English for Medical Practitioners Not only fOR emergencies
Dominique Neyts and Catherine Verguts
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Academia Press Coupure Rechts 88 9000 Gent België www.academiapress.be Academia Press is a subsidiary of Lannoo Publishers.
isbn 978 94 014 7628 7 D/2020/45/645 nur 115
Catherine Verguts & Dominique Neyts English for Medical Practitioners. Not only for Emergencies Gent, Academia Press, 2020, 312 p.
Cover: Studio Lannoo, Keppie & Keppie Layout: Printmagazijn
© Catherine Verguts & Dominique Neyts © Lannoo Publishers
No part of this publication may be reproduced in print, by photocopy, microfilm or any other means, without the prior written permission of the publisher.
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Table of contentS
Preface IX Exercises 1 Unit 1: Medical education and practice 3 Exercise 1: Professional statements 4 Exercise 2: (Para-)medical job titles 6 Exercise 3: Medical education 10 Exercise 4: Medical specialists 16 Exercise 5: (Para-)medical skills in job ads 17 Unit 2: Patient intake 23 Exercise 1: Making a doctor’s appointment 24 Exercise 2: Welcoming the patient 25 Exercise 3: A doctor’s visit from the patient’s point of view 26 Exercise 4: Patient admission 28 Exercise 5: The patient encounter 32 Exercise 6: Patient-doctor communication 35 Exercise 7: Taking a history 40 Exercise 8: Describing pain 45 Exercise 9: Role-play 48 Unit 3: Human anatomy 51 Exercise 1: Introduction 52 Exercise 2: The nervous system 54 Exercise 3: The respiratory system 58 Exercise 4: The cardiovascular system 60 Exercise 5: The gastrointestinal system 65 Exercise 6: The urinary system 66 Exercise 7: The reproductive system 69 Exercise 8: The teeth 72 Exercise 9: The musculoskeletal system 73 Exercise 10: The sense organs 78 Unit 4: Examining a patient 87 Exercise 1: Giving instructions 88 Exercise 2: Reassuring a patient 89
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Exercise 3: Explaining a procedure Exercise 4: Discussing medical tests Unit 5: Diagnosis and treatment Exercise 1: Making a diagnosis Exercise 2: Giving a prognosis Exercise 3: Treatment Exercise 4: Medication Exercise 5: Medical procedures and equipment Exercise 6: Ethical dilemmas Unit 6: Prevention and screening Exercise 1: Social history and lifestyle Exercise 2: Prevention and immunization Exercise 3: Infections Exercise 4: Final presentation and argumentation
91 95 101 102 108 110 112 118 120 125 126 133 139 142
Role-plays 143 Reference section 1. Medical education and practice 1.1. Medical education 1.2. Medical practice 1. Doctor and physician 2. General practice and primary care 3. Specialists 4. Clinic vs. hospital 5. Nursing 6. Mental health 2. Human anatomy 2.1. General anatomy 1. The head 2. The human body 2.2. The respiratory system 2.3. The cardiovascular system 2.4. The gastrointestinal system 2.5. The musculoskeletal system 1. The muscles 2. The bones 3. The joints 2.6. Reproductive and urinary systems 1. Female 2. Male
VI
151 153 153 154 154 154 156 157 158 159 159 159 160 162 163 164 165 165 166 168 169 169 170
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2.7.
