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The Immigrants Doctors Want

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The Immigrants Doctors Want
The Need for "Medical Interpreters"

Forbes.com August 27, 2015
OtherPhilanthropy

It can be trite to describe some events as being possible only in America—but it can also be true. That is certainly the strong impression left by the Memorial Day weekend graduation ceremony of the group called Found in Translation. The student keynoters—who almost all have difficulty holding back tears—come from around the world, and might well never be in the same room together in almost any other country, yet are here in a local community center with their children, parents, and husbands. They are immigrant women whose first languages include Hindi, Somali, Russian, Portuguese, Haitian Creole, Mandarin, Spanish, and Arabic. All express their thanks—in English—for the program, and for what they uniformly describe as an extended family with whom they've completed the 14-week program they are hoping will lead them to a new career: that of medical interpreter. It's a role in which they are trained to explain to immigrant patients what health care professionals are saying about disease diagnosis and treatment—literally in the language the patient can understand. To qualify, they've attended four-days-a-week classes, held in space donated by one of Boston's leading hospitals, where both paid and volunteer coaches help them, through written examinations as well as role-playing, to learn the basics of, for instance, anatomy and physiology, C-sections, chemotherapy, and blood sugar levels. They do so in order to explain to patients, conversationally and without medical jargon, what's going on. In turn, they'll explain to physicians the concerns of their patients. It's a combination that can be life-saving.

It is not often that you see women in tattoos and tank tops laughing along with women in burkas. But the FIT graduates have built a true sisterhood based on hours of hard work and a sense of accomplishment.

The four-year-old program for immigrant women has itself been built by an immigrant woman. Russian-born, 29-year-old Maria Vertkin, whose parents brought her to Boston after having first emigrated to Israel, is a trained social worker who, while at work in a high school guidance program designed to help immigrant adolescents, had an idea: to turn the fact that many are truly bilingual into a means to improve their economic prospects. Or, as she puts it, “unleashing their skills into the workforce. They should be doing more than earning $7 an hour at Walgreen's.” Hers is a program that is already both robust (400 applications for 30 spaces this past year) and rigorous (essays and interviews to screen applicants, oral and written examinations to graduate) and for which Vertkin has big plans, including a new fee-for-service program component to offer ‘pop-up' interpretation departments for health providers and in this way cover training costs for each subsequent class—as well as innovative apprenticeship training and expansion into court interpretation. One should not bet against her. She's clearly been entrepreneurial in building FIT—finding a partner in Beth Israel Deaconess Hospital, a Harvard Medical School affiliate that hosts the classes (and has hired a few graduates), seeing a market opportunity in admitting women fluent in rare languages, such as Swahili, for which there is great market demand, and creating post-graduate training opportunities in a community health clinic run by Tufts Medical School (and soon, more training slots at a Tufts dental clinic).

One can think of Found in Translation as serving many missions. It's most clearly helping immigrant women move up the economic ladder. Many of the women, says a former board member, “have been on public assistance and want to get off. And they want to be a model for the kids.” The organization's newsletter never fails to feature a story of upward mobility, such as that of graduate Denise, a single mother who once lived in a shelter. “I couldn't find an apartment and nobody wanted to hire me.” She was drawn to Found in Translation specifically because it was free—and offered childcare. She has gone on to hold a full-time position at United Health Care.

This is also an immigrant assimilation program, demonstrating to immigrant women—some of whom have professional-level backgrounds (last year's class included both a doctor and a lawyer), all with income below the poverty level but each legally qualified to work in the U.S.—that America wants to help them adapt and thrive. And the diversity of the group offers another lesson in assimilation—that one from any background and country can be accepted as an American. The training classes now include women speaking as many as 12 different languages.

To date, Found in Translation is promising but small. There have been four graduating classes with a total of 120 graduates. Employment success and wage growth for the group are extremely promising. Eighty one percent of the most recent graduating class was employed within three months of graduation. Two class members received job offers before they finished training. Considering that women are admitted from destitute circumstances (approximately 50% of each class is homeless and living in shelters, most with children), this hiring success is remarkable. FIT tracks outcome data carefully: the average wage for graduates has grown from $13.38 to $21.70 per hour, with each class earning job offers and wage growth faster each year. The wages earned by last year's class after one year were reached by this year's class after 3 months. Founding board member Mark Stewart attributes this success to a refined selection process protocol—which focuses on both merit (including English language fluency) and motivation (as reflected in a required essay about life setbacks and how the applicant has overcome them). This reflects the organization's decision not to charge tuition—but nonetheless to make sure participants feel a commitment to the program. FIT is an organization unapologetic about identifying and assisting only those with the best chance to succeed—a reflection of its twin desires to avoid wasting its investment and to establish its reputation among employers as a provider of top-quality job candidates. There are, in other words, a great many implicit cultural lessons about the U.S. on which Maria Vertkin is acting—and which she's implicitly passing on to students.

It is worth noting, as well, that the service provided by this non-profit competes with similar services by for-profit providers of interpretive training that charge about $1,000 for the basic course. Vertkin emphasizes that Found in Translation's selectivity is meant to differentiate it, in a positive way, from for-profit competitors who, of course, take all comers who can pay. The FIT exit exam is designed to be demanding; there has been a very small amount of class attrition (no more than two in any class) and some graduates have had to take the exit exam more than once. (They are allowed to retake it—but must ultimately score at least 85 percent). Ultimately, FIT is doing something that the for-profit providers do not aspire to. She is lifting women (and their families) out of poverty. The fact that Vertkin's team does this through a program more in-depth (100 hours of training vs. 40 hours at other courses) with a placement rate that brings graduates of other programs calling to her for help, is a testament to her vision and passion. Without the child care, professional mentoring, financial literacy training, and add-ons such as transportation assistance and post-grad training grants, these women would not be positioned to succeed if trained elsewhere.

It is not often that you see women in tattoos and tank tops laughing along with women in burkas. But the FIT graduates have built a true sisterhood based on hours of hard work and a sense of accomplishment. Vertkin has created a program culture where classmates help each other as they go out into the workforce, while FIT comes alongside with professional support as they seek jobs, national certification and further, specialized training. The result is a brighter future for these women and their families.

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