Thread: A Controversial but Serious Question

Originally Posted by treydampier

Gugi,
BTW, yes, I observe language barriers daily where I am at and get to witness many mistakes because the docs can't understand the patients, and the truth is that the translators aren't that much help. Yes, I am protectionist. But, no I don't care who practices because if people want substandard care, they can choose it. However, docs training in the US should be able to fill out a survey about their program of study without having a language barrier.

Ok, while the emphasized text is at odds with your thread title, from what I understand so far you don't care much about the actual practice of medicine, but instead you have a serious issue with people not understanding survey questions which results in poor rating of an institution. My take on this is that I simply don't believe the story you've presented. From what I see it's just as likely, if not even more likely that the poor rating is actually a true reflection of these people's perception.
Obviously you've been to medical school and I haven't, but I have friends who have been and I've also seen plenty of international students first hand to know that your generalizations are completely unfounded.

Originally Posted by BingoBango

Fluency in English should be part of their education and experience. The point going further - there need to be stricter guidelines on what qualifies as fluency. Being able to spell a few choice words or figure their way through a conversation should not qualify. Doctors, necessarily, are placed in demanding situations and we should not allow for trivial communication errors that can easily be avoided - let alone facilitate them.

It appears to me you don't really know much about the current tests, although I'd be rather interested in your idea of how and by whom 'stricter guidelines' should be determined and enforced.
Being a non american in US I have taken various tests and they actually are well beyond spelling few choice words. Incidentally my performance on that 'words' test was pathetic, I was in the bottom 15%. That didn't matter much though, apparently a phone interview was enough to alleviate whatever concerns had arisen from that one score. I suppose I may have gotten the interview because on another test I had a pretty standard score, so given that they wanted me based on my other qualifications it's a matter of figuring which was the representative one.

And, yes I agree that some admissions may be driven by administrators, but I don't think the medical school ones are such. At least not at the top schools. I know this from my friends who went to interview there and their interviews were with faculty, not with administrators.

I think that you should be able to speak the language of the country you live in, if you have decided to actually stay there. I can sort of understand about not being fluent if you work ex patriate and only stick around for a year or 2.

If you live in the US and work in the US, you should aim to be fluent in English. And depending on where you live, Spanish can be helpful as well (though optional of course).

And frankly, being a doctor is a public function so talking to him / her should be possible without problems, and not like talking to the HP helpdesk in mumbai.

I dont think its controversial, its just common sense.

If you dont have the skills (technical or language) to do your job correctly, then you shouldnt be performing that job.

If a Doctor cannot understand their patients, or miscommunicates a prescription or treatment then they could misdiagnose, treat incorrectly or possibly kill their patient.

It doesnt matter what the job is, its common sense that people have ALL the necessary skills to do it, and do it right.

Only if you have medicare otherwise they can run their private practice in any language they like, can't they?

Originally Posted by commiecat

Should a pilot have to know English in order to fly a plane?

They are required to know some in order to deal with ATC. AFAIK ATC is conducted in English, globally.

Anyway, I think it's important that people learn the language of the country they are choosing to reside in. In my experience, some people really get into it and some people don't. I guess if they want a job at the end of their what ever it is, they'll need to learn some english in order to get one.

Originally Posted by gregs656

They are required to know some in order to deal with ATC. AFAIK ATC is conducted in English, globally.

Anyway, I think it's important that people learn the language of the country they are choosing to reside in. In my experience, some people really get into it and some people don't. I guess if they want a job at the end of their what ever it is, they'll need to learn some english in order to get one.

I was speaking in the most literal of terms. The plane operates the same no matter what language you speak. It might be required for certifications and licensing by whatever agencies, but it's not required to actually operate the plane.

I was also assuming a basic level of English. The original question was about fluency, which I don't think should be mandatory. If you only know certain terms specific to your field then I think that's good enough to practice.

I am considered to be a slightly liberal person, and as such no one has ever understood why it is that I think people who live and work in a country should speak the language native to that country. Apparently that goes against the liberal handbook.

But it's really very simple, to me.

I won't even go to a country as a tourist without being able to count to 20, say please, thank you, "I'd like a room," "How much does this cost?", "I need help," "Pleased to meet you," and a couple other useful things, in the language native to the populace.

