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Tiempo Pasado con Pena Recordado: Effects of Health Disparities in Latino Communities in the Southwest Region

In the famous words of Jorge Agustín Nicolás Ruiz de Santayana y Borrás, better known by his English name as George Santayana, “Those who cannot remember the past are condemned to repeat it.” This statement continues to be true throughout the history of our country, seeing similar effects of health disparities in the Latino community as well as the sociopolitical climate that Latinos and Latino medical students face in the Southwest region. The LMSA Southwest region comprises Arkansas, Colorado, Louisiana, New Mexico, Oklahoma, and Texas. In interviewing Latino physicians for this chapter, we found many similarities in their sentiments about health disparities. Systems that perpetuate health disparities have negatively impacted the health of our Latino communities; addressing these health disparities served as a driver for some Latinos to go into medicine. However, without support, we, as a community, are doomed to continue this cyclical effect of health disparities.

Since the annexation of the southwest regions’ constitutive states in the late 1800s, disparities have been documented in the health of the then newest Americans. Initial public health surveys by Dr. John Hunter Pope noted that South Texas needed “drastic improvements in housing stock, basic primary care, and working conditions” to protect the Mexican people from future epidemics that could impact the rest of the country [1]. Unfortunately, despite the recommendations to improve the health of its new citizens, Latinos continued to face similar issues early in the twentieth century. John Mckiernan-González comments, “social class and political powerlessness limited [Mexicans’] access to clean water, decent housing, food, and sanitation services,” and notes the impact these factors had on healthcare such as infant mortality rates that were, “three times higher for Latinos than for Anglos,” during this time [1]. Due to the lack of support of its new government, the Latino community began to mobilize and help improve its health situation. Latinos began to pool their money together to create sociedades mutualistas to address deaths, injuries, and illnesses; with one of the largest being the Alianza Hispano Americana, co-founded by Dr. Mariano Samaniego, which spanned far north to Colorado and down to South Texas, to address deaths, injuries, and illnesses [1].

From the time of the Mexican Revolution to the Great Depression, infectious diseases began to considerably impact those in the border communities. Additionally, local community members added racist ideology to these diseases, demanding “the United States Public Health Service differentiate healthy Mexican border-crossers [from] anyone who looked like a ‘dirty and lousy immigrant” instead of improving the local health system [1]. The El Paso community blamed working-class immigrants for being carriers of tuberculosis (TB), smallpox, and typhus. Immigrants were sent for “inspections, fumigation of their bodies and their property, and unwanted vaccinations,” setting an unwelcoming tone for Latinos interacting with medicine in America [1].

The unwelcoming tone continued during the Great Depression, where the idea of citizenship and public charge played an important role. During this era, the government used public funds to “move approximately half a million ethnic Mexicans to Mexico, regardless of citizenship.” Moreover, those that had “received public assistance through medical clinics or relief offices [while in the U.S.] were likely to be considered a public charge,” and would be denied return to the U.S.; adding a dimension of healthcare issues that Latinos would face alongside immigration [1]. Racial re-categorization served as an additional barrier for Latinos in receiving equitable care. In the 1930s dysentery and infant mortality rates were high in Latino dense neighborhoods of San Antonio, but TB rates were the highest reported in the nation [1]. Data from the Texas Department of Health showed “Latinos were dying of TB at five times the rate of their white neighbors and twice the rate of their African American neighbors.” [1] To help address the issue, Texas health officials changed, “the racial category for Mexicans from ‘white’ to ‘colored,’” which was met with outrage by the community as this did not address the underlying societal issues [1].

Post-World War II, in the mid-1940s, the U.S. began to implement progressive initiatives in medical education to help fill needs in the country. The country increased the construction of new medical schools and pushed for desegregation of medical schools, in an effort to increase the number of available Latino doctors [1]. Nevertheless, desegregation did not eliminate continued racial discrimination in the country. Dr. Héctor Pérez García, later mentioned in this chapter, was described as being denied residency in his home state. Working with the Veteran’s Administration hospital in Corpus Christi, Texas, he saw how race impacted the treatment of veterans of color – veterans were left in the halls waiting while there were vacant beds in the white wards. However, with his white coat, he was able to advocate and demand that “the hospital treat Mexican veterans like white patients.” [1]

Although the Civil Rights Movement brought racism and discrimination to the national forefront during the sixties, the advent of the sexual exploration showed there was still more work to be done in terms of health disparities. It was not until 1978 that Thomas McKeown first described the concept of social determinants of health, where he discussed the idea that the health of an individual had both biological and socioeconomic components [2]. Dr. Hector Chapa, an OBGYN faculty member at Texas A&M University College of Medicine, recalls his time as a medical student at the University of Texas Southwestern in the mid-1990s and saw the impact of social determinants of health in the Latino community he served.

