Becoming a Bilingual Medical Provider

When I was in medical school, one of my biggest goals was to become certified to provide medical care in Spanish. Why was this a goal of mine? Because I saw how much it impacted Spanish-speaking patients. Whenever I worked with a doctor who spoke Spanish, I could literally see relief flood the faces of their patients when they discovered that their doctor could speak their language. Research has shown that language-concordant providers can play a role in reducing health disparities and improving access to care. I felt that in order to be an equitable provider within the state of California, I needed to be able to provide care in both English and in Spanish.

As a Southern California native, Spanish was all around me. I could hear Spanish phrases and Latin music drifting through my car windows as I navigated through the streets of Los Angeles. Many restaurants and signs on streets and buildings were written in both Spanish and English. I learned my first Spanish words from my babysitter, and in kindergarten, I was simultaneously taught how to count to 100 in both Spanish and English.

I continued my formal education in Spanish throughout middle and high school, but always found that even though I could perform well on tests and on written essays, I still had trouble speaking the language and understanding the more casual Spanish I would hear outside of school. I found myself feeling a sense of yearning to be able to communicate with a larger portion of the country, and of the world. According to the Los Angeles Almanac, approximately 40% of residents in Los Angeles County aged 5 and older speak Spanish at home. I was extremely fortunate to get several opportunities to study, work, and volunteer abroad in Mexico, Costa Rica, and the Dominican Republic. However, each one of those experiences was another wake-up call that I needed to put in a lot more work to be able to communicate with my future patients in Spanish.

The streets of Santo Domingo, the capital city of the Dominican Republic

Many medical students and residents have asked me how I learned medical Spanish, so I am putting this post together to share the methods I used to go from an intermediate-level Spanish speaker to a bilingual medical provider. I do want to take a moment to recognize that just because I am “certified” does not mean I am a native Spanish speaker or an expert in Latin cultures. There are certain dialects or phrases that I still do not understand very well. I continue to study Spanish in a variety of ways to improve my communication with my patients. Just as medicine is a lifelong learning process, learning how to provide medical care in Spanish should be, too.  

Study Plan

My first step was to expand my medical Spanish vocabulary. As great as it was that I could say things like “voy a la biblioteca,” I didn’t actually know that many Spanish words that would be useful in a medical setting. I happened to pick up an old study resource for a medical board exam that I took in 2017 and realized that it was full of medical vocabulary, questions to take a full patient history, and scripts for counseling patients on their medical conditions.

Note: I can imagine this book may go out of print soon as this test is no longer required for medical certification, so it may be worth looking for other resource guides for learning history-taking and patient counseling.  

I found a classmate who was also motivated to learn medical Spanish, and we decided to spend two hours a day on the following process:

Step 1: We made and reviewed flashcards on medical Spanish vocabulary. We used the First Aid sections “Common Questions to Ask the Patient” and “Physical Exam Review” to create flashcards on Quizlet.com. We also played Latin pop music playlists in the background, which was a fun introduction to Maluma, Becky G, Ozuna, and many more amazing artists.

Step 2: We then went through a 3-4 First Aid practice cases. For this, we would alternate roles for each case – for example, I would be the doctor and she would be a patient with abdominal pain. I would take a history and do a physical exam, then share my thoughts about next steps, all in Spanish. Then we would switch roles and take on a new chief complaint.

Step 3: We ended our study sessions by watching a show in Spanish on Netflix. I now have a huge list of amazing Spanish-language shows filmed all over Central/South America and Spain that I would recommend, including but not limited to La Reina del Flow (The Queen of Flow), Toy Boy, Elite, Monarca, La casa de Papel (Money Heist), The Club, and Valeria.

Language Immersion

While studying from books is helpful, being immersed in a Spanish-speaking area or a country is even more helpful to take your Spanish to the next level. I participated in two immersion programs, one in college, and one in medical school, which greatly improved my Spanish and gave me a really meaningful and informative inside look at the provision of medical care in other countries. I could write entire blog posts about each of these experiences, but for now I’ll just share a brief description of both.

Foundation for the Medical Relief of Children (FIMRC)

During my freshman year in college, I joined Princeton’s chapter of FIMRC, a global organization with the mission of providing access to healthcare for low-resource and medically underserved families around the world. I spent a year working on fundraising for one of their clinics in Alajuelita, Costa Rica. At the end of the year, two classmates and I participated in their Global Health Volunteer Program during which we spent a week living with a host family, working in the clinic, and exploring the city.

