How to Become a Hospital Interpreter

By: Mary Ziegler

Last Updated: Dec 11, 2018

Hospital interpreters use their skills in English and a foreign language to provide invaluable services to patients and medical practitioners alike. The ability for patients and healthcare professionals to communicate is fundamentally important to the safety and comfort of the patient during care, yet over 24 million Americans do not speak enough English to communicate effectively with their healthcare provider. Professional interpreters bridge this gap to ensure that patients receive accurate diagnoses and appropriate treatment.

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Interpreters assist during each step of the healthcare process: admission, examination, consultation, procedures and many other provider-patient interactions. They enable direct communication between the provider and patient by interpreting each expressed concept thoroughly and accurately in the language of the listener. Interpreters usually remain in the background, but may tactfully interject into the conversation to clarify information, correct misunderstandings or respond to a patient’s discomfort. Interpreters actively advocate for both the patient and the healthcare provider.

Interpreters also help providers to develop a better understanding of a patient’s cultural background and how it may influence essential healthcare decisions. The efforts of hospital interpreters ensure that underserved patients have equal access to healthcare regardless of language, background or immigration status. In fact, federal law requires hospitals that receive Medicare, Medicaid and other government funds to provide interpretation services free of charge. Research shows that the use of trained interpreters (instead of family members or bilingual staff) results in more accurate interpretation for patients, thereby increasing overall satisfaction with their care.

Serving as a hospital interpreter is an enormous responsibility and is also extremely rewarding. Read on to learn more about this important career.

Workplace Details

The Bureau of Labor Statistics estimates that 23 percent of interpreters and translators are self-employed. These individuals are usually well established in the field and work for several facilities on a freelance basis.

The majority of hospital interpreters are employed by hospitals or interpretation agencies. Interpreters work in a wide variety of settings from operating rooms to financial services departments. They often travel to attend appointments at physician offices and patients’ homes. In some cases, they interpret by telephone or via video conferencing.

Most medical interpreters work full time during regular business hours. Staff interpreters may be on-call some evenings and weekends. Self-employed interpreters work highly variable hours and can be called in at any time.

In addition to oral interpretation, hospital interpreters perform some paper work, including translation of written documents and documentation. They also follow up with patients to see if they have questions or need additional assistance.

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The U.S. Bureau of Labor Statistics reports that the annual median salary for interpreters employed in general medical and surgical hospitals is $47,640. The lowest-paid 10% of interpreters and translators earn less than $22,240, while the highest-paid 10% earn more than $80,650. Earnings generally increase with experience, skill, certification and education. Pay also varies by language – those whose working language is in high demand in their area generally earn more.

According to the U.S. Department of Labor, job growth for interpreters and translators is expected to increase by 46% between 2012 and 2022, which is considered much faster than average for all occupations. This increase is due in part to diversification - America’s immigrant population grew 140 percent between 1980 and 2010. It continues to rise. Recent focus on hospital safety has also fueled demand for qualified interpreters. Demand is highest for certified, experienced interpreters with a four-year degree and a proven track record of success.

Hospital interpreter jobs are posted on the websites of hospitals, health systems and other healthcare providers. The websites of NCIHC and IMIA also list hospital interpreter jobs.

The overriding qualification to become a hospital interpreter is fluency in both English and a foreign language. Prospective interpreters gain their skills in a variety of ways, including growing up in a household where two or more languages are spoken; studying a foreign language in school; and spending time abroad.

While there are no set education requirements for hospital interpreters, most employers prefer a four-year degree. Registry for Interpreters of the Deaf (RID) requires a bachelor’s degree or equivalent experience for certification as an interpreter of American Sign Language (ASL). Sixty percent of the interpreters employed by the Stanford University health system have master’s degrees.

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While proficiency is crucial, it’s not necessary for aspiring hospital interpreters to major in a language. However, classes in the life sciences, medical terminology and cross-cultural communication are beneficial. If you’re pursuing a career as an ASL interpreter, you should obtain a bachelor’s or even a graduate degree in the field. RID maintains a searchable directory of educational programs on its website.

In addition to a bachelor’s degree, hospital interpreters benefit from job-specific training. A respected program for foreign language interpreters is Bridging the Gap, a 40-hour introductory course offered around the country by The Cross Cultural Health Care Program. Training courses are also available through community colleges, universities, career centers, minority health agencies and professional organizations. The International Medical Interpreters Association (IMIA) maintains a searchable directory of training programs on its website.

