Medical Translations: Challenges and Solutions

The medical translation field is highly complex, posing constant challenges of disseminating new knowledge and discoveries across cultural boundaries worldwide.

Austrian born American medical translator, Henry Fischbach (1921 - 2008), is famous for stating that "medical translation may well be the most universal and oldest form of scientific translation because of the ubiquitousness of human anatomy and physiology (after all, the human body is much the same everywhere)."

As Fischbach puts it, the demand for medical translation and interpretation is continuous, as, since time immemorial, studies of the human body have focused on exploring common features and finding universal solutions for the inherent issues all humans face alike.

Let's take a diachronic look into how medical translation discourse has evolved over the ages.

Long before English was adopted as the lingua franca of medical discourse, Latin and Greek terminology dominated life sciences—both from an educational and a practical standpoint.

According to Leon McMorrow in his work "Breaking the Greco-Roman Mold in Medical Writing: The Many Languages of 20th Century Medicine," (1998) Latin and Greek shaped the linguistic conventions for scientific discourse for more than two millennia, disseminating and imparting advanced medical knowledge across the cultural boundaries of civilizations.

Starting from the Middle Ages onwards, we can speak of the concomitance of both Latin and Middle English in medical communication, which will go on until the break of the 19th century, thus putting an end to the solemn reign of Latin in teaching and writing regarding medicine.

Which brings us to more recent times, over the past two centuries, engulfed by social and political turmoil that took a toll on medical knowledge and language alike, generating major changes in medical terminology and enfolding its classical heritage with many layers of heterogeneous novelty.

Nowadays, modern medical texts exhibit an even wider range of types and forms: medical textbooks or plain medical records, prescriptions, summaries of products, guidelines of instructions, clinical trial protocols, highly-detailed medical journals, drug ads or patient forms or consents.

When translating medical texts abundant with scientific and technical terminology, "thou shalt understand thy source text" represents the basic, mandatory creed.

Adding to this rule of thumb, the underlining features implied by all of these content forms is represented by style, tone, veracity, accuracy, and consistency.

The tone of each medical translation text type changes in relation to the culture-dependent and region-specific audience it targets and a high-quality medical translation piece of writing has to effectively cater to the spectrum of needs of this specific audience.

The terminology language and the way it is used in different medical-related fields are typically aimed at a specialized community, implying a professional command of both medical knowledge and expertise.

Specialists commonly coin it "scientific language", highlighting the lack of emotional output, biased interpretation, subjective connotation, and—most importantly—the impossibility to guess or approximate it.

Along these lines, the main concern of medical translation is establishing an inextricable link or interdependence between the user, the field of use, and the specialized domain of application of the medical language employed.

For example, if the medical communication is conducted between an expert and lay reader, such as between a doctor and patient, or a medical device/drug manufacturer and an end-user, the translation must adopt a more neutral tone, exhibiting less complex language and terminology, also providing further insight to fill in the blanks of understanding the specialized terminology from the end-user/lay reader's side.

On the other hand, in highly scientific translation cases, specialization represents a must, and clients adamantly require that translators strictly follow the jargon and other scientific terminology desired by the professionals at whom the medical translations are aimed.

In the medical translation field, to translate or not to translate: that is the question!

The success or failure of a medical translation is always ensured by how exact and accurate the terminology is employed in relation to the context, as well as the level of knowledge and understanding of the subject field exhibited by the linguist and their awareness of what should or should not be translated.
The pitfalls and challenges in the medical translation field could be classified based on the criteria of equivalence, readability, eponyms, acronyms, affixation, doublet, and polysemy, which represent major stylistic and lexical issues that can make or break a medical translation.

Let's take into consideration some medical translation-specific examples, such as the relentless issue of eponyms or the question of target-culture equivalence.

Medical eponyms represent specific terminology in the field of medicine, indicating medical conditions or disorders that take their name after people (and occasionally places or things).

According to academic works such as "Medical Translation Step by Step – Learning by Drafting" by Vicent Montalt and Maria González Davies (Routledge, 2014), Basedow's disease, Flajani's disease, Graves' disease, all refer to "hyperthyroidism", while Barlow’s disease, Barlow’s syndrome are variants of the plain "vitamin C deficiency syndrome".

Given the broad spectrum of the terminology employed in the field of life sciences, a question of choosing between an eponym and another equivalent term arises, as particular attention must be given to employing terminology also based on which option is more commonly or widely used in the target culture.

Moreover, beyond the intricate vocabulary and technicalities, the challenges of medical translation on a global scale also come down to a matter of accuracy and compliance with market specifics. This goes beyond the exclusive approach of abiding by the source and not taking too many liberties with the text and is also subject to new and far more stringent requirements and regulations. Additionally, it is important to pay attention to terminology equivalence in order to avoid mistranslations.

If we could pinpoint the single most relevant difference between medical translation expectations and those of other industries, the keywords “standard” and "quality" would definitely stand out.

The main requirement for medical translation vendors and their linguist pool is to have hands-on experience, a flawless command of theoretical frameworks, and, of course, knowledge of field-specific terminology.

Customers of an LSP (Language Service Provider company) that specializes in Medical Translation Service should expect a highly-standardized translation process with quality in mind resulting in the highest degree of translation quality.

Moreover, any potential buyers of medical translations place a very high value on continuous assessment and regulatory compliance with accredited frameworks and regulations from their LSP's side, thus reducing the risks of bad feedback and negative backlash.

It is paramount to be fully acquainted and aware of the MDD (Medical Devices Directive), other local government standards and regulations for their specific markets.

Also, the standardized medical translation processes regulated by International Quality Standards (ISO) is paramount towards meeting the Quality demands delivered by an LSP.

Therefore, a two-fold approach is critical in translating medical texts—translations must cater both to the terminology and stylistic rigours and demands of the targeted markets.

