A Spanish immersion program that doubles as global health outreach is a once-in-a-lifetime opportunity that will shape your practice and improve the way you care for patients throughout your career, says one participant.
When Haywood Hall, MD, FACEP, founded the Pan American Collaborative Emergency Medicine Development program — PACE MD — in 2002, his goal was to improve health care, emergency systems, and medical education in Mexico and Latin America.
To that end, PACE has established a variety of courses and programs advocating for better patient care on many fronts: out-of-hospital efforts, OB/GYN, emergency, advanced life support, and more. Physicians, nurses, and other health care providers — many from the U.S. — volunteer as mentors and course instructors, helping train local health care teams and thus creating lasting improvements.
But for as much as they give, these volunteers gain even more. PACE’s MedSpanish participants, for example, get a Spanish language immersion experience specific to health care, as they endeavor to learn the language while teaching medical concepts. It’s a symbiotic experience that can make you a better doctor in many ways, according to one participant.
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Medical Education in San Miguel de Allende
While nearing the end of residency, I wanted to do something different with my elective time, so I decided to head south of the border to San Miguel de Allende, Mexico, with PACE MD’s MedSpanish program. Not only did this rotation exceed all of my expectations, but it changed me as an individual, broadening my horizons while affording me a new skill set that will help me throughout my career.
To start, San Miguel is a place like no other. Its heart, character, and history have made it a UNESCO World Heritage cultural site where a vibrant downtown frequently features live music, festivals, and celebrations on nearly every corner. The food is richly diverse, the people are proud, and it creates a culture that is full of life. Meanwhile the city is surrounded by incredible nature and history.
I was fortunate to begin my MedSpanish rotation when PACE was holding its Global Forum for Emergency Care and Obstetrics. This was a conference like no other I’ve attended. There was an intrinsic goal among all providers to expand knowledge and improve care throughout the places they love in Latin America. From Chile to Brazil to the U.S. and our neighbors in Mexico, everyone came together in training. Thousands of practitioners were participating in various courses, including ACLS, Helping Babies Breathe, PALS, BLS, and ALSO (Advanced Life Support in Obstetrics). Throughout the week, training also continued on the use of diagnostic bedside ultrasound. Lectures were provided by Judith Tintinalli, Robert Suter, Terrence Mulligan, Jeff Solheim (president of ENA), Ken Iserson, and many other world-renowned medical educators.
Following the conference, my days included a few hours of one-on.one instruction in medical and basic Spanish. My tutor was friendly and fun, with a wealth of experience in teaching. Fluent in both English and Spanish, she quickly recognized my knowledge gaps that required closer attention and improvement, and I looked forward to meeting with her daily. After my language lesson, I would head to one of my 4 clinical rotations: working with the Mexican Red Cross (Cruz Roja Mexicana), Rural Health Brigades, CAISES public health clinic, and the public hospital ED.
I began by working with the Cruz Roja Mexicana, focusing on prehospital care in Mexico. Their providers were highly trained and equipped with familiar tools such as chest tube and cricothyrotomy kits. They integrated me seamlessly into their team, eager to learn whatever I knew that could help them improve their practices. Together we developed straightforward lectures on airway, electrocardiogram, and ACLS for their team.
Next, I headed to the government-run CAISES health clinic where general practitioners care for those with government insurance (Seguro Popular) throughout Mexico. Their spectrum of care far exceeded what I expected. While working alongside my friend, Dr. Diego Elias, I witnessed him utilize ultrasound to diagnose a long list of complaints, while managing various complex cases outside the hospital. Most patient presentations echoed what we see in EDs back home, though without the resources normally available to us — making the history and physical exam that much more important. For MedSpanish participants, it’s a golden opportunity to practice Spanish in the context of emergency medicine.
MedSpanish participants also take part in community health brigades multiple times per week. Mobile health clinics are set up outside of schools and other highly trafficked areas, with the focus on seeing as many patients as possible. For instance, we set up in a poverty-stricken ranching neighborhood, not far from the outskirts of San Miguel. While seeing patients alongside physicians who run this initiative, we encountered another team of PACE educators teaching CPR to parents and community members.
During my ED rotation, I saw our specialty as it began in the U.S.: clinically rich but resource-limited — so using those valuable resources requires a higher level of justification. In some aspects this creates a more highly skilled practitioner when it comes to putting hands on the patient. At the same time, we had a high-quality ultrasound to help with bedside diagnosis — and lots of interest from the house staff in learning any tips we could share for using it. My favorite part of rotating through the ED was the culture among the staff. Every day I was welcomed genuinely, and the whole staff took pride in spending their days together helping members of their community.
Since leaving Mexico, I’ve found the knowledge I gained through the MedSpanish program to be highly useful. No matter if you’re a junior resident or a senior physician, if you’re passably fluent or you lack any Spanish vocabulary — I strongly advocate for you to find a way to participate in this program. As a residency elective, it was a once-in-a-lifetime opportunity to learn and grow in a beautiful culture. I now plan to continuously return to Mexico and embrace this opportunity throughout life.
For more information on PACE MD and its outreach programs, visit http://www.pacemd.org.