Balancing Medical and Linguistic Expertise: An Interview with Dr. Lizbeth Mendoza

By Sharon Heller
CTA Social Media Coordinator

March 5, 2017

For the past years and continuing this year, Dr. Lizbeth Mendoza, co-chair of the International Medical Interpreters Association’s Colorado chapter, has presented workshops for interpreters at the Annual Conference of the Colorado Translators Association. We talked to her about her passion for medicine and languages.

Dr. Lizbeth Mendoza, co-chair of the Colorado IMIA Chapter
Dr. Lizbeth Mendoza, co-chair of the Colorado IMIA Chapter

Sharon Heller: We would love to know more about your background. In particular, when you decided to study medicine, did you plan to enter the interpreting field?

Lizbeth Mendoza: I love this question!!  I graduated as a medical doctor from the National Autonomous University of Mexico, a very diverse institution, and one of the oldest campuses in Latin America, and I am also a Certified Medical Interpreter CMI-Spanish by the National Board of Certification for Medical Interpreters (NBCMI). From the time I was a young child, I wanted to be a doctor, or an astronaut, because I always loved science. Yet I was also fascinated by the ability to speak different languages. Before I could, I used to play ‘pretend’ to speak English fluently, just as I used to play ‘pretend’ to be a doctor or a scientist. I attended bilingual schools all the way until university, so I was speaking English from an early age. When I traveled with my parents I was their interpreter as they don’t speak English fluently. This was general interpreting in stores, airports and the like, not medical, but I recall that I loved doing it.

When I attended medical school, English was not part of the curriculum, but English being the universal language of science, and considering that the most up-to-date scientific books and journals are in English, students, faculty and researchers were constantly reviewing information in English. English proficiency is so important for us that one of the requirements for graduation at my medical school is to pass an English Proficiency Examination provided by the school of foreign languages of the same university.

As a participant in different research projects for eight years, I was constantly generating abstracts, posters, conferences, and papers for journals, all in English. Being a student, I began to do translations for other students as a way to earn money. Later on, I got a job with a continuing medical education company, translating medical news articles from Reuters into Spanish and generating medical content (articles) for their website.

Upon graduation, I went to Maastricht University, in the Netherlands, to learn more about healthcare professions education, and during that trip I interacted with people from many different countries, all of them healthcare educators. It gave me a new perspective on other cultures, as well as my own.

Eventually, I opened a private practice in a small town (Akumal) in the jungle on the Mayan Riviera. This was an eye-opener for me as most of my elderly patients did not speak Spanish, therefore they came to appointments with relatives acting as Mayan-Spanish interpreters. I resorted to Mayan interpreting services in order to learn from the traditional healers about the traditional healing practices in the area, and about the dynamics of the culture. As it turned out, Akumal was a place of interest for tourists from the U.S. and other countries so I often found myself providing medical attention to people from other cultures, with different belief systems and expectations. It was by accident that I ended up in this situation working with multiple cultures and languages, but here I was again combining medicine and language. It was a very enriching experience as well.

After seven years I moved to Mérida to work in the hospital. When I became pregnant, and pretty much when I had my baby in my arms, I decided I wanted to stay with her all the time and be a full-time mom. My husband is American and we moved to Colorado. One evening a friend mentioned medical interpreting and I had no idea then that it was such an important profession here. I began to research the profession and discovered organizations like IMIA and CCHI.  Soon I completed my medical interpreter training, started working as a medical content learning facilitator with a training company, got my first official interpreting assignments with a local agency and completed the NBCMI certification.

SH: Do you have plans to practice medicine in the United States?

LM: Yes. Fortunately, my university education is recognized here, but I do have to complete a medical residency in the United States. Now that my child is a bit older I have more time to study and attend classes, so I’m going through the process now.

SH: How did you get involved with IMIA?

LM: As I mentioned, when I began researching medical interpreting in the USA, I learned about IMIA and CCHI. My mentor during my medical interpreter training had been very involved with IMIA for several years, and she mentioned it a couple of times during our practice sessions. Once I finished my training, I decided to become an IMIA member and I contacted the IMIA Colorado Chapter chair, as well as the IMIA Education Committee, to join them. Eventually, I became the IMIA Colorado Chapter vice-chair, an active member of the IMIA Education Committee, and I was invited to join the Commission for Medical Interpreter Education (CMIE).

SH: How does your approach differ from interpreters who don’t have formal medical training?

