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‘I believe that doctors need to draw on two sets of skills to do their job effectively for both themselves and the patient’

Language is the core to everything, but it is often taken for granted. Applied linguistics specialist John Pill explains why language is fundamental to any occupation, including for health professionals.


‘To think that 30 or 40 years ago, a good doctor could be someone who knew their content and who could do their job well. Of course, that’s the kind of person you still need nowadays, but they also now need to have good communication skills. This inseparability of content and language is at the core of specific-purpose language testing.

I was lucky that I didn’t have to start my PhD idea from scratch. I was invited to take part in an Australian Research Council (ARC) funded project in 2009.

The focus of the project was to do research on the Occupational English Test (OET) based in Melbourne. It’s an English language test specifically for health professionals who want to work in Australia. I left my job to be part of this project and work on my PhD at the same time.


There’s a kind of traditional view of what language is and we have this idea that language can be measured in various ways – whether it’s through your pronunciation or intelligibility, the vocabulary you are using, or how accurately you use grammar.

That scope of assessment is quite limited though, because language is so much broader than that. The main challenge of my thesis was trying to work out what matters to health professionals and make sure that what matters to them was reflected to the best extent it could in this specific-purpose language test.

The whole point of the project was to assess the effectiveness of interaction between doctors and patients in a way that has not been done in language testing previously. I wanted to propose a more sophisticated way of measuring whether doctors from a different language background would have the skills to work and communicate effectively in an English language context.

The OET is divided into four elements – speaking, reading, writing and listening. My thesis focused on the speaking sub-section of the OET, which is essentially made up of two role-plays.

The test simulates real-life tasks to see how well candidates can perform given the demands of the workplace. The candidate plays the role of the health professional and the interviewer plays the role of the patient.

This part of the test assesses whether candidates have the English language skills to communicate effectively. (The OET must focus only on language skills; candidates’ professional knowledge and skills are assessed by other professional and clinical exams.)

Therefore, I proposed two new criteria to be added to the OET speaking sub-test — ‘clinician engagement’ and ‘management of interaction’.

Clinician engagement is about how a doctor uses language to engage with the patient and to show awareness of the patient’s needs and concerns.

Management of interaction is about how a doctor uses language to collect and share information effectively with a patient. An example could be a doctor’s ability to help a patient explain their symptoms through asking the right questions.

These suggestions are aimed to help make the OET a better test and consequently help candidates understand what is required of them if they want to excel as future doctors in Australia.

I found that participants in the study were very focused on the patient as a whole, be it through considering a patient’s physical, social and psychological needs.

The ability to demonstrate awareness of the patient was highly valued by health professionals. Are they recognising what is wrong with the patient? Are they aware of the patient’s body language? Are they able to pick up issues that the patient is trying to hint at but maybe not explaining?

From a health professional’s perspective, language is perhaps not as recognised in comparison to clinical skills and knowledge, and that’s fair enough.

From my perspective as a linguist, I believe that doctors need to draw on two sets of skills to do their job effectively for both themselves and the patient – the skills they have has as doctors as well as those they have as language users.’  

John Pill is a part-time research fellow in the Language Testing Research Centre at The University of Melbourne. His PhD thesis is titled: ‘What doctors value in consultations and the implications for specific-purpose language testing’.

My PhD is an irregular series in which The Citizen speaks with recent Melbourne University PhD graduates. 

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