Social determinants of health were present, the concept was there, but it wasn’t described. In medical school, I worked in Dallas county with a large indigent community. HIV/AIDS was still a death sentence at the time. These patients would come in with PCP, Meningitis, or Crypto and die. The patient demographics I saw would be skewed. A lot were undocumented and didn’t have access to these services. People were critically ill at the time. Diseases were characterized by ethnicities. There were illness presentations then, as there are now too, like diabetes, that disproportionately affected Hispanics. I noticed that these high-risk populations were always designated/grouped together not by disease processes or diagnoses, but by ethnicities. I grew up in Laredo, Texas. Not until I went to college, I learned other people had more than me growing up. In medical school, I learned that certain races and ethnicities were disproportionately affected by certain diseases and diagnoses [3].

The nineties brought its own set of health issues to the Texas-Mexico Border. This was a time of increased urbanization brought on by the maquiladora or assembly plants, a boom led on by foreign industries that wanted to make use of the low wages and operating costs in Mexico [4]. With the demand for low-income housing brought on by the increase in population rates for the region, landowners took advantage of the abundant supply of idle agricultural fields to sell plots of land for people to build their homes [4, 5]. The new homes in these lots are what spurred the growth of the colonias in South Texas. Due to lax development regulation, people bought these pieces of unincorporated land, sacrificing access to portable water, sewers, utility services, and paved roads, which led to the creation of health issues such as waterborne illnesses among others [4, 5]. Access to ambulances, firefighters, police, or other city infrastructure became an issue in these communities because the “responsibility for colonias [became] complex due to the considerable ambiguity surrounding government and service provider jurisdictions.” [5] Moreover, the access to healthcare was limited to those living in colonias, as few hospitals were able to care for low-income individuals, referring patients to hospitals miles away [5].

Apart from the issues brought on by urban and colonia development, maquiladoras proved to cause issues among its workers. Maquiladoras exposed its workers to “poor ventilation, few rest periods, excessive noise levels, unsafe machinery, … and exposure to toxic chemicals and carcinogens.” [6] These working environments led to health conditions such as depression, pulmonary issues, eye problems, dermatitis, and hand injuries, among many other devastating ailments [6]. Unfortunately, these health issues fell short of the femicides that made national and global news. Women made up about two-thirds of workers in the maquiladoras, and were thought to play the role of “the ‘liberation’ of women from the household and their dependency role.” [4] Unfortunately, growing rates of murdered women and failure of “the state to provide murdered women—and their families—rights and justice”, challenged women’s newfound freedom [7].

Dr. Chapa has noticed that over time, health issues in the Latino community have improved [4]. Medical schools continue to create initiatives to diversify medicine and train physicians to address health disparities in the country. However, some issues that the Latino community faced in the past, including but not limited to overt Latino discrimination, sexism, and immigration, has continued to play a prevalent role today. Dr. Chapa stated, “While improving, it remains critical for us to look back at history and continue to reassess issues not addressed so that we can play an active role in improving the health equity of our underserved Latino communities.”

Ni De Aquí, Ni De Allá: The Ever Changing Border of the South and Its Role in Identity

The sentiment of not belonging is a common thread amongst medical students, particularly those from underrepresented backgrounds. Latino medical students face impostor syndrome as they step into the classroom, feeling different from their peers, whether it be because of differences in ethnicity, race, gender, or socioeconomic status (amongst some of the feelings) [8]. Furthermore, some reflect on the idea of feeling like outsiders since they were young. The concept of ni de aquí, ni de allá, highlights the struggle that bicultural students face when both groups they belong to challenge their identity. The concept is most interesting in the Southwest region, where many Latinos stress the idea that the border crossed them not the other way around.

