Letters Locum issues

English as she is spoke

BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c3882 (Published 21 July 2010) Cite this as: BMJ 2010;341:c3882
  1. Abhijit M Bal, consultant1
  1. 1Department of Microbiology, Crosshouse Hospital, Kilmarnock KA2 0BE
  1. abhijit.bal{at}nhs.net

    I was a specialist registrar (SpR) in medical microbiology. My consultant and I were discussing a complicated case of an elderly man admitted to the surgery ward. I had earlier asked the surgery SpR to hold off antibiotics and instead monitor the patient. My consultant thought otherwise and wanted antibiotics started. “I would speak to him,” he said as he finished the conversation. I assumed that my consultant had decided to speak to the surgery SpR himself to start antibiotic treatment and so I did nothing. I later realised that “I would” had meant “You should”.

    I was born and brought up in India and came to the UK several years after my primary medical qualification. English as spoken in India is an entirely different language in many ways. Native languages (India has 18 official languages and hundreds of dialects) are often translated into English in the mind of the speaker before words are uttered, and will and would, shall and should, can and could, and may and might are often used interchangeably during conversations. Context and gestures are therefore extremely important.

    Even trivial misunderstanding can lead to serious consequences. Anyone educated in a non-English speaking country should undergo language checks.1 In my case described above, the error was spotted in time and no harm was done.


    Cite this as: BMJ 2010;341:c3882


    • Competing interests: None declared.


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