Legal vs. Medical Transcription: Guide for Transcriptionists

Are you considering a career—or a side hustle—that leverages speedy typing skills? Transcription offers flexible opportunities, including remote work you can tackle during your preferred work hours. 

But before you invest in training or equipment, learn the difference between the two primary career specializations of legal transcription vs. medical transcription. From day-to-day tasks to optional certifications, each path has unique requirements.

Key Differences Between Legal and Medical Transcription

The primary function of legal and medical transcription is to convert audio files to text documents, but both industries have formal aspects that require custom knowledge and practices.

Terminology and Industry Language

Part of transcription is understanding an industry’s common terminology and language. This includes: 

• Legal – Courtroom and legal proceeding protocol and practices, language used in legal contracts and research, legal case citings, legal acronyms, and abbreviations

• Medical – Terms related to anatomy, lab tests, medical procedures, surgeries, medications, treatment recommendations and monitoring, medical billing, and healthcare acronyms and abbreviations

Formatting and Documentation Standards

Few transcription assignments will start with an entirely blank word-processing document. Instead, you’ll typically enter and arrange text inside templates and formatted documents such as: 

• Legal – Deposition and courtroom transcripts, legal correspondence and memorandums, sworn statements and affidavits, pleadings, phone call wiretaps, recorded 911 calls, and video transcription such as law enforcement body camera and social media footage

• Medical – Patient history, physical examination, consultation, operative, pathology, radiology, and laboratory reports; discharge summaries, progress notes, referral letters, and billing correspondence 

Each industry has some commonality across requirements for consistent: 

• Sequence, sections, and separations
• Margins, headers, and footers
• Fonts and text formatting
• Bullets and numbering

Confidentiality, Compliance, and Legal Requirements

Both legal and medical transcription involve handling confidential files guarded by formal privacy and security policies. 

Medical

Medical transcription files will almost always fall under the guidelines provided by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). You’ll need to be familiar with the basics of the HIPAA Privacy and Security Rules and follow specific protocols provided by employers or agencies on: 

• Locked-door and password-protected care of any files in your hands
• Software and hardware requirements and practices to maintain secure files
• What you can and cannot disclose about your work to others

There may also be state-specific medical data privacy regulations that apply in addition to HIPAA. 

Legal

Legal transcriptionists must carefully follow protocols provided by employers or agencies on how to access and safeguard legal files. For most legal files, attorneys and firms are responsible for establishing security protocols for digital and paper content based on a combination of:

• Professional organization rules of conduct (i.e., ABA Rule 1.6 Duty of Confidentiality)¹
• Attorney-client privilege 
• Cybersecurity protocols and frameworks
• HIPAA and state-specific requirements for any legal use of medical data
• Practice area-specific data regulations such as PCI DSS for financial data

Skills and Training: What It Takes to Succeed in Each Specialty

Quick fingers and an interest in language and learning are great starting points for transcriptionists. 

Core Knowledge Requirements

Before adding any bells or whistles, legal and medical transcriptionists need to master the basics. This includes: 

• Typing speed of at least 75 WPM (words per minute)²
• Transcript proofreading and revision
• Understanding of industry protocols and document types 
• Familiarity with industry terminology, abbreviations, and jargon

Certification and Training Options

There are no absolute mandates on education or certification for transcriptionists, so it’s possible to gain the skills and knowledge you need with on-the-job training and experience. However, most employers will be looking for professionals with a blend of formal training and certifications. 

Legal transcriptionists can get a leg up on the competition with³:

• Education – Legal transcriptionist career diploma programs offered by vocational, technical, or professional schools typically last 5 – 12 months and are often available online. 

• Certification – The Certified Electronic Transcriber (CET) designation is available from the American Association of Electronic Reporters and Transcribers (AAERT).

Medical transcriptionists can choose to pursue⁴:

• Education – Medical transcription programs can lead to a diploma or associate’s degree from a vocational school, community college, or career institute. Diploma programs usually take under one year, while an associate’s degree can take two years. 

• Certification – The Association for Healthcare Documentation Integrity offers two sequential designations: Registered Healthcare Documentation Specialist (RHDS) and Certified Healthcare Documentation Specialist (CHDS).

