Getting Started
Prior to taking part in health related experiences abroad, students or practitioners may desire a period of time to study a host country language. A number of resources are available in the area, and a variety of methods may be useful for language acquisition, both in formal study programs and by utilizing more informal techniques. Medical students in particular have significant schedule constraints; the resources listed are therefore intended to guide those who must maximize learning in a short period of time. This guide lists a number of general study resources. However, of note is the recent establishment of several new programs for development of competence in the Spanish language with a special medical orientation.

Language departments at local universities, in addition to providing courses, make tapes and other learning aids available, and may have access to native speakers, even in relatively less commonly spoken languages. The Foreign Service Institute of the U.S. Department of State and the Defense Department’s Defense Language Institute, as well as universities and other non-government organizations, have developed comprehensive text and tape courses. For those who are progressing in their learning, video movies in the language of choice and short wave radio broadcasts from abroad may help with listening skills. Additionally, several excellent interactive computerized language study programs have recently been developed.

 In many countries, enrollment in well organized intensive courses can be arranged for periods ranging from a few days to several months. A number of U.S. organizations facilitate short term coursework overseas, and national consulates and tourist offices can be helpful with questions about specific opportunities. Some of these programs are designed principally for health care personnel (see listings in resources). We emphasize Spanish in this guide since it is the primary language for millions of North Americans, and resources are correspondingly more abundant.

In-Country Language Centers
Among more active centers of Spanish language instruction for short term visitors include the cities of Cuernavaca and San Miguel de Allende, Mexico; Antigua, Guatemala; and Quito, Ecuador. Language academies frequently structure half-day courses for groups of three to ten people (in Guatemala and Ecuador individual tutoring is a more common format), provide regional culture study, and locate housing with local residents. It is possible to write for information; offerings vary considerably, however, so the prospective student may wish to compare programs in person before enrolling. Those who make arrangements prior to arrival generally will pay a premium for the convenience, a not insignificant consideration for students attempting to make ends meet with education loans. On the other hand, prearranged programs with North American academic affiliations may offer university level credits for those who have such needs.

Once inside a country, local tourist offices list addresses, and it can be worthwhile to ask in places where foreigners congregate, such as hotels and museums. Schedules are generally flexible, and students may frequently begin on most Mondays during the year, enrolling for periods of one week at a time. In general, academies are able to arrange for students to begin instruction with as little as one day advance notice. Appropriate study levels are determined by a brief examination administered upon enrollment. If making arrangements onsite, one would expect to pay $75-200 per week for tuition and a similar amount for a family homestay. Special visa arrangements beyond those required for tourists are generally not necessary for limited visits.

For aspiring francophones, the Alliance Française and Eurocentres operate language and culture centers in France, the United States, and other countries around the world. Additionally, numerous universities and private organizations in French-speaking countries of Europe and Africa and, closer to home, in Canada offer short term studies for foreigners. Electing to study in a medium-size university city with an active cultural calendar may be an appropriate choice for the student who wishes a relatively brief immersion experience.

Program Advantages : Programs are structured for progressively improving skills; a secure environment is provided; and it’s easy to meet others working in and traveling around a host country. Special cultural activities provided through language academies can be a good introduction to unique aspects of a specific region.

Program Disadvantages : Surrounded by other North Americans, the temptation to speak English is nearly irresistible. Also, a school environment may limit opportunities for interaction with local residents. Participants observe that spending more than three or four hours a day, or longer than two weeks in an intensive course can become tedious for some.

Before embarking on a study course, the student might consider perspectives IHMEC members have offered from their experiences with language acquisition. Chris Krogh, MD, has noted a few precautionary comments on language and health work:

The following seems so obvious as to be hardly worth mentioning; but it may be the most disregarded advice....Contrary to what many students think, English will not suffice everywhere! Many nuances of meaning are lost through translation or interpretation. A language the student studied in junior high [school] will not necessarily “come back” with use either; nor can a language usually be learned in the two weeks before one leaves for an elective - at least not well enough for one to follow the innuendos of health - and illness - related conversation.