The sense organs 1. The eye 2. The nose 3. The ear 4. The skin 5. The tongue and the oral cavity 2.8. The teeth 1. Teeth 2. Section of a molar tooth 3. Disorders, symptoms and treatment 3.1. Disorders and symptoms in general 1. Disease, illness, disorder 2. To develop a disease 3. To exhibit symptoms 4. To run a fever 5. To become infected 6. To feel pain 7. To die 3.2. Disorders and symptoms associated with specialities 1. Neurology 2. Otolaryngology or ENT (ears, nose and throat) 3. Pulmonology 4. Cardiology and haematology 5. Gastroenterology 6. Dietetics and nutrition 7. Orthopaedics and physiotherapy 8. Nephrology 9. Obstetrics, gynaecology and maternity 10. Dermatology 11. Ophthalmology 12. Surgery 13. Oncology 14. Paediatrics 15. Mental health 16. Accident and Emergency 17. Dentistry 3.3. Treatment 1. Discussing treatment 2. Medical dressings and supports 3. Medication 4. Alternative medicine
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170 170 171 171 172 172 173 173 173 175 175 175 175 176 177 177 178 180 181 181 182 183 184 184 186 187 188 188 189 190 191 192 192 193 193 194 195 195 196 196 198
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4. Communication skills 4.1. Communicating with patients 1. A patient-centred approach to communication 2. Welcoming a patient 3. Taking a medical history 4. Involving the patient when gathering information 5. Dealing with sensitive issues 6. Examining and reassuring 7. Giving a diagnosis 8. Describing cause and effect 9. Explaining medical terminology 10. Breaking bad news 11. Planning treatment 12. Closing the interview 4.2. Communicating with colleagues 1. Expressing opinion 2. Writing a referral letter 5. Language focus 5.1. Spelling 1. British and American spelling 2. Latin and Greek words in medical English 5.2. Pronunciation 5.3. Language functions 1. Expressing obligation and advice 2. Describing location 3. Using do for emphasis and confirmation 4. Degrees of certainty 5. Linking expressions 5.4. Grammar 1. Adjective vs. adverb 2. Conditional sentences 3. Passive 4. Relative clauses 5. Tenses 6. Appendix: common medical abbreviations
VIII
199 199 199 200 200 206 207 208 211 212 213 214 216 219 219 219 221 225 225 225 226 229 229 229 230 232 232 234 236 236 237 239 240 242 247
Key
257
Endnotes
297
To read more, to know more
301
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Preface
As a medical practitioner, be it a general physician, specialist, medical student, nurse, dentist or physiotherapist, you have the professional medical skills to deal with patients, colleagues and health institutions. However, you may to some extent lack the language skills to accurately and effectively do so in English, and want to improve your English communication proficiency, e.g. because you have patients for whom English is your only common language, or because you plan to train or work in an international setting. This book focuses on the language and communication skills you need. It aims at improving your English proficiency, thus enhancing your confidence and effectiveness in medical interactions. The course will train you how to communicate in English in a wide range of situations, based on authentic professional contexts. There are 6 units of exercises, each focusing on a particular aspect of medical practice: medical education and job skills (terminology, cultural awareness, job descriptions, tasks and skills), patient intake (taking a history, responding adequately to patients, asking about symptoms and pain), anatomy (anatomical systems and the associated disorders and symptoms), examinations (giving instructions, explaining procedures, reassuring the patient), diagnosis and treatment (making a diagnosis, discussing treatment and medication), and prevention and screening (social history, lifestyle, immunization, infectious diseases). A reference section complements the class exercises with more in-depth background information, detailed vocabulary lists, typical phrases used in medical practice and a grammar chapter. The listening extracts can be found on the online learning platform Ufora (UGent). Here, we will also post complementary exercises (discussion topics, extra listening exercises, etc.), interesting links and up-to-date information accompanying this course book. The book is designed to cover a 20-hour course, but there is enough material to elaborate on some exercises or omit others, based on the specific needs. Two hours have been allotted for units 1 and 6; four hours for units 2, 3, 4, 5. You can also use this book for independent study and concentrate on those areas that are specifically helpful to you (both in the exercises and in the reference section). The entry level is upper-intermediate (B2 of the Common European Framework). We would like to give special thanks to the following people for supporting our project: Silvia Alonso Morillo who helped to develop some parts of the reference section; the Prins Filipsfonds (Koning Boudewijnstichting) for funding a fruitful collaboration with Université de Liège in which Christine Bouvy and Veronique Doppagne gave feedback; Elke Weylandt and Nele Noë for letting
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us reuse the illustrations from their book on medical French; Tom De Moor for proofreading the final draft; the University Language Centre (Ghent University) for providing the means to develop this book and for organizing the course; and, last but not least, Peter Laroy and Academia Press for giving their support to this publication. Do not only open in case of an emergency! Dominique Neyts and Catherine Verguts January 2014
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EXERCISES
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Unit 1 Medical education and practice
topics covered in this unit - communication skills: • using common professional statements in several practices • describing job tasks and requirements • discussing current issues in healthcare • presenting arguments pro or contra in matters of medical education - vocabulary: • job titles in medical practice • medical education • collocations (typical word combinations) • (para-)medical skills - language focus: • defining (para-)medical professions • skimming texts and summarizing - writing skills: • typical features of a CV
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Exercise 1: Professional statements A. Which of the following statements are the most common in your own (para-)medical practice? Choose 3. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
11. 12. 13. 14. 15. 16. 17.
