Introduction: Policymakers have recommended recruiting and/or training more US physicians who can provide care in Spanish. Few longitudinal medical Spanish programs have been described and evaluated. Aim: To describe development and evaluation of the preclinical phase of a fouryear program designed to graduate physicians who can provide languageconcordant care in Spanish. Setting: One public medical school in southeastern US. Program description: The program targeted intermediate/advanced Spanish speakers. Standardized fluency assessments were used to determine eligibility and evaluate participants' progress. Curriculum included didactic coursework, simulated patients, socio-cultural seminars, clinical skills rotations at sites serving Latinos, service-learning, and international immersion. Program evaluation: For the first two cohorts (n=45) qualitative evaluation identified program improvement opportunities and found participants believed the program helped them maintain their Spanish skills. Mean interim (two-year) speaking proficiency scores were unchanged from baseline: 9.0 versus 8.7 at baseline on 12-point scale (p=.15). Mean interim listening comprehension scores (second cohort only, n=25) increased from a baseline of 77% to 86% (p=.003). Proportions passing the listening comprehension test increased from 72% to 92% (p=0.06). Discussion: We describe development of a longitudinal Spanish program within a medical school. Participation was associated with improved Spanish listening comprehension and no change in speaking proficiency.