It is wiser to take accurate stock of what language(s) one actually knows, and then to select an [overseas health care] site for which one’s language capabilities are appropriate. Otherwise, the bulk of the experience - the process of communicating, exchanging information, understanding local perceptions, and living within a new culture - is not likely to be very profound. 1

A complementary point of view is offered by Kay Wotton, MD, of the University of Manitoba:
Much of my international health experience has been spent in places where the attitude more than the skill was important. So while I have taken courses in [several languages], I remain stuck in a unilingual state....I got something more out of the attempt than a halting ability to move about in the market or town. I secured some insight into thinking and viewing of the world that is part of that culture. I feel particularly strongly...that [acquiring such] insights into other world views is critical to our survival as a species, and a most compelling reason [to emphasize work] in [language study and] international health. 2

 ____________________

 1. Krogh C, Pust R. International Health: A Manual for Advisors and Students, 1990. Kansas City: Society of Teachers of Family Medicine.

 2. Wotton K, Personal Communication. 

 ____________________

 With good advice as a starting point, below are resource lists to help readers meet their foreign language needs.

Editors’ note: While all efforts have been made to provide accurate information, no guarantees about current availability or quality can be made, and the user of this guide is urged to use personal discretion before expending significant resources on programs or study materials.

General Resources
1. Intensive language courses are available domestically through a number of North American universities, primarily during summer sessions. Especially diverse programs are offered by Boston University, Yale University, the University of Wisconsin, and the University of California campuses in Berkeley and Los Angeles. For those anticipating work in Africa the Summer Cooperative African Language Institute (SCALI) presents an eight week program each summer at one of the member universities on a rotating basis. Several languages are taught, and a small amount of tuition assistance is available. The summer 2002 program is located at Michigan State University, http://isp.msu.edu/africanstudies/scali/scali.htm. The University of Wisconsin also coordinates the Southeast Asian Studies Summer Institute (SEASSI), an eight week program with instruction in nine Southeast Asian languages. Information from Center for Southeast Asian Studies, 207 Ingraham Hall, 1155 Observatory Dr., Madison, WI 53706, 608-263-1755, http://wiscinfo.doit.wisc.edu/seassi. As the name implies, the Less Commonly Taught Languages Project of the Center for Advanced Research on Language Acquisition (CARLA) at the University of Minnesota provides resources on less commonly spoken languages worldwide, 612-624-9016, http://carla.acad.umn.edu/lctl/ access.html, with the web site listing summer 2002 courses.

2. Audio-Forum: The Language Source. Catalog listing with audio and video cassettes and other study materials for more than 100 languages, including medical Spanish. 96 Broad Street, Guilford, Connecticut 06437, 800-243-1234, http://www.audioforum.com.

3. Eurocentres, extensive selection of short term European and Japanese language courses abroad. A small amount of scholarship assistance may be available. 101 N. Union Street, Alexandria, VA 22314, 800-648-4809, http://www.eurocentres.com. The Alliance Française offers French language instruction at their centers worldwide. 1900 L Street, NW, Suite 314, Washington, DC 20036-5027, 800-637-2623; or 101 Boulevard Raspail, 75270 Paris Cedex 06, France, Telephone (011-33)45-44-3828, http://www.afusa.org.

4. Council on International Educational Exchange (CIEE). Information on short term service and work overseas, in addition to other opportunities for students wishing to spend time abroad. 633 Third Ave., New York, NY 10017, 888-268-6245, http://www.ciee.org. 

5. Several web sites now list language study opportunities. The World Wide Classroom indexes language study centers overseas at http://www.worldwide.edu. Additionally, http://www. languages-on–the-web.com provides a wide variety of online resources.

6. Many interactive computer language study programs have become available in recent years, with a good selection generally available at major computer stores. Several now claim to offer voice recognition functions, although this capability may be somewhat rudimentary. Information on two programs with medical language instruction is available online at http://idrama.com/medspan.htm and http://www. medicalamazon.com/medtech/532.html.

7. Travel guidebooks frequently list addresses of language schools overseas. Notable in this regard include Lonely Planet, Footprint, Rough Guide, and Let’s Go: series of guides.

