English Proficiency for IMGs – My Impressions as a native speaker

Step 2 CS is the bare minimum for english proficiency

Every year, about 75% of IMGs pass the Step 2 CS on their first try while 65-70% pass on their repeat attempt. Considering that Step 2 CS tests the bare minimum English proficiency you need, there is a big concern among residency programs and certainly the ECFMG that English might limit the IMG’s chances at matching and performance as a resident. Today, we’ll look at some of the challenges of English proficiency and talk about ways to improve your English.Two of us learned English as a second language. It’s certainly not easy. Learning it as an adult is extra hard.

 English Proficiency for IMG

ECFMG 2014 Annual Report – Applications from around the world

IMGs applicants come from all over the world –  India, Pakistan, the Philippines, China, Nigeria, the Netherlands, Nigeria, and Colombia are the most represented.

I worked for a year in a program where 100% of the categorical internal medicine residents were IMGs. They came to the program from a variety of places: India, Pakistan, the Middle East, Nigeria, and others from many parts of the globe. All of them had strong communication skills in English. Of course, some were easier to understand than others. But, sign outs and oral presentations were clear.

The challenges of English

When I asked an Internal Medicine chief resident what was the biggest language problem for applicants interviewing for residency, he said this:

“Accents are the biggest problem…sometimes I can’t understand what they are saying – and that puts them at a significant disadvantage.”

Accents are difficult. Some accents are easier to understand than others. Spanish and French accents may be easier to understand as the languages are closer to English. Nigerian accents may be harder. It all depends.

To make accents less noticeable, speaking more slowly and pronouncing each syllable is your best strategy. Fast speech and thicker accents make communication in English more difficult.

Informal language and Axioms:

I asked a current IMG resident who did his training in India, what was the biggest challenge to English proficiency for you, and he said:

“Day to day language was the biggest challenge, there were a lot of phrases people use which I didn’t know.”

 He said this while acknowledging that his medical language and “professional communication” was not a problem at all for him. We agree this happens a lot. Patients will often use informal speech. They want to use phrases and terms that are not standard English. This makes it challenging for some doctors who are not native speakers to pick up on this.

Any time you are watching an American movie, TV or reading an English novel look up any unfamiliar phrases. Slowly, over time, you’ll start to build your own dictionary. If you use the phrases in everyday speech, you’re more likely to remember them.

Quick Tips

  1. Speak slowly
  2. Pronounce every syllable
  3. Look up any terms you are not familiar with
  4. Consider 1:1 English tutoring
  5. Do not be afraid to use your English – practicing in real situations is key