"Miami is not an American city with a Latin flavor — it is a Latin American city on American soil, with Haitian, Caribbean, and global communities woven through every neighborhood. Miller trains physicians who can care for all of it, in multiple languages, across multiple health belief systems."
"Jackson Memorial Hospital — the largest public hospital in the southeastern US — is Miller's primary teaching hospital. It serves Miami's uninsured and underinsured with extraordinary clinical diversity. Your training here will prepare you for global health before you leave the city."
"A Haitian Creole-speaking patient presents to Jackson Memorial with unexplained weight loss, night sweats, and fatigue. He delayed coming in because he feared both the cost and that a diagnosis would affect his immigration case. He has also been receiving treatment from a Haitian traditional healer. How do you approach this encounter?"
Practice this scenario with AI →Miami's Cuban, Venezuelan, Haitian, Colombian, and Nicaraguan communities have distinct political contexts, health profiles, and health-seeking behaviors.
voodoo healing practices have specific clinical interactions that require genuine curiosity, not dismissal.
it is not just a hospital but the clinical and ethical backbone of Miami-Dade's public health system.
Miami has a large uninsured population and the clinical ethics of uncompensated care at Jackson are central.
"In 14 years of examining I have never failed a candidate for giving the 'wrong' answer. I have failed candidates for how they treated the person in the room with them."
Miami is not just "Hispanic" — know the differences: Cuban Americans (primarily Republican, established, many born in US), Venezuelan newcomers (recent arrivals fleeing political crisis), Haitian community (complex immigration context, Haitian Creole NOT the same as French).
Know that Little Haiti in Miami has been under intense gentrification pressure, with health services being displaced along with residents.
Know that political context shapes health-seeking behavior — Cuban American patients and Venezuelan newcomers have very different relationships with government healthcare systems based on their experiences.
Haitian Creole is distinct from French — a clinician who speaks French cannot assume they can communicate adequately with a Haitian Creole-speaking patient.
Voodoo and Santería are genuine systems of healing with their own pharmacopoeia and ritual practices. Respectful engagement means asking what treatments the patient is already receiving, not dismissing them.
TB is more prevalent in recent Haitian immigrants than in other South Florida communities — clinical awareness of TB risk factors is appropriate.
Miami is sinking as well as flooding — the combination of sea level rise and land subsidence makes Miami one of the most climatically vulnerable cities in the US.
Know which Miami neighborhoods are most vulnerable: Little Havana, Liberty City, Overtown — all low-income, predominantly Black or Latino, all at risk of flooding before wealthier neighborhoods.
Environmental justice framing: the communities who contributed least to climate change are disproportionately exposed to its worst health effects. Practice applying this framework to Miami specifically.
The Haitian patient station was directly about a patient with untreated TB who had been using traditional remedies and feared that a diagnosis would affect his immigration case. Layers of barriers — language, immigration, traditional medicine, poverty — all in one case. Know each barrier specifically.
Miami's climate crisis came up in a station about which neighborhood should receive priority access to a new community health center when city funding was limited. Know Miami's specific vulnerable neighborhoods and why they're at highest climate risk.
UM Miller is genuinely multicultural in its clinical training. One station involved a patient using Santería alongside prescribed cardiac medications. They wanted to see whether I engaged the traditional practice with curiosity or dismissed it. Know what respectful integration looks like.