Basic Language Skills within the Context of Medical English: Introductory Notes to New Enrollees in in Medical Colleges By:

Mohammad Mustafa General Overview Few decades ago , the term " medical English " (ME) was an elusive concepts for many people including those who study or work in the fields of medicine and health. For those , language is an abstract means of communication and cannot be branded according to specified field such as medicine , engineering , literature , or computer . Medical doctors , dentists , pharmacists , nurses and medical technicians do not speak special English other than English spoken by other professionals. However , over the past decades , the experts of teaching English as a second language (TESL) used two terms to distinguish between types and orientation of the materials used in teaching and learning a foreign language. These terms are stated in two domains : [1] English for General Purposes (EGP) , and [2] English for Specific Purposes (ESP) . A third domain has also emerged : 'English for Academic Purposes (EAP)" which is categorized as a branch of the latter . EGP focuses on the four basic skills : listening , reading , speaking , and Writing . Within the spectrum of this domain learners of English study the foreign language with intension to acquire adequate level that enables them dealing with English for cultural and daily life activities, i.e. EGP has no any orientation towards a specified field of knowledge . English, a student had studied in schools before he/she joined the university is EGP . The selected pieces which students had been exposed to, within their study of English when they were in the secondary school encompass diverse reading passages from history , geography , literature , physics , culture , economics, and of course health. ESP deals with learning of English with special orientation of the learning materials to a specified field that matches the specialization or the profession which the learner is going to undertake. Therefore Medical English is a term used to describe the learning materials, and not the language itself , i. e. it is a matter of the syllabus contents. ESP serves two purposes : the academic and the professional dealings with texts and vocabulary associated with the target field. English for academic purposes (EAP) is a type of ESP but it is thought as a confined field that provides students with adequate knowledge of the English language particularly for those who peruse their studies ,in whatever specialty, in English . In most cases , students in colleges undertake at least one or two courses in EAP for research and reading purposes while they receive their courses in their native language. Thus , English here is not undertaken as a majoring field but as a means to academic culture and leading.

Medical English or 'English for Medical purposes' is taught to students because they are medical students who must approach the language of medicine. It is estimated that more than 65 % of the world medical materials is written in English. What is written in your native language , Arabic, comprises only 1 or 2 % .Students also need ME because English is the means of instruction in their faculty. Accordingly, ME helps students study medical text easily , make use of medical books, journals, and references in their college's library ; and retrieve diverse materials in thousands medical websites. It also helps them use technical English when they become medical professionals. Worth mentioning, EGP and ESP are not corresponding concepts . Medical English , is comparable , for instance, to computer English , business English and literary English. Syllabuses of these disciplines are often taught beyond leaning EGP, or in other words a student can not learn English as ESP before he/she gets a satisfying aptitude in EGP . The contents of medical English is focused on diverse interrelated aspects that will help learners achieve the following objectives: 1. To study the most commonly used medical terminologies of diseases , techniques , drugs , electronic devices , medical sciences, substances , health conditions and ..etc. The product of this study is mastering the meanings , pronunciation and morphological structure of each terminology. 2. To study medical affixes (prefixes & suffixes) That will aid students with a good proficiency to identify medical terms without going to their dictionaries. Presume that a student knows that prefix 'hepa' which means liver , and suffix 'itis' means inflammation , then a student will directly recognize the meaning of the term 'hepatitis' as 'inflammation of the liver' when he/she comes across this term for the first time in a text. 3. To identify the abbreviated terms , e.g. 'ELISA' 'Enzyme linked immunosorbent assay' , when mentioned in a medical text without full words that the abbreviation stands for. Within this course students are going to study the common medical abbreviations (acronyms, alphabetized, and signs) with words that the abbreviation stands for in addition to definition , e.g. ELIZA is the test used to detect HIV/AIDS. 4. To acquire general and basic information about health matters that helps learners be familiar with the academic specialized courses taught in English. However , most of reading passages in medical English are selected from texts written for public readers who seek medical culture and general knowledge. 5. To develop the learners' proficiency in listening , reading , speaking , and writing with special orientation towards health and medical matters. 6. To deepen the level of the learned general English for academic and professional purposes. Learners will not only learn medical terminologies but idioms , sentence structures , verbs , nouns , adjectives , and adverbials that are commonly used by health workers and physicians. ASSIGNMENT : Search in the internet for medical English and write about its importance for a learner of medical sciences.

