Spanish-Speaking Resident Physicians in the United States: Aligning Workforce Skill and Population Need.

The growing Spanish-speaking population in the United States experiences disparities in healthcare access and quality due to frequent language discordance between patients and physicians. Prior research has highlighted a deficit in US Spanish-speaking physicians, but the existing Spanish-speaking physician workforce has not been well described. This study aimed to characterize the profile of US Spanish-speaking first-year resident physicians and their distribution relative to the Spanish-speaking population. We conducted a secondary analysis of language data from 107,610 first-year resident physicians between 2021 and 2024, using data from the Association of American Medical Colleges and the Accreditation Council for Graduate Medical Education. Of 107,610 physicians, 46,935 (43.2%) reported speaking Spanish at any level. The largest proportion of Spanish-speaking physicians reported basic proficiency (43.7%, 20,504/46,935). Only 22.7% (10,661/46,935) self-assessed as advanced/native, the levels most consistent with language-concordant care. Physicians who acquired Spanish as a heritage language were likelier to report advanced/native proficiency compared with non-heritage learners (adjusted odds ratio, 44.1 [95% CI, 40.2–48.5], p<.001). However, most Spanish-speaking physicians were non-heritage learners (84.4% 26,590/31,511). Geographic analysis showed a modest relationship between advanced/native-Spanish-speaking physician distribution and county-level Spanish-language need (Pearson r = .596). Given the prevalence of physician Spanish-language skills at varied proficiency levels, health and medical education systems should establish clear, evidence-based standards for qualified multilingual clinicians to ensure safe, high-quality care that meets population language needs.