The landscape of interpreting, notably in the healthcare sector in Ontario, has undergone significant changes over the last 20 years; the misconception once used to be that a bilingual with spare time could effortlessly take up the practice, giving the profession a falsely amateurish and unimpressive appearance. Now, a dynamic group of medical interpreters are creating waves as the pioneers of the first-of-its-kind accreditation in Canada, specifically for interpreting in healthcare. Helena Wong, a recently Certified Medical Interpreter (CMI), and the first Cantonese interpreter accredited by the qualifying system newly introduced in Canada from the U.S., is incontestably neither unimpressive nor an amateur. A freelance Cantonese interpreter for the past 14 years, Helena’s genuine passion for interpreting resulted in her taking on roles in the legal sector, healthcare, and many other fields in both the public and private spheres. As she candidly paints an honest portrayal of the medical interpreting field, it grows increasingly evident that the importance of CMI accreditation cannot be emphasized enough.
“In the U.S., CMI has been long well established, but it is barely known in Canada,”* Helena remarks.
“We need a lot of education so people—from agencies to clients to the interpreters themselves— see the value in CMI accreditation; that is, foremost about raising interpreters’ standards so as to protect patient’s rights and to ensure patient safety.”
To shed some light on the CMI test; it is comprised of two components, written and oral, with the entire cost including registration totalling US$450. The written section comprises of multiple choices on the Interpreter’s Standards of Practice, Code of Ethics, legislation and regulations, medical terminology and cultural awareness. The oral focuses on sight translation and role-play scenarios. To Helena, who hones her language skills on an ongoing basis, the qualification has made her more alert and focused than had an impact on her day to day work performance.
The road to accreditation proved to be a lengthy one. In March 2012, the pilot test was carried through, which Helena volunteered to participate in. She took the written test, the first in a two-part series, that August, and then waited out an entire year for the oral segment, finally receiving accreditation in August 2014. Despite all the hurdles in its setup, the program, still in its infancy, is proving to gain recognition slowly but surely in the Canadian system.
Helena stresses how more resources are needed to promote the examination, and this subject opens up an inescapable truth of the current landscape of the medical interpreting system in Canada.
“Independent medical interpreters are not recognized in healthcare, unlike in the legal field. It is in the Constitution of Canada, Section 14 of the Charter of Rights and Freedoms and adhered to strictly in court, but not in healthcare.”
She goes on to explain how the lack of CMI accreditation poses a liability issue.
“During a family meeting on a healthcare team, I might need to tell the patient sitting next to me, ‘you have three months left to live.’ With inexperienced interpreting, messages get lost and you don’t get a true sense of what is conveyed. Errors are caused at the patient’s expense. When clients complain about the interpreters, our reputation is further damaged. Only when the healthcare providers ask ‘are you CMI certified?’ our work will be taken seriously.”
She nails her point with a shocking story.
“Two weeks ago, I arrived [early] at an assignment in a hospital only to discover that the patient had left, and was informed by the nurse that a staff technician had interpreted instead.” In another case, the hospital failed to notify the patient’s family that an interpreter had been arranged for a pre-medical screening, and on arrival she had been curtly told by the relatives that her services were not required.
“As the situation unfolded, they soon realized the medical terminology was beyond them and at the end of the session expressed how grateful they are for my work.”
Helena commends agencies such as Multi-Languages Corporation, Access Alliance and University Health Network for supporting CMI interpreters and hopes that in time, with greater awareness and education, more service providers, clients and even the interpreters themselves will recognize the importance of CMI as the primary credential for medical interpretation.
By Yohani Mendis
*The National Board of Certification for Medical Interpreters reports that to-date, there are 500+ CMIs in the U.S. whereas there are only seven in Canada; 2 Cantonese, 3 Russian, and 2 Spanish.