Medical Spanish Language Courses
8. International Community Health and Medical Spanish, Mexico. University of Southern California program for first year medical students in Baja California, includes classroom study of medical Spanish, and observation of urban and rural community health programs and clinics. Family homestay is arranged for participants. Directed in July by IHMEC member Dennis Mull. Department of Family Medicine, University of Southern California, 1420 San Pablo St., PMB-B205, Los Angeles, CA 90033, 323-442-1325, hazel@hsc.usc.edu, http://abbc3.hsc.usc.edu/ med.spanish.

 9. Interhealth South America , Ecuador . Program for first year medical students, offered in June-July by IHMEC members Don Wedemeyer and Marta Alarcón. Medical Spanish language immersion, clinical practicum, and Andes Mountains study tour program in international health. Don Wedemeyer, MD, Marta Alarcón, MD, Interhealth South America, 4202 E. Fowler Ave., USF 30404, Tampa, FL 33620, 813-935-3480, dwedemeyer@pol.net, http://www.InterhealthSouthAmerica.net.

 10. Ohiyesa Language Proficiency Program, Guatemala . Summer Spanish language course with an introduction to the country's health care system and culture, coordinated by IHMEC member John Lyons. Room and board is with a Guatemalan family. John Lyons MD, Department of Anatomy, Dartmouth Medical School, Hanover, NH 03755, 603-650-1640.

  11. Medical Spanish/International Health Course , Guatemala . Onsite exposure to primary and community health care in Guatemala with immersion Spanish language study, sponsored by the University of Nebraska Medical Center. Course coordinators are IHMEC members Sara Pirtle and Alfredo Garcia. Program scheduled February, April, June, and July. Sara Pirtle, MBA, International Studies & Programs, University of Nebraska Medical Center, Omaha, NE 68198-5735, 402-559-2924, sepirtle@unmc.edu, http://www.unmc.edu/isp.

 12. International Health Central American Institute, Costa Rica. “The Spanish Patient” is coordinated at various times during the year by IHMEC member Mario Tristan. Mario Tristan, PhD, P.O. Box 1677-2100, San Jose, Costa Rica, ihcai1@racsa.co.cr; or Gail Landry, Tulane University School of Medicine, New Orleans, LA, 504-988-4706, alandry2@mailhost. tcs.tulane.edu.

 13. Salud program for medical Spanish study, offered each summer at different Latin American sites. Endorsed by AMSA. 703-620-6600, http://www.amsa.org/sc/salud.html.

 14. MEDICC. Individual placements for medical and other health professional students in Cuba, includes a medical language study component in its programs. Emory University School of Nursing Building, 1520 Clifton Rd., Rm. 438, Atlanta, GA 30322-4207, http://www.medicc.org. 

15. Child Family Health International. Student electives in Ecuador, Mexico, and India, includes opportunities for language instruction. Child Family Health International, 2149 Lyon St. #5, San Francisco, CA 94115, 415-863-4900, http://www.cfhi.org.

 16. Rios Associates. Health professional intensive medical Spanish four day programs offered at various sites in California and the Southwest, and one week in Baja California, Mexico. 1351 E. Ft. Lowell Rd. Suite C, Tucson, AZ 85719, 520-907-3318, http://www.proespanol.com.

  17. Weekend en Español. Periodic weekend and one day medical Spanish programs in San Francisco. 1908 Buchanan Street, San Francisco, CA 94115, 415-923-0754, http://www.weekendenespanol. com/medical.htm.  

18. The following language academies offer ongoing or periodic medical components in their general Spanish language programs. The reader is advised to seek information at the respective web sites for each:

Costa Rica:

 · Centro Panamericano de Idiomas (CPI) - http://www.spanishlanguageschool.com

· Comunicare – http://www.comunicare.co.cr/medical.html

 · Hispaniola Spanish Language School – http://hispaniola.org/medical-spanish.htm

Mexico :

 · Cemanahuac Educational Community – http://www.cemanahuac.com

· Mar de Jade – http://www.mardejade.com

Venezuela:

  · CELA – http://www.cela-ve.com

Selected References and Medial Resources for Medical Language Study
19. Fuller G, How to Learn a Foreign Language, Storm King Press; and Brown-Azarowicz M, Stannard C, Goldin M, Yes! You Can Learn a Foreign Language, Passport Books. Short handbooks with practical advice for those who have not previously studied a foreign language, or who have had a disappointing experience trying to learn one.

