Since there are more than 40 million Spanish speakers in the United States, training more bilingual physicians could potentially improve equitable care in Latino communities, according to an article published on July 18, 2023, by the Association of American Medical Colleges (AAMC).¹
To provide better care to Spanish-speaking patients, there is a call for medical schools and residencies to recruit and retain more Hispanic, Latino and multilingual doctors, and to provide medical Spanish language training and proficiency testing to medical students and physicians to enhance their ability to communicate with and relate to their patients.
Patients without language-concordant healthcare providers are more likely to experience miscommunication and adverse events, are less likely to comply with medications and medical advice, and are less likely to come to follow-up appointments, according to a case study published in February 2023.²
Moreover, only 2% of physicians speak Spanish, according to AAMC diversity facts and figures from 2019, which is a very low number compared to the demand that exists among Spanish-speaking patients in the U.S. According to a more specific poll conducted by the Society for Vascular Surgery (SVS) that was published in 2012, only 3.7% of vascular surgeons are Hispanic. It is unknown how many speak Spanish.³
So, how can we address this issue as a specialty? By implementing Spanish-language competency programs—especially in training regions with large Spanish-speaking populations during the course of surgical training—we could significantly improve patient care.
The goal of medical Spanish proficiency classes is not to create perfect Spanish interpreters or bilingual fluency geniuses, but to have enough Spanish knowledge to get your point across to a patient in basic medical terms in order to gain patient trust. The classes can be implemented for those trainees practicing in areas where most of the patient population speaks Spanish and has limited English proficiency, and ideally students enrolled have at least intermediate Spanish skills and an interest in working in the Hispanic-Latino community.
Medical schools with higher Spanish-speaking populated cities such as Texas Tech University Health Sciences Center in El Paso, Texas, and Loyola University Chicago Stritch School of Medicine in Chicago, where I went to medical school, teach medical Spanish as a part of the pre-clerkship curriculum for students. However, few residency programs offer medical Spanish courses, most likely due to pre-existing, busy service obligations.
Here in Tucson where I am a resident, one hour from the U.S.-Mexico border, there is a large Spanish-speaking and Sonoran Mexican population. At the University of Arizona College of Medicine-Tucson, there is a weekly medical Spanish class for advanced speakers to learn medical terminology offered through the Diversity Equity and Inclusion Department that takes place every Thursday. The course is to be completed over a two-year period. This schedule is ideal for the first couple of years of surgical residency when residents are doing more floor work, intensive care unit (ICU), and night shifts so that attendance can be optimized prior to busy operative senior years. The classes are built such that if you miss the first Thursday of the month class (for Main campus), you can still make it to the third Thursday class (for South campus). This allows flexibility in the schedule.
Then, there is an ALTA Language Services exam at the end of the year to show competency. If graduates attain >80% proficiency on the oral exam, they receive a badge confirming they can speak with patients in Spanish and even consent them for procedures without the need for an interpreter. This can potentially allow for more efficiency, better patient-physician relationships and fewer miscommunications.
As a fellow champion of the argument for increased medical Spanish training, I plan to develop a booklet that can be carried around in providers’ white coats or in a phone app. These will contain key medical and surgical terminology in Spanish to help describe common pathology and interventions relevant to vascular surgery, so those trainees who don’t have access to classes can utilize this platform to make connections with their Spanish-speaking patients more feasible.
Please reach out to be involved in this future project via LinkedIn or Twitter (@MelissaDAndrea4).
References
- https://www.aamc.org/news/united-states-needs-more-spanish-speaking-physicians
- Lopez Vera A, Thomas K, Trinh C, Nausheen F. A case study of the impact of language concordance on patient care, satisfaction, and comfort with sharing sensitive information during medical care. J Immigr Minor Health. 2023 Dec;25(6):1261–1269.
- Woo K, Kalata EA, Hingorani AP. Society for Vascular Surgery Diversity, Equity and Inclusion Committee. Diversity in vascular surgery. J Vasc Surg. 2012; 56: 1710–1716
Melissa D’Andrea is a fourth-year integrated vascular surgery resident at the University of Arizona-Tuscon.
