Journal of Clinical Monitoring and Computing (2005) 19: 179181 DOI: 10.

1007/s10877-005-2667-5

Springer 2005

SOME NOTES ON MEDICAL ENGLISH

Vincenzo Lanza

Lanza V. Some notes on medical English J Clin Monit Comput 2005; 19: 179181

ABSTRACT. Writing medical papers is a challenge in any language, but writing in a foreign language such as English can be especially difcult. This paper provides some suggestions on how to overcome common problems in preparing medical papers and presentations, for writers whose native language isnt English. Stylistic and grammatical peculiarities of the English language are considered, as well as Americanizations of Latin terminology, scientic (international) notation, variations in usage between Britain and the U.S.A., scientic and ethical standards of medical publications in English, and some resources for foreign-language researchers who want to compose papers or presentations in English. KEY WORDS. English language, medical papers, abstracts, posters, presentations.

Department, Ospedale Buccheri la Ferla Fatebenefratelli, Via M. Marine, 197, 90123-Palermo, Italy. Received and accepted for publication 6 February, 2005. Address correspondence to V. Lanza, Chief of Anesthesia Department, Ospedale Buccheri la Ferla Fatebenefratelli, Via M. Marine, 197, 90123-Palermo, Italy. E-mail: lanza@unipa.it

Ideally, authors should immediately identify the category of their paper: editorial, clinical trial, original research, literature review, conference report, book/web site review, brief comment, etc., although some works may be difcult to categorize in simple terms. Researchers should establish and declare their professional standards by mentioning that they obtained independent ethical review of the study design and protocols, as well as reproductive, representative, effective, respectively, and some specialized grammatical terms (such as innitive). The words derivative and derivation are both correct, but have different meanings (only the former means by-product) [2]. Some Latin words and expressions are not written differently in English: e.g. (for example), i.e. (that is), etc. (and so on), per (as in 40 ml per hour), et al. (and others), and many anatomical and physiological names: cranium, vertebra, humerus, endocardium, uterus, and so on. Unlike some languages such as German, exclamation points (!) are rarely used in English and almost never in medical writing as they are interpreted as expressing strong emotion. In general, linguistic usage, spelling and punctuation differences between the U.S., Britain and other English-speaking countries are minor in the context of medical writing: center vs. centre, grey vs. gray. Most minor variations are acceptable. When submitting work to a British journal the single quotation mark . . . is used for indirect speech, rather than the American double quotes . . . The punctuation mark at the end of a sentence is called a full stop by the British but a period by Americans. We say dot in web domains: World Teach dot com. Standard guidelines for manuscript preparation are described in the Helsinki Declaration and the Uniform Requirements for Manuscripts Submitted to Biomedical Journals [3].

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Although international or scientic notation is fairly universal, some common errors continue to appear in manuscripts submitted by speakers of other languages. English-speaking countries use a comma , to express place in whole-number quantities, where some other languages use a decimal . For example, ten thousand is written 10,000 not 10.000. Fractions such as 2/3 and 4/5 are written two-thirds and four-fths respectively. In quantities the decimal is read point, as in 0.05: zero point zero ve. The number 1,000,000,000 is called one billion, not one miliard. Although there is a strong temptation for authors in some academic elds to write and publish papers primarily to advance their own careers, submitting uneeded or frivolous papers in medicine may be considered a form of scientic misconduct, as is fabrication or falsication of data. Its a good idea to anticipate any suspicion of bias in your research, and your paper should describe how you avoided that risk. Expressions of humility are a mark of scientic professionalism. Reviewers who nd evidence of serious scientic misconduct may ask an editor to notify the authors employers or the local medical authority. Research protocols should be carefully prepared, strictly followed and permanently recorded for future investigators. Appropriate credit should be given to anyone who contributed to the paper [4]. If contributions to the conception, design, data collection, writing, etc. are substantial but do not qualify the individual contributors as authors, a separate acknowledgements section should list the contributors and describe their contributions. In the case of papers previously published in other languages, the previous publication details should be disclosed even if the paper has been modied. Any nancial support and possible conicts of interest should also be disclosed. If a paper concerns a highly specialized informed consent from all human subjects, following recognized international guidelines concerning scientic integrity. The abstract is merely a brief summary of your paper or presentation, usually 100 to 500 words, the preferred length specied by the journal or congress to which it is submitted. It should consist of short sentences in the impersonal voice, addressed to the potential readers, and be organized into three or four sections just as the paper itself: Introduction, Aims (or Patients) and Methods, Results, Conclusion. Each section of the abstract should consist of one paragraph made up of several sentences, while the body of the paper should consist of several paragraphs or pages for each Section [1]. The abstract should be a concise, general overview of your work and avoid too many details. In the English-speaking world short, clear sentences are