Baby T outside of the FIMRC Costa Rica clinic in 2012 (above) and enjoying moments with the clinical team, organizing medical donations, and shadowing pediatric providers (below).
Clínica de Familia La Romana

At the beginning of my fourth year of medical school, I started exploring the option of doing a global health rotation in a Spanish-speaking country. I found Clínica de Familia through my school’s global health website and planned a month-long away rotation in January 2020. During the month, I lived with three Dominican medical students and a Peace Corp volunteer, worked in the clinic and surrounding hospitals, performed a research project for the clinic, and took Spanish classes with a tutor who soon became a good friend.

With some of the amazing CFLR staff members in La Romana in January 2020 (above) and enjoying days off by the ocean with my new friends (below).

Feel free to explore these options, or do a quick Google search for Spanish language/ medical Spanish courses abroad to find something that fits with your schedule and budget.

Clinical Experiences

Pre-medical and medical students have unique opportunities to shadow clinical visits without having to be the primary person responsible for the patient’s care. This is an extremely helpful way to see firsthand how certain questions are phrased in Spanish, and how to communicate with patients in a warm, compassionate manner. You can explore this option by volunteering with a clinic or organization that provides health care for predominantly Spanish-speaking populations or reaching out to a specific physician that you know is bilingual to ask if you can shadow them.

I personally volunteered at Clínica Martín-Baró in the Mission district of San Francisco during my first and second years of medical school. In this clinic, I was able to practice taking a medical history in Spanish with the direct supervision and assistance of a certified interpreter and an attending physician.

In addition, when you are on your clinical rotations learning about different conditions, treatment, anatomy, etc. look out for opportunities to learn new Spanish vocabulary as it relates to your patients! This is a good way to incorporate your learning into your day-to-day life. I continue to do this in my professional career as a resident physician. For example, just the other day I was listening to a lecture about gender-affirming care for transgender and non-binary youth and realized that my Spanish vocabulary for gender and sexuality is very limited. Another great opportunity to learn!

Other Resources

I would like to mention that what works for one person may not work for everyone. There are a bunch of different ways to learn medical Spanish! Check out these resources from an old classmate of mine, Dr. Nikhil Rajapuram, for more ideas on what to do:

  1. Medical Spanish Podcast https://docmolly.com/medical-spanish/ (also on Apple podcasts)
    1. A doc walks you through various patient scenarios in Spanish at a slow pace with the opportunity to speak along to test yourself and reinforce medical vocabulary
    2. Loved these while driving/commuting to practice listening and grammar skills! I used the free ones on Apple podcasts but looks like there are some premium ones as well which might be worth the money.
  2. Babbel – Language Learning App
    1. Student Discount – $15/month for 3 months https://www.babbel.com/en/magazine/student-promo-online-language-learning
    2. I really like this app since you can use it on the web/iPhone/iPad. It’s very interactive so it’s great if you’re not a textbook person like me. It can also adjust to pretty much any level of Spanish. I would use this mainly to work on grammar, particularly if you’re still at a beginner/intermediate level or if you’re just out of practice. There isn’t much here in terms of medical-specific vocabulary.
  3. Practicing Medical Spanish Website Medical Spanish – Phrases, Terms, Dialogues, Anatomy, all online
    1. A PHENOMENAL website which looks like it was made in the 90s but is actually very comprehensive. I wish I had used this when I was studying but it’s actually really useful when I’m going in to take a history on a patient and I want brush up on relevant terminology
    2. I especially recommend looking through the list of chief complaints to see the specific vocab/questions that are asked for each: http://www.practicingspanish.com/archive.html
  4. Med Spanish WebsiteMedical Spanish Vocabulary and Terminology
    1. A slightly clunkier site dedicated to medical Spanish but mainly useful for learning vocab and referencing terminology for specific anatomy 
  5. Online classes
    1. Cachamsi: endorsed by a few students
    2. Lengalia: Can do 2 of 5 lessons for free by registering

Conclusion

I hope these tips and tricks are helpful to you on your journey to learning medical Spanish. Remember, learning a new language is hard and can be frustrating at times. Get comfortable stepping out of your comfort zone, be kind to yourself in the learning process, and don’t be afraid to ask questions as you go! We definitely need more providers in the medical field who can speak Spanish comfortably, so please consider diving into this field if you have time and space to do so. Thanks for reading, y buena suerte!

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