AAMC Reporter: October 2005

Nereida Correa, M.D., M.P.H., Obstetrician/ Gynecologist and co-director, Hispanic Center of Excellence, Albert Einstein College of Medicine, Yeshiva University

In Multicultural Bronx, 'Communication Is Key'

By Scott Harris

In the Bronx, the population is highly diverse—and so are the health challenges. Just ask Nereida Correa, M.D., M.P.H.

During her medical training in the New York borough, one challenge arose when she attempted to treat a Vietnamese patient who spoke no English. Correa found a translator, but that led to another hurdle: The translator was of Cambodian origin. "These two cultures have a history of strife," Correa said. "So as he translated, the Cambodian man turned his back on us as a sign of disrespect. His message was, 'I will help only because I feel I have to.'"

Correa is adamant that communication is key.

"It's important in health care to be able to express what you're feeling," she says. "Otherwise, it's the end of access."

Perhaps not everyone shares her strong commitment to helping patients communicate, she concedes. But, she said, "One thing that cuts to my core is that when people come into a hospital and can't speak the language, they are treated badly, or told to go home and get a translator. I've seen [health care professionals] yell at a patient, louder and louder, because the patient couldn't understand English."

Helping to foster communication and cross-cultural understanding, particularly in the Bronx and among people like herself (for whom Spanish is a first language), is a central goal for the Puerto Rico-born Correa, who is an obstetrician/gynecologist as well as co-director—with Elizabeth Lee-Rey, M.D.—of the Hispanic Center of Excellence at Yeshiva University's Albert Einstein College of Medicine.

But improving communication is just one aspect of the center's mission. It also seeks to improve the quality of patient care for Latinos and other minorities, as well as to increase the number of Hispanic physicians in the United States—soon to become the country with the second-highest population of Spanish speakers, after Mexico. Today only 5 percent of American medical school graduates are Hispanic and Latino.

The Einstein center opened in October 2002 as one of only two such facilities in the Northeast. Nationwide, 31 centers receive annual Centers of Excellence grants from the Bureau of Health Professions in the Department of Health and Human Services to help minorities in medical education.

At Einstein, current and prospective minority students and faculty members receive a broad range of educational support services, including MCAT® examination preparation, and research mentorships and fellowships. Each year, two Hispanic or Latino students who narrowly missed admission to the school are selected to attend the University at Buffalo School of Medicine and Biological Sciences for a year of intensive, all-expenses-paid study, followed by guaranteed entrance to Einstein the following year, pending successful course completion at Buffalo.

To lower language barriers and encourage cross-cultural communication, Einstein's center offers Spanish education programs to all medical students. Meanwhile, native Spanish speakers receive specialized instruction in medical terminology and patient interviewing. In addition, through the Einstein Community Health Outreach Free Clinic, whose patient base is largely uninsured, medical students get first-hand experience in treating members of the Bronx's population, a multicultural tapestry of people with Asian, African, and Middle Eastern backgrounds, along with those of Hispanic and Latino descent.

Correa, who first came to the Bronx when she was 4, said helping diverse and underserved populations—and helping others do the same—is a cause that hits home for her.

"I didn't speak English when I came here," she said, "and I became very interested in people who had problems accessing health care because of language barriers or cultural barriers. So this issue has been something I've been interested in all my life. As an Ob/Gyn, I will sometimes treat patients who are culturally unable to see male physicians. But sometimes they have to be examined by a male physician because he is the only one available and it is important for the safety of their child. These kinds of situations require a great deal of sensitivity.

"We all come from our own culture, and we cherish that and hold it dear," Correa said. "I feel that health care discussions are just as important as the discussions that go on in the United Nations. We all have to be able to understand each other."

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