Foreign-born doctors walk in Iowans' shoes

Imagine walking into a room where people communicate solely with inside jokes. This is what it may feel like to be one of the many foreign-born doctors now practicing in the United States. Although actually speaking English may never have been a problem, there is a certain code for conversation that varies from state to state, and Iowa is no exception.

Mark Grey and Michele Devlin Teach Cultural Competency Course

Photo courtesy of Mercy Medical Center-North Iowa

UNI professors Mark Grey and Michele Devlin teach a cultural competency course at Mercy Medical Center in Mason City, Iowa, to foreign-born doctors.

Two professors at the University of Northern Iowa, Mark Grey and Michele Devlin, have been teaching a cultural competency course at Mercy Medical Center in Mason City, Iowa, designed for foreign-born doctors. Each class is 90 minutes long and can range anywhere from learning how to make small talk with Iowans to learning about Iowa's history and traditions, crops and climate.

Devlin, director of the Iowa Center on Health Disparities, and Grey, director of the Iowa Center for Immigrant Leadership and Integration, have spent much of the last decade developing curricula on immigration and diversity issues for Iowa educators, law enforcement, social service providers and other groups.

About a quarter of all medical doctors in the U.S. are foreign-born, with the percentage often higher in rural areas. According to the federal government, in Iowa, 63 percent of the counties have a shortage of physicians; foreign doctors provide the backbone for many communities.

The necessity of these classes may seem confusing to some Iowans, but they are undoubtedly crucial for these doctors. With so many new foreign doctors becoming integrated into the medical community today, the need for these classes will likely increase. These physicians not only have to be able to make small talk with their patients, but also have to make the correct diagnoses, which calls for an understanding about how Iowans actually work. For example, one of the topics hit on in the curriculum is an understanding of the tendency for Iowans to understate the level of their problems.

"Iowa nice" is about bashful hospitality-- being modest, polite and understated. So Iowans are likely to underreport pain. "What isn't said can be as important as what is said," Grey observes.

The number of Iowa-born doctors who actually practice in Iowa is decreasing. Foreign-born doctors are becoming increasingly important in this state, as is the necessity for them to become accustomed to the culture. As push comes to shove, this so-called "small" talk has never been so big.