Japan and Medical English Skills in the age of Medical Tourism

David Robertson, 24 September 2020.

Japan for many years has seen itself as a potential hotspot for medical tourism. Government directives, action committees, and focus groups have been set up to develop policies towards medical tourism, and exactly what Japan needs in order to capitalize on this growing market1. With an ageing population that requires advanced medical treatment and care, the medical industry in Japan, and in particular research into aged care, is exemplary. Medical tourists, in particular from Southeast Asia and the Indian subcontinent, are looking for quality medical care that passes international standards, and this care can be received in Japan.


Source: Nippon.com, 2015, Japanese Healthcare Attracts Medical Tourists, accessed 24 September 2020, <https://www.nippon.com/en/features/h00125/>. 

One major area of concern has been the internationalisation of healthcare in Japan. While Japan’s population now includes over two million foreigners, making up over 2% of the population2, there is a lag in the ability to communicate efficiently and constructively with non-Japanese patients. While international clinics usually have numerous languages available, in particular English, outside of these clinics it is difficult to find clinics and hospitals with staff that can communicate using a degree of empathy and language competency required to ensure the patient’s concerns are adequately met.

Image source: A Japanese OET nursing student taking a trial OET Speaking test, July 6 2015, Melbourne Language Centre, viewed 24 September 2020, <https://youtu.be/bvuk52zFN6k>. 

In the past few years, medical English has created a small niche in the Japanese marketplace. One constant issue for Japan is the quality of medical English programmes are not up to any international standard, and are usually based on learning phrases and vocabulary, which does not lead to an authentic patient-focused experience. It has always been commonplace to simply start a course with an off-the-shelf textbook and unqualified staff, but this is not acceptable for medical communication. Accreditations and quality must be guaranteed as patients deserve the best in regards to their healthcare, and in particular medical tourists paying millions of yen for treatment.


Image source: David Robertson

With the assistance of the Occupational English Test (OET)3 and the National English Language Teaching Accreditation Scheme (NEAS)1, a syllabus is being written now to introduce cut-down 45 minute lessons based on the OET nurse training requirements. This syllabus takes into account specific needs for Japanese nurses without losing the performance criteria set out by OET. In many ways it is a ‘scaffold-up’ approach for nurses who have not studied English past high school. Feedback from trial lessons has been excellent, with people reporting that they are starting to think about language in the context of a consultation, which is very different from how medical translation and phrase-based vocabulary learning is conducted. The use of a notional-functional approach has been reported to build up knowledge of the context at an acceptable speed.

With such a high quality and professionally accredited programme being developed, there is a need to train teachers to a quality standard. Most English teachers in Japan have no formal teaching qualifications, and this is something that calls into question Japan’s falling ability in EFL rankings5.  A decision to only allow qualified TESOL trainers to teach the courses was made to ensure the quality standards are maintained. This is often a requirement for NEAS accreditation, which is paramount to receiving the recognition required to ensure the highest quality of training programme is available to medical professionals in Japan.


Image source: Occupational English Test 2019, Occupational English Test Product Disclosure Statement in Japanese, received 12 August 2018.

With the development of a high quality syllabus suitable for nursing professionals made available in Japan for English in a healthcare context coupled with accredited trainers, the medical tourism industry can start working towards the the goal of having medical professionals competent in healthcare-contextualised English language competencies, a must if the medical tourism industry is to succeed and excel in Japan.

  1. https://www.nippon.com/en/features/h00125/
  2. https://www.statista.com/statistics/687809/japan-foreign-residents-total-number/
  3. https://www.occupationalenglishtest.org/
    https://neas.org.au/
  4. https://www.ef.com/wwen/epi/regions/asia/