlus – Medical Dictionary. (2012). Retrieved October 31, 2012 from http://www.nlm.nih.gov/medlineplus/mplusdictionary.html

The Merck Manual. (2012). Retrieved October 1, 2012 from http://www.merckmanuals.com/professional/index.html

Salute e Diagnostica – Glossario Medico. CIDIMU:IT. (n.d.). Retrieved September 28, 2012, from http://www.cidimu.it/home/gloss.asp

Sleep Terms, Definitions and Abbreviations. (2011). Retrieved October 1, 2012 from http://www.sleepnet.com/definition.html

Vocabolario Medico. Pneumonet. (2012). Retrieved September 27, 2012, from http://www.pneumonet.it/scientifico/vocabolario/default.html


EU and International Guidelines

Always Read the Leaflet – getting the best information with every medicine. (2005, July). Retrieved November 5, 2012 from http://www.mhra.gov.uk/home/groups/pl-a/documents/publication/con2018041.pdf

Comunicazione della Commissione — Linee guida dettagliate sulla domanda di autorizzazione relativa a una sperimentazione clinica di un medicinale per uso umano indirizzata alle autorità competenti, sulla notificazione di modifiche sostanziali e sulla dichiarazione di cessazione della sperimentazione («CT-1»). (2010, March 30). Gazzetta Ufficiale dell’Unione Europea. Retrieved November 4, 2012, from http://ec.europa.eu/health/files/eudralex/vol10/2010_c82_01/2010_c82_01_it.pdf

Detailed guidelines for the request for authorisation of a clinical trial on a medicinal product for human use to the competent authorities, notification of substantial amendments and declaration of the end of the trial. 2005, October. Revision 1. Retrieved November 24, 2012, from http://ec.europa.eu/health/files/pharmacos/docs/doc2005/10_05/ca_14-2005_en.pdf

Directive 92/27/EEC. Council directive 92/27/EEC of 31 March 1992 on the labelling of medicinal products for human use and on package leaflets. (1992). Official Journal L - 113 , 30/04/1992, 0008 – 0012. Retrieved January 8, 2012 from http://www.ikev.org/docs/eu/392L0027.pdf

Directive 2001/83/EC of the European Parliament and of the council of 6 November 2001 on the community code relating to medicinal products for human use. (2004). Official Journal L – 311, 28/11/2004, 67 – 128. Retrieved January 9, 2102 from http://www.edctp.org/fileadmin/documents/ethics/DIRECTIVE_200183EC_OF_THE_EUROPEAN_PARLIAMENT.pdf

Directive 2004/27/EC of the European Parliament and the council of 31 March 2004
amending directive 2001/83/EC on the community code relating to medicinal products for
human use. (2004). Official Journal L – 136, 30/04/2004, 34 – 57. Retrieved January 8, 2012 from http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2004:136:0034:0057:EN:PDF

DIRETTIVA 2001/20/CE DEL PARLAMENTO EUROPEO E DEL CONSIGLIO del 4 aprile 2001 concernente il ravvicinamento delle disposizioni legislative, regolamentari ed amministrative degli Stati membri relative all'applicazione della buona pratica clinica nell'esecuzione della sperimentazione clinica di medicinali ad uso umano. (2001, May 1). Gazzetta Ufficiale dell’Unione Europea. Retrieved December 14, 2012, from http://ec.europa.eu/health/files/eudralex/vol-1/dir_2001_20/dir_2001_20_it.pdf

eMC – Electronic Medical Compendium. (2012). Retrieved October 2, 2012 from http://www.medicines.org.uk/emc/

European Commission. (2011, June 8). Draft labelling guidance, Retrieved January 4, 2012, from
http://ec.europa.eu/enterprise/tbt/tbt_repository/EEC381_EN_1_1.pdf

European Medicines Agency. (2002, July). ICH Topic E 6 (R1) Guideline for Good Clinical Practice. Retrieved January 14, 2012, from http://www.ema.europa.eu/pdfs/human/ich/013595en.pdf

