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Roxana C. Del Barco is the medical interpretation coordinator at University of Maryland Medical Center.
Roxana C. Del Barco is the medical interpretation coordinator at University of Maryland Medical Center. (Kenneth K. Lam, Baltimore Sun)

Roxana Del Barco is the Medical Interpretation Coordinator at University of Maryland Medical Center and the Maryland State Chapter Chair of the International Medical Interpreters Association. She has been a nationally Certified Medical Interpreter since 2011.

What does your job entail?

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As a medical interpreter, I facilitate effective communication between patients and families with limited English proficiency and their doctors, nurses, therapists, and other healthcare professionals. My job entails converting the content and spirit of the spoken messages from one language to another accurately and completely, maintaining impartiality and keeping all information confidential. A medical interpreter needs to speak, read and write fluently in at least two languages (in my case, English and Spanish), be familiar with specialized medical terminology, and understand the healthcare context. Even the most skilled clinician cannot provide high-quality healthcare services without a trained, qualified medical interpreter. Otherwise, communication errors may occur, posing risks to patients and liability to healthcare providers and institutions. The provision of language access services is mandated by federal law and supported by accreditation entities like CMS and The Joint Commission. One of the most important aspects of my job is educating patients and providers about language rights, the interpreter’s role, and how to work with interpreters to enhance patient safety.

On a typical assignment, I’ll be required to listen carefully to the speakers’ messages, assimilate them quickly (including jargon, regionalisms and medical acronyms), then analyze and deliver them promptly in the other language. This demands great concentration and focus. I’ll often have with me specialist vocabulary lists and write notes to aid my memory. Sometimes I may be required to sight-translate (orally translate documents into the patient’s language) or act as a cultural broker to support a patient’s treatment plan. For complex cases, such as in genetics, I usually have to research concepts or terminology. In my current position as Medical Interpretation Coordinator at University of Maryland Medical Center, I also organize the workload, assign jobs, maintain our database, and have supervisory responsibilities.

What kind of schooling or training did you go through?

I received a B.A. in English and a B.A. in public translation with a minor in Interpreting from the National University of La Plata, Argentina, an academic program approved by the American Translators Association. Besides the language fundamentals, the training included rigorous course work in medical/scientific and legal translation. Then, I obtained my master’s in intercultural communications from University of Maryland Baltimore County. On-the-job training at Johns Hopkins International, my first employer, included workshops on interpreting, medical terminology, and cultural competence. In 2011, I took the exams of the National Board of Certification for Medical Interpreters and earned my Certified Medical Interpreter credentials. I attend professional conferences and pursue ongoing continuing education.

What inspired you to this career?

I’m a translator by training and translators are very well adjusted to solitude. Interpreting, on the other hand, involves a lot of people interaction so initially it was a bit intimidating. An experience I had a few years back is probably what inspired me to choose this career. I experienced a serious health emergency while living in Germany as an exchange student. I’ll never forget the fear, anxiety, and vulnerability of being placed at a communication disadvantage. Knowing firsthand what a patient with limited language ability goes through, I am certain that being the bridge between two languages and cultures, being capable of removing the barriers to access care is what I want to do.

What do you like best about your job?

One thing I truly like about my job is that it is intellectually stimulating, especially at a large academic center with multiple specialties. A medical interpreter never stops learning to keep up with the rapid advancements in medicine. I love being able to effectively help patients and providers understand each other so that they are empowered to make informed decisions. Being entrusted with their words and meanings is both a privilege and a great responsibility. My best reward is to think that my work protects someone’s health and that it may even help improve someone’s life.

Lately, it’s been fascinating to watch how the medical interpreting profession is growing, gaining relevance, and opening doors. Especially since becoming certified, I’ve participated in research studies and focus groups. Just recently, I was recruited by the Canadian non-profit Project H.A.N.D.S. to go on a surgical mission trip to South America as a Certified Medical Interpreter. It was an extraordinary experience! Only a few years back, such opportunities were not available to us.

What are the challenges?

At a large academic institution, the volume of patients and the pace of work can often be demanding. In this environment, where an interpreter covers complex cases on a daily basis, recalling medical terminology rapidly and accurately each time can pose some challenges. Certain areas, like mental health or oncology, can be additionally difficult due to the emotional toll on providers, patients and the interpreter. Some patients may not only face language barriers, but socioeconomic and health literacy issues as well. As medical interpreters, we must keep that in mind as we strive to address their communication needs. Despite the challenges, I'm certain that my job matters, and it's meaningful to others. That's all the reward I need!

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