As the United States grows more culturally diverse and we hear more languages spoken around us, clinical medical education has had to evolve as well. And with national population growth, particularly in big cities like New York and Los Angeles, which are popular with medical students, those students must not only know their jobs, but also need to know their hospitals.
How do these changes affect your medical school experience?
You will encounter different compositions of patient populations if you go to medical school in Minnesota or in southern California. After your first one or two years of medical school—depending on whether you go to a school that offers the traditional, two-year basic science curriculum—you are usually sent to different academic or community hospitals. Your patients might speak only Spanish, French, Russian, German, Arabic, or another language with which you may not be familiar.
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As a senior resident in psychiatry at the Keck School of Medicine at University of Southern California—not only one of the busiest hospitals in the nation, but also one of the most culturally and linguistically diverse—I have been called to consult on many situations where medical students and residents mistook a language barrier for a psychiatric issue.
It can be difficult for medical students and residents to evaluate a patient who does not speak their own language. Since you're probably already tired and physically taxed, it can be tough waiting for an interpreter, and you never know definitively if what you stated was conveyed accurately—especially in a field like psychiatry.
To ensure you are aware of the different compositions of patient populations at medical schools in different geographic regions, you should do the following.
• Research schools thoroughly: You should always feel comfortable in your geographic region, but you should also be aware of potential language and cultural barriers that could present themselves, often unexpectedly, in a situation where you may have already been on the wards for many hours.
How can you be proactive to ensure that a patient isn't waiting for you to figure out whether he or she is speaking German or Russian? Be prepared by knowing your surroundings. Familiarize yourself with language charts, which list languages that patients can point to in order to identify their native tongue, so that you can call in an interpreter.
Or if an interpreter is not physically on site, many hospitals have a video interpretation option—particularly for less-commonly spoken languages—where an interpreter on a computer screen can interpret for you at the patient's bedside.
• Consider medically-oriented language courses: Because patients are increasingly either non-English speaking or only comfortable communicating in their primary language, it could be helpful to consider taking medical Spanish, or other languages, if you want to train in a medical center that has a significant proportion of non-English speaking patients. It would make your life easier, since it may take hours to wait for an interpreter.
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Your medical education is probably most influenced by factors other than language, such as whether you feel happy in the city in which you decide to live. But it can be helpful and important to be aware of cultural factors as well. It could not only make a strenuous training experience a little easier, but could also help you learn how to handle an increasingly diverse U.S. patient population most effectively.
Ibrahim Busnaina, M.D. is a graduate of the University of Pennsylvania School of Medicine and coauthor of "Examkrackers' How to Get Into Medical School." He has been consulting with prospective medical school applicants, with a special focus on minority and other nontraditional candidates, since 2006.