Because if I don't, I feel a little embarrassed with myself. How selfish of me, to walk into someone else's country and expect them to speak my language. That's just very inconsiderate and rude.

I would sure a hell never expect to be allowed to LIVE in a country if I can't speak the language. It is not everyone else's responsibility to cater to me. If I want to move countries, and stay there, it is MY responsibility to suit myself to the laws of the land, which were there long before I got there.

So yes, I think people who want to live in America should speak English. The same way I think people who want to move to France should speak French, or those who want to move to Brazil should speak Portuguese.

The idea that we would entrust the livelihood of others to someone who can't even understand their patient's description of symptoms is ludicrous to me.

Originally Posted by commiecat

but it's not required to actually operate the plane.

Just take off and land at the right time, in the right place

Arguably, when it comes to dealing with patients, the certain terms specific to your field would be fluency, or at least, approaching it.

This is becoming a very interesting thread. I am a medical doctor from a foreign medical school, so I guess this does apply to me to some extent (though I am involved more in research and not in clinical care directly). IMO a doctor should be fluent enough in the local language so as to be able to communicate with the patient about his problems and the possible solutions. Where I come from, the medium of instruction in med schools is English so I haven't faced these issues over here in the US. The only reason I am replying to your post is because I have a few concerns about it.

Originally Posted by treydampier

JimR
First, their English is not even close to mine, either written or verbal. The problem is the institution is getting bad reviews based on a University of Wisconsin survey because the residents don't understand fully what they are filling out. It is a problem if the residents can't fill out a survey in English and then be expected to understand a patient giving a history.

Is this something that you can generalize to the entire resident population in your hospital because it is kind of hard for me to believe that they would be able to make it through USMLE steps 1, 2 CK and CS with decent enough scores to be able to match without knowing English. What I have come across more often are problems with different accents rather than lack of understanding of English.

CommieCat.
Obviously you don't know much about the students I am referring to. Many may not be qualified, but some of them have the scores and grades, but Daddy wasn't a doctor or doesn't have the pull to get them in the back door. The school I attend is better than 1/3 of the US schools in both MCAT scores and entering GPA. We go overseas because politics or some twerp keeps us out. Also, the students outscore most of these international grads from foreign countries adn in my school's situation we have the same number of 99th percentile test takers as Harvard on the USMLE. The reason they get hired is because the department heads themselves are foreign, NOT because the quality is better. Plus these US students who leave, have bachelor's degrees where most foreigners do not. That is why a US doc can practice the world over, yet a foreign trained doc must train in the US to practice.
I was asking a question and the same people advocate against anything that might demand responsibility out of people.

Again I am not sure if your statement on foreign head of departments is generalizable. I have seen how resident selection committees work and I don't see how the department head alone can have a say in the final selection of residents. For argument's sake lets assume that they can have a major influence on resident selection, I am not sure if they would want to select a poor candidate and end up blemishing their credibility.

I am a bit confused by the second highlighted sentence in this paragraph. Are you suggesting that because US med docs have a bachelor's degree, it entitles them to practice anywhere in the world ? There are licensing requirements for all foreign docs in the my country, which includes a licensing exam. I have a feeling that this might be true for many other countries.

Gugi,
BTW, yes, I observe language barriers daily where I am at and get to witness many mistakes because the docs can't understand the patients, and the truth is that the translators aren't that much help. Yes, I am protectionist. But, no I don't care who practices because if people want substandard care, they can choose it. However, docs training in the US should be able to fill out a survey about their program of study without having a language barrier.
Sorry to all the people whom I may offend. Everyone has their own opinion and its equal or better than mine.

I agree wholeheartedly that there is an increased likelihood of medical errors if there is mis-communication between the patient and his doc but that could be equally true for a fluent English speaker. I would guess that a well-trained doc (fluent or non-fluent English speaker) would try and understand the patient's symptoms correctly before prescribing anything to him/her. In my experience more often than not it is the patient who fails to make any sense of the doc's medical jargonistic crap. Even very fluent English speakers (US and non-US) forget that they are not yapping in a department meeting but are in fact talking to someone who simply is not familiar with medical terms.

All said and done, IMO practicing medicine is more about understanding your patient's symptoms, providing a close enough or accurate diagnosis and treating the medical condition correctly based on set guidelines/ protocols.

They should speak the Queens English. I feel much more confident about my doctor when he has an English accent.