preferred to long-winded eloquence (long sentences with several clauses). A poster for a medical congress also follows the form of an abstract, though a bold title and the addition of colorful graphics (table, chart or photographic image) are essential. In a spoken presentation the speakers tone and style should obviously be much more informal than a written paper, and may even include a brief joke to entertain the audience. It isnt necessary to use complex grammer such as the present perfect or subjunctive, as these tenses are seldom used by native speakers in an informal conversation. Foreign speakers shouldnt worry that their pronunciation isnt perfect, and after the presentation may even request that questioners speak slowly and clearly. It is quite acceptable to ask a questioner to repeat his question or comment more slowly, or for a foreign speaker to admit that he doesnt understand a particular question and cant answer it. Communication problems are sometimes the fault of the native speaker who isnt experienced in communicating with foreign speakers. One way to achieve clarity is to respect standard English word order. First: subject, then: verb, direct object, indirect object. For example: Recent studies have found no signicant difference in the various approaches. Time terms such as the previous year are placed at the beginning or end of the sentence or clause, never between the subject and verb. Unlike many other languages, word order in English is not very exible, although native speakers may bend the rules occasionally. A common problem is that while some languages use the innitive of a verb as a subject, in English the gerund is preferred: Understanding is facilitated by practice, (not To understand is facilitated . . . ). The innitive in English is often used to express purpose: The study attempted to discover any signicant side effects. Although the passive voice is common in scientic writing (Nitrates are known to have such effects . . . ), make sure that the subject can be identied and all claims veried if requested. English was originally a Germanic language, but it was heavily inuenced by Latin, and has now taken on some unique characteristics. While words of Latin origin are extremely common in English, they are usually spelled differently. For example, we write signicant (not signicative), demonstrate (not demonstrative). substantial (not substantive), and infectious is preferred to infective. However, we do say connective (e.g. connective tissue), preoperative, perioperative and postoperative, as well as topic, it is not inappropriate for the authors to recommend reviewers to the journal editor upon submission. Authors should not hesitate to submit papers that challenge or criticize advertising or previous papers in a journal,

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since aws in research are sometimes inevitable and editors have the responsibilty to recognize and correct errors when discovered and to publish constructive criticism [5]. The World Association of Medical Editors asserts that editors should have the freedom to choose the content of their journals based solely on the validity of the material and its importance to readers, rather than commercial considerations. Regardless of how uent in English a foreign author may be, its always wise to have a manuscript checked for linguistic errors by a native speaker before submission to a journal. A poorly written paper is not enjoyable to read, and may reect on the authors diligence. Busy editorial ofces cannot be expected to proofread and correct linguistic imperfections. A web site where English teachers, translators and proofreaders can be found is: www.englishmed.com

Thanks to Frank Adamo for assistance in the composition and nal corrections of the English text. English4Doctors@Yahoo.com.

RESOURCES
1. Focus on Medical English, Enrico Cillari, Lidia Di Maggio & Sheila McIntyre, McGraw-Hill (Milan, 1993). 2. English for Medical Congresses I & II, Marina DeLuca & John Irving, Archimedica (Torin, 1997). 3. Uniform Requirements for Manuscripts Submitted to Biomedical Journals. International Committee of Medical Journal Editors (Nov. 2003). www.icmje.org. 4. Guidelines for Good Publications Practice, Committee on Publications Ethics (Revised 2001). www.publicationethics.org.uk. 5. Learning to write: can books help? Cummins RO. J Med Educ 1981; 56(2):12832.