UCLA states need for underrepresented language skills

[Toutie]

Some languages are grossly overrepresented, such as Farsi and Hindi, among California Doctors. Spanish is grossly underrepresented.

LPPI study recommends med school students study underrepresented languages

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[Lawpy]

I would agree with @gyngyn that Spanish should be among the most important prereqs for medical school. Spanish language skills are invaluable.

 

[getdown]

I agree it would be helpful. I disagree when people say students are required to study these languages in order to better communicate with your underrepresented patients.

 

[OneTwoThreeFour]

I agree it would be helpful. I disagree when people say students are required to study these languages in order to better communicate with your underrepresented patients.

In places where >50% of your patients speak a language I would argue it borders on required to speak that language.

 

[LAIsTheBestPlaceEver]

In places where >50% of your patients speak a language I would argue it borders on required to speak that language.

I get your good intention though... But I feel like there's something fundamentally wrong with this statement.

 

[deleted480308]

In places where >50% of your patients speak a language I would argue it borders on required to speak that language.

That same logic would require english to come here.....so no

The provider speaks the languages they speak and they can hire translator services

Medicine is what the docs need to know, med school is not a language school

 

[RNtoMD87]

We have nurses that are fluent in speaking foreign languages (some grew up in China, Vietnam, etc and didn't come here until up to 30 years old), and they aren't allowed to translate for patients. They are required to get an interpreter.

 

[Catalystik]

In places where >50% of your patients speak a language I would argue it borders on required to speak that language.

. . . particularly as it is not efficient or (sometimes) medically desirable to wait for a translator, who might take up to two hours to show up.

 

[RNtoMD87]

. . . particularly as it is not efficient or (sometimes) medically desirable to wait for a translator, who might take up to two hours to show up.

Well that’s why these nurses find these policies completely *****ic. These aren’t even people who learned the language as a second language. ENGLISH is their second language.


Where I live however, learning a second language is less useful. In three years of nursing I’ve only had 1 patient that only spoke Spanish fluently, and maybe 4-5 that even spoke Spanish. And it has been the predominant secondary language.

Vietnamese and Cajun French are both runners up.

 

[Catalystik]

Well that’s why these nurses find these policies completely *****ic. These aren’t even people who learned the language as a second language. ENGLISH is their second language.

One would think they might do well to just take the qualifying test to be an interpreter, but I learned from a student who tried this that you also also need a competent legal vocabulary to qualify.

 

[OneTwoThreeFour]

That same logic would require english to come here.....so no

The provider speaks the languages they speak and they can hire translator services

Medicine is what the docs need to know, med school is not a language school

I have yet to meet a doctor in the US that doesn't speak English.

 

[WedgeDawg]

. . . particularly as it is not efficient or (sometimes) medically desirable to wait for a translator, who might take up to two hours to show up.

That’s why phone interpreters are so useful! Also there are healthcare workers that speak a language “well enough” but not totally proficiently and thus this translates to poorer patient care when they inevitably miss things. Phone translation has its own set of problems but the potential for inaccurate translation is lower than with a good but not great speaker.

 

[deleted480308]

I have yet to meet a doctor in the US that doesn't speak English.

I was talking about the other side of the equation.

But until all the admins who aren’t bilingual resign, I’m completely uninterested in the notion that all the doctors need to be bilingual

 

[OneTwoThreeFour]

I was talking about the other side of the equation.

But until all the admins who aren’t bilingual resign, I’m completely uninterested in the notion that all the doctors need to be bilingual

I feel like you're misunderstanding my point. I think it "borders on required" to speak spanish in a majority spanish speaking area just like it borders on required to have research at stanford, be URM at Howard, have a 520 MCAT at NYU.
Feel free to be dismissive and uninterested but I've seen the carnage when a non-English speaker rolls into the critical care bay.

