Medical and life sciences translation is an intimidating specialization for linguists lacking a scientific or technical background. The technical terminology, handwritten doctor notes, acronyms, complex medical phraseology, and regulatory requirements can leave novices treading in troubled waters. In this presentation, we will tackle the primary barriers to entry, explore linguistic and medical resources to build a better understanding of medical terminology and concepts, and examine the structure and scope of commonly translated documents (reports, journal articles, regulatory submissions, trial protocols, etc.). We will also discuss appropriate points of entry, industry standards, and language- and locale-specific challenges.

1. Please take the quiz
while you wait.
So You’re Not a Doctor:
Taking the Plunge into Medial
Translation without an MD

2. Quiz review: Question 1
In “Administer 300 IU/kg of body weight,”
“IU” means:
A. Iodine Unit
B. 5-Iodouracil
C. International Unit
D. Intrauterine
Quiz

3. Quiz review: Question 2
Which of these does not belong?
A. Anjina (TR)
B. (RU)
C. Angina (EN)
D. Angine (FR)
Quiz

4. Quiz review: Question 3
The largest therapeutic category for drug
development is:
A. Central Nervous System
B. Infections (HIV, Hepatitis, etc.)
C. Autoimmune & Inflammatory Diseases
D. Cancer
Quiz

5. Quiz review: Question 4
Which of the following is an invasive procedure?
A. Stress Echocardiography
B. Transesophageal Echocardiogram
C. Plain Abdominal X-ray
D. Transthoracic Echocardiogram
Quiz

6. Quiz review: Question 5
Which of the following is not a national
regulatory body?
A. FDA
B. AFSSAPS
C. AQuMed
D. Health Canada
Quiz

7. Presentation overview
1 Introduction & background
2 Challenges & barriers to entry
3 Getting it right
4 A closer look
5 Resources & standards

8. 1. Introduction & background

9. Industry overview: Fast facts
Growth industry
2011 pharma sales > $880 bn
Regulatory opportunities
It takes the FDA an average
of 16 months to approve a
new product
Expanding geographic/linguistic requirements
25-27% growth in top 17
“pharmerging” countries
Sustained growth/aggressive vertical
Average cost to bring to
market = $500 mn;
Average product life cycle
= 10 years
1- Introduction & background

10. World market trends
1- Introduction & background

11. Clinical trials around the world
1- Introduction & background

12. “Pharmerging” markets
Tier 1: China
Number 3 market with sales
driven by locally
manufactured generics &
imported products
Consistent double-digit growth Tier 2: Brazil, Russia, India
with rising middle-class
populations, improved
infrastructure, and IP rights
Complex, rapidly changing Tier 3: Fast followers
markets contributing $1 – 5 bn
(Venezuela, Poland, Argentina,
Turkey, Mexico, Vietnam, etc.)
1- Introduction & background

13. Increases in medical
translation volumes
Globalization Communications and Development Pipeline
IT Technology
Aggressive overseas More products in the
marketing for sustained Increase in text-based pipeline to ensure ROI/
growth information “blockbuster” products
1- Introduction & background

14. What it means to specialize
It’s not enough to know anatomy
and biology to be a doctor, so why
would simply being bilingual be
enough to be a medical translator
or interpreter?
1- Introduction & background

15. The perks of specializing
Medical translation prioritizes quality
and expertise over deadlines and costs
more profitable market for
proficient specialists
1- Introduction & background

16. … and what will I be translating?
• Case report forms/SOAPs
• Clinical and instrumental reports
• Clinical development/trial data
• Drug monographs
• Multilingual consulting
• Informed Consent Forms
• Linguistic validation
• Marketing materials
• Medical/scientific journal articles
• Packaging and labeling
• Pharmacovigilance/safety reporting
• PRO and QoL instruments
• Regulatory documentation
• Sales materials
• Software and website localization
1- Introduction & background

17. Stakeholders & clients
1- Introduction & background

18. Spectrum of points of entry
PH Brochures RA + QC Drug monographs
In-country
validation
Minimally Extremely
specialized specialized
ICFs
Protocols
1- Introduction & background