The Southwest has faced several political and geographic transformations in comparison to other parts of the country. The U.S.-Mexico border evolved considerably throughout the years with the colonization by the Spanish and French, later having established countries such as Mexico and Texas, and having its border finalized by the Treaty of Guadalupe Hidalgo after the Mexican-American War in 1848 [9]. This long history of Spanish and Mexican rule in the region thus forms identity issues that differ from those found in other regions of the country such as the Northeast. Moreover, Louisiana, unlike other parts of our Southwest region, was controlled by Spain for 4 years, but “the culture and society of Louisiana remained French,” due to its long history of French control [9].

Post-Treaty of Guadalupe Hidalgo, many “former Mexicans suddenly became U.S. citizens” becoming the new Latinos in the nation, with “86% of the nation’s new Latinos [living] in New Mexico, which remained the only dense concentration of Latinos in U.S. territory for many years.” [9] This sudden change in identity has had lasting impacts on not only those that continue to live there but also new immigrants that enter. Dr. Mary Headley Treviño de Edgerton was one of the first few Latina physicians recorded in history to have gone through discrimination of belonging and being accepted in the country. Despite being one of the “first Tejanos to attend medical school in Texas … at the University of Texas—Medical Branch in Galveston… [and] graduating at the top of her class and receiving the highest grade in the state medical exam in 1909,” there was not a county medical association that would allow her to practice other than her home county of Starr, on the Texas-Mexico border [1]. Although Dr. Headley Treviño de Edgerton struggled to find a job in the U.S., her story was not unique during this time. Between 1890 and 1920, “the [number] of Latino doctors trained in American medical institutions fell,” as did physicians from other underrepresented groups in that time [1].

Wartime brought more Mexicans to the U.S. during both World War I and II with the introduction of programs like the Braceros program to offset labor populations that went off to war [9]. Postwar time would follow cycles of discrimination where American workers felt as though Mexicans were taking away their jobs. The sentiment was followed by xenophobic rhetoric in favor of restricting immigration [10]. These emotions bled into the educational system that children of immigrant workers would enter. Muñoz notes how the American educational system encouraged students to assimilate into the American way, showing students the “‘virtues of American democracy,’ [and] that Mexican culture was a major factor in the “backwardness” of Mexican Americans.” [10]

Dr. Héctor Pérez García was a physician that grew up in South Texas during these times, attending a segregated Mexican school. Similar to Dr. Headley Treviño de Edgerton, through his hard work he graduated cum laude from the University of Texas Medical Branch—Galveston in 1940; however, “every hospital in Texas rejected him because he was ‘Mexican.’“ [1] He returned to South Texas in 1946 after he acquired a residency in Omaha, Nebraska and after volunteering for the Army Medical Corps in World War II, he secured a job in the Veteran’s Administration hospital in Corpus Christi, the only hospital that provided him visiting privileges [1].

These discriminatory attitudes persisted for many decades. Dr. Carlos Campos, a family physician in New Braunfels, TX, remembered the impact of Latino discrimination in his journey into medicine. Dr. Campos recalls growing up in a segregated town, which inspired him to go into medicine so that he could go back to his hometown and help those neglected in his community. Dr. Campos graduated from Baylor College of Medicine in 1981. During his time, not only did he experience rejection from segregation in New Braunfels, but he still vividly recalls being unwanted by a Mexican patient, a person of a similar background he hoped to serve.

As a third-year medical student, I rotated at Kelsey Seybold. I had a patient, a Mexican lady, from Mexico City. When I went in to introduce myself, she said, ‘I didn’t come to Houston to see a Mexican doctor. I came to see a white doctor.’ I still remember my attending, who later went in to talk to the patient and told her, ‘If you don’t want to see my medical student, you can grab your stuff and leave. He is part of my medical team and will see you as well.’ After that, the patient grabbed her bag and left [11].

A few years later, Dr. Carrie Byington, a graduate of Baylor College of Medicine in 1989 and current Executive Vice President and Head of the University of California Health, recollects similar sentiments of not belonging as a medical student.

As a woman and Latina, the first time I saw LMSA was as faculty at the University of Utah. I appreciated how much advice people had for pre-meds. I could have used all those things. I always felt alone. When applying to medical school, I didn’t have anyone to go to. It was a lonely process, anxiety-provoking. I couldn’t judge how to get in. I couldn’t imagine how interviews would go. It was all a surprise. Felt lucky I got in and made the best of it [12].

