Demand for medical Spanish courses has grown with the rising needs of Spanish-speaking patients in the United States, but while there is no shortage of beginning medical Spanish textbooks, very few target the intermediate level. This article examines eighteen medical Spanish texts published in the last twenty years with respect to seven factors: 1) targeted proficiency level, 2) vocabulary, 3) oral and aural activities, 4) grammatical concepts, 5) pertinent cultural and sociolinguistic information beliefs, 6) pragmatic concepts, and 7) real-world situations. Although studies have shown negative medical outcomes associated with health providers' limited Spanish proficiency (Derose and Baker 2000; Diamond and Reuland 2009; Flores et al. 1998; Manson 1988), most texts currently aim at beginning levels. Only six of the books are designed for intermediate-level students, and only three offer communicative activities targeting oral proficiency, even though oral and cultural skills have been prioritized for prehealth professionals (Lepetit and Chicocki 2002). Likewise, cultural information is often relegated to simplified paragraphs. Beginner textbooks vary considerably and generally do not offer communicative oral activities or adequate cultural information. Recommendations are offered for improvements in future intermediate textbooks with respect to each of the targeted categories. (Contains 7 notes and 2 tables.)