Three Components of Medical Translation
Rapid and cost effective production of high-quality translations for the pharmaceutical
and clinical research industries requires integration of three components:

Specialized teams of medical translators, editors, proofreaders, and project managers;
Translation Tools, such as a state-of-the-art Translation Memory system; and
Rigorous quality control processes.

Medical Translation Teams: Roles and Qualifications
At L10N Technology, medical translation teams consist of one or more translators,
an editor, a proofreader, a project manager, and possibly a multilingual graphics specialist.
Translation teams are assembled for each individual project based on specific requirements
of the project.If a project involves more than one language pair, a separate team is assigned
to each pair.

Each translation team has one to four translators but only one editor. It is hard for an editor
to maintain quality and consistency of translation when working with more than four translators
simultaneously. For large projects with short deadlines, when more than four translators working
in parallel are required, the Project Manager assembles several translation teams and assigns
one Editor-in-Chief for each language pair (see below).

Translators perform the initial translation of the document. The Editor verifies the quality of
translation,coordinates terminology and style usage, resolves terminological disagreements among
the translators,as well as maintains and updates project-specific Glossary, Translation Memory,
and the Style Sheet.

Glossaries and Translation Memory are vitally important for maintaining consistency of translation
not just among the several translators but between various versions of the same document
and the other documents for the same client. Consistency and standardization are particularly important
when translating documents containing clinical data. This is because programs that identify statistical patterns
in data from different sites cannot recognize identical phrases with different spacing or punctuation
or synonyms such as "pain" and "ache".

Proofreaders have various roles. They verify correctness of numerical transcriptions, assemble
the translated fragments from different translations into a whole document, re-insert graphics, and verify
that all parts of the source document have been included. They do the final reading of the fully assembled
document to ensure that the translation reads at least as well in the target language
as does the source text.

The Project Manager is responsible for the timely delivery of the final translation according
to the exact client specifications. Project Manager's tasks include assembling the medical translation team
with skills that are appropriate to the subject matter and style of the source documents. In addition,
the PM must preserve mutual anonymity between translators and editors. As with peer review of academic journals,
mutual anonymity enables editors to comment frankly on translators' work.

A translation team should be able to change its capacity according to demand. The fixed members are
the project manager, editor, and the proof-reader, whilst the number of translators at any one time should vary
according to demand. If more than four translators are needed, a second editor should also be hired,
and the most senior editor should coordinate all work in a particular language.

The five most important qualifications of a medical translator are:
Medical training and knowledge specific to the material to be translated
   (e.g. pharmaceutical trials if the document is a case report form);
Experience in the relevant scientific field in a country in which the target language
   is the medium of communication. The target language is the language into which
   the document is to be translated, usually English;
Experience in a country in which the source language is the medium of communication.
   The source language is the language in which the document to be translated was written,
   for instance Russian;
Native grasp of the target language (English);
The ability to write well in the target language (English).

The importance of the above qualifications varies. For example, the ability to write well in the target
language matters more when translating an article for publication than when translating patient notes
for a clinical trial. It is crucial for the translator to be able to write clearly, in current idioms.
Few people can write well in a foreign language - indeed, many cannot even write clearly
even in their native language.

You Mean Your Translators Are Real Physicians???
Many people are surprised to learn that a medical translator needs medical training and medical experience.
Consider, for example, the phrase "potassium channel blocker."A translator without a background in neuroscience
cannot know whether the phrase means a potassium blocker of channels or a blocker of potassium channels.
Furthermore, he cannot translate each word literally, because a chain of three nouns is
- in most languages - ungrammatical.

By contrast, a translator with a background in neuroscience knows that the second translation is correct.
(Other examples of why technical translation ought to be performed by subject matter specialists are
elaborated in the "Is Subject Matter Expertise Really Important for Technical Translation?"
section of this site.)

Ideally, the translator should reside in the target country and the editor in the source country.
This way, it is more likely that the translator has a sound grasp of current idioms. Furthermore,
the editor is well positioned to ask the document's authors to clarify ambiguous passages,
or seek their permission to make non-literal translations. Lastly, a translator and editor who reside
in different countries are more likely not to know each other, hence preserving the "peer review"
aspect of quality control of translation.

Translation Tools: A Critical Component of Translation Quality Management System
Quality and speed of translation require more than just a good translation team.
They require the use - synchronously and longitudinally - of translation tools,
including client-specific glossaries and translation memory. Client-specific Medical Glossaries
Client-specific Medical Glossaries are built by translation teams because even the most
qualified translators in the world do not always agree on the best translation of every term.
Often several translation options are valid; however, inconsistent selection of these terms,
and switching among alternative styles, are unacceptable and lead to loss of comprehension.

To maintain consistent terminology usage between the translators and editors during translation work,
and to ensure that all future translations use the same terminology, translation teams create specialized
glossaries for each subject and document type they translate. These client-specific medical glossaries
are maintained and updated by the Editor-in-Chief.

Use of Translation Memory Systems in Medical Translation
Our Medical Translation Group at L10N Technology relies heavily on Translation Memory (TM) tools.
Translation Memory should not be confused with Machine Translation:
Machine Translation is decades away from being sufficiently useful for medical translation.

Translation Memory, on the other hand, is a database application technology we have been using
for over 15 years. The TM system monitors the progress of translation in real time and memorizes
each linguistic unit (sentence, phrase or block of text) with its translation.
When the linguistic unit re-occurs, the TM tool notifies the translator and allows him
to insert the saved translation if he so desires.

These Translation Memory systems can both increase productivity of our translators and
enhance the quality of their translation. The use of Translation Memory leads to greater consistency
as the same phrases and terminology are translated identically throughout each revision of each document,
even if different translators work on different portions of the document or revisions of the document.
Translation Memory can also significantly decrease the time spent translating, thus lowering the cost
to the client and allowing quicker turnaround of translation projects.

Translation Workflow Integration and the Total Cost of Medical Translation
The direct cost of translation - the money paid to the translation agencies or to the in-house translation team
- is often less than half of the indirect cost of translation. Indirect costs involve not just management
of the translation team and the usual corporate overhead, but the costs of integrating the translation process
into the client company's own workflow.

Internal Costs of Translation Projects
Not only does one need to keep meticulous track of what has been translated in the past to avoid unnecessary
re-translation and to keep track of the various multilingual versions of each document - a large portion
of the indirect cost of translation is inserting the translated text into the right place in the databases
and document management systems.

For example, during the recent multi-site multinational clinical trial conducted by one of L10N Technology's
clients, a major US-based Clinical Research Organization, our translators received hundreds of documents
from foreign sites each month over the course of several years. Many of the documents were one-page patient notes,
operative reports, autopsy reports, hospital records, adverse event reports, etc.

That data was typically sent from each local site to the CRO's local offices, faxed from there
to the trial coordinators, forwarded to the L10N Technology translation team dispersed over a dozen countries,
then sent back to the trial coordinators, and only after that entered into the trial database.

All these document transfers increase the likelihood of introducing errors, mislabeling the information,
incorrectly naming the documents, and inadvertently breaching the trial confidentiality.
If the documents, on the other hand, from the start were
(a) entered by the local research team into the online database,
(b) the translation team was electronically notified of the new additions, and
(c) the team could work directly within the trial database, not only would the possibilities of errors
   and data loss be reduced, but the costs of pushing the documents around the world could be largely eliminated.