Soft Skills That Set You Apart

What do employers look for in a transcriptionist? Medical work could impact life-or-death decisions, and legal assignments may end up influencing case judgments and even future legislation. Skills that help you assure interviewers of your competency include: 

• Technology expertise, including emerging developments relevant to your field
• A mastery of the language with keen editing skills
• Time management and a track record of meeting deadlines
• Professionalism, discretion, and an understanding of ethics and security concerns
• Proven familiarity with industry systems, procedures, and protocols 

Technology and Tools Used in Each Field

You’ll need to be familiar with word-processing software plus specialized transcription software and tools before you begin. If you enter the field as an independent contractor, you’ll also need to set up your own shop with:

• Specialized software such as Express Scribe²
• A foot pedal to start, stop, and rewind the audio
• Noise-canceling headphones
• Computer with adequate storage and speed
• Ergonomic keyboard, mouse, chair, and desk setup
• Reliable high-speed internet and WiFi

AI and Voice Recognition in Legal and Medical Settings

While AI and voice recognition technologies aren’t replacing the need for transcription professionals, their fast growth is rippling across the legal and medical support fields. What we’re seeing today is: 

• Strong focus on automation in consumer-facing and general transcription
• Hybrid models that blend human and computer-based transcription
• Use of technology to increase human transcriptionists’ efficiency
• Recognition of AI/VR as less precise than human transcription

Career Outlook

What are your chances of satisfaction and success now and in the years ahead with a career in transcription? There’s no crystal ball, but you can consider how and where transcriptionists are working today, their earning potential, and what experts predict for the future.

Work Settings and Job Types

Both types of transcription can provide full-time, part-time, or contract work, as well as a mix of remote and on-site assignments. 

For legal transcriptionists, jobs or assignments in courthouses, law firms, or corporate settings require professional dress and undertaking work in a public or formal setting. Working from home as part of a trial or other legal proceeding still entails professional dress, with on-camera appointments that can last for hours. 

Medical transcriptionists often work from home, but even in a healthcare facility or office setting, they do “behind-the-scenes” work, which is typically much more informal. 

Pay, Growth Potential, and Job Stability

Let’s examine the nitty-gritty of earning potential, job stability, and leveraging experience. 

Legal transcriptionists: 

• Wages – ZipRecruiter displays a June 2025 average of $23 per hour, with the top 10% earning $24.76 – $29.33.⁵

• Growth opportunities – Transcriptionists can specialize in particular legal practice areas, transition to managerial roles, or add to their training and move into higher-paying court reporter, simultaneous captioner, and stenographer positions.

• Job stability – The U.S. Bureau of Labor Statistics doesn’t track legal transcription specifically, so most studies replace it with court reporter and simultaneous captioner data (anticipated to grow 2% in the next decade). However, these positions are more specialized than legal transcription, meaning it is likely we’ll see a single-digit drop in openings due to technological advances, including speech recognition similar to what is predicted for medical transcriptionists. 

For medical transcriptionists:

• Wages – ZipRecruiter displays a June 2025 average of $21 per hour, with the top 10% earning $24.04 – $28.61.⁵

• Growth opportunities – Transcriptionists can specialize in particular medical fields, move on to managerial roles, or move into a higher-paying adjacent position, such as becoming a medical coder.

• Job stability – The demand for medical transcriptionists is only expected to decline by 5% over the next decade due to technology growth, which means there will still be plenty of opportunities to enter the field.⁴

Note that the wage figures above are based on national data with no variables taken into account. Actual wages will vary based on: 

• Location
• Experience
• Certification
• Education

Final Thoughts: Choosing the Right Path as a Transcriptionist

There are unique facets to each transcriptionist career path, but for many professionals, it comes down to interest and opportunity. Doing your research on real-world career options can help you decide whether to go the medical or legal route.

U.S. Legal Support partners with a nationwide network of 5,000+ transcriptionists and court reporters, offering nationwide on-site and remote assignments. We can match you with opportunities based on your skills, experience, and job preferences. 

We’ve been in business for nearly 30 years, supporting lawyers in nearly every practice area—but that’s not all. Our transcription services are sought by multiple industries and types of businesses, providing a wide range of assignment varieties. U.S. Legal Support clients need your talent and skills, and you can earn competitive rates while managing your preferred work schedule. 

Ready to learn more? See more details about our transcription services in general and about work opportunities with us.

Sources: 

1. American Bar Association. Rule 1.6: Confidentiality of Information. https://www.americanbar.org/groups/professional_responsibility/publications/model_rules_of_professional_conduct/rule_1_6_confidentiality_of_information/
2. ParalegalEDU.org. Legal Transcriptionist: What it is & How to Become One. https://www.paralegaledu.org/blog/legal-transcriptionist/
3. BecomeAParalegal.com. How to Become a Legal Transcriptionist. https://www.becomeaparalegal.org/how-to-become-a-legal-transcriptionist/
4. U.S. Bureau of Labor Statistics. Occupational Outlook Handbook: Medical Transcriptionists. https://www.bls.gov/ooh/healthcare/medical-transcriptionists.htm
5. ZipRecruiter. Legal Transcriptionist Salary. https://www.ziprecruiter.com/Salaries/Legal-Transcriptionist-Salary
   ZipRecruiter. Medical Transcriptionist Salary. https://www.ziprecruiter.com/Salaries/Medical-Transcriptionist-Salary