Eight members of Geisel School of Medicine’s MD Class of 2025 have been certified to provide clinical care in both Spanish and English. This is the medical school’s first cohort of graduates in the newly developed Medical Spanish Pathway of Distinction. Their status as having completed the requirements of the Pathway is noted on their diploma.
Among those certified is Macri Gil Diaz MED ’25, who along with fellow classmate Kevin Puerta MED ’24, developed the initial semester-long Medical Spanish elective that led to the Medical Spanish Pathway. Their goal was to increase fluency in Spanish by giving students an opportunity to practice their communication skills, gain a deeper understanding of cultural aspects pertinent to the healthcare of Spanish-speaking communities, and instill confidence.
“For me, the Medical Spanish Pathway is a source of pride but also an incredible opportunity for people who care about providing better health outcomes for this population,” she says. “Those of us who have gone through this good training and are certified hope to make a difference for patients who speak Spanish,” Gil Diaz says. “Having providers who can communicate effectively to provide this care is important. I’m hoping we see an increasing number of bilingual providers in the future.”
The Medical Spanish Pathway of Distinction is a longitudinal, integrated experience within the medical school’s MD curriculum co-directed by Diana Rojas-Soto, MD and Anais Ovalle, MD, MPH—both assistant professors of medicine at Geisel—and supported by Terri Eastman, director for Integrated Curricula.
“It is both gratifying and inspiring to celebrate the first cohort of students graduating with this distinction. In addition to fulfilling all the requirements of the Pathway, the members of this inaugural cohort have been instrumental in co-creating the Medical Spanish Pathway. They developed and presented the framework to the Medical Education Committee (MEC) for approval, they worked closely with our leadership team to develop the experiential learning opportunities, collaborated with our Clinical Education team to define the required clinical elements, and partnered with the Medical Spanish Pathway leadership team to refine the Pathway and improve it year over year,” says Sonia N. Chimienti, MD, dean of educational affairs.
In Spring 2022, Gil-Diaz and Puerta meet with Chimienti to explore the possibility of developing a Medical Spanish Pathway, based on Chimienti’s prior experiences. Gil-Diaz, Puerta, Eddy Corea-Dilbert MED ’25, and student members of Geisel’s Latino Medical Student Association (LMSA), collaborated over a period of months to develop the framework for the pathway. Gil-Diaz presented their proposal to the MEC, the committee that oversees Geisel’s MD curriculum, and received enthusiastic support for this new element of Geisel’s MD program. Rojas-Soto and Ovalle were appointed as Pathway Co-Directors, and together with Eastman, they have continued to build and refine the program, ensuring a deliverable and sustainable model featuring preceptors who are fluent in both languages teaching clinical skills that translate into better care. Students in the Class of 2025 who completed the Medical Spanish enrichment opportunity during their first year were eligible to continue with the Pathway. In the fall of 2022, the Pathway enrolled a cohort of 13 medical students who will complete all four years of the program in May 2026.
“As physicians and future healthcare leaders in the U.S. where 30 percent of the population will be Spanish speaking, they need to be ready,” Ovalle says.
During 17 two-hour sessions throughout the first academic year, medical students in the Pathway are taught how to provide bilingual clinical care and prepare for the bilingual proficiency test, Rojas-Soto notes. “When they pass this exam, they are able to serve patients in Spanish speaking sites, ideally throughout their clerkships and residency.”
Sessions begin with a 30-minute vocabulary lesson before students break into pairs to role play using their new vocabulary to take medical histories and perform examinations.
“The conversations are open and free flowing,” Ovalle says. “Some students are native Spanish speakers, others worked as interpreters, and those who are intermediate level speakers—none with knowledge of medical Spanish—and they teach each other throughout the role play.”
They also learn nuances of the language depending on the country of origin because Spanish-speaking countries use different words or names for pathologies or symptoms, Rojas-Soto explains.
Throughout their role play, medical students learn to treat patients with cultural humility, to understand that being Latino or Hispanic is not monolithic, to be comfortable with patients who speak English as a second language, how to provide culturally appropriate healthcare counseling, and to be advocates.
Students further developed their language skills during Objective Structured Clinical Examination (OSCE) that are part of the medical school’s curriculum where students review clinical cases and patient symptoms using standardized patients to sharpen clinical and diagnostic skills to come up with a patient care plan.
“We were able to replicate this in Spanish with a standardized patient, who was also able to provide feedback in Spanish—some of which was provided by upper-class students,” Rojas-Soto says.
In the third year, during the core clinical rotations, students are required to complete some rotations in locations where they can care for patients who speak Spanish. The Medical Spanish Pathway leadership team worked closely with the Office of Clinical Education to identify core rotations that would meet the needs of the Pathway students. Students are also required to complete a sub-internship at a U.S.-based rotation site that primarily serves Spanish speakers, or a fourth-year elective abroad in a Spanish-speaking country. According to Chimienti, “While the Pathway has rigorous clinical and experiential learning requirements, there is great flexibility for students in where they are able to complete their clinical experiences—aligned with Geisel’s MD program graduation requirements—and the co-curricular and scholarly requirements.”
And extra-curricular opportunities in the Upper Valley, such as Project Salud also gives medical students relevant experience to put what they are learning into practice.
“The Pathway is the marriage of my dedication to this population and my commitment to medical education,” Gil Diaz says. “My love for that came together in developing the Pathway to push the needle to achieve better care for patients. I am grateful that Geisel has supported me and my love for medical education.”