As noted by Dr. Byington, being Latina and the first to go to medical school, or for that matter, college, poses another dimension worth considering. Dr. Maria del Carmen Espinoza, a graduate of the University of Texas Health Science Center at Houston in 1995 and currently a private practice pediatrician, discusses her experience wanting to go to medical school.

When I was young, even though I always wanted to be a doctor, I was the only girl in my family. I came from a family that had never had anybody go to college… When I told my dad I wanted to go away for school [college], he asked ‘Why don’t you just stay here and become a secretary?’ [13]

Being the first in your family to pursue higher education comes at a cost. Not only is it unknown to the student, but it is also new territory to family members. Discouragement may not necessarily stem from disparagement of a student’s skills, but rather from fear of the unknown. The Latino community has roots in communal traditions. Sometimes Dr. Espinoza found it difficult to explain why she would be absent from so many family functions.

They didn’t understand that I was constantly studying, pretty much 24/7. It was a challenge with the family events. I would have to say ‘I can’t go. I can’t go to this because I have to study.’ [13]

Despite Latinos becoming the largest non-white minority group in the country, Latinos continue to be marginalized and underrepresented in medicine. According to AAMC data from 2019 to 2020, 7.6% of matriculants in Texas identified as Latino or Hispanic, whereas 39.6% of the Texas population identifies as Latino or Hispanic [14, 15]. Additionally, even though the number of medical school matriculants from underrepresented groups has increased by 30% nationally from 1997 to 2007, there has been an unfortunate 16% decrease in URM matriculants due to the overall increase in the first-year medical school slots [16].

Medical schools have learned to appreciate the value of diversity in the physician workforce and have attempted to address the low rates by creating pipeline programs. For example, Baylor College of Medicine and the University of Texas – Pan American, now formally known as the University of Texas Rio Grande Valley (UTRGV), created a BS to MD partnership initiative in 1994 to increase access to medical education for residents in South Texas. By 2008, the program produced 134 medical school matriculants, with 82% identifying as underrepresented racial and ethnic minorities and 79% identifying as Latino [17]. They also produced 65 MDs to date, 55 of which were Latino [17]. Dr. Monica Verduzco-Gutierrez, a graduate of Baylor College of Medicine in 2005 and Department Chair of Physical Medicine and Rehabilitation at UT Health San Antonio, was part of a similar pipeline program. Dr. Verduzco-Gutierrez notes her experience in the program and its importance in diversifying the physician workforce.

There were always barriers to getting into medicine. Coming from one of the most impoverished areas in the US, the Rio Grande Valley, I didn't have the best high school education. College was hard for Latinos with a lot of competition. Plus, there we were not rich, so it was hard to access the MCAT courses. I have many Latino friends from undergrad who wanted to be physicians, but lack of privilege, systemic Hispanic discrimination, and poverty basically blocked them. I was in a pipeline program and was very grateful for that. Most of the Latino (and other URM) students in my medical school class were from pipeline programs. And for the most part, we may have had our struggles, but we made it out as outstanding physicians [18].

Being a Latino medical student poses identity struggles through the lack of shared experiences with peers or mentorship from individuals of the same background. Moreover, growing up in a country where one’s nationality is put into question, the medical school classroom intensifies the feeling of not belonging. Fortunately, organizations such as LMSA, have helped to create a space of shared experiences that allows for students to thrive.

En Búsqueda De La Igualdad: Texas Student Chicano Movements for Educational Equity

The 1960s was a time for revolution and organization to create change against discriminatory actions against minority populations. In particular, the Chicano movements inspired many youths to take action into their hands. During this time, textbooks had omitted contributions of Mexican Americans, and teachers reprimanded students for speaking Spanish [19, 20]. School officials encouraged Latino students to “pursue manual labor jobs, learn a trade, or join the military” if they were male and consider lives as homemakers if they were female instead of encouraging them to go to college like their Anglo peers [17]. Students were chastised at higher rates than their white classmates for similar issues such as the length of skirts or sideburns [14]. These unfair treatments were absurd, as Mexican-American students made up about ninety percent of the student population [17].

