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Medical residents receive training from IUPUI language and culture center

Indiana is facing an acute shortage of primary care physicians, a problem that may continue to grow with changes in healthcare reform. More and more international physicians are coming to the U.S. to work, and experts say they are essential to fill those gaps.

"According to the American Medical Association, 25 percent of all practicing physicians in the U.S. are now overseas medical school graduates," said Ulla Connor, director of the Indiana Center for Intercultural Communication (ICIC), a language and cultural training center that is part of the School of Liberal Arts at Indiana University-Purdue University Indianapolis.

Some of those doctors may face challenges connecting with U.S. patients. "Research indicates that cross-cultural communication challenges between doctors and patients often arise from both linguistic barriers and cultural differences," noted Connor.

Doctor Language Training

Medical residents take part in classes offered by the Indiana Center for Intercultural Communication.

Print-Quality Photo

That's why ICIC has designed programs to help international physicians communicate with their patients and colleagues. The programs have proven so effective that all new residents in the Family Practice Program at Indiana University School of Medicine now have two days of required training and assessment with ICIC as part of their orientation program. Residents identified for follow-up training with ICIC will receive individual or small-group instruction to improve their skills.

All of the incoming residents in the Family Practice Program starting in summer 2011 are international medical school graduates, according to Sharree Grannis, director of the IU Health Family Medicine Residency Program and an assistant professor of clinical family medicine at IU School of Medicine.

"They are just as strong academically (as their U.S. trained peers) but unfortunately, if they make grammatical errors they are often perceived as less competent," she said. "If they fully participate in the ICIC program, it helps them tremendously."

ICIC staff members will evaluate residents' oral and written English communication skills and medical culture perceptions, using proprietary assessment tools developed with the School of Medicine. Additional training in specific areas of communication may be recommended for some of the residents.

Resident Diana Morales Zelaya went to medical school in Honduras and participated in ICIC's program last year. "They helped me with my pronunciation skills so I could be understood more clearly," she said. She found the follow-up sessions, where she was paired with other medical residents who had the same goals, very helpful. "It's the small things, like choosing between using the word 'surgery', 'operation' or 'procedure' that can make the difference when talking with patients. All of the residency programs should incorporate ICIC in their training."

Much of ICIC's work centers around the language of healthcare -- helping doctors from overseas connect with patients here -- and helping all physicians communicate more effectively with an increasingly diverse U.S. patient population.

"National requirements for doctors are increasingly focused on communication skills, making these sorts of programs essential training for all physicians and healthcare workers," Connor said.

Two of the bilingual Family Practice residents will eventually be working at a hospital in Lafayette, where as many as 30 percent of the patients are Hispanic, according to Grannis.

Given the enormous influx of immigrants over the last decade, physicians experienced in cross-cultural challenges are invaluable. "I will never forget a patient who was so grateful to finally be able to speak with a doctor in her own language," Grannnis said. "She told me, through her tears, 'No one has ever taken the time to listen to me before.' Having doctors who can speak languages in addition to English is a tremendous asset."