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According to the Medical Council of Malawi, one of the conditions for a licence to be granted to an individual who wants to practise medicine in Malawi is the practitioner's ability to speak and write English fluently. This means that the expatriate medical practitioner is not required by law to demonstrate fluency in Chichewa (the national language) or any other relevant indigenous language(s). On the basis of a sociolinguistic study that was conducted at a major referral hospital in a predominantly Chitumbuka-speaking town, this paper argues that the Medical Council of Malawi erroneously assumes that English is the main language of doctor–patient communication in Malawian hospitals since the country is linguistically categorised as an English speaking African country. Yet only a minority of the population is competent in English. The national language (Chichewa), and other indigenous languages remain the main medium through which much of the health service provider–patient communication takes place. A more realistic and comprehensive language proficiency testing should cover English (the main international language of medicine) and at least one indigenous language (the lingua franca of the area in which a particular hospital is located).