In light of the abovementioned, let’s also take a look at the key benefits that set the medical translation field apart from other types of translation fields sought after by stakeholders worldwide:

Now, speaking of the main requirements from linguists undergoing medical translation processes, the following rank high in customer expectations and distinguish an experienced medical linguist from a non-medical one:

All the aforementioned points being taken, the field of medical translation ensures growing opportunities and challenges for LSPs, translation companies, and translators to test their limits and contribute to the maintenance and development of the well-being of humanity through a solid and quality-oriented medical translation that checks all the requirement boxes of any stakeholder.

Currently, in the context of pharma, biotech, chemical, and medical device industries soaring in terms of research and investment opportunities across the globe, the demand from LSPs and translation companies to tackle as diversified of a medical content as possible has never been more pressing.

Thus, we cannot overlook how competitive this specific translation field is, especially when it comes to entrusting such a great responsibility of translating patient-sensitive data or highly-specialized medical research studies that impact our world tremendously to the right contender.

We can discuss the key factors that differentiate and set aside a competent, prolific medical field LSP from generic translation companies in terms of the following:

With regards to the versatile content, we can count the following: medical website/marketing materials, medical signage content, patient forms, clinical trial documents/medical research papers on different products, and prescription labels as some of the trendiest and most popular.

Hospital website content is not far behind the leading marketing contenders out there, and the need to promote medical content into various languages is growing in demand in order to reach and secure as many potential clients as possible.

Large medical facilities or medical company conglomerates are in high-demand of translations in a wide range of languages for their signs, with the goal of enabling patients worldwide to navigate and access their designated areas of treatment more easily.
Also, as medical facilities are constantly populated by patients who seek different medical services in a myriad of languages, translating patient forms has never been more sought after.

Moreover, the medical translation of clinical trial and medical research documents or prescription labels is highly popular, as it ensures the communication gap is covered between the developers of medical services/products and users worldwide.

With regards to regional medical market standards compliance, staying compliant with national and international medical translation regulations is like navigating a sinuous maze translation that vendors, linguists and clients alike must navigate.

One of the main references in this respect is the MDD directive, which categorizes the medical content for translation in labels, safety instructions, and instructions for use: each category being subject to different approaches in the specific country or region in which it is applied.

One valuable example in this sense for the EU would be Estonia or Finland, which make a clear distinction between the professional and public user in its description and translation of medical labels, displaying text in both English or other languages for professional use and only in the local language for public use.

In Canada, the duality of English and French as official languages prompts translators and service providers of medical translation to abide by the guidelines for labelling medical devices, which require the bilingual rendition of the content for general consumption.

In contrast, the Asian market is more exclusive as Asian medical translation regulations for pharmaceutical labels in Japan and China have underlined the necessity of Japanese or Chinese-exclusive language content, submitted for approval by the Ministry of Health, Labor, and Welfare (MHLW).

Over the last decade, China has risen as a considerable market and a valuable outlet for expanding medical devices and is currently competing arduously with the U.S., Germany, and Japan, running efficient and thorough assessments of their medical labelling in variations of Mandarin Chinese and other dialects to ensure the reliability of their medical content.

Therefore, each medical company needs to thoroughly localize their content into various languages that cater to the standards and requirements of the targeted markets, stressing the importance and value of LSPs that can provide custom-tailored linguistic solutions to their specific wants and needs, beyond any boundary.

In line with the above knowledge of the region and market-specific medical regulations comes the effective technical management of medical translation processes.

In this respect, a quality medical translation is also ensured by the adequate equivalence and adjustments of metrics from the source to the target language.

Be it converting specific units from Imperial to metric or plainly terminological consistency from source to target, the utmost attention to localization details must be ensured in order to generate a favourable, high-quality translation result.

Adapting to cultural sensitivities

And of course, it goes without saying that in the field of medical translations complying with these official directives and regulations and effectively localizing the medical content to cater to target languages must also be doubled by an awareness of cultural sensitivities.

A savvy medical service provider or company can adjust to any scenario in terms of linguistic output as exhibiting an in-depth grounding in the two cultures involved in the translation process represents a key asset of any professional LSP specialized in the field.

Medical translation poses continuous challenges and raises constant issues that translators, translation service vendors, and medical service buyers and stakeholders have to brave and overcome. It is also a valuable bridge between cultures and identities, conveying in so many different languages the message bound to a single voice.

In this article, we briefly explored the evolution of medical translation from its advent to modern times, observing the linguistic challenges in light of culture-specific sensitivities, to get a better understanding of the interdependence between medical language and its practical use in relation to the target audience.

Ultimately, we went through some key business practices and features of medical translations, acknowledging the ever-growing potential of this translation field on a global scale for buyers and stakeholders worldwide.

For nearly two decades, AD VERBUM has been working diligently to raise awareness as well as develop its own medical translation linguistic basis, delivering extensive and quality-oriented medical translation services while navigating the twists and turns of this ever-growing maze.

We do hope that these facts and best practices have inspired you to seek out more about this diverse field of medical translations, as well as given you a glance at its business potential and the value behind translating medical materials with the use of an LSP certified to work with medical content.

McMorrow, Leon. (1998), Breaking the Greco-Roman Mold in Medical Writing: The Many Languages of 20th Century Medicine, J. Benjamins Publishing Company: Amsterdam.

Montalt, Vincent. González Davies, Maria. (2015). Medical Translation Step by Step – Learning by Drafting, Routledge.

Fischbach, Henry. 1998. Translation and Medicine. J. Benjamins Publishing Company: USA.

US National Library of Medicine, Bull Med Libr Assoc. 1962 Jul; 50(3): 462–472. Article – “Problems of Medical Translation” by Henry Fisbach retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC197861/