In the U.S. Census Bureau’s 2024 American Community Survey, over 74 million Americans reported speaking a language other than English. Furthermore, in a recent national survey of 6,000 physicians, 39.7% reported speaking an additional language. However, only 9.6% reported using their multilingual skills “always” or “often” in patient care. This gap between language fluency and clinical application introduces an important question: How can we support future physicians in bridging conversational fluency with clinical fluency?
I first started thinking about this question during a video call in late 2020 with my great-grandmother, who lived in India. We were speaking in Telugu, our native language, when the conversation shifted to the recent news about COVID-19 vaccine development. But my brain suddenly went blank … What is a “vaccine” called in Telugu? I opened up the Google Translate app on my phone, and the screen lit up with the word టీకా (pronounced TEE-kah).
Though I was born and raised in California, Telugu was my first language. I learned to speak, read, and write fluently from my parents, who immigrated to the U.S. in the late 1990s. That makes me what is often called a “heritage speaker,” someone who was raised in and speaks a language outside of the dominant one, and who has cultural connections to a community.
Yet that day was the first time that I had ever looked up “vaccine” in Telugu. It had never occurred to me before then to ask my family how to say “vaccine” in our language or to look it up online, and it made me realize the large gap between my everyday language skills and my medical language skills.
In addition to learning Telugu from my family, language learning has been a constant component of my education. I had the privilege of being able to attend a Spanish magnet program starting in first grade, then continued studying the language up through completing AP Spanish in high school, and then took advanced-level Spanish coursework as a Medical Humanities major in college. Now, in medical school in Los Angeles, I am participating in a monthly medical Spanish learning group with students and faculty, as well as preparing for the “Clinical Cultural and Linguistic Assessment” exam, which would allow me to interpret Spanish for patients while working alongside faculty preceptors. In Los Angeles, where I live and where Spanish is widely spoken, this is a vital component of my “clinical toolkit.”
Beyond my Spanish-language preparations, I also seek to learn how to use Telugu in clinical contexts. My goal is not only to serve Telugu-speaking immigrants here in the U.S., but also to contribute to global health efforts in India (especially in the states of Andhra Pradesh and Telangana, where 84 million and 35 million people, respectively, predominantly speak Telugu). By developing medical Telugu fluency, I could provide care more directly, build trust, and better understand patients’ concerns and goals both here and abroad.
However, this is easier said than done. There is a lack of specialized training resources and Telugu medical terminology education, a gap that reflects a broader trend: English becoming the dominant medium of instruction in not only Indian medical education, but also across the world. This shortage in resources makes it difficult for clinicians and students like me to develop medical fluency in other languages. Additionally, it perpetuates health disparities for Telugu-speaking and other non-English-speaking communities. When health information is available only in English, or when there are no clinicians available who can communicate medical concepts accurately in patients’ native languages, it widens inequities in understanding, access, and trust.
The time required to build medical fluency in one’s heritage language is not easy to fit into the busy schedule of medical school, but it is essential. Being able to speak a shared language with patients not only improves diagnostic accuracy and addresses concerns, but also often brings cultural insight that can strengthen communication. Developing medical fluency as a heritage speaker should not simply be viewed as an extracurricular activity, but rather as an experience in our medical training that is vital for health care equity and access.
Medical students and schools can work toward this goal through various approaches. Starting on-campus medical language interest groups (or expanding existing ones) that incorporate modules about best practices for working toward language fluency, for one. Forming partnerships with community health centers, free clinics, or faith-based organizations to provide opportunities for immersive practice, for another. In my hometown of Sacramento, for example, a local temple hosts a monthly free clinic where physicians utilize their heritage fluency in Telugu to care for community members and older adults, many of whom speak limited English.
Medical schools can also integrate language immersion into electives and rotations. At my institution, third-year students have the opportunity to participate in a medical elective in Tijuana, Mexico, where they balance studying Spanish in a classroom setting and volunteering at a community clinic throughout the week. A similar model could be expanded to various other regions (whether it be Kenya, Tanzania, Nepal, or India), tailoring language learning and preparation to the local context.
However, it is important to acknowledge that students may not always be able to find peers at their institution who share their heritage language, considering the vast diversity in linguistic and cultural communities that medical students come from. National organizations such as the Asian Pacific American Medical Student Association, for instance, can help fill this gap through fostering national and regional conferences and online initiatives that extend beyond individual schools, providing spaces where heritage speakers can exchange resources and strategies. Furthermore, peer-to-peer teaching and mentorship among bilingual and multilingual students can provide valuable insights — even across languages. From my own conversations with peers who speak languages such as Hindi, Igbo, Korean, and beyond, I have learned about strategies for finding accurate translations, navigating cultural nuance, and exploring how idioms and colloquial expressions in our languages shape patients’ understanding of health and illness.
Ultimately, medical fluency is not just about creating vocabulary lists or flashcards. It is about understanding how words and language shape the ways in which patients express their concerns, and how trust is built in clinical environments. I hope medical education continues to create spaces and opportunities for heritage speakers to develop medical fluency. For me, whether it is in a Los Angeles medical office, a temple-based free clinic, or a rural hospital in India, I know that my understanding of Telugu is a valuable tool for providing better care. And I am sure that what is true for me as a Telugu-speaking student is true for countless other multilingual medical students nationally.
Do you speak another language? Share in the comments!
Chinmayi Balusu is a medical student at the Kaiser Permanente Bernard J. Tyson School of Medicine in California. She is passionate about medical humanities, public health, and neuroethics, and hopes to pursue a career in neurosurgery. In her free time, she enjoys reading, practicing taekwondo, and watching South Indian (Telugu) movies. She tweets at @chinmayi_balusu. Chinmayi is a 2025–2026 Doximity Op-Med Fellow.
Illustration by Diana Connolly