 

[deleted480308]

I feel like you're misunderstanding my point. I think it "borders on required" to speak spanish in a majority spanish speaking area just like it borders on required to have research at stanford, be URM at Howard, have a 520 MCAT at NYU.
Feel free to be dismissive and uninterested but I've seen the carnage when a non-English speaker rolls into the critical care bay.

then the hospital should hire an interpreter to hang out there

 

[OneTwoThreeFour]

then the hospital should hire an interpreter to hang out there

I'm assuming given how long you've been around and how often you post that you're either in medical school, a resident, or an attending. When have you ever seen a hospital choose to shell out money when they don't have to? A 24 hour in person medical interpreter is quite expensive when compared to preferentially hiring/admitting Spanish speaking trainees. Furthermore, I'm not just talking about the emergency department-this is internal medicine floors, ICUs, step downs, everything. I can't imagine doing surgery rounds and needing to call an interpreter every 5 minutes to make sure a patient is passing gas.
Speaking Spanish should most definitely be a significant leg up for practicing in places like Puerto Rico or LA or New Mexico or Southwestern Texas.

 

[getdown]

hence why it would be USEFUL to have knowing you're going into these situations. Which is different than being told you HAVE TO BE ABLE to speak these languages upon applying to medical school. That's all we're all saying. To make it a requirement would be silly as no one can predict where they'll be and how often they'll be able to use it.

 

[OneTwoThreeFour]

hence why it would be USEFUL to have knowing you're going into these situations. Which is different than being told you HAVE TO BE ABLE to speak these languages upon applying to medical school. That's all we're all saying. To make it a requirement would be silly as no one can predict where they'll be and how often they'll be able to use it.

Again, I never said it was a requirement nor does the OP. To quote myself: I think it "borders on required" to speak spanish in a majority spanish speaking area just like it borders on required to have research at Stanford, be URM at Howard, have a 520 MCAT at NYU.

 

[OneTwoThreeFour]

And you don’t get what he’s saying. The research requirements at Stanford have to do with their mission. If a student goes to Stanford, they clearly want to do research in the future, hence why Stanford has said requirement. Most people, however, don’t know the future as to where they will be living in 10 years, which is why having medical schools “borderline require” (what does that even mean?) a foreign language makes no sense. Not to be political here (cough), but it would make more sense for people to learn English in the US based on your logic

A couple things:
1. Physicians exist in order to serve the community as a whole. Every school's-at the very least state school's- goal is to provide physicians to serve their community. We cannot control what language the population speaks. We can only adjust our practice in order to provide them with the best care. I am not saying this is a consideration for every medical school in the country- but in places like LA where the population is approximately 40% Spanish speaking (not to mention the school's mission is to "promote the health and well-being of the community, and an understanding of the special challenges and requirements of a diverse society" and to teach "Skills in effective communication, and commitment to education, including teaching students, colleagues, patients and the community") there is clearly value to speaking Spanish.
2. https://medschool.ucla.edu/workfiles/Site-Current/Match List 2018.pdf
That is UCLA's match list. Over 50% of graduates are staying in California with over half of those staying at UCLA. Most people who go to CA stay in CA.
3. I'll help define borderline require, though you basically did so yourself: emphasizing a specific part of an application for admission decision. MCAT score, race, working with the underserved, clinical experience, research experience. Some schools strongly weigh one aspect specifically. Medical schools in Puerto Rico actually do require Spanish fluency, I'm not suggesting UCLA go that far.

 

[getdown]

No one's arguing with you about how helpful knowing Spanish would be if you happen to work in an area like LA. The problem is that not every medical student ends up in UCLA or California for that matter. Considering how competitive the medical school app process is, a majority of applicants don't get to choose which school they want to go to. Same for residency. You end up where you end up. If you were a high school student or a college student who had the forethought to plan that far ahead (how many at this age plan this far ahead anyway), kudos to you. The population you serve can be very different depending on if you end up in Cincinnati, Oxford, New York or North Dakota.

