As California’s Latino population grows, so too does the need for doctors who speak fluent Spanish and who understand the Latino culture. Yet proportionately, few Latinos graduate from medical schools in California, and that’s created a void that threatens care to Spanish-speaking populations. But UCLA’s David Geffen School of Medicine has a solution in its novel International Medical Graduate's (IMG) program.
Dr. Blanca Campos was among the first to complete the program. For the past six months, she's spent her days seeing patients at the Wilmington Family Health Center. Most of her patients are Spanish-speakers who struggle with English, if they can speak it at all.
"Most of them are illegal, some are legal," Campos says. "Most of them don’t have jobs. You’ll see a lot of patients who have lost their insurances and are looking for clinics like this to help them with their basic needs."
Campos, 38, is a native of Belize. She’s among more than three dozen native Spanish-speaking medical school graduates hand-picked by UCLA to help fill California’s shortage of bilingual and bi-cultural Latino doctors. The UCLA program, offered through the university’s Department of Family Medicine, is the only one in the nation to address the linguistic and cultural barriers that stand between most US doctors and their Latino patients.
Campos says Spanish-speaking doctors are key to bringing quality medical care to the state's underserved communities, "because we understand how they grow up; we understand certain terminology that they use in Spanish that may not be in medical books, but we’ve heard it before and we understand what it means."
Without doctors like Campos, the aches and pains that lead to clinic visits can get lost in translation. And that often results in wasted dollars and poor medical care for many native-Spanish speakers.
"It leads to misdiagnosis and misunderstanding and errors and often a tremendous amount of over-testing," says Dr. Patrick Dowling, chairman of UCLA’s Department of Family Medicine. Six years ago, he started the IMG program that operates solely on private grants and donations. The program provides stipends for resident doctors as they study for their U-S medical exams. In exchange, the doctors commit to practicing medicine for up to three years in California’s low-income communities.
"When you don’t know what the patient’s saying, the easiest thing to do is refer them on for more testing," he says, which leads to costly and ineffective medical care. Yet that's becoming more commonplace in a state that graduates slightly more than a hundred Latino med students each year. "And it’s not clear how many of those are fluent in Spanish or have ever lived in or understand that culture."
Dowling’s colleague, Dr. Michelle Bholat, is co-founder and executive director of the IMG program that each year admits only about a dozen med school grads who meet narrow criteria:
"The ideal candidates are those that were born and raised in a Latin American Country; who have lived and worked in the United States and have learned to speak the language with some level of fluency," she says.
Foreign doctors who apply to the UCLA program must be US citizens or legal residents. For many potential candidates, that can mean working for years at jobs unrelated to medicine. Bholat says one of the doctors who applied for legal residency earned money as a book binder; another made and sold tamales – and yet another worked as a maid.
"She was 'Doctora Pion,' and when she got over here, she was somebody’s house cleaner."
Colombia native, Ingrid Sarmiento, is among the newest batch of UCLA international residents. She came to California under political asylum for death threats she received after providing medical care to a rebel. Now, she says, she's eager to show her thanks to the U.S.
"The United States has been a great support for me," Sarmiento says. "And I want to give them back. I’m going to be a great physician and I’m going to help people. That’s for sure."
And Sarmiento’s help is certain to become even more necessary as the year 2014 approaches. That’s when an estimated five million more Californians — many of them Latinos — are expected to become insured under the federal health care reform law. Dowling says it's his hope that all California med schools will begin recruiting bi-cultural, Spanish-speaking doctors to meet that need.