Latino parents recognized the discrimination in schools and many did not hesitate to give their children a better chance at education. Dr. Rodolfo Molina, a Baylor College of Medicine graduate from 1976 and current rheumatologist at a private practice, recollects his memories of when his family moved in search of better schools.

My dad moved our family to Corpus Christi because he didn't feel like Robstown, Texas was an appropriate place for his kids to grow up or have opportunities. I lived in a part of Corpus that was mostly Latino with some African Americans - almost no ‘Anglo’ people. In Junior high, my dad moved us to the ‘white’ side of town so that we could go to better schools. I felt like an outsider in the mostly white classrooms. I credit this move with helping meet one of my best friends, and helping me get into college. I was second in my family to go to college. My sister, just 2 years older was the first [21].

Unfortunately, not all students were as lucky to have the ability to change districts or cities. Students eventually mobilized and pressured school officials to set up meetings to address their grievances. Sadly, administrators and board members refused to listen to student demands [17]. Chicano students’ frustration thus fueled their ambition to take action into their own hands. Similar to the Los Angeles Walkouts, many cities throughout the country were inspired to voice their concerns about the American education system. For example, two high schools in South Texas, Edcouch-Elsa High School and Crystal City High School had walkouts in 1968 and 1969, respectively [17, 20]. Despite their efforts, both walkouts resulted in different endings.

The Edcouch-Elsa High School students received advice and support from the Mexican American Youth Association (MAYO), a San Antonio Chicano student group. MAYO’s preferred tactic was the walkouts, in order “to drastically lower a school’s average daily attendance and thereby reduce its educational funding” as a method to force the schools to give in to student demands [17]. After the first day, the principal warned students they would receive a “three-day suspension and be subject to action by the school board” as a way to stir up fear and break up the walkouts [17]. On the second day of student protests the school principal called sheriffs to arrest students [17]. The protests escalated and eventually the school board opened meetings with students involved in the walkouts.

R.P. (Bob) Sánchez, an attorney from nearby McAllen, worked with the Edcouch-Elsa High School, supporting their cause. In an interview with The Monitor, the local newspaper in McAllen, he said:

Our forefathers gave us some civil rights which the poor, downtrodden Mexican American students are just now waking up to and thank God they are.

Despite his support, the school board did not meet students’ request and expelled vital participants of the walkouts [17].

The story ended on a lighter note in the Crystal City walkouts a year later. Students went to their school board requesting fair treatment but found it challenging to make meetings to meet with the board. Texas senators got involved and took students to Washington D.C. to talk with “officials in the Civil Rights Division of the Department of Justice and the Department of Health, Education, and Welfare [and discussed] the serious situation in Texas.” [20] Through their struggle, school officials met student demands in 1970 [20].

These student movements continued throughout the nation, inspiring each other to bring about change in the educational system of Latinos. In 1969, all national groups, such as MAYO, came together to create the Movimiento Estudiantil Chicano de Aztlán, also known as MEChA [9]. Without the valiant efforts of these student groups in the late sixties, our educational system would not be where it is today. Although the effort to increase Latino representation in higher education continues, and more importantly to the theme of the book Latino physicians, we look back at these Chicano movements to resume their work for educational equity.

La Llamada A La Acción: The Formation of LMSA Southwest

With the Chicano Movement’s push for equity in education, the rates of students pursuing higher education increased. In interviewing physicians, few people recall knowing of organized Latino medical student groups in the 1980s in the Southwest region. However, this makes sense with the slow increase in Latinos in professional careers. Initial groups were geared to URM medical students, such as the Student National Medical Association (SNMA), which Dr. Hector Chapa participated in and which allowed him to be in a more encouraging and inclusive environment that provided mentorship [3]. Similarly, in New Mexico, Dr. Patrick Rendon, a graduate of the University of New Mexico (UNM) School of Medicine in 2009 and now an Associate Professor, was part of the Association for the Advancement of Minorities in Medicine because there were no organized Latino groups [22].

As Latino populations began growing and seeing the need to address Latino student specific-issues, organizations began to emerge. Dr. René Salazar, former Assistant Dean for Diversity at Dell Medical School, mentioned his involvement in the Texas Association of Latin American Medical Students. Dr. Salazar attended the University of Texas Health Science Center at San Antonio, graduating in 1999. He mentioned some of the issues students faced during this time were the lack of close-knit mentorship groups from people that looked like them as well as class retention [23].