  20. Bilingual Medical Dictionaries

Bilingual medical dictionaries for health professionals are published in a number of languages. Spilker B, Medical Dictionary in Six Languages, Raven Press, offers translations in French, Spanish, Italian, German, and Japanese. For Spanish, three convenient and relatively inexpensive pocket size dictionaries are available, Herrera McElroy O, Grabb L, English-Spanish, Spanish-English Medical Dictionary, Little, Brown; Rogers G, English-Spanish, Spanish-English Medical Dictionary, McGraw-Hill; and Kelz R, Delmar’s English/Spanish Pocket Dictionary for Health Professionals, Delmar Publishing. The first of these is especially recommended, and includes a brief section on basic Spanish grammar structure. For those who desire a monolingual Spanish medical dictionary, Stedman’s Medical Dictionary is translated as Stedman’s Diccionario de Ciéncias Médicas. In addition, Oxford-Duden (Bilingual) Pictorial Dictionaries, Oxford University Press, provide detailed illustrations on a variety of technical and non-technical topics, including medicine, nursing, allied health fields, dentistry, etc., and are available in several European and Asian languages.

  21. Medical Spanish:

Recommended for particularly effective use of high impact formats are (beginning level) Kearon T, Lorenzo-Kearon D, Medical Spanish; A Conversational Approach, 2 nd Edition, Holt, Rinehart and Winston, with audio CD; and (for those who already possess a basic knowledge of the language) Gonzalez-Lee T, Simon H, Medical Spanish: Interviewing the Latino Patient; A Cross-Cultural Perspective, Prentice Hall, with audio cassette. Salud: Medical Spanish for Health Professionals is a bi-weekly publication in newspaper format, with accompanying bilingual glossary and grammatical presentations. Educational News Service, P.O. Box 60478, Florence, MA 01060-0478, 800-600-4494. Also recommended is Sylvester N, Perry L, Glackin G, Medical Readings in Spanish. CBS College Publishing, 383 Madison Ave., NY, NY 10017. Practical Spanish for Health Care Providers, University of Arizona. Five module presentation includes videotapes, audio cassettes, and text. May be utilized by groups or individuals. Preview video available. John Condon, EdD, Program Director, Biomedical Communications, University of Arizona Health Science Center, Tucson, AZ 85724, 602-277-8867, jhall@biocom.arizona.edu.

 22. Medical French:

Books in the McGraw-Hill Schaum’s Foreign Language Series are designed to assist users become more proficient at communicating in French or Spanish about different professions or fields of study. Readers with some understanding of the subject matter and background in the language may utilize them most effectively. For health professions, the French is Lutz K, Schmitt C, Médecine et Soins Médicaux; Lectures et Vocabulaire en Français. At press time some titles in the series were out of print, including the medical Spanish text in the series. Dollinger R., Pocket Medical French, JDV Publishing, utilizes basic phrases for non speakers of the language, available with audio cassette.

 23. Medical Portuguese:

Practical Portuguese for Health Professionals , textbook and audio cassettes. Ordering information available from the publisher, Southeastern Massachusetts Area Health Education Center, Inc., P.O. Box 69, Marion, MA 02738, 508-748-0837, http://www.smahec.org/ news.php.

 24. Medical Russian

Dollinger R, Pocket Medical Russian, like the French edition uses basic phrases for non speakers of the language, and is available with audio cassette.

25. Werner D, Where There Is No Doctor, Hesperian Foundation. Werner’s guide for community health workers is translated into 80+ languages. While overseas it can be useful to have copies in both English and the host country language for general health information. The abundant use of simple illustrations makes them particularly valuable for vocabulary development. Other foundation publications are also available in translation. Hesperian Foundation, 1919 Addison St., Suite 304, Berkeley, CA 94704, 510-845-4507, http://www.hesperian.org.

Many thanks to the several GHEC members who offered their suggestions for language study.