Narrator:                                 00:00                     Hello, thank you for listening to Subject to Interpretation hosted by Agustin de la Mora. My name is Claudia. And my name’s Kayla. And we are the producers of this program. Before we get into today’s interview with our special guests Natalya Mytareva, who is the executive director at CCHI, which is the certification body for medical interpreters, we wanted to bring you the latest announcements from de la Mora Interpreter Training and a reminder, if you found us on Facebook, we’d like to remind you that you may download us directly to your phone wherever podcasts are available. Now onto some more exciting news. We wanted to announce some of our end of the year courses including our Language Neutral Court Interpreter Training Program, which is assigned to help prepare future court interpreters for the state oral exam. You will learn the core methods and practice that have made us a nationally recognized interpreter training company, and this is a big announcement, that this will be the very last one taking place this year, so don’t miss it. This course begins on October 1st, and will be taught by Beatrice Craney. Also to prepare for the 2019 federal exam, we have our course, which is the FCIC written prep course, beginning September 25th. With this course, we will prepare you for the written test by administering a practice test, reviewing and studying each section of the exam, and going over vocabulary exercises. The links for both of these courses will be included in the description, so be sure to check them out. Now stay tuned for next week’s podcast featuring Corinne Mckay. She is a certified French and English translator who also happens to be the president of ATA, which you may also know as the American Translator Association, which currently stands as the largest interpreter and translation association with over 10,000 members, so don’t miss it. We do appreciate you all for listening in. We pride ourselves in being one of the very few podcasts for professional interpreters out there, so please share us with all of your colleagues. We would love to hear your feedback, or if you have any questions, please feel free to contact our office. And you will most likely speak to one of us. Until next week! Now enjoy the interview with Natalya Mytareva. Goodbye!

Agustin:                               02:24                     Well, welcome everyone to another edition of Subject to Interpretation, where we discuss subject matter that is important to us interpreters in various fields, conference, medical, and legal interpretation. My name is Agustin de la Mora, I’m your host, and today I have the pleasure and the honor to have with me Natalya Mytareva, who is the executive director at the Certification Comission for Healthcare Interpreters, CCHI, and I had the pleasure of meeting Natalya many years ago, when we were foraying into thinking about starting to train interpreters in the medical field and she was very instrumental in getting us position and learning about how to get a certification as an interpreter. So without any further ado, let me say good morning, Natalya, how are you doing?

Natalya:                               03:15                     Good morning, Agustin! Thank you very much for this lovely introduction. Yes, it’s been years since we’ve known each other, and I’m really happy that we can reconnect virtually.

Agustin:                               03:25                     Yes. And so Natalya tell us, I think the first thing that I would like you to tell us, first of all, how did you end up being a medical interpreter? Is this something that when you were a little kid playing with toys, you thought, I’m going to be a medical interpreter. Is that how it happened?

Natalya:                               03:40                     No, when I was a little kid I wanted to be a ballerina. So that didn’t happen and I decided, well, the next big thing in Russia, that’s where I’m from, is to do something where I can talk to people from different countries. And remember, it was at that time Soviet Union, so everything foreign was fascinating to me. So I decided I wanted to learn a foreign language and my career started as first, teacher of English at the high school. Uh, but then I was assistant professor at the University in Southern Russia, Volgograd, and there I taught Interpreting Theory and Practice to students of a interpretation, translation, of those who wanted to be teachers, students of law, economics, so different kinds of fields. And um, that’s when I started doing conference interpreting. And so my first introduction to the profession was a conference interpreter. I was different kinds, whatever happened in our city, and then in 96, moved to the United States. And so it’s, “what am I going to do here?” I tried some adjunct teaching at Kent State University. It’s great, but it doesn’t feel that you’re connected to the world as much when you’re in academia. It’s lovely. I love it, but it is not as vibrant as being in the thick of things. So I, uh, started working for a nonprofit organization which resettled refugees in Akron area in Ohio. That’s where I’m residing, and it’s called the International Institute of Akron. And for 13 years I was their manager of interpreting and translation services. And again, the story continues. It’s a very thick plot here.

