OMG! Upon agreeing with a colleague, a Certified Medical Interpreter(CMI), who requested to remain anonymous for fear of retaliation with her employer to investigate information for this blog, I began to realize just how crazy things were. The more I started digging, the more forthcoming people were with information, and the more backlash I received. Some of it was downright nasty too. There were statements made such as ‘this is a dead horse,’ and ‘here we go again.’ What was the reason for the attempts to keep me silent on this issue? Fear that the truth will come out? That CMI’s will begin to question the information they are being fed? Have you ever heard the expression “If it looks like a duck, swims like a duck, and quacks like a duck, then it is probably a duck?” As you read through this blog, keep that little saying in your mind.
For those who are unaware, a Certified Medical Interpreter (CMI) certification is awarded by the National Board of Certified Interpreters (NBCMI) for interpreters who have passed a very rigorous written and oral exam. In a poll I created in three different Facebook Interpreter forums I gave the following three options:
>“The lack of ‘accreditation’ HAS impacted the validity of the CMI certification within the Medical Community.”
>“The lack of ‘accreditation’ HAS NOT impacted the validity of the CMI certification within the Medical Community,”
> “I don’t know.”
As a clarification, the word ‘validity’ for the purposes of the poll was used in the sense of being accepted and equal to that of other recognized certifications accepted within the Medical Community. Because this was not clear in the poll, some respondents may have used a different meaning.
Jazmin Manjarrez, Chair of the National Board of Certified Medical Interpreters (NBCMI), in the Facebook group, ‘Medical Translation and Interpretation Crew’ stated in response to the polls mentioned above, “Remember, that the CMI certification encompasses six languages. Spanish was the only one that held an accreditation.” I am not really sure what this statement had to do with the poll questions; however, I want to point out that she is correct. The only accreditation was for the Spanish language, not the other languages for which NBCMI offers certification. On this same Facebook forum page, the Administrator of the page wrote “Hi David, out of curiosity, why are you “giving CPR” to this subject?” She further stated, “Some months ago, it caused a lot of confusion and worried a lot of CMI-Spanish interpreters….” I took these statements to mean, don’t get this started again on social media.
The question that immediately came to my mind (I am the curious type) was, what is there to hide? I know that when the accreditation issue was first rampant in social media, a lot of interpreters were scared, and rightfully so. While the hoopla seems to have died down on social media, it doesn’t mean that the issues have miraculously disappeared. In fact, just the opposite according to those who have emailed, called and messaged me on Facebook.
Although I respect the views of the Chair of NBCMI and the Administrator of the Facebook forum mentioned above, I have an opposite view. I believe that this should be brought out into the open on social media. If there was a lot of misinformation being spread on Social Media, then common sense says to use Social media to dispel those myths, not go silent in hopes that it will all go away. Quoting from the April 2018 NBCMI Newsletter article written by Manjarrez, “Extra! Extra! Get Your Facts Here,” “Social media can be a great resource for many interpreters, but it can sometimes have an opposite effect by promulgating myths, misinformation, and rumors.” There is truth in this statement. Being silent and not dispelling the misinformation is just as dangerous, in my opinion. Besides, who is really being protected by remaining silent? Not the CMI’s, that’s for sure and not the profession.
Instead of sweeping this under the rug, let’s instead rise to the occasion and debunk some of those myths. First, let me make it clear that the CMI certification is still an accepted credential among many medical and government entities –at least for now. Those that hold this certification studied hard, sacrificed and achieved something that is nationally recognized. The accreditation or non-accreditation in no way, shape or form changes the fact that these interpreters passed a challenging exam. There are other prestigious certifications such as the ATA Translation certification, CA Court Interpreter certification, the Federal Court Interpreter certification and the RID certification that are not ‘accredited’ and yet they are all recognized for what they are –proof of meeting established standards of the profession. NBCMI for many years, however, promoted their Spanish certification exam as ‘accredited’ and this is what interpreters who took the certification thought they were paying for –an accredited certification exam.
The above being stated, do CMI’s need to worry? Not necessarily, but in my opinion based on the fact that some entities have begun to reject the CMI credential they should keep themselves informed. They should watch what those who use the services of the interpreter are doing. Just this morning a reader who is going after her Medical Interpreter certification emailed me from the state of Texas and stated, “The recruiter told me [it] is not even worth getting NBCMI because the majority of health institutions in Texas don’t even accept it.” When she attempted to dispel this myth with the recruiter, she received the following response. “…honey let me tell you, they might convince you that [it] is valid but healthcare organizations don’t view it as valid anymore.” Is this an isolated case? What are hospitals, government entities, medical offices, and others doing in your area? On the opposite side of the spectrum, interpreters are saying that this simply is not true. Their employers, according to them, accept the CMI credential. What this tells me is that the perception, which is their reality, is not the same across the board.
The idea for this blog started because I received an email from a CMI who I will call Sally Sue (made up name) informing me that the hospital where she works told those with the CMI certification that they have one year (until the end of 2019) to obtain their Certified Healthcare Interpreter (CMI) certification to maintain their employment. Now, let me be clear here that this in and of itself doesn’t mean anything. Both organizations, CCHI, and NBCMI at times offer some really nice discounts to various entities if their entire staff has ‘their’ certification. I don’t know if this is the case in this particular example. The letter issued by the Human Resources department for this hospital did not mention the reason for having all interpreters CHI certified. This, by the way, is the second hospital I know to do this. If there are any others, I am not aware. On the podcast of May 11, 2018 “In Other Words” by “Westbridge Solutions, LLC,” in an interview with Manjarrez she addresses a question from a participant about another entity that had taken the same position of requiring their interpreters to get the CHI certification. You can listen to the interview here, which by the way is very informative.
