Being able to communicate with increasingly diverse patient communities is a key to success for physicians-in-training.
In a unique, community-based course, every day over the course of a month Harvard Medical School students are learning Spanish directly from elderly native Spanish-speaking tutors. The intensive medical Spanish course is designed to help students become better prepared to serve all of the patients they will someday see.
Nazaria Centeno, 69, one of the tutors from Spanish Immersion Jamaica Plain said, it is not easy to go to a doctor and only talk to them through a translator.
“I have had four doctors who do not speak to me in Spanish,” said Centeno. “I have learned many things with [the HMS students]. I am very happy with this program. Hopefully, next year I will come back and ... learn something new from them too.”
Twenty senior citizens from nearby HMS neighborhoods participate in the course, rotating as volunteer tutors for one-on-one conversations. All come from different Spanish-speaking countries and have varied backgrounds and accents.
The course was created by Manuel Guillermo Herrera-Acena, an HMS lecturer who ran the Spanish Clinic at Brigham and Women’s Hospital for many years and served as faculty director of the intensive Spanish course until 2018. He said he has long noted a need for Boston clinics and hospitals to provide access to adequate health care for Spanish-speaking patients.
“There was an inability in hospitals to take care of our neighbors in Mission Hill,” said Herrera-Acena.
People from Spanish-speaking countries who speak only Spanish often have difficulty connecting with physicians who do not speak their language and can feel culturally alienated in clinics and waiting rooms, said Herrera-Acena. Which is why he, along with the help of HMS students who recognized the need for Spanish-speaking medical professionals, started the medical Spanish course at HMS in the early 1970s.
The program began with one session a week, but soon after Herrera-Acena found that more was needed and one session a week turned into five, he said.
“It was former HMS professor Chad Wright, an extraordinary man, who suggested intensive language training. It was categorically different. It consisted of eight hours of language training a day; a difficult demand for almost anyone, but not for HMS students,” said Herrera-Acena.
Along with developing the intensive medical Spanish course, Herrera-Acena, established elective exchange sites in Latin America, where HMS students participate in clinical rotations.
Intensive medical Spanish
Now, the language course as well as the clinical exchange program is directed by Nicte Mejia, HMS assistant professor of neurology at the Massachusetts General Hospital.
The HMS Intensive Medical Spanish course is a full-time, four-week elective offered to third- or fourth-year students, providing them with language skills training important for clinical encounters with patients from other cultures. It also promotes an awareness of language barriers in achieving health equity.
In addition to daily one-on-one discussions with tutors, HMS students receive five hours of instruction from educators from Costa Rica.
“The fact that we get to speak to people from other places and hear doctors present lectures to us in Spanish is all very useful,” said Julia Hyman, a fourth-year HMS student.
“One of the biggest reasons I wanted to take this course is because I have had many Spanish-speaking patients and typically patients who speak a different language receive substandard care. I wanted to learn how to be more fluent and, at the least, be able to communicate the basics to the patients so they feel that they are getting better care,” said Inkyu Kim, a fourth-year HMS student.
The students’ tutors come from the nonprofit organization Spanish Immersion Jamaica Plain and Brookline. Giovanna Tapia founded the organization in 2006 in response to local Spanish-speaking seniors wishing to be active in their community.
“We have many valuable experiences that we want to share with students…we can contribute, give advice and encourage them. We are grateful to have the opportunity to collaborate with students,” said Laurencia Milla, 88, a tutor from Spanish Immersion. “At the same time, it encourages us and makes us feel useful to the community.”
Communicating with patients is a huge part of medicine, and half of medicine is the contact between the provider and those who need care, said Herrera-Acena.
There is more when it comes to course offerings.
Students who take the intensive medical Spanish course or who are fluent in Spanish have the opportunity to enroll in a one- or two-month elective exchange program in medical schools located in Guatemala, Chile, Costa Rica or Colombia.
At those sites, HMS students not only learn about medical practices in other countries but also consolidate their Spanish skills. As a part of the exchange, students from those partner medical schools are selected by their schools to apply for clerkships at HMS. Once accepted, they train at Harvard-affiliated hospitals and improve their English skills.
This cross-cultural, medically-focused program has been training HMS students for more than 45 years.
Images: Gretchen Ertl