June 25 to July 2, 2005

Dear MedSpanish,

            My one week in the MedSpanish program was an outstanding experience.  It met all my expectations and more.  It was the perfect combination of Spanish instruction, Mexican culture, exposure to the health care delivery system in Mexico, patient care and international health.

            The private lessons in Spanish were thorough and practical.  Lilia is an excellent teacher who helped me apply book knowledge to real world situations both inside and outside the hospital.  The class setting on the patio underneath bougainvillea was relaxing and stimulating, with great coffee and authentic Mexican cuisine to enjoy during study breaks.  Tony, as both tour guide and friend, was also a great help in developing my language skills and understanding of the history, people, and culture of San Miguel de Allende.  (Tony also showed me where to find the best paletas and helado!)

            The exposure to the health care delivery system in Mexico was very enlightening and reminded me of why I went into medicine in the first place.  My time in the Clinica and the Hospital General with the compassionate staff and appreciative, hardworking patients helped me forget about the everyday headaches practicing emergency medicine in the United States.  I went into emergency medicine to help patients in their time of greatest need and adversity, through the extremes of the human condition; and not to do paperwork and practice defensive medicine.  This exposure to patient care and international health without these everyday headaches was truly refreshing and reinforced my long-held belief that the practice of medicine is both art and science combining both humanistic and scientific approaches.  Moreover, it stressed the importance of the doctor-patient relationship; indeed, medicine in its purest form.

            My sincerest thanks to PACEMD, MedSpanish staff, and everyone else I was fortunate to meet and work with during my week.  I will certainly be back again! (con mi esposa next time!)    

Sincerely,

Matthew Smith, M.D.

Attending Physician
EMS Base Hospital Medical Director

San Francisco General Hospital

Dear MedSpanish,

I'm a neurologist from Arkansas, and I spoke no Spanish at all before coming to San Miguel.  We have a large, and growing population of Hispanic patients where I work, so I spent two weeks at the MedSpanish Course in San Miguel. The Medspanish course was a terrific experience. I Went there with my sister (also a physician) and her two children, aged 7 and 14.  We flew into the airport in Leon which is excellent, small, safe and efficient. We went through customs in less than fifteen minutes and were met just outside customs by a driver from the Medspanish course holding up a sign with our names. We were escorted onto a comfortable van, and driven through some very beautiful countryside to San Miguel, arriving in the late afternoon. 

San Miguel is a beautiful, colonial city that probably looks much as it did 200 years ago. Colonial houses face onto narrow pebble stone streets, which give out in turn onto squares adorned by churches and fountains.  It is extremely clean, the people are friendly, and there are very few beggars (usually old Women whose children have gone to the US).  In San Miguel, we were driven to a comfortable lodging house with an interior courtyard and roof terraces in the Spanish style where we would spend the next two weeks.

Our landlady spoke very little English, however Tony, a representative from the Medspanish program arrived a few minutes later, and welcomed us, and took us on a tour of the city, showing us also the school and hospital where we would study, and the Spanish day cam that the children would attend.

We began classes the next day, and we found our teacher (Blanca) both excellent and extremely rigorous.  Spanish teachers in Mexico apparently have much higher expectations for their students than do those in the US, and using a combination of the US Foreign service text, together with a handbook on medical Spanish we covered almost 100 pages a day.  The hospital experience was also quite good.

The general hospital has a small emergency room, with both pediatric and general medical wards.  There is also an outpatient clinic, and a medical van that goes to the rural areas of Mexico several times a week. Different students had different approaches to using the medical resources available.  My usual routine was to begin in the hospital at 8:00 with breakfast with the medical residents (on whom I would practice my broken conversational Spanish.  We would then usually have a resident lecture at 8:30(quite good with PowerPoint presentation on various topics which ended at about 9:30)  I understood about 20% of the material presented the first day (mostly on the strength of the pictures and my previous medical knowledge) and about 80% by the end.  After resident rounds, the first week I went to the general medical ward where I followed the attending around as they rounded on their patients, and then read the charts.  After a few days, however, I found that I learned more by hanging out in the emergency room, either participating in new evaluations or simply watching the attending there evaluate new patients.  As I got better, I took my medical Spanish book with me, and practiced on the patients on the ward.  I did not attend the outpatient clinic or go on the van to the rural areas because I felt that my needs were better met in the emergency room.  However, I'm told that many other students went to those areas and thought they were excellent.

We didn't always study, though I think I was more studious than most.  Many students spent the evenings salsa dancing and attending San Miguel's many attractions.  Since we both really wanted to master Spanish, and also had young children we tended to stay in and study at night, however this was not compulsory.  Had we wished to there are a lot of very fine ranches and other amusements for children in the area, as well as free foreign films in the plaza and swimming.  However the children were in Spanish camp during the day (at the Bilingual institute) often had play dates with the children they met in camp in the evening, and already went on "field trips" to the ranches and museums, so we felt we could concentrate on studying in the evenings. 

On the two weekends, however we did go sightseeing.  This involved two trips to Mexico City, one to see the government buildings, the archeological museum and a small pyramid that is currently being excavated, and the other to see the two great pyramids of the Sun and the Moon just outside of Mexico City.  We also went to view the famous tilma of the Virgin of Guadelupe, and attended Mass at the famous basilica there. I think this was a great experience.  In two weeks, I went from no Spanish at all to being able to stumble through a history and physical.  I also found I could understand laboratory reports from Mexico, after the experience (a necessity as many Hispanic patients arrive in my clinic with a stack of medical papers written in Spanish from their previous hospitalizations, but do not know what those reports actually say). 

Over the course of the next two weeks, I estimate that I achieved a Spanish competence about equivalent to that achieved after about 2 to 3 years in a (good) US high school.  This does not make me any expert; however it does mean that I now have a very solid base with which to converse with my patients, however brokenly, and I plan to continue to study while in the US, and to return next year to learn more.  I think I will learn even more next year, because vocabulary builds on itself, and one learns the most the more one knows.

I definitely would recommend this course to anybody.

Shari DeSilva MD