SubscribeMedical translation is not just a 'downstream' service, but should be taken into account while writing.
If that happens, the quality of the translations will go up, the time it takes will go down, and as a result cost are saved. Medical translators can do a better job and work more efficiently if they don't need to resolve source text issues.
Nowadays, the output of medical writers may be translated into anything between just Spanish for domestic (i.e. US) use and over 20 official EU languages, and more. Translation is quite a bit less expensive than writing, but for a dozen or so languages it still adds up to a big cost item. So, whatever can be done during the writing process to facilitate translation, will have an effect on cost and - sometimes more importantly - time.
Translation is also a risk opportunity, i.e. an opening to incorporate errors. When something goes wrong with a medical translation, this may have serious consequences: a patient may die, or the FDA, its European counterpart the EMeA, or similar organizations in Asia, may delay marketing authorisation for a product. Which is also rather serious, as this shortens the patent protection period during which the development cost of medicines have to be earned back.
'Why translate if everybody speaks English?'
Apart from the obvious marketing reasons to translate medical information, and of course the genuine intention to make sure that users/patients understand what they do or swallow, there are many legal reasons. A handful of European Union Directives concerning medicines as well as different types of medical devices, in-vitro diagnostics (pregnancy, cholesterol, hepatitis C, HIV tests) and implantable medical devices (pacemakers) specify what information needs to be available for the user and in most EU countries there is a legal requirement that this information has to be translated. If this does not happen, it is illegal to sell the medicine or the medical device or test kit in that country, simple as that. To not translate is not an option.
What does a medical translator look like?
First of all, most look like women. Actually, most (6:1) are women. Another characteristic is that their background is most often in languages or translation, but quite a few have a medical background (4:1). No matter where they come from, good medical translators have many years of experience and usually they are involved in medical translation most or all of their time. Medical translators typically are independent contractors - practically no in-house translation department with staff translators has survived the outsourcing trends of the 80s and 90s.
What types of work do they do?
Most of the work medical translators do concerns medicines, clininal trials, medical information in general, or medical devices and equipment. Typical jobs are users' instructions for medical devices, information about medicines for professionals and for patients, clinical trial protocols, instructions for investigators, patient questionnaires, articles from medical journals, and so on. It is probably safe to say that anything medical writers produce, medical translators across the world may get to translate.
How come translation is so strong in Europe?
Medical writing should be done close to the development of products, which is why there are so many medical writers in the USA, where most HQs of pharmaceutical companies and medical device manufacturers are based. Medical translation, however, should be done close to the end user, preferably in the country where the target language is spoken. This is why there are more medical writers in the USA than in Europe and more medical translators in Europe than in the USA. With a membership of over 5,300, the American Medical Writers' Association (AMWA) is almost ten times bigger than its European counterpart EMWA.
Translation quality problems
There are three main causes of translation quality problems:
1) Incompetence of the translator: this can be argued to be the customer's responsibility (who apparently made a selection error), but usually it is just the translator or translation company who overestimated his or their abilities or who did not want - or could not afford - to say 'no'. It can also be the result of a customer looking for a cheap deal ('pay peanuts, get monkeys').
2) Lack of time is another main cause of translation problems. Very often there is simply not enough time available for the translator to dedicate the amount of care a quality translation deserves. No matter how well the source text has been written and no matter how qualified the translator is, if there is not enough time to do the work, the quality is jeopardised.
3) The final main cause of translation quality problems is - even if the translator is competent and there are no time restraints - the source text, or rather: the shortcomings of the source text.
Source text problems
The source text can have shortcomings in three main areas: 1) the actual contents, 2) the lack of 'internationalization', and 3) issues related to the format and layout of the document.
The contents may have problems caused by typing errors, incorrect choice of terms, writing errors, and ambiguities. An incorrectly placed decimal point in '0.01 mg' results in a difference of at least a factor 10, which may kill a patient. If 'mg' is (incorrectly) used for microgram but is, understandably, assumed to mean milligram, this is a difference of a factor 1,000.
Even though a spellchecker would accept both nephritic and nephrotic, arthritis and arteritis, or ureter and urethra, these words have totally different meanings. Other writing issues translators have to solve are things like non-standard abbeviations and acronyms (please write them out at least once), trade names of medicines (please also use the generic name), the use of vague terms like 'dropperfull' (how full is that, to upper calibration mark, or brim full, or a dropper supplied with a different product?).
Also, what is meant by 'should': 'must' or 'it is recommended'? Please be clear in such cases, as a translator hás to select one meaning, and may select the wrong one. In general, it is better to not use different terms for the same concept, or terms that have a different meaning, unless you are sure the reader can't go wrong (how often can you be sure of that?).
If a text is 'internationalized' this means it is 'translation-ready', or 'world-ready'. It should be free of local or national circumstances or references to local populations and statistics, unless these are relevant for readers in - say - Lithuania. Also, the writer of a translation-ready text has been very careful with illustrations and colors. Many of us know a dog as a great pet, but in many parts of the world a reference to or a picture of a dog is culturally offensive. With pigs, it is even worse, and in some cultures even an illustration of a woman may bring across the wrong message.
Same with colors: in the Western world, red often refers to happiness but in other cultures red may have a different connotation. We associate black with death and funerals, but in China the color white has that meaning, while in the Western world white is associated with purity. Also, stay away from references to 'first base' and 'bottom of the ninth' as baseball doesn't mean a thing in Europe. And please be aware that, like good wine, humor usually does not travel very well...
Format and layout issues
Most European languages need more space than English. Allow up to 20% extra space for normal body text, 100% for headings, and 250% for short headings and for engraved terms on key caps, buttons or machines. Make sure the translator can reach (and change) the text in illustrations, use fonts that are generally available, and always, please always use index markers to generate an index.
Please note that for languages such as Arabic, Hebrew and Japanese the page formatting work has to almost start from scratch, due to the different reading direction of these languages (top to bottom, or right to left). PDF files are great to read or print, but they are not suitable as input for translators; always try to also provide the underlying file (Quark, Word, PageMaker, InDesign).
Cost of writing vs. translation
The cost of medical writing is around 8 times higher than the cost of translation. It is therefore better to write once, and then translate into all required languages, but in that case a high quality level of the source text is key. At $0.25 or so per word, translation does not have to be expensive, but only as long as the process is smooth. Updates and last-minute corrections take a lot of energy and create an opening for new errors. It is obviousy better to fix a writing error in the source text, before translation, than doing it in 25 language versions.
Consequences of translation quality issues
The certification process of medical devices and the marketing authorization application for medicines can be delayed if there is a serious problem with even just one of the languages. This means loss of time-to-market and, in the case of medicines, a shortening of the patent protection period, which is the time window of several years during which the development investment of hundreds of millions can be earned back.
If a translation problem ends up in printed and distributed patient or user information, consequences may even be more serious. If something goes wrong with a drug or a medical device and the patient or the user of the device feels that the information or the instructions were not clear, this may very well lead to heavy damages claims, which cost money, hurt corporate image, and may eventually bring a company down. In keeping translation in mind, medical writers can help prevent this from happening.