By Pedram Mizani, MD, MHSA, family physician and chief clinical officer of the AmeriClerkships Medical Society

Published in Residency Program Alert* on September 2017

It’s well-known that your ability to acquire a new language declines with age. Although there is no established cut-off point for a precise year or developmental stage, language acquisition in the late teens and beyonds ensures that the speaker will never truly speak at native fluency—they will always have an accent.

It is for this reason that many international medical graduates can be highly self-conscious about their accents and fluency level, especially as they prepare to interview for a seat in a U.S. medical residency program.

How Important is English Fluency for a Prospective Medical Graduate?

There are no two ways about it.

You must have a bare minimum of a working proficiency of the English language to present yourself as a competitive candidate.

In fact, one of the primary ACGME core competencies upon which U.S. medical residents are judged is specifically their interpersonal and communication skills. Poor English skills naturally present a communication barrier that makes medical practice more challenging. As you complete your clinical observerships and medical externships, you are presented with an opportunity to hone your English skills. You should be actively pursuing this opportunity along with any additional classes and training that you can afford.

Does my Accent Make Me Seem Unprofessional?

No. Your accent does not make you any less competitive in and of itself.

In fact, an accent can actually work in your advantage depending upon your patient demographic and level of fluency. Americans romanticize certain regions of the world and appreciate some accents as quaint and endearing. More importantly, speaking at a higher level of fluency than the average native speaker (i.e. with a larger vocabulary and a better understanding of grammar and syntax) can actually make a residency candidate, a doctor, or any kind of professional seem even more impressive.

The presence of an accent with a clear, strong understanding of the language makes it apparent that you have mastered English as a second language—and done a fantastic job of it. While you may always struggle pronouncing certain words and sounds, anyone can reach an impressive level of language fluency given enough practice, exposure, and study.

Speak with Confidence

With that in mind, you should never feel embarrassed about your accent. Especially because your confidence and comfort levels have a profound effect on your ability to acquire a new language. As an international medical graduate, language acquisition can be a humbling experience. You’re used to speaking with eloquence and certainty in your native tongue. Yet, all of a sudden, you stutter and stumble trying to convey simple ideas to another person. But, your confidence to speak the language directly affects your level of exposure, and, in turn, your ability to learn. With or without errors or eloquence, speaking the language provides you an opportunity to develop your profficiency.

Finally, if you have the working proficiency to communicate within a medical setting, your confidence in your language skills is what is going to make the difference in your consideration for a residency seat. Feeling nervous and insecure during your interview can present you at a level of fluency far lower than you can actually speak, whereas showing confidence and a strong presence during an interview can elevate the level of language comprehension that your interviewer will see in your responses.

The best thing you can do either for improving your English proficiency or increasing your success rate in an interview is to work on your comfort levels and confidence in speaking.


Overton, R., & Dunleavy, D. (2017). The AAMC standardized video interview. [Webinar]. Retrieved from


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  • Published with permission from HCPro/Residency Program Alert. Also published on HCPro.
  • About Residency Program Alert: Residency program managers in all specialties are challenged to effectively manage their programs as accrediting agencies focus on outcome measures, the core competencies, proper documentation, resident supervision, and program, faculty, and resident evaluation. Add to those responsibilities the challenge to prepare for site visits, develop budgets for your program, and mitigate legal risks. Residency Program Alert is the source you need to confidently meet these challenges. This monthly resource provides residency managers with essential tips, tools, and best practices from the most well-respected, in-the-trenches experts. Dr. Pedram Mizani, the AmeriClerkships’ Chief Clinical Officer, is a writer and contributors to Residency Program Alert.