B. Listening in Medical English Listening in learning English as a second Language does not mean to hear what is presented in front of students in English but to understand and assimilate it to make a required response. When a student comes to a lecture on one of the academic regular course he/she may encounter two difficulties: 1. To understand the foreign language in which the lesson is lectured. 2. to understand the content and achieve the objectives of the lessons stated in terms of students' behavior. By listening learners make at least four kinds of responses. a. Mental comprehension, i.e. to understand what is spoken in front of them. b. Physical nonverbal response , e.g. to raise your hand if the instructor asks "Who can answer this question? c. Verbal response , i.e. to give an answer or make comments to what is spoken. d. Imitating response , i.e. to reproduce what is spoken in the same words or by rephrasing it. Presumably, If students study the same lesson in their native language, they will face only one challenge which is the assimilation of the content. Yet , a student may wish to tell the instructor to speak slowly , translate, and/or use explanatory procedures to simplify the content. The more a student needs such tips , the more he/she needs to develop listening capacity. Experts of TESL may tell students that the best to do to improve listening skill is to listen and train oneself to overcome the challenging difficulty. Techniques that are often used by instructors of English to help learners develop their listening include the following: 1. Listening is not a separate skill from other skills particularly reading , therefore a learner should associate improvement of listening capacities with reading exercises. 2. Listening can be improved through audio-visuals , e.g. learners can utilize watching films. 3. Listening can be improved by speaking because when a student train him/herself to speak he/she makes structures and the foreign language turns familiar and easier. Of course, the relationship between speaking and listening is reciprocal because a student also develops speaking skills. 4. Listening can not be developed without developing the vocabulary power of the learners. At this position the learner should recognize the most important 3000 words commonly used in spoken English. (these words will be shown later ). Difficulty of listening ,sometimes, lies either on inappropriate pronunciation of the speaker , or the defective hearing sense of the listener . However, both these problems are not the major causes of the difficulty which may be due to the too many unfamiliar words to the listener. Thus, instructors as well as learners should consider these difficulties and others to create a shared learning strategy to overcome them.

5. When a student listens to a lecture , he/she takes notes. Thus writing motivates learners to improve listening. A medical student should expect to listen to the following: a. Description of diseases with respect to causes , symptoms , stages , and treatment. b. Similarities and differences between practical methods in dealing with a certain health or medical phenomenon. c. The human body: Description, mechanisms , systems ..etc. d. Technology associated with health and medical practices. e. The impact of environment on health. f. Medical chemical compounds and drugs. g. Spatial and time relations, and factors associated with health and medical cases. h. Results of some researches including quantitative information expressed in numbers. ASSIGNMENT : While attending a medical lecture of your academic program (in any course other than this course) take notes that can memorize you the major facts said by the instructor . Show what you have noted by listening to the instructor of the medical English to get a feedback about your proficiency . C. Reading in Medical English Reading is like listening because these two skills share receptive activities ( to receive what is spoken or written) , whereas speaking and writing are productive skills ( to tell others orally or in written words) . Most of the reading an individual achieves is silently done. Still we need to develop audible reading for some cases . Teachers , and media presenters like radio and TV commentators use audible reading professionally, and for this reason , they have to develop fluency and pronunciation . An instructor during a lecture may request a student to read loudly from the enforced text, and students should be ready for that. Reading for the experts of English as a second language ESL is the most important skill because by reading we approach the other skills ( listening , speaking and writing) . To read is to understand what is written , but a student has to ask him/herself about the time he/she spends in reading and comprehension of one page. For this reason reading is measured by the degree of speed and fluency. A beginner reader reads slowly , and others can see his lips move when he reads. His face and eyes are bewildering and deeply gazing . A trained reader reads faster , and looks to the written words as if he looks to a picture. Some learners are fluent in silent reading but they are still having pronunciation difficulties. How many times does a student refer to the dictionary when he/she reads a page in English ? If he/she needs too much reference, then he/she is not a fluent reader in