Agustin:                               05:38                     Well we like thick plots, because we’re interpreters, we’re always interested.

Natalya:                               05:39                     That’s right. That’s right. So I was thinking like, what should I do? Translation, interpreting, or interpreting in court, or medical. And I had a wonderful friend who you definitely know, and many of listeners may know Isabel Framer. And so she said, well, let’s have a gig in court interpreting. Well, I went to court twice, and I said, you know, I really don’t like Russian defendants. Uh, I already think that they’re all guilty so I cannot be a court interpreter. I could be a court interpreter trainer. And I did that for awhile. I mean, it’s because I, you know, back in Russia taught students of law, the English and interpreting and translation, in Russia in English. So I liked that area, but I am not a court interpreter. I could not, uh, be neutral. Uh, and I’m fine for victims. I mean, in terms of like I love them and I’m on their side 100 percent right? So I don’t think I would be a good interpreter..

Agustin:                               06:41                     You’re a little biased, let’s say.

Natalya:                               06:42                     That’s right. That’s right. But you see the thing is to realize your limitations, and then act on them, either, you know, train yourself to be neutral, which I couldn’t in this case. And I decided, no, I’m going to medical interpreting because there, I can see that I’m doing good for both sides, providers and patients, and I could be neutral and I could do good and that’s how I ended up.

Agustin:                               07:05                     Yes. And obviously that one of the main differences, the environment, you know, when I started in the law it was, as you say, very, it’s adversarial, and you do not always interpret for nice people, sometimes they’re not nice at all. And then in a medical field where it’s collaborative, you don’t have that problem, actually you, and the medical provider, and the patient, you all have the same goal, and that’s for the patient to get well, so that’s interesting. So you stuck with medical interpreting and then, uh, was there certification when you started in the field? And by the way you mentioned this, I think everybody knows Isabel Framer. One of these days I’m going to see if I can invite her. She’s a very interesting person. She’s super busy, but I’m gonna see if I catch her one of these days, and I’ll invite her to be in one of our podcasts. I think she really has been a champion for the interpreting profession forever and a day in Ohio. So tell me, how did you, uh, when you made the jump, was there certification at the time or…?

Natalya:                               08:10                     No, and that’s, you know, what was baffling to me, because back in Russia you can call yourself an interpreter after you get your master’s degree in Interpreting. And my master’s was in philology. So even though I did conference interpreting, it was looked down upon as the second tier because I really didn’t get a master’s in interpreting, so, uh, I only got the jobs which nobody else wanted to take, right. And I learned to still love it, but I didn’t want to get another master’s, obviously. So when I started the career here, in 2000, I did the search. Google was still our friend there, and I found the article by Holly Mikkelson about professionalization of community interpreting. And that’s when I realized that, hey, all you need to do in this country is to call yourself an interpreter. If you speak two languages and you’re good to go. And I felt from that very moment that, that’s simply wrong. You know, if you think of the complexity of our job as interpreters, and any field, of the years of study. It’s comparable to doctors, not to attorneys who studied, but they don’t study as long as doctors do, right? You go through your medical school, you go through your residency, then you decide, you know, whether you want specialists and if you want to be a neurosurgeon, then you have to even have more training and specialization and certification. Interpreters, we take eight to ten years to learn the language to the level which we could start interpreting and translating, right? And then we specialize either interpreting or translators and then we specialize court medical conference, and so why there is no requirement? So that’s how I got passionate about starting to establish some standards and having ease, as my mentor helped too because she was fighting for certification in Ohio for court interpreters. And I, uh, whenever the national body of several associations in the United States NCIHC the National Council for Interpreting and Healthcare, ATA Translators Association, CHIA, which is California Healthcare Interpreters Association, and IMIA, they got together in around 2006, and put out a national proposal for anybody who wants to work on certification, welcome to apply, we will form a coalition, and that’s when I applied. Then they picked me, as, you know, fitting one of the stakeholder groups. Uh, I was representing refugee interpreting, because I worked with refugee resettlement, and by extension languages of lesser diffusion, and after working on the coalition from 2007 until 2009, uh, out of that coalition, National Coalition for Certification in Healthcare Interpreting CCHI was born. And I was one of the founding commissioners. Then in 2012 became chair of CCHI, and then in 2013, we matured as an organization to hire the first full time staff person, director, and that became me. So, uh, that’s the short version of the path of how. I feel very honored and proud to be part of creating this certification body and being part of the movement towards better quality of interpreting in the United States.

