I am looking to find out if the residencies in Puerto Rico are conducted in english or spanish? I have an interview coming up in Puerto Rico for an ACGME certified EM residency. The email inviting me out for an interview was all in spanish. Its obvious I will have to communicate verbally in spanish with the majority of the patients, however, i was wondering about the paperwork. Are the patient notes/HPI's in spanish? Are the institution based tests in spanish? Anybody have an opinion on doing residency in Puerto Rico?