LM: I believe that the quantity and quality of information that I have access to while interpreting, due to my background, is a key difference because it gives me a richer context to work with. I can ponder the information provided, contextualize it and make more specific decisions when interpreting. Since context is extremely relevant for anyone working as an interpreter, I believe a deeper understanding of the medical culture, the human body, the diseases, and other aspects of healthcare, makes it easier for any interpreter to successfully work with a variety of circumstances and to anticipate potential conflicts. You may hear a word that you don’t know, or that seems odd in a certain situation, and if you have context you can ask specific questions and use your clarification protocol with ease for more accuracy and precision. It works well also for complex situations, procedures or instructions where you can process big chunks of information faster and better if you have enough previous knowledge. I can see how having advanced medical literacy skills makes it much easier to put difficult and delicate medical situations into proper context to be able to handle them better. Another aspect that I try to bring to the table is the fact that also in medical language, as in any other language, we have regionalisms, so we find terms that differ from country to country, therefore the more up-to-date an interpreter is in the medical language and literature, the more context that interpreter will gain. My primary concern is of course safety, so I believe every medical interpreter should be extensively trained, should strive to become certified, and should be willing to keep learning all the time.

Another point is that I have to remember my role as interpreter. When I started interpreting here for surgeons it was great because I knew the terminology. But at times it’s hard not to interfere because of my medical knowledge. Sometimes there is a temptation to offer more information to help the patient or the practitioner, but as an interpreter I can’t do that.

SH: Is there fair recognition for certified healthcare interpreters? Do you see room for improvement?

LM: Certified medical and healthcare interpreters are seen as highly respected professionals. They have worked for their credentials and reached the highest level of recognition in the field. They have demonstrated that they have a very high level of skill. Yet I see that the difference in agency rates for certified and non-certified interpreters is very small if any at all, and I believe there should be better remuneration for certified medical and healthcare interpreters because this is a highly specialized field. Certified interpreters need to fight for fair remuneration that reflects how much they have committed to the profession and how much they have invested in continuing education. Right now, I do not believe certified interpreters are paid fairly, however we are reaching a critical mass of certified interpreters that can actually make a change.

SH: I read that you’re the developer and director of BVCMI Interpreter Training and Freelance Medical Interpreting Services. Please tell us more about your organization.

LM: BVCMI is primarily a Medical Interpreting Training and Continuing Education company. We offer 40, 60 and 120-hour medical interpreter training programs, that are self-paced and mostly completed through asynchronous online activities, with a small component of live webinars. We are also providers of IMIA CEU’s and CCHI CE units for certified interpreters who need to recertify. I also have special courses and one-on-one mentoring sessions for those preparing to take oral certification examinations.

Something your readers might find of interest is that I have developed a tool to assess the medical interpreting skills of hospital employees who have ‘dual roles’ in that they are expected to be bilingual. The positions range from nurses to secretaries to janitors. I design dialogues to test their skills before they receive interpreter training, and then I evaluate the recordings before and after training. Hospitals can use (and have used) this tool to determine if the employee has the capacity for a dual role position.

SH: The CTA is very excited to have you conduct another workshop at this year’s conference! Would you like to give readers a brief overview of what to expect, and what attendees will take away from your workshop?

LM: This year’s workshop will be on a high risk scenario for patients with LEP: The Emergency Department. I will present research on the most frequent reasons why people go to ED, by age and gender, the most common complaints, diagnosis, and medications at the ED. There will be a brief introduction to toxicology, and the most common drugs administered. Attendees will come away with the knowledge of what happens in the ED, what can they expect as interpreters of an ED, and the type of information that interpreters should know before they step in.SHWhat advice would you offer to those entering the profession?LMFirst and foremost, ensure that you are fully bilingual. There is standardized testing whereby you can check your competence level. You can pursue a degree in translation or interpreting. Be prepared to study hard as medical interpreting is a lifelong learning process. Be humble enough to know what you need to learn. Participate actively in the industry: join professional associations on a local and national level, read their journals, blogs and social media posts. Then get ready to enter the wonderful but challenging world of healthcare. It can be overwhelming, but very rewarding.  There is a need for certified medical interpreters so keep preparing. Don’t let yourself be influenced by groups that are not committed. Don’t let anyone distract you from being a professional. You don’t want to violate the ethics of the profession.

SH: Anything else you would like to add that you think readers should know about you?

LM: As you can tell I am passionate about medical interpreter education! If your readers would like to know more, they can read my essay on why medical interpreter education is key to professionalization.

SH: Thank you very much for your time. We really look forward to seeing you at the CTA conference in April.

LM: I am looking forward to participating in another CTA conference! See you in Boulder!