HOW AUTHORS CAN COPE WITH THE BURDEN OF ENGLISH AS AN INTERNATIONAL LANGUAGE

E nglish is the language of the most widely read and quoted medical journals. This poses a challenge for many authors whose native language is not English. Such authors struggle with the English language burden just as native English-speaking professionals are challenged by language barriers in countries where another language is spoken.1 Given these linguistic challenges, English as an international language (EIL) authors tend to believe that their manuscripts are significantly less likely to be accepted than manuscripts from native speakers. In reality, at least 50% of the publications in many of the best peer-reviewed journals are contributed by EIL authors. For example, from 2003 to 2005, the Journal of Thoracic and Cardiovascular Surgery received 59 to 63% of its manuscript submissions from EIL authors (P. Fried, MBA; personal communication; January 2006) and the experience of the Annals of Thoracic Surgery was essentially the same (H. Pusztay, BA; personal communication; January 2006). For both journals, the acceptance rates of EIL-authored manuscripts is essentially the same as that for native speakers.2 EIL author manuscripts often do require more work from reviewers and editors than manuscripts from native speakers. For example, the EIL author manuscripts for which we studied the review process in detail required significantly more revisions to achieve clarity of expression compared to similar manuscripts from native speakers during the same period of time.2 We believe that the privilege of being native English speakers comes with a responsibility to help EIL colleagues with their English.3 Accordingly, within the past 5 years we have conducted 15 interactive workshops for EIL cardiothoracic surgeons along with 3 similar sessions for other surgical specialties and for gastroenterologists in the United States and Japan. All interactive sessions that we presented had curricula that were specific to the specialties we were addressing. The examples we used as the basis for exercises that the EIL participants completed were drawn from EIL manuscripts and from written comments from reviewers and editors. All curricula were jointly prepared by a peer (J.R.B.) and an English for academic purposes language professional (C.B.F.). Dr. Benfield was a clinically active faculty member for 36 years in academic surgery. He has served on eight editorial boards, including 15 years as associate editor of the Annals of Thoracic Surgery, and as editorial consultant to 11 publications, including CHEST and the New England Journal of Medicine. Ms. Feak teaches at the English Language Institute of the University of Michigan. She has coauthored two books about academic writing and is on the editorial board of the journal English for Specific Purposes. She has worked as an EIL teacher for 22 years and has served as consultant for the US Department of State. Both authors brought different strengths to the audience during the interactive sessions of instruction, as indicated by the written evaluations provided by the audience. During preparation of learning exercises, the lanFrom the Division of Cardiothoracic Surgery (Dr. Benfield), David Geffen School of Medicine at UCLA, Los Angeles, CA; and the English Language Institute (Ms. Feak), University of Michigan, Ann Arbor, MI. Manuscript received March 31, 2006; accepted March 31, 2006. Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal. org/misc/reprints.shtml). Correspondence to: John R. Benfield, MD, David Geffen School of Medicine at UCLA, 11611 Terryhill Place, Los Angeles, CA 90049; e-mail: j.benfield@verizon.net Postgraduate Education Corner