 

[RNtoMD87]

No one's arguing with you about how helpful knowing Spanish would be if you happen to work in an area like LA. The problem is that not every medical student ends up in UCLA or California for that matter. Considering how competitive the medical school app process is, a majority of applicants don't get to choose which school they want to go to. Same for residency. You end up where you end up. If you were a high school student or a college student who had the forethought to plan that far ahead (how many at this age plan this far ahead anyway), kudos to you. The population you serve can be very different depending on if you end up in Cincinnati, Oxford, New York or North Dakota.

Exactly. I don’t care to learn Spanish or Chinese, and I don’t care if it’s useful for some places. I won’t use it where I plan to practice often and I may just be going to that school because it’s where I got in.

 

[OneTwoThreeFour]

No one's arguing with you about how helpful knowing Spanish would be if you happen to work in an area like LA. The problem is that not every medical student ends up in UCLA or California for that matter. Considering how competitive the medical school app process is, a majority of applicants don't get to choose which school they want to go to. Same for residency. You end up where you end up. If you were a high school student or a college student who had the forethought to plan that far ahead (how many at this age plan this far ahead anyway), kudos to you. The population you serve can be very different depending on if you end up in Cincinnati, Oxford, New York or North Dakota.

I think I’m seeing our disconnect. I don’t think EVERYONE needs to learn Spanish in order to go to medical school. I think that UCLA IN PARTICULAR should be selecting students based in part on their language proficiency.

Many HBC graduates don’t practice in underserved community. Many Ponce graduates work stateside. Many Stanford grads don’t continue with research. But each school still selects students with their mission in mind. If UCLA’s mission is to serve their community they should do so. A majority of med schools don’t see a majority-Spanish speaking patient base. English-only students can go there instead.

 

[OneTwoThreeFour]

Exactly. I don’t care to learn Spanish or Chinese, and I don’t care if it’s useful for some places. I won’t use it where I plan to practice often and I may just be going to that school because it’s where I got in.

Don’t apply places where you don’t fit their mission. Imagine if you felt this way about Loma Linda.

 

[dr_kateb]

'Hayes-Bautista added that learning a language is a decision anyone can make.

“Anybody can learn to speak one of those (underrepresented) languages. I have a four-year-old grandson; he speaks Spanish perfectly well,” Hayes-Bautista said. “It’s not impossible.”'

Bruh. This is coming from a professor? The peak language learning time is like 5 - 7 years old, and it gets pretty hard when you get older. I get the United States doesn't have an official language, but if you come to live here I think you should learn the language that is most accepted here and not complain it's not the one where you came from.

 

[LAIsTheBestPlaceEver]

I think I’m seeing our disconnect. I don’t think EVERYONE needs to learn Spanish in order to go to medical school. I think that UCLA IN PARTICULAR should be selecting students based in part on their language proficiency.

I think all UC and UT do take applicant's interest and proficiency in Spanish into consideration...

 

[CherryRedDracul]

I have yet to meet a doctor in the US that doesn't speak English.

You can thank Step 2 CS for that.


Step 2 CS: "You're welcome."

 

[wb100]

.

 

[tanbrucewayne]

I have family in LA who came to the US in middle-age and they never had an issue getting by with limited English skills. IMO there is a difference between having a doctor that can speak Spanish vs one who uses an interpreter in terms of the establishing a relationship/report with a patient. As was said before, med schools can use Spanish fluency as an additional metric for applicants fit for their mission of taking care of their but making language skills a pre-requisite goes is a step too far.

Here is a short interview on acculturation, cultural competence, and role of language in taking care of specific populations
Interview with neurologist Dr. Liliana Ramirez Gomez – Multicultural Alzheimer Prevention Program

 

[Stagg737]

Don’t apply places where you don’t fit their mission. Imagine if you felt this way about Loma Linda.

The problem arises when someone can only get into schools of a certain caliber and that students goals don't completely align with the school's mission. In your example, is someone attending an LA school supposed to turn down an acceptance because they don't want to work in a population with a high volume of Spanish speakers?

While I understand your point, the ideal outcome and reality are often very different and I'm uncertain about the practicality of such requirements for individuals entering medical school without any sort of policy or incentive to guarantee that mission will be upheld after they graduate med school as well as residency.