These Latino student groups allowed learners to have a safe space to grow and motivate each other through the struggles of medical school. Many students were motivated to come back as faculty in medical schools and to provide mentorship to students and lead diversity efforts at their institutions. Dr. Valerie Romero-Leggott, a graduate of UNM School of Medicine in 1992 and current Vice President for Diversity, Equity & Inclusion for the UNM Health Sciences Center, notes the importance of these affinity groups.

Although an organization like LMSA or SNMA did not exist while I was in medical school, I have a true appreciation for how important these organizations are in supporting students. They are a place to celebrate identity, culture, language, and belonging. You look for that. You yearn to feel a sense of community and belonging. It doesn't matter where you're from, these similarities bring you together. Mentors are another critically important part of medical student success, actually life success. We have all been the beneficiaries of mentors; many of whom did not have opportunities but made sure that we did [24].

Over time, students realized that these Latino student groups were all on the same mission. Dr. Anthony Oliva, a graduate of the University of Colorado School of Medicine in 2009 and now Assistant Professor of Anesthesiology played a vital role in the unification of all these Hispanic chapters across the nation. Attending the National Hispanic Medical Association (NHMA) conference in 2001 inspired him to take action in uniting Latino medical students across the nation.

I attended the NHMA conference my first year of medical school. I didn’t know about the Latino student group that existed throughout the country, for example, ULAMS [the United Latin American Medical Students] in Texas, the Chicano Medical Student Association, and the Boricua Health Organization in the Northeast. I solicited to become an officer right away, and with the help of the national president at the time, Omar Rashid, and Dr. Elena Rios, President & CEO of NHMA, we worked in unifying the regions into the National Network of Latino American Medical Students (NNLAMS). Later I became president-elect and worked on having a unified nomenclature for all Latino student organizations to adopt. We wanted to work on the NMA [National Medical Association] and the SNMA model with NHMA, but we ended up adopting LMSA as the name [25].

With his hard work and other Latino medical students across the nation, NNLAMS held its first conference in conjunction with NHMA in 2006 [26]. NHMA and NNLAMS held conferences for a few years. However, in 2009, the NNLAMS Executive Board of Directors unanimously voted in favor of an independent National Conference as well as the common name of the Latino Medical Student Association [27].

Dr. Oliva helped to bring the Southwest region into the spotlight with his national presence, precipitating its start in 2007. Unfortunately, despite the unification of LMSA as a national organization, the Southwest region of LMSA historically suffered from a lack of communication and high officer turnover, among other factors [28]. The lack of strong leadership in the Southwest triggered the region to be fragmented and lose communication with the national organization shortly after the 2007 National Conference [28]. Although the population of the Southwest at the time was roughly a quarter Latino, many of the medical schools in the region did not know about LMSA [28]. Surviving chapters had motivated students that kept their individual LMSA entities afloat. Over time, the number of chapters increased and they eventually reached out to the national organization [28].

Dr. Ray Morales played a vital role in bringing back LMSA to the region in 2011. He contacted LMSA chapters at the major medical schools in the Southwest region leading efforts to hold face-to-face House of Delegate meetings to reconnect the region and centralize communication [28]. Dr. Ray Morales met with chapter leaders on November 5, 2011, at the University of Texas Southwestern [28]. With his help, the LMSA SW Regional Board drafted a constitution and reconnected the region to the national LMSA network, and most importantly, the students from various medical schools across the Southwest region [28].

In 2012, several Southwest regional officers (Table 5.1) attended the National LMSA Conference in Boston and the Garcia Leadership & Advocacy Seminar (GLAS), coming back inspired and with a vision for the future of the Southwest region [28]. GLAS was a leadership seminar created to commemorate Dr. Héctor Pérez García’s work in civil and educational rights of Mexican-Americans, being appointed into Commission on Civil Rights in 1968 and the the first Mexican-American to serve as an ambassador to the United Nations in 1987 [29]. Attending these meetings served as essential learning experiences to help LMSA Southwest organize its first national conference in 2012 [28].

