How Can We Help Pharmacy Students, Foreign Graduates When Their First Language is Not English?

I learned most of my English in kindergarten after starting off speaking Spanish. I know, to a small extent, the disadvantage of not speaking the language. I find that I am especially empathetic to those who didn’t speak English as their first language.

I get pre-pharmacy calls from around the country and in speaking to one pre-pharmacy student, I asked, “Why didn’t you pick that pharmacy school? It’s in your hometown.” The student said simply, “I didn’t see anyone like me.” While this student had a thick accent, the student also had a perfect grade point average with a PCATthat was only weak in the English communication components. With the upcoming communication component from the National Association of Boards of Pharmacy, the debate may arise whether weak English communication skills are requisite for someone to earn a license as a pharmacist.

Understandably, speaking to someone in a retail pharmacy would require excellent communication skills, but only if that pharmacy is in a mostly English speaking area. I started my career in central Phoenix, and for many of my patients, it was my fluency in Spanish that improved their health outcomes, not my English. Are pharmacy schools equipped, however to help these students with English?

The profession is working to expand the criteria for a successful pharmacy applicant in a holistic admissions process. The Holistic Admissions Institute, held from January 23^rd to January 25^th, 2017 in Herndon, Virginia by AACP, examines these questions. In the meeting, the participants review and assess their own admissions practices to see how they align to diversity and mission.

A diverse pharmacy workforce will be especially important if the legislation now going into the senate and House of Representatives passes. Recently, Senator Chuck Grassley (R-Iowa), Bob Casey (D-Penn), and Sherrod Brown (D-Ohio) reintroduced the Pharmacy and Medically Underserved Areas Enhancement Act (S. 109). This legislation, if passed, could give pharmacists a health care provider designation under Medicare Part B. A few days later the companion bill, (H.R. 592) made its way into the House of Representatives. But what does it mean for our profession to start our provider status journey serving the medically underserved? It means a commitment to embracing those students who identify as wanting to serve in these underserved areas. One standout P4 student from the University of Iowa who has committed himself to serving in a rural community of Winterset, Iowa, made famous by The Bridges of Madison County book and movie is Brandon Gerleman. In this podcast episode, he makes clear that he wants to bring all he has learned in pharmacy school back to his community.

Aside from the rural population is the often immigrant-rich urban population. While pharmacy schools have students complete experiences in underserved areas, there are other methods to further help students whose first language is not English. One technique, found in the academic literature, is to have classes that provide other language instruction like Spanish in over-the-counter medications, for example. In a graduate oral linguistics course, I learned a simple way to help a non-native speaker better capture the rhythm of a word. This, technique, I found works for medication names. It’s called backbuilding. That is with acetaminophen, for example, one would say:

phen

no phen

mi no phen

ta mi no phen

ce ta mi no phen

a ce ta mi no phen

By starting with the last syllable, then the second to last and last and so on, it helps establish the correct accent. You can find a quick video on backbuilding for pronunciation here:

https://youtu.be/qUHotdaaBzg?list=PLCVrPKWoior0BVJI04FpnRidmOr9fsOs3

Nonetheless, if S. 109 and H.R. 592 pass, it's imperative we have the pharmacy workforce culturally and geographically diverse enough to meet the need that legislation would require.