“Doctora, no soy bruta” a patient confided in me. This means “Doctor, I’m not dumb” She went on to describe how she feels the sting of discrimination for not speaking English and how she dedicates her time trying to navigate her way through life, even just to find a doctor, like myself, who can speak in her own language.
Language skills specific to the patient-doctor encounter are critical for those who engage in clinical medicine around the world.
If we, the authors, were superheroes and could choose to have any power, we would choose omnilingualism – the ability to communicate seamlessly across languages and cultural contexts. The United States, like many other countries, is becoming increasingly diverse with immigrants from all over the world finding a new home here. As physicians, we meet patients from all walks of life who speak different languages. Listening to their journeys is one of the most inspirational parts of our work and communicating directly with linguistically diverse patients is important for building rapport and cultivating trust in the patient-doctor relationship and the broader health system.
In our Debate, published this month in BMC Medical Education, we argue for medical schools to increase opportunities for medical language courses and integrate them into the curriculum with evidence-based teaching strategies, content about health equity, and standardized language assessments. Language skills specific to the patient-doctor encounter are critical for physicians who practice in the United States and for those who engage in clinical medicine around the world. Given the unprecedented interest in global health work among medical students, it is time to professionalize language preparedness as part of global health education.
To achieve our mission, we are actively working to integrate cultural humility and health equity into our curriculum.
Like many other medical schools, Harvard Medical School (HMS) offers non-English language training as part of the undergraduate medical curriculum. Our Medical Language Program includes elective language courses in beginner, intermediate, and advanced Spanish, Portuguese, and Mandarin. We also offer opportunities for students to do electives in other countries to solidify their language skills in addition to their clinical skills. The first medical Spanish course was started in the 1970s, and there are over 1000 alumni who have taken a language elective at HMS since then. Our mission is to promote awareness of and skills to address language barriers to achieving health equity by equipping medical students with language skills to provide language-concordant and culturally-humble care for diverse patient populations. To achieve our mission, we are actively working to integrate cultural humility and health equity into our curriculum. In addition, we are working toward standardizing assessments of language competency suitable for clinical encounters.
We hope our Debate sparks discussions among leaders in medical schools about the importance of language instruction as part of undergraduate medical education.