need for getting rid of this deficiency by increasing his/ her vocabulary power . Improving reading skill also requires to read more and more. Reading in medical English does not differ from reading in other subjects. Of course medical professionals can read medical subjects more fluently if compared with nonprofessional ones when reading medical matters. To improve reading fluency , a student can select diverse medical themes to read. The texts of these notes (this book) are originally written for general culture in medical matters for both specialist and non-specialist people. Before a student starts reading medical matters , he/she may wish to recognize the most commonly used words. To conclude , reading proficiency can be developed through these practices: 1. Increase vocabulary power. 2. Practice more reading. 3. Make summaries. 4. Read aloud and focus on proper pronunciation. 5. Read to comprehend. 6. Increase times for reading. 7. Associate reading with listening. ASSIGNMENT : Make a list of the deficiencies and difficulties that a student may encounter when reading a medical text. Writing this list will be very useful for you and your instructor who is going to put forward a remedial strategy for improving both the teaching approach and the learning process. D. Speaking Medical English Everyone wishes to speak English as native speakers do . However, to improve speaking skill a student can do the following: 1. Listen to native speakers in media(radio, TV, & software ), Try this time not only to understand what you hear but also to create similar structures. 2. Give more attention to idiomatic expressions, and collocations such as 'detect the disease'/ 'induce anesthesia'/ 'check patient' / 'diagnose health problems / 'it's really a question I've to find an answer" / " what I want to say is this " / 'medically speaking I would say . "/ while diagnosing this disease it was found that ." / " to my surprise , I observed that " / '' It would be easier to " / 3. Do not feel embarrassed of making some grammatical or pronunciation errors. Speak whatever you can express disregarding adequate grammatical structures or pronunciation. This will be better than never to speak .With time you will improve. 4. Learn the most important common words used in English. 5. Use short sentences. 6. ask yourself : Am I a good speaker in my native language when I share others communication ? According to John Clark , one of specialists in TESL , the skill to

speak a foreign language correlates highly positively with the aptitudes to communicate in the native language. 7. No doubt that speaking with English native speakers, or living for sometimes in a foreign country is the most efficient way to develop speaking skill. However , not all good speakers in English had experiences of living abroad. You can have very good spoken English in your country by means of reading, listening and writing. The more a student tries to speak the more he/she can improve speaking skill rapidly. 8. Reading and writing dialogues is one of the exercises to train yourself in speaking. Imagine conversational situations and write some dialogues , first ,in your native language, then translate the dialogue into English. Later, you can step further to write the dialogue in English from the first time . Use in these dialogues all words that you expect to use in the anticipated conversation including those you do not know their equivalents . Your bilingual dictionary or translation software can help you get at their right translation. 9. To speak is to give special attention to pronunciation. Use electronic dictionary or computer software to learn pronunciation . Within this course , you are going also to have explanatory and practical lectures in reading International phonetic alphabet (IPA). 10. To speak is to make questions and give answers Therefore give yourself some times to study forms of interrogatives such as Yes/No questions / tag / information question : what ? who ? which ? , whose ? where ? when ? why ? how ? how many ? how much ? whom? . ASSIGNMENT: 1. Imagine a dialogue (conversation) shared by you (Sami) with a physician during a learning visit to a general hospital. Write this conversation in one page. 2. Select a short passage from your textbook to use facts and ideas contained in the passage and write a dialogue shared by two or three partners in a discussion meeting. Of course You need to add additional statements not included in the passage. E. Writing Medical English , and Grammar When we write we write sentences and when we combine these sentence we create a paragraph. A set of unified paragraphs makes a composition or an essay . Writing needs two things : ideas and information. One day a teacher of ESL asked his freshman students to write a short paragraph about pain. Some students wrote three or four short sentences. Others could not write a single sentence. The teacher tried to help his students by writing on the chalkboard some questions about pain such as : what is pain? why people feel Pain ? , what is painful ? what does a person do when he feels pain ? how can we alleviate pain ? how pains are different ? The students are told not to write direct answers for these questions but to generate ideas and remember information they know about pain and arrange these in a sensible

