Texas is one out of five states in the country that is considered a majority-minority state, according to data that was gathered by the U.S. Census Bureau. The number of Spanish speakers has increased over the years and is predicted to steadily increase throughout. Learning Spanish has now become a vital skill in many people’s professional lives.

Students at UT Health San Antonio can sign up to take a class called “Intermediate Medical Spanish”. Although not yet an official elective, students get a certificate signed by Dr. Ruth Berggren, head of the Center for Medical Humanities and Ethics, documenting their completion of the course’s requirements. According to the syllabus, “the Intermediate Medical Spanish course is an interactive class that introduces pertinent medical vocabulary and phrasing for the purposes of assessing patients’ histories of present illnesses.”

This class is taught by the team of Frontera de Salud and is led by Eithan Kotkowski, a M.D./Ph.D. candidate who is passionate about helping the disadvantaged from his community.

“There has historically been a problem in Texas and other places with large non-English speaking populations whereby children forced to learn in English do worse academically and are held back. I was part of an innovative program growing across the nation that takes this into account and allows kids to transition over the course of their elementary school years from Spanish-only to English-only classes without the impediment of learning a language before being taught the material.”

Eithan’s change of the curriculum was influenced by his experience as a dual language elementary school teacher. This is where he learned how to write a curriculum that makes the self-learning of English more effective.

“I was a bit disappointed to see that UT Health San Antonio did not have a standardized curriculum to train their future medical professionals in Medical Spanish, considering that 36 percent of San Antonio’s population speaks Spanish as a first language. That was when I decided to essentially rewrite the curriculum from scratch and teach the class myself. It took a lot of work, but I am proud to say that students now have access to the 100-page manual I created along with a class that has been developing and improving over the years I’ve been teaching it. My goal is for Medical Spanish to be an integral part of the UT Health San Antonio curriculum for all health professionals.”

“A not-insignificant number of people in the Hispanic community are skeptical and distrustful of the healthcare system for a variety of reasons and are reluctant to see a doctor until their condition gets to a point where it becomes unbearable. Part of what Frontera de Salud does is educate patients on obtaining proper screenings, like blood lipids and blood glucose, since diseases like type II diabetes are much more prevalent among the Hispanic community. The Medical Spanish class also incorporates a cultural learning component to help students understand the socio-economic, political, and historical factors that play a role in disease discrepancies experienced by the Hispanic population in Texas.”

Eithan also says that many are worried about their legal status, but explains that “preventative medicine is a crucial component of our healthcare system and it doesn’t matter if you are here illegally or not. If a woman with non-legal status has pre-diabetes that she is unaware of waits until she has life-threatening complications to go see a doctor, she will 1) not receive adequate treatment and 2) will cost the hospital a great deal of money in emergency treatment costs. This is why preventative care and routine glucose and lipid screenings provided by Frontera de Salud events are a huge benefit for the patients and the communities in which they live.”

Frontera de Salud, and by extension the Medical Spanish class, is able to get funding from Methodist Healthcare Ministries through the hard work put in by the Frontera de Salud student leaders, especially the grant writers. Ryan Reyes, another MD/PhD student, became involved with Frontera de Salud as a grant writer because he believes in its mission to further preventative healthcare and bridge the gap of cultural understanding between the medical establishment and the community.

“Here in South Texas the access to healthcare is lower than anywhere else in the state and the five poorest counties are actually all in the South Texas region.”

Ryan understands that the course will be beneficial to medical students who reside in here Texas.

“Learning Spanish is so vital because I know my future career will depend on it if I still want to engage this community. I know I desperately need to work on learning how to speak the language if I want to continue connecting with Spanish speakers.”

Because the Spanish course is not yet accredited to be taught as an elective, it is being taught as a component of Frontera de Salud for the purpose of encouraging student volunteers who attend Frontera trips to learn about the culture and language of the patients they will encounter on trips and even in the hospital during their clinical rotations.

The biggest challenge facing the Intermediate Medical Spanish class has been student retention, despite tremendous interest. In the Spring semester of 2018, a total of 75 students (both MS1 and MS2) attended the first lecture and lab for the Medical Spanish course, demonstrating that students at UT Health San Antonio are eager to learn and work on their Spanish for the purpose of becoming more effective physicians in the future. Unfortunately, by the end of the semester only 13 students out of the 75 met the criteria for obtaining the certificate. Although there are numerous reasons students drop out, it’s non-official status as a course elective appears to be one of the most dominant factors.

Eithan wants the class to be engaging to students who want to become better physicians in a community with a large Spanish-speaking population. He understands the impact this course can have on the lives of medical students and their future Spanish-speaking patients here in San Antonio and around Texas.

Having grown up in a multicultural and multilingual environment, Eithan lives by the words of former South African president Nelson Mandela “If you talk to a man in a language he understands, that goes to his head. If you talk to him in his language, that goes to his heart.”