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There is a significant need for effective medical Spanish programs based on solid SLA principles and research methods.

The US health care system faces linguistic challenges. Disparities in language-concordant care for Spanish speakers persist due to current demographics and a paucity of bilingual providers. A proliferation of courses in Spanish for health care professions suggests that universities and post-graduate institutions are attempting to meet this need; however, the quantity of programs does not necessarily indicate quality or achievement of desired outcomes. The current study examined medical Spanish programs at the undergraduate, graduate, and post-graduate level that were described in academic literature over a 38-year period. Programs generally were underreported and not comparable, well evaluated, nor easily replicated. Regrettably, in the medical domain, modest language proficiency is considered adequate and programs targeting advanced proficiency are rare. Suggestions are offered to make curricula in Spanish for health care more evidence based, longitudinal, and collaborative.

Demand for medical Spanish courses has grown with the rising needs of Spanish-speaking patients in the United States, but while there is no shortage of beginning medical Spanish textbooks, very few target the intermediate level. This article examines eighteen medical Spanish texts published in the last twenty years with respect to seven factors: 1) targeted proficiency level, 2) vocabulary, 3) oral and aural activities, 4) grammatical concepts, 5) pertinent cultural and sociolinguistic information beliefs, 6) pragmatic concepts, and 7) real-world situations. Although studies have shown negative medical outcomes associated with health providers' limited Spanish proficiency (Derose and Baker 2000; Diamond and Reuland 2009; Flores et al. 1998; Manson 1988), most texts currently aim at beginning levels. Only six of the books are designed for intermediate-level students, and only three offer communicative activities targeting oral proficiency, even though oral and cultural skills have been prioritized for prehealth professionals (Lepetit and Chicocki 2002). Likewise, cultural information is often relegated to simplified paragraphs. Beginner textbooks vary considerably and generally do not offer communicative oral activities or adequate cultural information. Recommendations are offered for improvements in future intermediate textbooks with respect to each of the targeted categories.

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