19. Medical life cycle opportunities
Clinical stage
R&D
Regulatory
Manufacturing Sales &
Marketing
1- Introduction & background

20. 2. Challenges & barriers to entry

21. Regional divergences
• Regional differences in the regulatory/
approval process
• Locale-specific terminology
• Variations in healthcare systems
• Readability index for target population (consent
forms, patient information leaflets, etc.)
2- Challenges & barriers to entry

22. Deciphering handwritten notes
Extremely common!
2- Challenges & barriers to entry

23. A known problem!
From an ISMP – FDA – HHS Campaign
2- Challenges & barriers to entry

24. … further complicated by
translation
2- Challenges & barriers to entry

25. A practical example
Yikes!
2- Challenges & barriers to entry

26. Decoding acronyms & symbols
Symbols and shorthand are common:
Be vigilant about creating glossaries/
references for your future reference
* = birth, † = death
= diastolic blood pressure, v = systolic pressure
= before, = after
= start of operation, = end of operation
= psychologist
( ) = possibly significant
= right upper quadrant
= plantar response, = extensor response
M = murmur
= fluid ounce
# = fracture
= pulse rate, = anesthesia
2- Challenges & barriers to entry

27. Understanding regulatory
requirements
• EU Medical Device Directive 93/42/EEC requires
companies to adopt a specific multilingual
documentation process
• Use of fully prescribed name
• Adequate communication of indication
• Disclosing risk information
Back-translation is now an essential
benchmarking tool and quality strategy
2- Challenges & barriers to entry

28. Medical terminology & jargon
Transport pt to OT tid via W/C
A. Transport patient to occupational therapy
three times a day via wheelchair
B. Transport patient for outpatient treatment
three times a day per
worker’s compensation
C. Transport patient to occupational therapy
three times a week via wheelchair
D. Transport patient to outpatient treatment
three times a week via wheelchair
2- Challenges & barriers to entry

29. The learning gap
1. Know your limitations
2. Learn about the regulatory environment for
your country/language combinations
3. Research existing products & companies in
your target language
4. Invest in your terminology
5. Never make assumptions! Check, then
double check!
2- Challenges & barriers to entry

30. 3. Getting it right

31. Defensive translating
Part of being a good translator is
knowing how to diagnose potential
mistakes before you make them
3- Getting it right

32. Common misinterpretations
3- Getting it right

33. Faux amis – False friends
Cognates and faux amis can be deadly in a
clinical context
Source Faux amis translation Correct translation
(RU) Angina (EN) Tonsillitis
Auricle (FR) Auricle (EN) Atrium
After (DE) After (EN) Anus
Carbunco (ES) Carbuncle (EN) Anthrax
Aspirazione (IT) Aspiration (EN) Suction
3- Getting it right

34. Terminology shifts
English has a relatively large vocabulary, creating
language shifts during translation
Source Translation Comment
Aches and pains Rigidez (ES) 2 words do not exist in
Spanish for “aches”
and “pains”
Cytomegalovirus No abbreviation available in
(CMV) (--) (EL) Greek, use full term
Magnetic Resonance Segulómun (MRI) Interchangeable use of full
Imaging (MRI) (IS) Icelandic term and borrowed
EN term
3- Getting it right

35. Geographic usage
Observation:
Canada tends to use the
verb recommander, which
makes it impossible to use
recommandations as the
subject of the verb
Term France Belgium Switzerland Canada
Recommandations 9 2
Lignes directrices 1 2
Guides 1 1
Source: “Répertoire des lignes directrices de pratique médicale et tables rondes
consensus francophones, ” http://www.chu-rouen.fr/ssf/recomfr.html, p. 1-6.
3- Getting it right

36. Know international standards
• ICH Good Clinical Practice Guidelines
How trials should be conducted, roles and
responsibilities of sponsors,
investigators, and monitors
• Declaration of Helsinki
Ethical principles on human experimentation;
cornerstone document for human
research ethics
3- Getting it right

37. Medical usage & abusage
• Default to literal/equivalence translations may be
inappropriate and/or deadly
• Medical writing uses a specific style and jargon
that can be foreign to linguists
• Interlinguistic shifts in terminology
3- Getting it right

38. Translation strategies
1. Be methodical: Decode acronyms
source expanded source expanded target target acronym
2. Never be satisfied: Research the source term,
then find proof in the target language
3. Know your audience: Where does your term fall
on the scientific spectrum?
3- Getting it right

39. 4. A closer look

40. Back to our example…
“Physical exam”
Sometimes we see “examen
objectif” => “objective exam”
is a common false friend
Vital signs
Learn these by heart in your
language(s) – along with all
shorthand/abbreviations
Systems
Learn the organ systems
and associated
systematic examinations
Abbreviations
You will see these… all the time:
4- A closer look I promise!