LMSA Southwest held its first regional conference on October 13, 2012 (Table 5.2), with the help of the Doctors Hospital at Renaissance [28]. The theme was Salud En La Frontera: Inspiring Future Leaders Through Mentorship and Education. The conference topic helped to reflect, “the culmination of many months of hard work from the conference organizers and the potential for growth in our region.” [28] Through hard work, the first conference attracted over 75 medical students from various medical schools in the region and 30 undergraduates from the University of Texas – Pan American [28].

As the region gained momentum, the Southwest region hosted its first National Conference on April 2014, co-hosted by The University of Texas Health Science Houston, now known as McGovern Medical School, and Baylor College of Medicine [28]. This conference helped to demonstrate the infrastructure the Southwest Regional Board predecessors established for Latino medical students in the region to the national organization.

Slowly, LMSA Southwest began expanding outside its Texas borders, adding chapters from Louisiana in 2016 and 2017 (Table 5.3). Motivated by the previous conference, Davis Mas, chapter president at the time and three-time Regional Chief Development Officer, from Louisiana State University Health Sciences Center (LSUHSC) New Orleans pushed his institution to host the sixth regional conference in 2018. He and other students believed it was an ideal location due to the city’s “plethora of diverse ethnicities and identities along with a top-class hospital” [30]. This conference was monumental for the region holding its first conference outside of Texas, as well as having to move the conference from LSUHSC to the University Medical Center within a few days’ notice due to inclement weather [30]. Despite this setback, the conference was successful at attracting 60 medical students along with pre-medical students [30].

The conference also highlighted a year of growth for the Southwest region, expanding chapters to two states, Arkansas and New Mexico. Similar to LSUHSC New Orleans, R. J. Parkinson, a medical student at the New York Institute of Technology (NYTI) College of Osteopathic Medicine at Arkansas State University, was inspired by attending an LMSA Southwest regional conference to create a chapter.

Our school was pretty new. We had students from Texas, Florida, and Southern California. The reason why we started our LMSA chapters was that we wanted a club where we could talk in Spanish and celebrate the Latino culture. Majority of our Spanish-speaking populations are migratory farm workers in northeast Arkansas. I have seen patients that only spoke Spanish, probably one of the few that could at school. I’ve encountered patients whose eyes light up when they see someone that could speak their language. Although I’m not Latino, having someone that shares or understands your culture helped the patient encounter [31].

His chapter elected him chapter president for his exceptional leadership and strong advocacy for Latino communities, inducting the chapter into the Southwest region in 2018.

In 2019, LMSA Southwest had the opportunity to host once again the National LMSA Conference at Texas Tech University Health Sciences Center School of Medicine in Lubbock, Texas. The conference was a resounding success with over 350 attendees from across the country [32]. Apart from its successful attendance, the Southwest region continued to grow its outreach to more states in the region, inducting the University of Colorado School of Medicine. Additionally, LMSA Southwest began to inspire and work with undergraduates to help increase mentorship with the addition of two LMSA PLUS chapters, one at UTRGV and the other at Texas Tech University.

Despite LMSA Southwest’s flourishing momentum, the lack of communication and the announcement of officer turnover, shook the region at the end of 2019 and start of 2020, repeating errors from the region’s early start. However, through extraordinary leadership from Dr. Christian Aquino and Isabel López-García, the Southwest Regional Board was able to hold its eighth annual regional conference at UTRGV School of Medicine. The conference was titled “Identidad Latina: Soy más que…” which explored the intersectionality of Latino identity. The speakers and workshops “allowed participants to challenge the stereotypes that may be associated with Latinos in the medical field.” [33]

The LMSA Southwest region has built community partnerships for health fairs, scholarships, and research symposia and continues working to engage all students about health in our underserved communities and professional development. The culmination of hard work from many individuals has helped the Southwest increase in the number of members as well as increase connections between various institutions. Despite its short organized presence in comparison to other LMSA regions, the Southwest region has left a lasting impact in its chapters and LHS+ medical students through a shared space of experience and encouragement to become leaders in medicine.

Table 5.1 List of Southwest Co-Directors
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Table 5.2 list of regional conference title and host schools and institutions between 2012 and 2023
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Table 5.3 List of States and School Chapters (stand alone or connected) in the LMSA Southwest Region (as of December 2022)
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