manner to create paragraphs. Most of the student became busy in writing their composition and some of them wrote more than twenty lines in few minutes. The first thing to do if you want to write is to collect ideas and information about the subject you want to write about. Sometimes a student spent several nights studying for the exams , but when he comes to the exam he found himself unable to remember what he had studied . Such a student can simply recall his memories by making questions : what , which , who , why , when , where , how ? By making such questions everyone can find what to write even if he was asked to write about a "circle" If you do not want to use hypothetical questions , then you can use outlines. For example we can make the following outlines for a composition about pain: - definition of pain. - Pain and sickness. - Physical pain and psychological pain. - Alleviation of pains - Conclusion Experts of TESL advise learners to utilize these guidelines to develop writing skills : 1. Write short sentences before you jump to longer sentences. 2. Use, only at the beginning, your native language to write a draft of the composition. However, Do not make this a long-lasting habit. 3. Use leading questions or outlines that help you generate ideas and information. Train yourself by writing different types of sentences ( simple , compound , complex . negative , interrogative , reporting ''direct speech" , reported " indirect speech " interrogative , appositional , conjunctive , adjunctive , definitional , conditional , etc.). You can select such sentences from this text, e.g. Although black and white television projection of the image seen by the surgeon under the microscope has been available in the past, it has been of little value in neurosurgery because the anatomical structures within the head cannot be identified unless they are seen in color. 4. With regard to grammar, there is no special different grammar for medical English . Medical language uses the same grammatical rules used in EGP. Grammar for medical students is a matter of studying rules by examples loaded with medical facts or situations. When you write be sure that you can write sentences in active and passive voices using all tenses: 1. Simple present : He takes drugs. 2. Simple past : He took drugs. 3. Simple future : He will take drugs. 4. Perfect present : He has taken drugs . 5. Perfect past { sentences of this tense is always compound } : He had taken drugs before he slept. 6. Perfect future :He will have taken drugs. 7. Continuous present : He is taking drugs.

8. Continuous past { sentences of this tense is always compound }: He was taking drugs when he suffered pneumonia. 9. Continuous future : He will be taking drugs. 10.Perfect continuous present : He has been taking drugs . 11.Perfect continuous past { always compound} " He had been taking drugs before he had an operation. 12.Perfect continuous future : He will have been taking drugs. Make rapid review of grammatical lessons that you have studied within EGP . At this point , a student needs to use correctly rules of articles , pronouns , nouns, verbs , adjectives , modals, determiners, adverbs , conjuncts , prepositions , etc. Remember that grammar is not a skill in itself but an important knowledge for speaking and writing correctly. All medical literature is written in a formative descriptive manner , but it is very important for a student to be familiar with typology of pieces which includes ( narrative , descriptive , analytical , comparative , chronological , and miscellaneous focuses ) 6. Reading is the best skill that help students develop writing skill . 7. Writing needs you to learn punctuation marks: [. ] full stop {period} [ , ] comma [ ; ]semi colon [: ]colon [? ]question mark [ ' ] apostrophe [ !] Exclamation mark [ '' '' ] quotation marks ( ) parentheses [ -] hyphen and else. 8. Students must use capital and small letters appropriately. 9. Use numbers appropriately . 10. When writing a medical case , use techniques to write key sentences and supporting sentences. 11. Do not start a sentence with words like " and" or with a number . 12. Use rephrasing techniques (called also substitution technique) : This technique depends on written models {sentences} including " hard structure" ; i.e. clauses , phrases or standardized idioms that can be used in a variety of sentences after you replace the "soft structures" and substitute them by different structures . For example , the underlined items in this sentence represent its hard structure which can be maintained in the next sentence: * In Asia the rates of HIV infection remain low relative to many other areas, but the number of reported cases markedly increased in recent years.. By the end of 1999 nearly 4 million adults in India were HIV positive due to conditions of poverty-stricken people. The same hard structures can be used like this : In many regions the rates of malaria remain low relative to many other areas, but the number of reported cases markedly increased in the last decade .. By the end of 2005 nearly 300 000 children in the middle region were infected due to spread of mosquitoes. ASSIGNMENT : TENSES: Write three meaningful medical contextual sentences for each tense.

5.