Nicholas Lehman, MD ’28, at El Centro Gerontológico La Recoleta in Cusco, Peru

Last summer, second-year medical student Richa Sharma was working in the labor and delivery ward of a health care center in Spain when she witnessed a birth that was fast becoming a crisis situation. Labor was slowed down by shoulder dystocia — meaning the baby’s shoulder had lodged in the mother’s pelvis, and they had five minutes to determine whether the mother would need an emergency c-section.

“For a moment, I didn’t know what I was seeing, whether it was going to be a stillbirth,” Sharma says. “The baby came out blue and the team whisked the baby away to the NICU. It was a very scary moment, but what made it worse is that the mother didn’t speak Spanish, as she was from Germany, and her English was limited as well.”

Ironically, Sharma, who had completed Drexel’s Spanish for Medical Professionals elective the previous spring, was in Spain to practice her medical Spanish. While her second language wasn’t helpful to this mother, the experience only confirmed for Sharma how meaningful and useful the class had been. With more language skills, providers can be that much more effective in reaching patients.

“Thankfully, the baby and the mother were stable, but I could see how important it was to put the patient at ease, and the role communication plays in that process.”

More Than Words

Part of the Global Health Education program, Spanish for Medical Professionals is an elective for medical students who want to improve their language proficiency, understand the cultural nuances of interacting with Spanish-speaking patients, and improve health care communication in general with diverse patient populations.

The yearlong elective, taught by Carlos Gonzalez- Ferrin, focuses on medical vocabulary, dialogue modeling and note-taking skills, with a goal of improving students’ listening comprehension and pronunciation. The class is designed for intermediate-low level Spanish speakers at any stage in their medical education, and it meets once a week.

“The requirement is that the students come in with conversational language skills, so the medical Spanish builds upon their knowledge base,” says Nielufar Varjavand, MD, professor of medicine and director of global health education at the College of Medicine. “Medical students have to learn how to practice medicine not just here but in the whole world. Spanish is the second most common language spoken in the United States, and it is valuable for our students to communicate well with patients, wherever they are.”

While many disease names — especially proper nouns — are the same across languages, the words for symptoms and treatments can vary widely. That’s where the vocabulary lists are particularly helpful.

Richa Sharma, MD ’28, during her visit to Spain

“Descriptors like ‘wheezing’ or ‘swelling’ won’t come up in conversational Spanish classes. But when a patient comes to you and tells you the story of what they’re going through and what they’re having trouble with, it’s incredibly helpful to know those words to understand what a patient is saying,” Sharma says.

In the class, students also read medical articles, research medical interventions and watch Spanish language videos. They note differences in health conditions and health promotion efforts across different areas of the world, so they come away with a deeper understanding of health care systems, as well as differences in health care culture among Spanish-speaking regions.

As a first-year student, Nicholas Lehman, MD ’28, eagerly enrolled in the Medical Spanish class. Lehman majored in Spanish in college, but due to COVID lockdowns, he missed out on opportunities to travel and study abroad. Continuing his study at Drexel not only allowed him to deepen his existing knowledge but it gave him a new practical application for it.

“As an undergraduate, I studied history and literature,” Lehman says. “This class helped me expand my knowledge of everyday Spanish for the medical setting. Every week we would conduct role-playing scenarios where we take on the role of the doctor or the patient and run a mock evaluation. It’s things like knowing when to use the formal usted, subtle vocabulary differences and sentence structure, that can show a patient that you respect their culture and are here to help.”

Putting Learning Into Practice

Upon completion of the course, students are encouraged to get involved with Spanish-speaking community health programs at St. Christopher’s Hospital for Children and Puentas de Salud, to enroll in global health experiences in the summer after their first year or as a fourth-year elective in Spanish-speaking countries, or to join the student group Mesa de Español to continue practicing their newly acquired skills.

Like Sharma, Lehman opted for a summer immersion program. At the end of his first year, Lehman traveled to Cusco, Peru, for six weeks with the Máximo Nivel program, where he was placed in a clinic called El Centro Gerontológico La Recoleta, which focuses on geriatric care. He also continued his study of Spanish with additional classes there.

“I was responsible for physiotherapy and rehabilitation services, and assisting with patients’ activities of daily living. This experience was especially interesting because many of my patients only spoke Quechua, so I was able to learn a bit of that language as well,” he says.

Fluent in Compassion

Something else happens when students learn how to provide health care in more than one language — it breaks down silence and builds emotional connections.

“Students report that after they have taken this course, not only do they become better Spanish speakers but they come away with more empathy for individuals who lack proficiency in English,” Varjavand says.

Sharma saw firsthand how making an effort to directly communicate with a patient in their language went a long way toward building trust. It also allowed her to better understand the patient’s experience of feeling scared and alone.

“Even knowing that someone is just trying to communicate with you in your language makes a world of a difference,” she says. “In many situations there will be an interpreter or another person who’s fluent in a provider setting. But as the doctor, having a little bit of language competency to talk to your patients and look them in the eyes is a way of saying I understand you and I care about what you are going through.”

In the case of the mother in Spain, the provider spoke some English and they were able to convey that it had been an emergency situation, the baby would need to go to the NICU, but they would both be stable, and the mother could see her child shortly. It was enough to put her at ease, Sharma said, but there’s no such thing as too effective communication.

“It was very much an eye-opening experience and definitely made me want to pursue speaking Spanish even more, so that I could always communicate with patients in tough situations and help them understand what’s going on.”

Lehman during a hike to Machu Picchu

Bridging the Communication Gap

For Lehman, who hopes to go into emergency medicine and ideally practice in an urban setting, having the skills to communicate with patients quickly and correctly will be a major asset.

“We can and do use translators all the time in these settings, but being able to speak Spanish makes patients feel more comfortable. In an emergency setting it will save time and allow me to act more quickly.”

Sharma is considering a career in pediatrics, women’s health or community medicine, and she is especially interested in health equity. Originally from Texas, she anticipates that she may complete her training in the Northeast and return to her home state to eventually practice medicine and/or conduct research, and the medical Spanish will be especially useful amid the significant Spanish-speaking population there.

Regardless of where she and Lehman ultimately land, having the additional language skill on their resume will be a bonus, and having a stronger connection to their patients will only benefit their care.

“When we teach medicine, we are teaching communication,” Varjavand says. “It’s not just for the people on our block, in our city or even in our community. We are citizens of the world; we should help everyone.”