KARACHI: The Internal Medicine Interest Group of Sindh Medical College, Jinnah Sindh Medical University (JSMU), has developed Pakistan’s first multilingual clinical history-taking handbook to help bridge language barriers between doctors, medical students and patients, enabling clearer communication and supporting better clinical assessment.
The 137-page handbook will be available as a free digital resource and aims to help healthcare professionals understand the symptoms and medical concerns of patients who speak different regional languages across Pakistan.
According to JSMU, Pakistan is home to a linguistically diverse population, yet medical education and clinical history-taking in hospitals rely heavily on English. This can create difficulties when patients are unable to explain their symptoms, pain or medical history in a language understood by their doctors. Such communication gaps can affect the collection of essential clinical information, complicate diagnosis and undermine trust between patients and healthcare providers.
The handbook has been developed as a practical guide to help medical students and clinicians communicate with patients in their own languages and obtain the information required for a more comprehensive clinical assessment.
The resource includes a complete clinical history-taking framework in English, Urdu, Sindhi, Punjabi, Balochi and Pashto. It covers key aspects of a patient’s medical history, ranging from personal information and presenting complaints to symptoms, family background and socioeconomic circumstances.
During a medical examination, understanding the nature of a patient’s complaint, when symptoms began, the type and severity of pain, previous illnesses, medication use and family history can all contribute to clinical assessment. The handbook provides a structured approach to gathering this information, helping healthcare professionals ask relevant questions and better understand patients who may not speak English or be familiar with medical terminology.
In addition to general clinical history-taking, the handbook contains specialty-specific checklists of presenting complaints across several medical disciplines. These include neurology, cardiology, gastroenterology, nephrology, pulmonology, endocrinology, rheumatology, ear, nose and throat (ENT), and ophthalmology.
The checklists are designed to help students and clinicians ask relevant questions according to a patient’s symptoms and collect essential information in a systematic manner.
A key feature of the handbook is its Roman-script phonetic transliteration, which allows healthcare professionals to read translated questions aloud even if they cannot read the relevant regional script. This is intended to make communication easier for doctors and students who are unfamiliar with a patient’s native language.
The handbook also includes QR codes linked to pronunciation videos featuring native speakers for each language section. These videos are intended to help users learn the correct pronunciation of translated questions and phrases.
Additional glossary tables cover numbers, time, body parts, common symptom-related words and basic clinical instructions used during bedside examinations. These resources are designed to provide quick, practical assistance to healthcare professionals working in hospital wards and other clinical settings.
According to the information provided about the handbook, the translations underwent a multi-stage review process to improve accuracy and clarity. Initial translations were prepared by medical students who speak the respective languages. The material was then proofread by native-speaking house officers and postgraduate trainees before undergoing a final review by native-speaking professors and lecturers from Karachi, Peshawar and Quetta.
The handbook is intended for MBBS and BDS students, nursing and allied health students, house officers, postgraduate trainees and practising clinicians who treat patients from different regional language communities.
Its availability as a free, open-access digital publication is expected to make it accessible to healthcare professionals and medical institutions seeking practical tools to improve patient communication. The handbook may be particularly useful in hospitals and training environments where patients and healthcare providers do not share a common language.
The resource is available under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International licence, which permits users to copy, share and adapt the work for non-commercial purposes, subject to attribution and the licence conditions.
The initiative highlights the importance of effective communication as a fundamental part of healthcare. While a handbook cannot replace professional interpretation or clinical judgement where these are necessary, it can provide a practical resource for medical students and clinicians seeking to understand patients’ concerns more clearly.
If incorporated into medical education, clinical training and hospital practice, the handbook could help improve communication with patients from different linguistic backgrounds and support more inclusive healthcare services.