Agustin:                               11:42                     And that is wonderful. And that’s why we wanted you to be with us because I think it’s important for people to know that, even though for many of us, I think that my introduction to interpretation was something like, do you speak Spanish? Do you have any experience? I told the guy I had done one deposition and that qualified me immediately to be a court interpreter. And probably like you did, the first time I went to a court, I had no clue as to what I was saying, and I was baffled as to how was I already considered– actually they paid me for that day, which was even more baffling– to be court interpreter when I really had no idea what to do. So I, like you, started searching and finding ways to, to push for certification. That’s how I met Isa because I pushed very hard and we worked very hard here in Florida to get certification going. It took us only about 10 years to convince the legislature. But we got it done. So now you are the executive director of CCHI and I would like you to give us a little bit of perspective because I think out there, even though a lot of people want to be interpreters, and as you know, what we do in our company, we train interpreters in various fields including the medical field, and when they call us, some of them have tried to find something, but it’s a little complicated to navigate how to become certified. And I was a little dismayed, when I was doing one of my searches, that one of the things that popped up was an article that was saying something about don’t get certified or something like that. And I was discouraged to see it, but I realized that there’s a lot of misinformation out there. So if I could, first of all tell us, you guys are not an association. You don’t have a bunch of members that are medical interpreters, do you?

Natalya:                               13:37                     No, we don’t, and that’s a very important distinction for us, because when we formed the organization in July 2009– by the way, next year will be our 10th anniversary, we’re excited and doing the plans, because you said it took you 10 years, so we would be, you know, uh, doing a lot of educational activities next year to publicize the 10th anniversary of certification. So, one of the important things to understand is in the certification industry, let’s put aside interpreting for a minute, but there is an industry of certification which exists for different professions. Uh, architects, doctors, attorneys, right? And in this certification industry, there is a model where association is tied with the examination body, but it is not a common model. It’s more like an exception. The standard is the certifying body is not a membership association, which is totally independent from any industry interests or stakeholder groups and tries to combine the interests of everybody by creating the exam that benefits the public and the recipients of the service of that profession. In our case that will be patients. And so for that reason, CCHI is not an association. We are administering exams which are created based on the profession needs, and our governing body is the board of commissioners who are volunteers and each represents different stakeholder groups. Practicing interpreters, of course, already certified interpreters, because they need to have a voice in decisions. Language companies, educators like your company or yourself, and healthcare providers, and then public member, which is the person who is not related to interpreting or interpreting industry at all, just to make sure that we’re not creating something that the public at large will not benefit from. So, like a voice of reason, like, okay guys, what the heck are you doing? Tell me what you’re doing, and I’ll tell you if that fits into what the being the civic society in America is all about.

Agustin:                               15:59                     Right. That’s exactly a good point. And I like that concept of the independence of the board. So we don’t have any influence from membership that could push in this or other direction, instead of keeping this neutrality. So you formed CCHI with other people, and how do you support yourself then, if you don’t have any members?

Natalya:                               16:24                     Well, because certification is an industry and a business in a way, we support ourselves– right now we’re very proud to be self-sustained. In other words, we started with the help of the people, right? We couldn’t have started on this. We are very grateful to about five, six big companies that supported us in the beginning who contributed just hard cash, uh, to help us start the program. We got some smaller companies contributing. We got grants from the beginning, from Office of Minority Health to develop a written course, CCHI exam, and the first Spanish exam. We got grants from Robert Wood Johnson Foundation to develop our Arabic and Mandarin exams. Uh, we got grants from Kaiser Permanente to develop the network of– to develop the continuing education accreditation program and the network of disseminating information. So over the first maybe three, four years of existence, through the commissioners and public outreach, we raised over a million dollars to start this. Now we depend on fully and solely on the fees from examinations and continuing education accreditation fees.