41. Usage
Are you for or against vaccines?
Vaccin antigrippal, vaccin grippal, vaccin contre la grippe (FR)
Vacuna antigripal, vacuna gripal, vacuna contra la gripe (ES)
Flu vaccine (EN)
4- A closer look

42. Divergent medical terminology
Condition Cause of English French
condition
Natural sleep Sleep Sommeil
Condition in Hypnotism (non- Hypnosis Hypnose
which the drug-related Synonyms:
patient responds maneuvers) État hypnotique
to suggestion État hypnoïde
Narcoanalysis, Subnarcosis Subnarcose
Narcosynthesis Synonyms:
(Low doses of Hypnosis Narcose liminaire
anesthesia) Hypnose* (not rec.)
Artificial sleep, Drugs Narcosis Narcose
Loss of (somniferous Pharmacological
consciousness drugs, hypnosis
from anesthesia anesthesia) Sleep* (not rec.)
(deep sleep) Hypnosis* (not rec.) Hypnose* (not rec.)
4- A closer look

43. Term mapping
4- A closer look

44. Find your niche!
4- A closer look

45. 5. Resources & standards

46. Essential print references
Maxwell Quick Medical Reference
Quick pocket reference: ECGs, lab values,
formulas and equations, orders, and admission
and progress notes
The Massachusetts General Hospital
Handbook of Internal Medicine
A loose-leaf reference on common problems in
internal medicine, tables, diagrams,
and abbreviations
Medical Abbreviations
Alphabetic list of abbreviations and acronyms
with an index of expanded terms for
reverse research
5- Resources & standards

47. Medical terminology
Lab Tests Online
Clinical lab test resource
www.labtestsonline.org
MediLexicon
Medical abbreviations and dictionary (English with some
French, German, and Spanish translations)
www.medilexicon.com
Medline Plus Dictionary
National Library of Medicine Dictionary
www.nlm.nih.gov/medlineplus/mplusdictionary.html
Stanford Lay Language Dictionary
Glossary of medical terms and corresponding lay terms
and definitions
www.humansubjects.stanford.edu/new/docs/glossary_definit
ions/lay_language.pdf
5- Resources & standards

48. Approved terminology
EMA – QRD IHTSDO – SNOMED MedDRA
Multilingual QRD templates for Comprehensive collection of Clinically validated international
product information multilingual clinical medical terminology and
and packaging healthcare terminology AE dictionary
www.ema.europa.eu www.ihtsdo.org/snomed-ct www.meddramsso.com
5- Resources & standards

49. Registries and term banks
EU Clinical Trials Register Medline Plus Dictionary
EU clinical trials registry National Library of Medicine Dictionary
www.clinicaltrialsregister.eu www.nlm.nih.gov/medlineplus/mplusdiction
ary.html
WHO International Clinical Trials
Registry Platform (ICTRP) RxList
Online, multilingual international clinical Online drug index, including side effects,
trials registry interactions, etc.
www.who.it/ictrp/en www.rxlist.com
US Clinical Trials Database EMA
US registry of clinical trials in a Frequently used non-standard
harmonized format abbreviations
www.clinicaltrials.gov www.emea.europa.eu/htms/human/qrd/doc
s/listnonstandard.pdf
5- Resources & standards

50. A reference reference
Tool Box for the Medical Translator
by Alain Côté
An absolute essential for novice or experienced
translators with one of the most comprehensive
compilations of resources (French –
English focus)
www.groupetraduction.ca/do
cuments/ToolBox.pdf
5- Resources & standards

51. Questions?