In choosing a doctoral program, study time in China was essential to me. Prior to starting my Chinese medicine education I had traveled to China for several years for martial arts and Daoist studies, and through the years I had the great opportunity to observe several older Chinese medicine practitioners. I actually considered attending TCM school in Nanjing for my master’s and doctoral degrees, but the path was too long – two years of intensive Mandarin studies, five years for the bachelor’s degree in TCM, three years for the master’s program, and then two years or more for the doctorate. Even with my enthusiasm this was too much to consider, as my goal was always to live and practice in the U.S.A.
There are now a number of programs that offer significant study in China as part of their joint DAOM/Phd degree. These include Five Branches, ACCHS, and ATOM. Yo San University is in the process of creating their program as well. I enrolled in the Five Branches program in 2016, finished the DAOM portion at the end of 2018, and I am about half way through the Chinese degree at Zhejiang Chinese Medicine University in Hangzhou, China.
In the Chinese portion of the doctoral program, I travel to Hangzhou to spend time in a variety of hospitals and clinics, over a dozen locations during my first two years of the program. As my focus is herbal medicine, I work mostly in out-patient clinics, some specialized in oncology (my specialty), and others in general medicine. I also have observation hours in one acupuncture specialty clinic with Dr. Feng Ninghan who I met in the Five Branches DAOM program. He practices a unique style of acupuncture called 9-Palace Acupuncture, and after spending several days with him in the US I knew I needed more. He treats all manner of patients, but the most intriguing is a group of young women with spinal injuries, and post-encephalitic disorders resulting in paralysis. I’ve seen remarkable results from his acupuncture treatments and tuina. Several of the patients were able to regain bladder control and found increased movement of their lower limbs over a period of several months, even after the western medicine doctors had given up hope.
All clinics in China generally work on the same shift system, 8:30am until 11:30am (but most doctors work until noon or 12:30pm), then lunch, and patients again from 1:30pm-4:30pm. The afternoon sessions also run late until about 5:30pm. Essentially, the shift ends when there are no more patients in the waiting room. Most days, clinicians see anywhere from 60 to 120 patients. In one month’s time interns may see over 1,000 patients. This is one of the primary reasons to work or observe in Chinese clinics and hospitals. The pace is frenetic at times, but the sheer number of pulses and tongues, and variety of illnesses one sees in a Chinese clinic would be difficult to match in even the busiest American clinic. Also, there is a very good chance you will see diseases that have been mostly eradicated in the US such as mumps. It’s very exciting to be able to order blood tests, x-rays and ultrasounds, send the patient down the hall, and have them return within hours with the results. Seeing TCM work in conjunction with Western drugs, including antibiotics and chemotherapy, at the hospital level provides a full appreciation of the integrative perspective.
One criticism I have often heard in the states from American practitioners is that the Chinese model is very westernized and overly formulaic. What I have observed is the exact opposite – all of my teachers and advisors practice very differently. Earth School, Fire Spirit School, Shang Han Lun and others are all well represented. Students will also see schools of practice that are not widely taught, such as the 9-Palace Acupuncture system mentioned earlier. Of course, you will find doctors who utilize the same points for most patients, or even doctors who use the same base formula for everything. But even in that style of practice it can be incredibly informative to watch how many disorders one can treat with a formula such as Gui Pi Tang. Most notably, all of my teachers and mentors are well versed in the classics and have no problem reciting passages from the classic texts. Unfortunately, in the American TCM school model so much emphasis is placed on the state or national exams and the safety of practice (all important to be sure) that very little time is spent on studying the classic texts, or Chinese philosophy and history. Our peers in China, even at the bachelor’s degree level, have extensive knowledge of the classics and continue to inspire my own scholarship, especially of the Shang Han Lun, Jing Gui Yao Lue, and other herbal texts that have yet to be translated.
One incredible benefit I found from studying in China was not just the improvement of my conversational Chinese language skills, but also my understanding of TCM terminology that I thought I understood very well. By working through terminology in clinic with translators and other student practitioners, and with hundreds of patients, my depth of understanding has increased significantly. Over time the English translations have disappeared from my vocabulary, and I have begun to think about the terms only in Chinese. The one or two word definitions that we are often taught do not come close to the meaning behind the pulse qualities or pattern differentiations.
It may be impossible to learn this medicine in one lifetime, but through intense immersions we can leap forward in both our understanding of the medicine and our clinical practice skills. Observing and practicing in Chinese hospitals affords one the opportunity to work with many skilled practitioners and a very large patient base. I highly suggest spending time in an organized, advanced learning program in China. It is difficult, and I’ve known people who wanted to quit after just a few days; however, the rewards far outweigh the difficulties, and your practice and patients will greatly benefit from your studies.
Our profession is at an important crossroads of integration. I strongly believe we should increase our partnerships with Asian medicine schools and hospitals in China, Japan, Korea, and Taiwan in order to better understand how Asian medicine and Western medicine can be successfully integrated to enhance patient outcomes. We can then apply that knowledge to our own hospital, university and clinic partnerships here in the States, thereby enhancing the understanding and acceptance of Asian medicine in this ever-changing medical landscape.