Agustin                                 17:45                     So tell us, since you are a certifying body. What languages are you certifying at this point? And what do we call your certification?

Natalya:                               17:51                     Well, it’s a national certification and we have, if you want to make it a little simple, uh, it’s two tiers, right? And the reason there are two tiers is because, uh, even though our principal is inclusiveness and equity, at the same time, we understand languages and interpreters working in those languages are not equal, right? Uh, if you’re Spanish, obviously that’s the number one language. You have more opportunities for training, you have more opportunities for full time job, if you wish to be a staff person versus freelancer,. If you’re an interpreter of Russian, this already diminishes, but still it’s comparable. But if you’re interpreter of Burmese Nepalis, Kinyarwanda, even Swahili, they are pretty much no training opportunities for those languages. Uh, not in English, but in their language. And there are very few full time jobs across the country where you can be just an interpreter with those languages. So because of that, we have two tiers. The first tier is what we call Core Certification Healthcare Interpreter. And that is Core CHI. That is an English exam in writing, multiple choice, um, that is about the knowledge about the profession. So code of ethics, terminology, roll of the interpreter, how you interact with different parties during the encounter, that kind of thing. And that certification is accredited with the independent body, National Commission for Certifying Agencies, NCCA, and that is the first step. So, however we understand that we really need to make sure that people who know about interpreting, can actually interpret, and that’s our second tier, which is Certified Healthcare Interpreting credential, that’s CHI. And that exists in Spanish, Arabic and Mandarin. And right now, we have a little over 800 core CHI certificants, which represent all kinds of languages.

Natalya:                               20:03                     The top ones are Russian, Burmese, Korean Cantonese, um, Somali, then Portuguese, and um, Nepali and Hmong, close by, and French. So these are the top languages for these certificates. And then we have about over 26, 2,700 CHI certificants, majority of them Spanish. We have about 100 Mandarin and about 90 Arabic. And since we realized that the more you add the oral component in a specific language, the fewer candidates you would have who will take the exam, and even fewer who will pass the exam, because there are fewer training opportunities for these languages. What we have right now is a very exciting new project that we started this year. And we formed the national task force to help us proceed that direction. We are planning to conduct a study of possibility of creating an English to English oral performance exam for medical interpreters. It’s a new animal that existed in profession and we’re very excited about it. The field will hear more about it starting this fall.

Agustin:                               21:34                     Well, that’s wonderful. That’s very good news. I’m glad that we’re, I guess some of the first to hear it, so everybody will know and we’ll let our people, our students, know about it because this is very exciting and it’s always a difficult component because in the legal field that always has been the rub. Right. How do you get these languages of less diffusion, at least tested somehow, to see about their interpreting skills? So that’s very good news. And, and please, if we can help in any way, shape, or form, please count us in. We will love to participate in any form that we can in that project. So, well you already have, you said, about 1600 people that are certified CHI’s?

Natalya:                               22:26                     No, 37 total, if we subtract 800 it become what? 2900? So 2,900, around that area. The number, we have a public registry that’s on our website that you can search. The only tricky part right now is, because we’re in the middle of testing., we just finished testing for oral exams yesterday, and what happens is, we’re in the rating process which takes about six weeks, and the time when the scores are released, the date of certification goes back to July. So we have about a hundred or 200 people who are not in the registry yet because the scores are not released. But, if you count them altogether, that’s what we have. Yes.

Agustin:                               23:18                     Well that’s very encouraging to see the numbers growing in that proportion. So what do you think about the end users? Are there being more educated? Are you hearing more and more hospitals and healthcare providers asking for certification, rather than just asking the typical question, “do you speak Russian and can you be here tomorrow” as the only qualifying question?

