Residency Program Teaches Cultural Sensitivity

Growing culturally-competent doctors

Mayra Mendoza Dillon, MD, chief resident of the Scripps Family Medicine Residency program for the 2010–2011 academic year, is a Southern California native whose parents emigrated to the U.S. from Mexico.

Like other graduates from top American medical schools, she is completing her training in the Scripps Family Medicine Residency program. Half of the current residents in the program are members of underrepresented minorities, mostly bilingual and bicultural Latinos.

Of the 36 residency graduates to date, 80 percent are providing primary medical care in San Diego County and more than 70 percent are practicing in designated areas of unmet need in California.

Dr. Dillon is particularly proud of “Centering Pregnancy,” a curriculum she helped launch in 2009. “Prenatal care, which also includes fathers-to-be, is something we strive to start very early in pregnancy,” she says. This interactive prenatal education group teaches eight to 10 women and their partners about breastfeeding, stress in pregnancy, diet and exercise, domestic violence and post-partum depression, among other topics.

“Centering Pregnancy has been a huge success,” Dr. Dillon says. “The pregnant mothers have a wealth of information to share with each other. They do most of the talking and the clinicians act as group facilitators. The bond between women is incredible.”

Among the most important long-term benefits of the program is the number of culturally-competent physicians that it is producing. "There are Latino cultural practices that you just don’t learn in medical school. For example, Latinos favor traditional and alternative treatments, such as nopales, a type of cactus, to treat diabetes. I know cactus alone won’t work, but I can be sensitive to my patients’ desire to include cactus in their treatment plan,” explains Dr. Dillon. “The better a doctor knows the culture of their patients, the better the doctor will be at providing quality guidance, like nutritional information centered on traditional Latino diets of tortillas, rice, beans, fruits and vegetables.”

By training in their patients’ homes, Scripps medical residents learn that they can’t just offer Latinos standard information about the traditional American food pyramid, because they won’t follow it in their diets. Kendra Brandstein, director of Community Benefit Services at Scripps Mercy Hospital Chula Vista campus, says, “The program has improved the cultural competency of our health care providers so they can better understand the needs of the communities they serve.”