Establishing Medical Students' Cultural and Linguistic Competence for the Care of Spanish-Speaking Limited English Proficient Patients.

Limited English proficient (LEP) patients are at risk of disparities in health and health care quality. These disparities can be mitigated by providing care in a language they understand. Undergraduate medical education provides an opportunity to stress that language barriers negatively impact the quality and safety of health care for LEP patients and to teach students how to overcome them. Because the preponderance of LEP patients in the USA is Spanish speaking, the majority of US medical schools have established medical Spanish coursework for interested students. However, 70 % of medical schools note significant obstacles to delivering this curriculum. The most commonly cited obstacles include a lack of time to deliver it, heterogeneous student skill levels, and insufficient faculty support. We also note that educators need to make sure not to propagate disparities and medical errors for LEP patients. We provide recommendations for establishing medical students' linguistic and cultural competence for the care Spanish-speaking limited English proficiency patients, with the caution that this instruction must be coupled with education as to when to call on an interpreter if participants are not fluent in Spanish at the end of the course.