Natalya:                               23:41                     Oh, you know, it’s a philosophical question. Is the glass half full or half empty, right? But the good thing is, like seeing those, since I’ve had the chance and pleasure of witnessing this for over several years now, I feel personally that there are more and more providers across the country that actually feel that certification is the starting point. And it’s both hospitals and language companies. And it encourages, it is encouraging because, uh, you know, I can say that in every state there is at least one hospital that requires certified interpreters as their staff. And then the next layer, which they are working on right now, is to require from their contracting agencies, to have their freelance interpreters, certified, who to come to interpret for that hospital. The interesting part is, it’s not the biggest hospitals usually. I mean we have all the big hospitals covered too, but I’m always surprised when there are some small hospitals in some small towns in, you know, different states which adopt this. One of the examples could be a Valley View Hospital in Glenwood Springs, Colorado. That’s what they require. They provided for training of all their staff, they actually paid for this sort of vacation of their staff who interpret. They have bilingual staff interpreting. So they have a good team of about 20 certified interpreters. And that’s a small town. The other interesting example I can give you is there is a very interesting network of, uh, it’s a cooperative of sorts, of medical professionals who are not even a hospital. They are a group of different clinics and different physicians in rural Oregon, around Medford area. And they have a couple of other locations there in the middle of Oregon, who also require certification. And they’re the ones who reached out to us because they said, you know, we can evaluate our physicians on utilizing certified interpreters for their patients. And we have certain incentives for our physicians to encourage them to use certified interpreters, and how can we move it forward? So it’s really interesting initiatives and I’m so impressed with, uh, this and uh, actually, uh, the representative, uh, is coming to Oregon Healthcare Interpreter Association Conference on August 25th, to talk, probably, about this or just to learn more about us interpreters. So, it’s, a physician who is not a hospital, is interested in this kind of thing. So that’s fascinating.

Speaker 2:                           26:39                     That is fascinating. And I find it very encouraging too. And it’s interesting that you mentioned that because we have, here in Orlando, some huge hospitals, uh, that have staff and therapists that do not require them to be certified. And some confusion, I’m sure you’re aware of the fact that some companies out there claim that they certify their own interpreters. And I was really a little concerned, but I guess there’s not much we can do that. There was a company out there, I think they got bought, but it was called Certified Interpreters, the company itself.

Speaker 3:                           27:17                     Oh lovely!

Speaker 2:                           27:20                     So of course, I’m a certified interpreter, right? I worked for– I like saying I’m a language line interpreter, or that I’m a certified interpreter since I worked for the company. And so I went to this large hospital and they said, “oh no, all of our interpreters are certified,” and well that’s wonderful, you should advertise that because that’s not very common. And then when I asked them who certified them, it turns out that they have this certificate from a company that said, you know, we certified them, so and so took a class with us and passed our tests. But that’s not certification. So there was a little bit of confusion as to who is the certifying body. Have you found that around a lot when people ask you about certification?

Speaker 3:                           27:59                     Absolutely. And I agree 100 percent and education can never stop. But what we’re trying to do is to adopt the jargon of healthcare providers so that if they require evidence based medicine, right? So they need to make sure that they really pay attention to the evidence they gather about qualifications of their interpreters. And so, the reason we accredited our core CHI exam, because we totally understand that it is the minimal type of assessment, but it does meet the criteria of certifying you know, industry, and we have it accredited so we have an oversight, and report to somebody who can look at how it’s constructed, how it performs and rules. So we have CHI Spanish exam accredited with the national entity. So when we reach out to hospitals, we can tell them, hey, first of all, we use evidence in all our steps of creating certification exams. And through national surveys, through convening national panels of subject matter experts to write the content, and we have an overseeing body, and to say that oversees certifications for nurses, for obstetricians, for all of your specialties. So it’s the same body wearing the same stream as you are. And what is exciting about this new study, that English to English assessment for interpreters of languages of limited diffusion, is that this would be the first evidence based study that would compare, uh, the possibility of the equality of testing in English of some skills, and how it translates to dual language testing. So we will be publishing this study a lot among healthcare professionals and hope to publish it in a medical journal afterwards so that they can see that our profession is as evidence based and driven as they are. And hopefully they, will when we start speaking their language, we need to learn to speak their language, they will then stop being confused about what we’re doing.

