New Mexico Clinic Trains Bilingual Health Apprentices to Address Shortage

The year-long program at Casa de Salud places students in a clinic whose patients are predominantly Spanish-speaking and 80% uninsured. It is intended not only to help students from marginalized backgrounds enter medical programs but to keep them working in their own communities. At least a third of the students Casa de Salud has tracked have gone into healthcare, and more than half of those have attended medical school, according to the report.

Gisselle Martinez, 21, is a college student and bilingual health apprentice at the clinic. Between classes, she takes vital signs and demonstrates manual blood pressure checks in what the clinic describes as a trauma-informed manner. She is also certified in harm reduction, allowing her to run a needle exchange and distribute fentanyl test strips, and she understands how a patient’s trauma and past neglect can surface in an exam room.

Martinez said she spent much of her life translating for her Spanish-speaking parents at medical appointments. The responsibility sometimes felt overwhelming, she said, including when she did not know how to translate certain medical terms or when she had to explain anesthesia risks to her parents before undergoing the procedure herself. Through the apprenticeship, she is working toward becoming a certified nurse anesthetist.

New Mexico faces a broad shortage: 32 of its 33 counties lack sufficient healthcare workers, according to the report. Latinos make up 20% of the U.S. population but only about 6% of the physician workforce. Casa de Salud’s program requires bilingual apprentices; Colette Village Center, who developed the program and is from the Standing Rock Sioux Nation, said 100% of the apprentices are Latino and many are first-generation college students.

“You’re more likely to work in a community if you grew up in the community,” Village Center said. “We want to see more representation of lower-wealth individuals, under-represented individuals in healthcare, because that saves lives.”

Casa de Salud opened in 2004 after a local physician approached a group of promotoras, trusted liaisons between the community and healthcare workers, in Albuquerque’s predominantly Hispanic and Latino South Valley neighborhood. Lorraine Cordova, one of the clinic’s founders, said the women called themselves promotoras tradicionales and performed limpias, a spiritual cleansing common in the Mexican folk healing tradition of curanderismo that often uses herbs, prayer and intention-setting to process emotional stressors. The group met every few weeks at a gym in the South Valley and offered limpias, massage, reiki, accu-detox and other treatments.

Alejandra Casarrubias was among the apprenticeship program’s first students. She is now a registered nurse, a sexual assault nurse examiner and clinical manager at Casa de Salud. “You don’t only have to be bilingual, but bicultural,” she said, describing the importance of training providers who understand the communities they serve. The Association of American Medical Colleges says patients from minoritized races tend to fare better with doctors of the same race across metrics including infant mortality and compliance with healthcare plans, according to the report.

The clinic recruits apprentices from local colleges, the college assistance migrant program and a nearby high school that has historically provided the same training. Sebastian Hernandez, 19, a health apprentice studying biochemistry and film production, hopes to become an internal medicine physician. He said he already knew about Casa de Salud because his family used it in the past.

Many patients continue to use alternative medicines like those the founding promotoras offered. Village Center said patients are often disrespected for maintaining those traditions when they go to doctors, and the clinic still tries to teach health apprentices about the practices.

Editor’s Summary: Casa de Salud in Albuquerque, New Mexico, has trained more than 300 bilingual high school and college students as health apprentices since 2005 to help fill healthcare gaps in Latino and rural communities. The year-long program recruits bilingual, bicultural students, and the clinic says at least a third of tracked apprentices have entered healthcare. New Mexico faces a shortage in 32 of 33 counties, and Latinos remain underrepresented in the U.S. physician workforce.