Particularly considering the requirement of high reliability, we argue that the most appropriate architecture for a medical speech translator that can be realised using today's technology combines unidirectional (doctor to patient) translation, medium-vocabulary controlled language coverage, interlingua-based translation, an embedded help component, and deployability on a hand-held hardware platform. We present an overview of the Open Source MedSLT prototype, which has been developed in accordance with these design principles. The system is implemented on top of the Regulus and Nuance 8.5 platforms, translates patient examination questions for all language pairs in the set {English, French, Japanese, Arabic, Catalan}, using vocabularies of about 400 to 1 100 words, and can be run in a distributed client/server environment, where the client application is hosted on a Nokia Internet Tablet device.