Brenda B that is real hands on experience.

Before second year.

3rd and 4th are more.

Internship even more.

Rokshana you have very good points. But remember in Hispanic favorable schools in american only 12 to 15 percent of the graduating medical class call themselves hispanic. This says nothing about their spanish speaking skills.

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For what it's worth:

Let's contrast story #1 with a classic example from the United States. Many EMT's will be caught in a scenario where there is no paramedic or doctor to declare the time of death, so they are obligated to perform CPR, even if the person is blue in the face from anoxia and they are obviously dead. Such a situation can, and often does, get very convoluted, can be dangerous and traumatic for the family.
One such situation involved an EMT working on a Native Reservation, using an AED under a leaky roof, with family members scrambling to place buckets around the house to catch the rain water. More dangerous for the family and the EMT? For sure. Higher standard of care? That's not debatable in this case (especially because the person was dead to begin with). I'd say "Yikes" to this scenario any day over example #1 that Karplus mentioned. Over an hour went by before the paramedic arrived to declare him dead from MI, meanwhile other lives were put at risk to maintain the "higher standard of care" many perceive the U.S. as having.

OK, maybe I'm just trying to get my post count up.

This was posted from Lalo Blum who is from UAG and doing his residency right now.

"I am sorry; in what residency program are you currently enrolled? Or have you done any residency in the past?

Oh! I get it, you know a guy that knows a guy who is the nephew of the secretary of the program director in X residency program.

Your statements are indeed deep, but I can tell you that for someone that is actually DOING residency and INTERVIEWING for fellowship, most of the program I have worked with or visited are in great demand of bicultural/ bilingual residents.

Despite of what you think, we UAG grads have made our name in the US, and we will keep doing this because our bicultural/bilingual selling points.

Lalo"

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I think everyone would agree that speaking Spanish is a plus. USCE is also a plus.

Yeeeeaaaahhhhhh Riggghhhhhhhhht!!!!
U.S. medical schools don't graduate spanish speaking doctors!
There might be translators at the hospitals that speak spanish, but not American Medical Graduates that speak spanish. I'm talking about every body part, every symptom, every disease, every question that could be asked to a patient.

seriously??? you believe this? lets see one of my classmates is of cuban descent, raised in miami, FLUENT in spanish- MATCHED at U miami for neurology...i would imagine there are many just like her in US med schools across the country, nevermind in the Tx, Fla, and Cali school....

going to school in Mexico and training in spanish is NOT going to give you such an advantage over a US med school grad (even a NON spanish speaking AMG) even in a program in a predominantly spanish speaking area. Truly you are fooling yourself if you think so...

all things equal (and when i say all things equal i mean step scores), the AMG will be favored and if you as an IMG student speak spanish, but have the same step scores as a non spanish speaking AMG , more often than not the AMG WILL be favored.

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GI Elective [x].......Wards [x]
Wards [x] ............Night Float [x]
MICU [x] .............CCU []
Wards [x] ............PGY 1 1/2 []
Elective!![x]..........Move Complete[]
VACATION!!!! [x]

and the USCE will be the bigger plus.

NO where did i see spanish a requirement fro application to a residency program, but plenty of places states that USCE (hands on) WAS required....

__________________
GI Elective [x].......Wards [x]
Wards [x] ............Night Float [x]
MICU [x] .............CCU []
Wards [x] ............PGY 1 1/2 []
Elective!![x]..........Move Complete[]
VACATION!!!! [x]

Really, I was being facetious as to the U.S. schools not graduating ANY spanish speaking doctors. But what's the percent....0.1%? And I'm not talking about latino.... I'm talking about 'spanish speaking,' with fluency. Going further though, the true statistic that I want to know is what percent that are fluent in spanish know all of the body parts, symptoms, diseases, and critical questions to ask a patient in spanish? Do you see that difference? There is a difference in the usefulness. Being raised speaking spanish, doesn't teach medical spanish. It has to be learned somewhere else. Sure, the patient will be made to feel comfortable either way with someone speaking their language to them in the introduction and small talk, but some of the diagnostic questions may have to be made in english due to a lack of knowing how that question would be asked to them at their clinic back in the mother country. I'm more interested in following the people from their country of origin so the cultural advantages will be there also....so practicing in California, Arizona, Nevada, Texas....where the Mexicans really are. Viva La ****.

However, I didn't post that as an argument for the value of one applicant over another because that's not my bag, baby. I was just interested in commenting on your quote of having 'PLENTY' of spanish speaking doctors that came from American Medical Schools.

Rokshana, why are you bothering us?

It is a fact that the percentage of patients who speak spanish as a first language outweigh the percentage of doctors who can speak with them.

Be a doctor and do your research.

You can start at the New England Journal of Medicine
Volume 355:229-231 July 20, 2006 Number 3



"La semana pasada a el le dio mucho mareo y no tenía fiebre ni nada, y la familia por parte de papá todos padecen de diabetes."
(Last week, he had a lot of dizziness, and he didn't have fever or anything, and his dad's family all suffer from diabetes.)

"Uh hum," replied the physician.

The mother went on. "A mí me da miedo porque el lo que estaba mareado, mareado, mareado y no tenía fiebre ni nada."
(I'm scared because he's dizzy, dizzy, dizzy, and he didn't have fever or anything.)
Turning to Raul, the physician asked, "OK, so she's saying you look kind of yellow, is that what she's saying?"
Raul interpreted for his mother: "Es que si me vi amarillo?"
(Is it that I looked yellow?)
"Estaba como mareado, como pálido"
(You were like dizzy, like pale), his mother replied.
Raul turned back to the doctor. "Like I was like paralyzed, something like that," he said.
If Raul received inappropriate care owing to his misinterpretation, he would not be alone.

One interpreter, mistranslating for a nurse practitioner, told the mother of a seven-year-old girl with otitis media to put (oral) amoxicillin "in the ears."

In another case, a Spanish-speaking woman told a resident that her two-year-old had "hit herself" when she fell off her tricycle; the resident misinterpreted two words, understood the fracture to have resulted from abuse, and contacted the Department of Social Services (DSS). DSS sent a worker who, without an interpreter present, had the mother sign over custody of her two children.

Clearly, catastrophes can and do result from such miscommunication. Some 49.6 million Americans (18.7 percent of U.S. residents) speak a language other than English at home; 22.3 million (8.4 percent) have limited English proficiency, speaking English less than "very well," according to self-ratings. Between 1990 and 2000, the number of Americans who spoke a language other than English at home grew by 15.1 million (a 47 percent increase), and the number with limited English proficiency grew by 7.3 million. The numbers are particularly high in some places: in 2000, 40 percent of Californians and 75 percent of Miami residents spoke a language other than English at home, and 20 percent of Californians and 47 percent of Miami residents had limited English proficiency.

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There will be some programs where Spanish will trump USCE but those will be unusual. As Rokshana points out, USCE is a common requirement and where USCE is not a requirement, it is generally listed as strongly desireable. That is not to say that one won't get a residency without USCE but your options are immediately limited without it. If I had to choose, I would prefer to approach the match with USCE vs. Spanish. Better yet, if Spanish were important to my future, I might take a term/year off to take a Spanish immersion course AND get USCE.