United States. Food and Drug Administration. (2001, April 19). Guidance on Medical Device Patient Labeling. Retrieved January 3, 2012, from
http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm070782.htm

Guideline on the readability of the labelling and package leaflet of medicinal products for human use, Revision 1, European Commission, 2009, 12th January. (2009). Retrieved January 12, 2012, from http://ec.europa.eu/health/files/eudralex/vol-2/c/2009_01_12_readability_guideline_final_en.pdf

ICH Good Clinical Practice. (1996, May). Retrieved January 14, 2012, from http://www.ich.org/products/guidelines/efficacy/efficacy-single/article/good-clinical-practice.html

Ministero della Salute. (n.d.). Direzione generale dei farmaci e dei dispositivi medici [Directorate general for drugs and medical devices]. Retrieved September 27, 2012 from http://www.salute.gov.it/ministero/sezMinistero.jsp?label=dipq&id=314

Ministero della Salute. (nd.). Decreto Legislativo 24 aprile 2006, n. 219 [Legislative Decree of April 24, 2006, n. 219]. Retrieved December 7, 2012 from http://www.normativasanitaria.it/jsp/dettaglio.jsp?id=23926

Ministero della Salute. (n.d.). Direzione generale dei farmaci e dei dispositivi medici [Directorate general for drugs and medical devices]. Retrieved December 6, 2012 from http://www.salute.gov.it/ministero/sezMinistero.jsp?label=dipq&id=314


Useful papers and links relating to the medical field

Agenzia Italiana del Farmaco. (n.d.). Il foglio illustrativo [The patient information leaflet]. Retrieved September 30, 2012 from the AIFA website http://www.agenziafarmaco.gov.it/it/content/il-foglio-illustrativo

Bollettino d’informazione sui farmaci [Drug information newsletter]. (2004). Retrieved September 28, 2012 from http://www.agenziafarmaco.gov.it/wscs_render_attachment_by_id/111.34536.11376819661668ca4.pdf?id=111.34563.1137681966882

Clinical Trials resources. (2011, January 12). The University of Washington. Retrieved January 4, 2012, from http://www.washington.edu/research/guide/clinical.html

Hochhauser, M. (2009). Six Questions to Ask About Consent Form Readability. Retrieved December 4, 2012, from www.primr.org

ITI Medical and Pharmaceutical Network. (2012). Retrieved October 1, 2012 from http://www.itimedical.co.uk/about.php

Raynor, D. K., & Knapp, P. (2008, October). Improving Patient Information – where do we go from here. RAJ Pharma. Retrieved January 11, 2012, from http://www.pjbpubs.com/uploads/downloads/raj/RAJPharma_October_08(web)locked.pdf ]



Blogs and articles on medical translation

Il Blog di Easy Languages. (n.d.). Retrieved October 1, 2012 from http://www.traduzione-testi.com/traduzioni/agenzie-di-traduzione/il-blog-di-easy-languages-compie-un-anno.html

The Cycling Translator. (n.d.). Retrieved October 1, 2012 from http://thecyclingtranslator.com/2009/08/31/interview-with-karin-band-medical-translator/

eCPD Webinars. (n.d.). Retrieved October 1, 2012 from http://www.ecpdwebinars.co.uk/

How to gain a foothold as a medical translator in the clinical trials industry? (2011). Retrieved September 26, 2012 from http://tran-s.com/medical-translator-clinical-trials/

Life in the Fast Lane. (2012). Retrieved October 2, 2012 from http://lifeinthefastlane.com/

Wellmanns, R. (2012). eCPD Blog – Specialising in Medical Translation. Retrieved September 26, 2012 from http://ecpdwebinars.blogspot.it/2012/01/specialising-in-medical-translation.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+eCPDWebinars+(eCPD+Webinars)&utm_content=Google+Reader

Translating for Health: How far do we take ‘faithful translations?’ (2011, February, 20). Retrieved September 29, 2012 from http://s282007880.websitehome.co.uk/2011/02/20/translating-for-health-how-far-do-we-take-faithful-translations/