Interpretation is a complex skill that requires many years to master. For this reason, many hospital interpreters choose to work with a mentor during the first few years of their careers. IMIA currently offers a mentorship program to members who have completed a 40-hour training course and have one year of relevant work experience. The National Council on Interpreting in Health Care (NCIHC) also launched a mentorship program in 2012. ASL interpreters will soon be able to connect with potential mentors through the National Consortium of Interpreter Education Centers.

Many hospital interpreters complete an internship or volunteer work before seeking paid employment. This allows them to gain additional experience, sharpen their skills and make professional contacts. Many training programs include an internship component. Local professional organizations are also a great resource for locating these opportunities.

Interpreting skills are extremely difficult for potential employers to assess, due to the language barriers involved. Demand from both the healthcare industry and professional organizations resulted in the creation of the first national certifications for hospital interpreters during the first decade of the 21st century. While certification is voluntary, it is strongly desired by employers and well worth pursuing, especially if it is available in your working language.

The National Board of Certification for Medical Interpreters (a division of IMIA) offers a Certified Medical Interpreter (CMI) credential for English-Spanish interpreters. Candidates must pass a written exam in English and an oral exam in English and Spanish. They must also meet the following prerequisites:

• Age 18 or older
• Completion of a training program totaling at least 40 hours
• One year of work experience as a medical interpreter
• High school diploma or equivalent
• Demonstrated proficiency in both English and a foreign language

The National Board recently added credentials for interpreters of Mandarin, Cantonese, Korean, Vietnamese and Russian. Check the website for the latest updates.

The Certification Commission for Healthcare Interpreters (CCHI) offers two levels of certification. The Certified Healthcare Interpreter (CHI) credential requires candidates to pass both written and oral/practical exams; this credential is currently available to interpreters of Spanish, Arabic and Mandarin. Interpreters of other languages earn the Associate Healthcare Interpreter (AHI) credential by passing the written exam only. Prerequisites are the same as for the CMI.

ASL interpreters can pursue National Associate of the Deaf (NAD) through RID. Candidates must be at least 18 years of age and have a bachelor’s degree or equivalent work experience. To become certified, they must pass a written knowledge exam, practical exam and oral interview.

In addition to these national programs, a few states offer voluntary certification programs for hospital interpreters. For more information, contact your state’s health department or your local IMIA chapter.

Experienced hospital interpreters often advance to serve as department managers or directors of interpreting. Others start their own interpreting services or leave the clinical setting to train others. Interpreters of ASL enjoy the option of becoming tenured professors in their field.

Certified interpreters with demonstrated skill and experience generally have the greatest opportunity for advancement. A graduate degree is desirable if you wish to teach. Further business education will be to your benefit you’re looking to become a solo practitioner.

The mandatory qualification for becoming a hospital interpreter, also known as a medical interpreter, is fluency in English along with another language. Most interpreters grow up in a household with a second language, live abroad, or gain fluency studying the language in school.

Some employers hire interpreters with a high school diploma or equivalent and train them on the job. Candidates must generally pass the employer’s language proficiency exam. Some states have additional testing requirements.

New hires then train on the job under the supervision of an experienced interpreter.

This pathway provides a useful knowledge base for those new to interpreting or the healthcare field. For foreign language interpreters, it also provides a pathway to national certification.

The National Council on Interpreting in Health Care (NCIHC) recommends that all foreign language hospital interpreters undergo at least 40 hours of formal training in the field. This is the minimum certification requirement for both the Certification Commission for Healthcare Interpreters (CCHI) and the National Board of Certification for Medical Interpreters (NBCMI). (The rules are different for American Sign Language interpreters, as we’ll see in a minute.)

Interpreter training programs are available at community and technical colleges, continuing education departments, extension offices, and through private companies and non-profits. Both CCHI and the International Medical Interpreters Association (IMIA) list training programs on their websites. IMIA also accredits a small number of training programs that meet rigorous quality standards.

Hospital interpreter training typically includes:

Many employers now require hospital interpreters to complete some post-secondary education – most commonly a bachelor’s degree.

In many cases, a bachelor’s degree is required in order to become certified as an American Sign Language interpreter by the Registry of Interpreters for the Deaf (RID). However, RID does offer an alternative certification pathway for experienced interpreters who trained on the job.

Employers and credentialing organizations that require a bachelor’s degree generally accept candidates from all fields of study. Useful majors and minors include language interpretation and translation, foreign language, American Sign Language interpretation, and life sciences such as biology or physiology.

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Future interpreters can take advantage of the following in college:

Neither CCHI, NBCMI, nor RID currently offer advanced certifications. However, nationally certified interpreters must fulfill continuing education requirements. Many focus on a particular medical specialty, interpretation mode, or an issue such as domestic violence or end-of-life care.