Medical Student Elective

We generally place Medical students in the Community Clinic and the Brigada, although some hospital placements are occasionally arranged. Carie Chin-Garcia, describes her MedSpanish experience in the mobile rural health Brigadas and the Centro de Salud. She is a MS IV from Oregon Health Sciences Center and came with a group of students from that institution in April 2005. She plans to do a Med/Peds Residency Program in California. We found that groups of students or Residents that come from the same institution often improve the experience in many ways. We look forward to long term relationships with institutions.

She said: Numerous experiences in the MedSpanish program made these past few weeks an enriching endeavor.... The clinic at the Centro de Salud was an appropriate experience for all levels of Spanish ability. I worked daily with Dr. Arellano, a generalist who sees patients daily in the clinic and also one weekend day at the prison. In the clinic, we saw a broad range of patients-from pregnant women, children of all ages, and adults

By far, the focus is on primary care and preventive medicine. We saw patients for follow-ups during their pregnancies; follow ups on diabetes, hypertension, and general medication management as well as well-child checks with Dr. Arellano.

  I performed exams (including HEENT, CV, Pulmonary, Abdominal, Gyn, fundal height, etc. .) and advised patients on nutrition, lifestyle modifications & patient safety. If a student had less Spanish ability, they would still be able to observe and listen to the doctor-patient interaction, as well as ask questions. We saw approximately 10-15 per day spending 30-45 min per visit. Ancillary staff at the clinic was pleasant and helpful to student, particularly if students needed logistical assistance.

The brigada trips (rural mobile health units) are outstanding experience for the MedSpanish student.  The students are most helpful and benefit most from the experience if their language ability is at the intermediate level. I worked several times with Dr. Nora. Her team included a driver/social worker and, a pick-up truck with supplies in the back on often bumpy, dirt roads to ranchos about 40-90 minutes a way from the Centro de Salud. Students can see the schedule for the brigadas posted on the wall directly opposite the main entrance of the Centro de Salud.

Upon arriving to the destination, the MedSpanish students can ask how they would be most helpful, which could often mean grabbing some of the needed supplies out of the truck. Usually, there is a local person who organizes the day (i.e. sets up a table/chair/bed for exams; and takes a list pf people needing to be seen by the MD) The MedSpanish students may respectfully take initiative and bring in patients, one at a time, from the outside area where patients are waiting, take blood pressures, check capillary blood glucoses, and perform all of the exams. The physician has to fill out a significant amount of paperwork, so the ability to help on the part of the students is greatly appreciated. Patients have follow-up on diabetes, HTN; poor nutrition, and often need dental referrals. The MedSpanish student can obtain meds from the supply boxes if they are familiar with the names of the meds which can also greatly facilitate the visit. While the MD and student are working with patients, the nurse is often preparing to give vaccines and the driver/social worker is giving a lecture on a health topic (diabetes, diarrhea, nutrition) & may give supplements for the children. The MD may make referrals if necessary (i.e. 54 y.o. 7.c small, hard lump found in breast referred for mammography) Students can expect to see 20 patients; to sometimes go on side trips for home visits (very ill elderly or newborns needing blood tests); and to have varying facilities (i.e. someone's porch & bedroom to designated "Salud" satellite clinic.)

The teaching is outstanding with both Lilia and Blanca; my knowledge of not only medical Spanish, but essentials of grammar increased exponentially. Students will take classes in a courtyard near the MedSpanish/PACEMD office, which make for a relaxed environment conclusive of learning after a day of clinical duties. The MedSpanish student should expect to work hard and learn, but should also take some time on the weekends to get to know the culture and country from which patients they see are from. Undoubtedly, the students can fulfill and even surpass his or her objectives for their experience through the MedSpanish program. As the program continues to grow with PACEMD, so will the opportunities for participants. I am grateful for all that I have learned and all of the wonderful people (both staff and patients) who helped me make the most of this experience.