My Speech Pathology Externship in Puerto Rico

By Arielle Mayer
With the support of the graduate Communication Sciences and Disorders department, I was fortunate enough to recently complete a five-week externship in Puerto Rico. The opportunity was appealing to me because my ultimate professional goal is to be able to work as a bilingual speech pathologist. My Spanish experience has been primarily academic — I obtained a second major in Spanish Language Literature and Culture at Molloy — so I wanted to gain more experience speaking the language in the clinical setting. During this externship, I worked with adults in several settings including acute care, inpatient rehab, and a private practice.

My experience in Puerto Rico exposed me firsthand to the cultural differences as well the differences between the healthcare systems there and in the United States. Puerto Rico is considered a commonwealth and therefore part of the U.S.; however, many Puerto Ricans identify more with the Latin culture than with that of the mainland. The majority of doctors in Puerto Rico receive their education and training in the United States. Additionally, all of the medical facilities in Puerto Rico are required to meet the same healthcare standards as U.S. facilities. However, due to lack of resources, many healthcare professionals are unable to perform procedures utilizing the newer techniques in which they have been trained. Thus, they rely on older methods in order to treat their patients.

As a speech language pathologist, I was affected by the lack of medical resources as well. At Molloy’s Speech, Language, and Hearing Center, we have access to some of the most cutting edge instrumentation available. Not many clinicians in the U.S. have access to technology such as an ultrasound; however, I was fortunate enough to have spent an entire semester utilizing this instrument while treating clients. In Puerto Rico, I ultimately ended up learning how to diagnose and treat clients without being able to rely on these materials. Many of the standardized tests used to diagnose speech and language disorders are not normed in Spanish. Norm referenced tests are designed so that you can compare your current patient to the performance of other test takers in order to determine the severity/presence of their deficits. The fact that these tests aren’t normed in Spanish presents a problem because it won’t give you an entirely accurate diagnosis of your client. Therefore, I was required to become much more resourceful. My supervisor created all of his treatment materials by himself, often on the spot in front of a patient. As a result, I was required to do the same. While this was extremely daunting at first, I realized that it eventually helped me hone my clinical judgment and become a more adaptable clinician.

I feel that this experience completely pushed me out of my comfort zone. In addition to this being my first experience working with adults in the hospital setting, I was required to practice in a nonnative language. I learned so much about myself and about my profession in the process. I am so thankful to the Communications Sciences and Disorders department for supporting me throughout the entire externship process, and to the Modern Languages department for helping me develop enough proficiency in Spanish so that I could experience such an amazing professional opportunity.

Image courtesy of Arielle Mayer