 

[FroYoOreo]

I get the United States doesn't have an official language, but if you come to live here I think you should learn the language that is most accepted here and not complain it's not the one where you came from.

i don't know about that. I feel like speaking their own language is fine as long as they have a basic understanding of English and can get around pretty easily. For some of the immigrants/families, it is just hard to master another language in their mid-30s.

 

[dr_kateb]

i don't know about that. I feel like speaking their own language is fine as long as they have a basic understanding of English and can get around pretty easily. For some of the immigrants/families, it is just hard to master another language in their mid-30s.

To be completely fluent you need to be really young. I'm gonna ballpark (need to review psych for the MCAT) and say under 12 years old? I could also imagine a not-so-fluent doctor miscommunicating/misunderstanding things when having a conversation with a patient in a foreign language. It's kind of concerning how a professor doesn't seem to get this and gives a smug "it's not impossible" and has a say in health policy? Reminds me of the old men in congress telling what women can/can't do with their bodies.

In my opinion, yeah they can speak whatever they want here, but it goes both ways.

 

[RNtoMD87]

To be completely fluent you need to be really young. I'm gonna ballpark (need to review psych for the MCAT) and say under 12 years old? I could also imagine a not-so-fluent doctor miscommunicating/misunderstanding things when having a conversation with a patient in a foreign language. It's kind of concerning how a professor doesn't seem to get this and gives a smug "it's not impossible" and has a say in health policy? Reminds me of the old men in congress telling what women can/can't do with their bodies.

In my opinion, yeah they can speak whatever they want here, but it goes both ways.

I disagree. I have a nurse on my floor that only spoke Chinese until she was nearly 40, and she's pretty much as completely fluent as you can be. The only thing is she doesn't get some jokes. But as far as talking to patients, doctors, etc or cutting up with us, she is completely fluent.

Also my friend, another nurse on this floor only spoke Vietnamese until she was 15, and she sounds like a native English speaker. None of us realized she had ever lived in Vietnam even until she told us.

 

[nimbus]

I disagree. I have a nurse on my floor that only spoke Chinese until she was nearly 40, and she's pretty much as completely fluent as you can be. The only thing is she doesn't get some jokes. But as far as talking to patients, doctors, etc or cutting up with us, she is completely fluent.

Also my friend, another nurse on this floor only spoke Vietnamese until she was 15, and she sounds like a native English speaker. None of us realized she had ever lived in Vietnam even until she told us.

A foreign language speaker who learns English while living in the United States has the benefit of complete immersion. That is a different situation than a native English speaker in the US trying to learn a foreign language while living 99.9% of their life speaking English. That is my experience as someone who’s first language is not English. If I moved to Mexico City, I would pick up Spanish much faster than I would trying to learn Spanish in LA.

 

[dr_kateb]

I disagree. I have a nurse on my floor that only spoke Chinese until she was nearly 40, and she's pretty much as completely fluent as you can be. The only thing is she doesn't get some jokes. But as far as talking to patients, doctors, etc or cutting up with us, she is completely fluent.

Also my friend, another nurse on this floor only spoke Vietnamese until she was 15, and she sounds like a native English speaker. None of us realized she had ever lived in Vietnam even until she told us.

My parents are Chinese and are sort of fluent, but I'm not sure when they started learning English. They have a noticeable accent, not so great vocabulary, have a hard time saying certain words, and can be slow to read articles and interpret what other people are saying. It's why I speak Chinese with my parents. Don't know, but both my parents probably couldn't handle the complex medical terms doctors have to know and articulate.

 

[RNtoMD87]

My parents are Chinese and are sort of fluent, but I'm not sure when they started learning English. They have a noticeable accent, not so great vocabulary, have a hard time saying certain words, and can be slow to read articles and interpret what other people are saying. It's why I speak Chinese with my parents. Don't know, but both my parents probably couldn't handle the complex medical terms doctors have to know and articulate.

The one who learned English later in life has a strong accent, but I am amazed by her fluency. I'm impressed by both of them.