Agustin:                               30:09                     Right. That is awesome. And yes, I was thinking again, you know, these large companies here, these large hospitals that have some staff that are not certified. We just got contacted by a small teaching hospital, a couple of hours here from Orlando, and funny enough, all of their staff, the few members that they have in their staff, they are all certified. I don’t know what it is, but maybe maybe the size has something to do with the fact that they find it easy to comprehend. I don’t know what it is, but we’ll keep up the fight. So before I let you go, I would like you to give us in five steps, somebody calls me and says, Agustin, how do I get certified? They easy answer is to send them to your website, but tell us what are the steps that somebody has to go from “I don’t know anything about this,” to “I want to be as CHI.” What do I do?

Natalya:                               31:01                     Okay. First you need to understand that you need to have at least 40 hours of medical interpreter training. That’s the prerequisite so we can get you in the door. And you need to have the documentation because with our application process, you need to upload a certificate for that, or several certificates if you want to gather among different programs, and you need to have proof of your language proficiency. It could be different documents, doesn’t matter. You have to proof of language proficiency in two languages, English and the other language. Then after your application is reviewed, you need to take the written exam, and that’s what that 40 hours of training would help you to do. For Spanish, Arabic and Mandarin interpreters, 40 hours will not be enough to allow you to pass the oral exam. Yes, you can still take it, but you really need to have language specific skills training. Like, first of all, let me give a little plug for you, Christine, because I love your training about simultaneous interpreting, and on our exam we do have a simultaneous piece and it’s important for people at least to hear you in English talking about it, or any other training providers. But you do a wonderful job on this in particular, because I listened to this topic several times. I love that. So they really need to have this additional skills training before they sit for the oral exam, because 40 hours will never make any interpreter, but it’s a minimum kind of prerequisite to get you to start the process. And after you take your oral exam, you passed it, you are certified. If you’re a Spanish, Arabic or Mandarin interpreter, the process could be as quick as a three months. On average, people do about five months from the day you apply to the day you get your certificate.

Agustin:                               32:58                     Awesome. And when you get the oral exam, is it all done by computer now, or do you have to go to a specific location and do it in person?

Natalya:                               33:07                     It is computer based or web delivered, but you have to go to physical test sites for two reasons. One is security reasons on our end, right? Because we want to make sure that our content is not compromised, so we have to have proctors who observe you. But secondly, it’s the IT issues. Um, if, you know, if you have several people in your household and they all start watching different Netflix, you’ll start thinking. So it’s important that if, because we all have computers, but they’re not really capable sometimes to handle this part where we do simultaneous interpreting via web, because you’re uploading and downloading audio at the same time. And we really don’t, uh, you know, it’s even the testing side sometimes have problems with that. If the web is full of some updates that day, you may be unfortunate to have those problems. So that’s why we ask people to go to specific test sites.

Agustin:                               34:10                     Perfect. Well, Natalya, I know that we could spend the rest of the day talking to each other, but this was super informative and enlightening. And please let us know anything that we can do to help CHI. We’re going to have a conference here coming up in November. We’ll send you information if you want to send those brochures, or any information that you want us to share with the people participating. We’ll be happy to do that. And if we could in any way participate or help you guys with these education efforts for next year, for your 10 year anniversary. We’ll be happy to do that, too.

Natalya:                               34:44                     Well, thank you Agustin. Thank you, first of all, for the honor of being on your podcast, but also thank you very much for this. Definitely, we will collaborate and we’ll be in touch because we will need helpl from many to help us do that study. And also, we would love to be part of any local conferences or events, so that we can together help interpreters understand how to get a professional, and how to get better jobs because they have the right qualifications, and to educate the field of providers, of patients. So thank you very much.

Agustin:                               35:25                     Thank you Natalya. We’ll see you soon. Let’s make sure we see each other very soon!

Natalya:                               35:29                     Absolutely! Absolutely.