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Do you have any trouble walking? I will first take your medical history. Have there been any new admissions last night? Well done! You have lost another 2 kg. How do you feel about the start-torun programme? Could you accompany me on my ward round next Tuesday? You will be put on a waiting list for your hip replacement operation. The next tutorial in the training programme has been postponed to Friday 5 March. We only perform minor surgery. We refer to our report for further information on the identification of the deceased, the time and cause of death, and the type of weapon used. A 55-year-old man, who had been well until five months previously, complained of tiredness. He had gained 15 kg in weight. His presenting symptom was constipation. I will visit you at home after your hernia operation. The incubation period is the period between the invasion of the tissues by pathogens and the appearance of clinical features of infection. I’m afraid your wife has been diagnosed with obsessive-compulsive disorder. If you have any problems tracing the pulmonary artery in this cadaver, please call me over. Here are some exercises you can do at home to improve your knee joint flexibility. Did your colleagues notice any involuntary movements while you were unconscious? Our main objective is to diagnose and investigate health hazards in this community.
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B. Link the statements in part A to the following professions. A. lecturer B. clinical trainer C. general practitioner (GP) D. receptionist E. practice nurse F. district nurse G. physiotherapist H. anatomy demonstrator I. forensic expert / forensic pathologist J. healthcare official
C. Discuss in pairs: in what way do your 3 statements from A typically illustrate your job tasks? And which statements from A are not typical at all? Why?
D. Present your neighbour to the group without mentioning his / her job title. Can they deduce the specific medical profession?
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Exercise 2: (Para-)medical job titles A. Match the following (British!) job titles with the definitions below. 1. theatre nurse 2. health visitor 3. GP 4. paramedic 5. clinician 6. midwife 7. registrar 8. medical assistant 9. consultant 1
2
3
4
5
6
7
8
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a. a trained person who is usually a qualified nurse and is employed to visit nursing mothers in their homes and advise them on health matters b. a general term for doctors, nurses and other professionals working directly with patients in all parts of the health service c. a nurse who assists a surgeon during operations d. a doctor who is trained in general medicine and provides primary and continuing medical care for patients in a particular area or town e. a trained non-medical member of the ambulance service who can provide immediate care in an emergency f. a nurse who specializes in the delivery of babies g. a doctor who has completed the Foundation Programme (2 years of postgraduate training) and is training in one of the medical specialties h. a fully qualified specialist who is called in for professional advice or services in a particular area of medicine i. a person who performs a variety of patient-related tasks / tests, ensuring smooth patient and work flow in the clinical practice
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B. Complete the following definition of physiciani. A physician is a professional who pr____________ medicine, which is concerned with promoting, maintaining or re___________ human health, through the study, diagnosis, and tr_____________ of disease, inj__________, and other ph__________ and mental impairments. Physicians may focus their practice on certain disease categories, types of patients, or methods of treatment (specialist medical pr____________), or assume res_______________ for the provision of continuing and comprehensive medical c__________ to individuals, families, and communities (general pr______________). Medical practice requires a detailed knowledge of the academic di______________ (such as anatomy and ph____________), of underlying diseases and their treatment (the science of medicine), and also a decent com________________ in its applied practice (the craft of medicine). The et__________ of medicine require that physicians show con________________, compassion and benevolence towards their patients. In the United States and Canada, the term physician describes all medical pra___________________ holding a professional medical de___________.
