# A Qualified Multilingual Assessment for Medical Students: A Cohort Study

## TL;DR

A new assessment was tested to evaluate non-English language skills in medical students, showing it is feasible and helps improve communication with patients.

## Contribution

The study introduces a qualified multilingual assessment (QMA) for medical students and evaluates its feasibility and acceptance.

## Key findings

- 81 out of 92 eligible students passed at least one ALTA exam.
- Most students rated the assessment as very or extremely accurate.
- Students who completed clinical rotations reported using non-English languages with patients and interpreting for others.

## Abstract

Introduction

Effective clinical communication is essential for delivering high‑quality care and directly impacts the safety of patients who prefer a non‑English language. However, no national standard exists for assessing oral non-English language skills among multilingual medical students in the United States.

Methods

From June 2024 to November 2025, medical students who self-reported “very good” or “excellent” oral proficiency in a non-English language were invited to complete the ALTA Speaking and Listening Assessment, a qualified multilingual assessment (QMA) used to verify skills for direct communication in clinical care for patients with non-English language preference. Surveys captured students’ perceptions of the assessment and use of non-English languages with patients after their clinical rotations. We present descriptive statistics of quantitative data and content summaries of qualitative data.

Results

There were 92 eligible students who completed 102 ALTA exams. Of these, 81 students passed at least one assessment. Most participants rated the assessment as extremely or very accurate (n=28, 82.3%) and the scheduling process as very or extremely easy to schedule (n=35, 97.2%). Some found the assessment overly formal. Among the 24 students who completed clinical rotations, 66.7% were asked to interpret, and 50% regularly used a non-English language with patients. Students described increased confidence and rapport-building with patients.

Conclusion

The QMA was feasible and acceptable for medical students. More research is needed to differentiate skills for direct language-concordant care from medical interpretation.