Canada, like other first-world countries, relies in large part on professional immigrants trained in other cultures and languages to complement its workforce in a wide range of professions, including medicine. International medical graduates (IMGs) who are nonnative English-speaking (NNES) and who have trained in different medical contexts are often unfamiliar with the sociopragmatic norms underlying both general communication and medical practice in their new host countries, and as a result they can have difficulty using the pragmalinguistic resources needed to strike the appropriate interpersonal note in patient-centred approaches to communication. In this article we used data collected through role-plays performed in an Australian setting by practicing, locally trained, native English-speaking (NES) doctors and NNES IMGs to identify the features of patient-centred medical communication that the latter can find challenging. This approach allowed us to use the discourse to highlight those features of approachability that are likely to be relevant to immigrant professionals in both Canada and Australia. It also helped us to illustrate how discourse data can be used to identify culturally appropriate ways of communicating that can, in turn, contribute to an accurate evidence base from which culturally appropriate communication courses for IMGs and other professionals may be developed.