C. Add these words / phrases to the nouns in the table to make correct collocations. emergency - university entrance – flying – locum - follow-up – recommended – group - to swallow – to be in - psychiatric – to meet – family – herbal – a doctor in general – nursing - to seek – to administer – to send for a – to qualify in – to practise – to undergo – a dose of – to respond to – to comply with – dietary treatment
practice
medicine
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doctor
requirements
D. Work in pairs. Choose 2 terms you are both familiar with. Identify the main tasks and requirements for each job. Example: A visiting nurse is a nurse employed (by a hospital or social-service agency) to perform public health services (e.g. promoting health and well-being, assisting in prevention programmes) and to visit and provide care for sick persons in a community. A visiting nurse needs to be able to cope with stress situations (for instance emotional, physical and financial stress in home healthcare) and needs to be available in crisis situations. Required skills include empathy, basic medical expertise, use of laptop, and multicultural sensitivity. (also called public health nurse)
- - - - - -
registered nurse practical nurse nurse practitioner general duty nurse circulating nurse charge nurse
1. _____________________________________ : ______________________________________________________________________________ 2. _____________________________________ : ______________________________________________________________________________
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E. Look at these duties of a nurseii. Fill in the gaps. 1. Tri_______________ : the nurses will take in the patients’ information and they will categorize or prioritize according to the se__________________ and the complications of a particular injury or ailment. Some people may be taken in first, if there is a high risk of spreading, or if there are cases of unc________________ bleeding, unexplained rashes or unexplained vomiting. 2. Est______________________ IVs or other medical devices. 3. Fo______________ the doctor’s orders and upd_______________ the doctors with new suggestions of patient care. This may inc____________ coordinating tests such as blood tests, diagnostic imaging, biopsies. 4. Dis______________________ medications (e.g. by mouth, by inhaling, IV, rectally). 5. In_______________________ catheters: to permit injection, to dr__________ fluids, or to allow access by surgical instruments. 6. Pr_______________________ emotional and physical support to patients (and their families): this is very important as the patients are in a vuln____________________ state. 7. Tra___________________ a patient from a bed to a chair or a wheelchair, or from a wheel chair to a shower. 8. Help with personal h___________________ and dressing.
F.
Discuss (one of) the following statements. - - - -
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Nurses’ responsibilities are increasing. This is a positive evolution for healthcare in general. Engaging physician assistants1 in hospitals will solve the medical practitioners’ complaints about workload and fatigue. A nurse’s job equals that of a doctor, except for the salary. The medical profession is 1/3 education, 1/3 experience and 1/3 vocation.
Definition from Merriam-Webster: a specially trained person who is certified to provide basic medical services (as the diagnosis and treatment of common ailments) usually under the supervision of a licensed physician— also called PA
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Exercise 3: Medical education A. Read the information on your card. Card A is found here; go to ‘roleplays’ for card B. Summarize in the box by means of keywords.
Card A: United Kingdom: In the UK, doctors wishing to become GPs (general practitioners) take at least 5 years training after medical school, which is usually an undergraduate course of five to six years (or a graduate course of four to six years) leading to the degrees of Bachelor of Medicine and Bachelor of Surgery. Graduated medical practitioners have to do a minimum of 5 years postgraduate training: • two years of clinical Foundation Training (F1 and F2), in which the trainee will do a rotation around either six 4-month jobs or eight 3-month jobs - these include at least 3 months in general medicine and 3 months in general surgery, but will also include jobs in other areas; • A three year “run-through” GP Specialty Training Programme containing (GPSTP) 18 months as a Specialty Registrar in which time the trainee completes a variety of jobs in hospital specialties such as obstetrics, gynaecology, paediatrics, geriatric medicine, accident and emergency or psychiatry and 18 months as a GP Specialty Registrar in General Practice. • During the GP specialty training programme, the medical practitioner must complete a variety of assessments in order to be allowed to practise independently as a GP. There is a knowledge-based exam with multiple choice questions called the Applied Knowledge Test (AKT). The practical examination takes the form of a “simulated surgery” in which the doctor is presented with 13 clinical cases and assessment is made of data gathering, interpersonal skills and clinical management (Clinical Skills Assessment (CSA)). Throughout the year the doctor must complete an electronic portfolio which is made up of case-based discussions, critique of videoed consultations and reflective entries into a “learning log”. • Trainee GPs from 2008 onwards are compulsorily required to obtain the postgraduate qualification issued by the Royal College of General Practitioners in order to be able to practise. After passing the exam or assessment, they are awarded the specialist qualification of MRCGP (Member of the Royal College of General Practitioners). Previously qualified general practitioners (prior to 2008) are not required to hold the MRCGP, but it is considered desirable. In addition, many hold qualifications such as the DCH (Diploma in Child Health of the Royal College of Paediatrics and Child Health), and/or the
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