Hua Hai 海华, MD, PhD (Class-77)
Boston, MA

We graduated from a historically well-known medical school, where we made great efforts in studying modern medical sciences and clinical diagnostic/treatment skills. Naturally, once we made decision to practice medicine in the USA, every single one of our alumni would aim at the Western medicine path. And the record of our overseas alumni during the past 10 – 20 years has proven that our medical training at Xiangya is solid and well-done. The Xiangya’s education has nurtured so many outstanding clinicians in the US.

However, we are also the first generation of immigrants in the US. We have to face many, many incredible hardship and obstacles in our settlement here, e.g. study, work, legal immigration identity, job hunting, family life, etc. Most alumni had to struggle for nearly or over 10 years, including the extremely harsh residency, to finally obtain the full medical license in US. During such an arduous long journey, many of us (especially female alumni) had been in the dilemma: struggling all the way to reach the goal, or compromising career for raising children, for taking care of family, or for saving health? Some alumni had to make the painful decision of giving up their MD dream.

When one door closes, another door opens. This may sound trite, but we all know it is true. For those who could not enter or go through the MD path, I’d like to share with you my personal opinions in an alternative professional direction: practicing Traditional Chinese Medicine (TCM) in USA. I graduated from Xiangya in 1982 (“class 77”), and have been studying and working in Canada and USA since 1990. Half of my career has been spent in Western medicine, and another half in Eastern medicines. I have worked in Western medicine and TCM universities, hospitals, research labs and biopharmaceutical company, as a TCM practitioner, Western medicine physician, medical school teacher, post-doctoral fellow, or biotech scientist. I have settled down with practicing at my own TCM clinic in Boston since 2004. Therefore, I have had the opportunities to experience and compare the two medical systems.

The reasons I encourage our alumni to consider TCM practice as an alternate career are as follows:

1. TCM is a unique and cost-effective medical system. Its treatment methods are natural and holistic, which meets modern American’s desire of “Return to Nature”. Not only millions of ordinary Americans are seeking TCM for health care, but also more and more US hospitals and MDs are incorporating acupuncture into their practices, or encouraging and referring patients to take alternative medicine. Therefore, the TCM market in USA is expanding, and you will have great potential to build up a successful practice. 
2. To practice TCM in the US, you need to complete a 3-year Master program in acupuncture or in oriental medicine (i. e. acupuncture + herbal medicine) at a US accredited school. However, comparing with Western medical schools, TCM schools in the US have lower entrance standards, so your admission is usually guaranteed. In addition, as well-trained medical school graduates, our alumni are eligible for exemption in all science and Western medicine courses, such as anatomy, physiology, chemistry, microbiology, and various clinical courses. If you have advanced medical research experiences, e.g. you have a Master or PhD degree, with a few first author publications, all your research courses will also be exempted. These exemptions mean a tremendous saving in your time and money during the schooling. 
3. TCM education in US does not require medical residency. This offers a super feasibility for those alumni who have to carry job and family double burdens with little or no support from spouse or parents, or those who have healthy issues to survive the harsh residency.
4. TCM certification requires 3 modules of board examinations: Clean needle techniques, Acupuncture (including written part and point location part), and Biomedicine (i.e. Western medicine). If you want to practice herbal medicine, you have to pass the Chinese Herbology board, too. Based on my own TCM board exam experiences, I felt most questions, including the 50 Biomedicine questions, were short and straight forward. Majority of candidates handed in their exam paper ahead of time.
5. Setting up TCM practice is much easier than starting a Western medicine private practice. You don’t need dealing with any department/people for registering your practice in town. The startup expenses and routine business overheads are all dramatically lower, because the lab, complicated equipment/machine, medical/office staff, etc. are not necessary in a TCM clinic.
6. Compared with Western medicine, TCM practice in the US has much less risk of malpractice lawsuit, and nearly no headache in dealing with health insurance for billing issues.
7. As Chinese, we have certain advantages in TCM practice. After all, TCM was originated in China, and the largest population that has been using this medicine for the longest history is also in China. Therefore, US patients prefer better trained Chinese practitioners for “authentic” TCM treatments. Our language advantage is obvious, too. It facilitates so much in Chinese herbal medicine studies, and makes the expansion and updating of our TCM knowledge a lot faster than Westerners. With solid background in Western medicine, our alumni will have extra advantages in clinical interrogations and in understanding patients’ reports involving Western pathology, diagnosis, treatment and prognosis. These are really valuable assets that provide you great potential to collaborate with MDs, to join the TCM research teams, to teach in schools, and best of all, to generate a successful and safe practice.
8. Challenges in TCM studies and practice should also be mentioned. First of all, the TCM Master program is intensive. It has frequent exams every week. Hundreds of hours mandatory internship starts from the first year, and gets more concentrated like a full time job weaved with classes throughout the last 1 – 1.5 years of the program. Therefore, many students who work or care for children have to take night programs, sacrifice all their vacation days for internship, and/or postpone graduation. Secondly, health insurance does not cover TCM in most states of the US. Therefore, unlike MDs, most TCM practitioners are self-employed and in “cash-based” business. Although the start-up cost is low, establishing and maintaining a stable patient pool is usually a several months to years struggling process for new practitioners. Good clinical and business management skills are both essential.