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ZUSM-NCKU Reflections 2019.Pdf This past summer, I participated in both the Zhejiang University School of Medicine Traditional Chinese Medicine Program (6/23-7/12) and the National Cheng Kung University TCM and Bioethics Program. Both of these programs aimed to give PLME students an intro into Traditional Chinese Medicine while also presenting an opportunity to be immersed in the culture behind this practice. Both programs have their unique qualities, and I would highly recommend both of them to any student interested in the subject material, especially if he or she has a conversational level of fluency in Mandarin. The Hangzhou ZUSM program was the first one that I attended. The June session of the program is three weeks versus the four-week session in August. It is a shorter time which is a drawback, but a student’s decision should also take into consideration the timing of the start of the school year and other factors. The first week was mostly lecturing, giving us the foundation of knowledge of basic TCM concepts, philosophies, and history combined with Chinese culture that we would need to understand not only TCM but healthcare in China as well. Though it was just lecture, this portion was one of the most crucial, as it helped us better understand the more complicated processes that they showed us the latter two weeks. The second and third week of the programs were primarily spent in the two university affiliated hospitals observing doctors and getting a glimpse of each of their specialties. This experience was fascinating as we were able to observe interactions between doctors and patients that wouldn’t be possible in the U.S. as well as TCM treatments that we would never find in a hospital in the U.S. However, particularly for this portion of the program, being able to understand and speak Chinese is crucial, as many of the doctors are not nearly as comfortable with English as Mandarin, and in their attempt to translate, some of the meaning behind their words may be lost. My favorite component of the program was the freedom given to us in the overall planning. We had plenty of time to explore Hangzhou and even travel to other places during the weekends. This really helped in introducing us to the culture of China beyond the classroom and allowed us to explore. Staying in our own apartment also gave the four of us (the group members) an opportunity to really become closer to each other. Again, having at least one person who can speak Mandarin and one person who can read Mandarin (the more the better) really made a huge difference for us in terms of exploring outside of the classroom as well. The NCKU program was immediately after the ZUSM one, and there are several immediately noticable contrasts between the two. While the ZUSM has a maximum of four students total, the NCKU can have a maximum of up to 30, as it includes students from a host of other countries. In addition, with such a sizable group, the opportunity for clinical observation goes down, as handling such a crowd would be extremely difficult for any practitioner. The living arrangements are also in much tighter quarters. Despite the overall concept of TCM being the same, the material taught in the program was pleasantly different. There exists a significant difference in culture between Taiwan and China, and instructors in class made that clear throughout the course. The classroom setting also provides a different kind of instruction from the Hangzhou program. Participating in the two programs back to back is a unique and immersive experience. Being in Taiwan and China for a combined five weeks instead of just two or three gave me the opportunity to see the differences in lifestyle and culture that led to their approaches in medicine and their medical theories. Combined with the free time allotted in both programs, the entire experience is a solid combination of learning and fun. I would still emphasize the importance of having at least one Chinese speaker and reader in the group, but overall, the ZUSM and NCKU experience was amazing and I’d highly recommend it. --- The three weeks I spent in Hangzhou for the Zhejiang University student exchange program were filled with eye-opening experiences and enriching activities that were even beyond my expectations. I had the opportunity to not only learn the extent of integration of different aspects of TCM but was also able to experience and engage personally with patients, physicians, and faculty. The first week introduced us to the concepts integral to the understanding of functional systems which embody a relationship of the natural world and relationships to other organs – the concept of the Zhangfu. The interrelation of the organs and other parts of the body were further explored in each of the subsequent weeks through analysis in acupuncture and cupping to massage therapy. We were given a change to engage with our instructors, and practice techniques on each other. Perhaps the most interesting and profound subject was on how China delivers health in its own unique healthcare infrastructure. TCM is a very ancient and practiced field of health care that relies on thousands of years of observation and history. Its place in the Chinese health care system demonstrates a definite uniqueness in the way that China practices and delivers health. The cultural enrichment was also another aspect of the exchange program that was incredibly enjoyable. All of the students that were present in the program during the June to July weeks were to an extent familiar with an aspect of Chinese culture; we could conversationally speak, had family and friends present in Hangzhou and neighboring Shanghai, and were able to have personal and meaningful conversations with our mentors, faculty, and patients beyond a teacher-student, doctor-patient setting. Every day, we would explore the city and the tourist attractions around, from the West Lake and Quyuan gardens to the Leifeng Pagoda. The historical significance of TCM was apparent through our own travel and the field trip with Dr. Zhang during our first week. Overall, the ZUSM student exchange program provided a new level of insight and knowledge on the way that TCM is connected to health delivery in China and how its health care infrastructure works. The cultural exploration also allowed me to see how different they integrate health into daily life in China. This summer has fulfilled an understanding of TCM in both clinical practice and public health. I have learned not only of the usefulness of TCM in health delivery but of the importance of it in Chinese society at large. --- ZUSM’s program in China began a five-week long Traditional Medicine experience that was an immensely productive learning experience. We lived in dorms across the street from the hospital, in an accessible location by train and bus, as well as close to many dining options. Because our group had entirely Mandarin-speaking students, much of our curriculum was taught in Chinese, with a mixture of English to explain certain terms. The first week, we covered the conceptual side of traditional medicine in good depth – some of those concepts are unique to traditional medicine and additionally, should be thought and approached with an open mind. As a student of medical anthropology, I’m taught to not only appreciate the cultural variation in medicine, but to imbibe its lessons into my own practice. We began with concepts of yin-yang, the elements, and were introduced to the traditional herb pharmacy with its multitudes of scents and dried herbs. Our professor was immensely enthusiastic to teach us and was a great mentor while in China – he introduced us to Chinese fruits like yangmei and lychees, and treated us to lunch and dinner by the West Lake. The curriculums following the first week consisted mostly of shadowing doctors. We were able to watch doctors practice acupuncture, cupping, and moxibustion, as well as conduct them on each other. I highly recommend that experience – acupuncture, especially to Western eyes, seems to be terrifying and altogether mysterious in how it may heal. But once you feel the numbing sensation that the doctors speak of, you begin a journey to figuring out a new understanding of pain within the practice of medicine in China. A few aspects that stood out to me while shadowing the doctors included how pain was treated and perceived within practice. We often speak about the performance of pain in my classes, and how that can be extremely varied from culture to culture. In China, we saw comatose patients undergoing the most painful acupuncture procedures possible – in the most painful areas. We saw patients crying out of their eyes, despite being comatose. This was thought of as a method to help the patient regain sensation and wake up. In addition, we learned about how traditional medicine fulfills a void that exists in Western medicine, which in my opinion, points us in a different direction in how medicine (and healthcare) should be practiced. Acupuncture and massage therapy, for example, are proven to relieve pain which we learned in a lecture on evidence-based practices within acupuncture. This is a void that Western medicine often fills with medications, and in some part is in relation to the opioid crisis that dominates newspaper Headlines. Finally, one of my favorite shadowing experiences was in watching the Chinese equivalent of occupational speech therapy for patients. In America, this wouldn’t fit into the role of a physician, and wouldn’t necessarily be based in a hospital setting but might be thought of as alternative medicine.
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