Clinical linguistic proficiency programme: An approach to achieve multilingual proficiency

The article on medical education in indigenous languages raises critical concerns about the future of medical training in India.¹ While the debate continues, we present the clinical linguistic proficiency program (CLPP), at present trilingual, developed at National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru for residents in psychiatry as an innovative and practical solution that addresses many of these issues while maintaining the global competitiveness of Indian medical graduates.²

Initiated in September 2020, CLPP aims to bridge the communication gap between doctors and patients in psychiatry, a field where nuanced language comprehension is crucial. Unlike the wholesale shift to regional languages proposed by some, CLPP takes a balanced approach. It equips psychiatry residents with essential skills in Kannada, the local language, while maintaining English as the primary medium of instruction. This preserves the benefits of English-medium education while enhancing students’ ability to interact effectively with local patients.

The CLPP curriculum is built on the following principles: (i) adult learning models that prioritize active participation; (ii) peer teaching, leveraging the diverse linguistic backgrounds of residents; (iii) a trilingual approach (Kannada, Hindi, English) reflecting India’s linguistic diversity; (iv) focus on speaking skills first, followed by deeper language understanding; and (v) need-based learning tailored to common clinical encounters.

The program structure includes: (i) fortnightly one-hour classes in the first semester of psychiatry training; (ii) role-playing exercises in virtual classes to practice real-world scenarios; (iii) live clinical encounters for hands-on experience; (iv) a comprehensive manual with practical scripts and phrases in Kannada, complemented by Hindi and English translations.

What sets CLPP apart are its innovative features. These include: (i) an audio-integrated PDF manual enabling real-time pronunciation support during live consultations for on-spot live interaction with patients;³ (ii) emphasis on the ‘right question’ approach for effective clinical communication; (iii) plans for an interactive video series to bridge gaps in understanding patient responses; and (iv) future integration of AI-enhanced learning using ChatGPT for personalized language practice.

This model effectively addresses many concerns raised by Garg.¹ It maintains the standardization of medical education, preserves opportunities for international collaboration and career progression, and ensures effective communication in diverse healthcare settings. Importantly, it does so without compromising the quality or global relevance of medical education.

A key strength of CLPP is its potential for scalability and adaptation. It’s framework can be easily modified to incorporate other regional languages, making it a viable solution for medical institutions across multilinguistic India. This adaptability ensures that the benefits of enhanced doctor–patient communication can be realized nationwide while still maintaining a standardized core curriculum in English. Such an approach could improve patient outcomes and satisfaction, particularly in regions where language barriers have historically hindered effective healthcare delivery.

As we continue to debate the role of language in medical education, programmes such as CLPP offer a pragmatic middle ground that deserves serious consideration. It demonstrates that linguistic competence and cultural sensitivity can be seamlessly integrated into medical training, enhancing patient care without the need for a radical overhaul of the existing system.

We propose that the CLPP model be considered for wider implementation across medical institutions in India. Its adaptable framework could be tailored to different regional languages, providing a nationwide solution to the language barrier in medical education while maintaining India’s competitive edge in the global medical community.