Two hospitals deciding only to recognize CHI credentials may or may not be the beginning of a trend. Regardless, in my opinion, it is cause for concern. This goes back to what I stated earlier; keep yourself informed. After I posted the poll (mentioned above), I was inundated with emails from CMI’s naming specific language agencies whose management is telling them the same –they must get their CHI. Trainers writing they no longer offer continuing education courses (CE’s) because of the hassle and cost involved, and I quote, “I had to cease crediting interpreters with NBCMI credential because, IMIA no longer accepts RID, CEAD/CCHI, and ATA approved CE’s. IMIA charges independent trainers additional fees to stamp workshops/webinars as “IMIA-Approved.” It is my understanding after speaking with the Chair of NBCMI, Jazmin Manjarrez, that the difference now is that International Medical Interpreters Association (IMIA) will now only approve ‘medically’ related courses, whereas before courses such as accounting may have been approved. Yet, in another email received from XYZ Agency (name changed), “IMIA and NBCMI changed the CE regulations by requiring all CE units to be approved by IMIA. To seek approval, companies and individuals must pay IMIA fees to acquire approval. At this point, XYZ has decided not to pursue approval [due] to economic burdens, and [is] therefore unable to offer CE units to CMIs. If XYZ obtains IMIA approval, we will have to increase our training courses fees, and that is something we want to avoid, to continue [to] offer affordable courses to our interpreters.” The NBCMI is an independent division of the International Medical Interpreters Association (IMIA), just to be clear.
So, let me do a quick recap. I have received information that two hospitals no longer accept the CMI credential (again, I have no idea if there are more), and one agency and one trainer saying the new CE regulations are an economic burden, and a recruiter saying the CMI is no longer valid. And, these are only a few examples from the emails I have received. What the heck is really going on?
On the one hand, NBCMI says look at all of these other certifying bodies that are not accredited, yet very valid –just like us– but out of the other side of their mouth, they are saying we won’t accept their training unless they pay us. Hmm? Seems like more of a way of sticking it to the Certified Commission for Healthcare Interpreters (CCHI), NBCMI’s arch enemy. If it quacks like a duck…. I seriously doubt NBCMI or CCHI will ever admit to bad blood between themselves. These are, however, two organizations going after the same audience – interpreters and the medical community. Think about that for a moment. If you are interested in learning more about how CCHI was created, I invite you to do a Google search using the term “CCHI history” and read the “2018 – CCHI-History.pdf” file.
Getting back to the poll, there was not much participation with only 95 responses, however, between the three forums where the survey was placed the results were as follows: 40% don’t believe the lack of accreditation has had any effect within the medical community, 38% think that it has, and 22% responded “I don’t know.” You can read into this what you will. Personally, I think a more scientific poll should be done to get a more accurate pulse, but that is just me.
Perception is a reality. Remember the duck? Until NBCMI figures out a strategy to change the perception outside of the self-imposed bubble of the interpreting world, not much is going to change. In fact, it will probably get worse. What is important is what the CMI’s think (the purpose of my non-scientific poll), and more important than this, what those who use the services of the interpreter profession think. If a hospital thinks the CMI certification is no longer valid, guess what? If it looks like a duck…
In conversations I have had with other interpreters and those who use interpreters there are some who believe that eventually there will be only one certifying organization left standing in the fight for dominance between CCHI and NBCMI. As of right now, based on all that has happened and is happening, CCHI is winning this battle. This doesn’t mean, however, that NBCMI isn’t going to come back strong. CCHI is rightfully using to their advantage that their CHI-Spanish certification is accredited. Now before anyone starts blowing raspberries and going yeah, take that NBCMI, keep in mind that there is absolutely nothing to say that CCHI won’t one day decide to drop the accreditation just like NBCMI did.
There is no way to cover everything in one blog, so a sequel may follow. Before I end, though, I do want to talk about Jazmin Manjarrez, the Chair of NBCMI. I had the privilege of speaking with her concerning this blog, and what is happening in the field. In fact, we talked for about two hours. I found her to be extremely approachable, open and concerned. Although she is relatively new to this position, she has experience in the interpreting profession and genuinely wants to make a positive difference.
Remember what I stated earlier about going to the source? Ms. Manjarrez kindly gave me permission to publish her email, which I have done below. She wants to hear from you. She wants to turn the perception around, and she is doing a great job in trying to do so. Write to her. Ask questions. Please, though, remember that she is only one person so please be kind and give her time to respond.
This is a battle for our profession. For our livelihood. Regardless of which side you are on, we all lose if the perception from those outside the profession has of us does not change. From the movie “Hunger Game,” (2012), “May the odds be ever in your favor.”
To correspond directly with Jazmin Manjarrez, Chair of NBCMI, please write to her at firstname.lastname@example.org.
Side note: Here is why, according to Manjarrez, CE’s have to be through IMIA.
“Education, Training, and Certification
• Demonstration of impartiality of individuals related to education or
training leading to initial certification.
• Clarification that a related entity (and not the certification board
or exam development participants) may provide review courses and materials, but they must not be endorsed or required.”ctor