Philadelphia University + Thomas Jefferson University

China-America Medical Education Exchange

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Jimmy giving a hands-on ultrasound lesson

When he first arrived at Jefferson in 1987, it was a big change for Dr. Ji-Bin (Jimmy) Liu—a world away and a whole new way of thinking about medicine. He came to be as a research fellow under the tutelage of ultrasound innovators like Dr. Barry Goldberg, staying on for the past 28 years to dedicate to research on contrast-enhanced and intraoperative ultrasound (see Connect-the-Docs in the previous issue) among many other contributions. Since then, he’s not only been involved with a myriad of research projects, but he has also helped to stimulate scientific-cultural exchange between his native China and the United States, and trained more than 400 fellows.

The Jefferson Ultrasound and Radiology Education Institute (JUREI) has parlayed its portfolio of industry and foundation partnerships into an effective form of “educational angel investing,” using industry-donated machines and technology to establish training centers throughout the world. In line with the “teach the teachers” model, JUREI educators train each Center’s leaders, so that they can establish a robust ultrasound education curriculum within their own country.

Through Dr. Liu’s efforts, 5 JUREI affiliated education Centers were established in Beijing, Shanghai, Chengdu, Xian and Inner Mongolia. Over the years, the program has fostered a lasting exchange between the Centers and Jefferson, with educators from both countries traveling back and forth frequently. Indeed, JUREI’s Leading Edge ultrasound conference is visited each year by a sizable contingent of Chinese ultrasound physicians to promote further cross-pollination.

The Program

In 2013, JUREI collaborated with Chinese ultrasound societies to establish the China-America Ultrasound Scholar Training Program (CAUSTP) to accommodate the Department’s quickly growing educational demands.  As program director, Jimmy, working with Dr. Jinrui Wang (co-director in China), has served as a liaison to supervise and coordinate the program.  CAUSTP gives visiting physicians the opportunity to study for 1-3, 6 and 12-month terms, and also offer a two-week Advanced Ultrasound Symposium.

Under the auspices of JUREI, the exchange offers Chinese ultrasound physicians a variety of courses and mentorship opportunities designed to enhance not just their knowledge base but their capacity to think creatively about ultrasound practice.

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Trainees are able to take courses with many of JUREI’s and the Department’s ultrasound instructors, like vice chair for education Dr. Levon Nazarian or director of ultrasound Dr. Laurence Needleman. Fellows also work closely with Flemming Forsberg and John Eisenbrey, two PhD researchers who are among the leading authorities on contrast-enhanced ultrasound and other advanced applications. With them, visiting scholars spend time doing small animal imaging research in order to get a better understanding of the diagnostic and therapeutic possibilities that ultrasound affords.

Far from being fresh out of school, CAUSTP’s visiting fellows must have a master’s degree and at least five years of clinical ultrasound experience, which means they come to Jefferson as seasoned physicians and leaders at their home institutions.

Among the current cohort of China-America scholars are Drs. Xiangning Liu and Hongjia Zhao, two MD/PhDs from Guang'anmen Hospital in Beijing and Fujian University of Traditional Chinese Medicine, respectively.

Each is staying for a full year term, and for Zhao, a physician, professor and dean of her University’s nursing college, this will be her second year here after a productive first stay five years ago. Liu comes to Jefferson as the head of her hospital’s ultrasound department (ultrasound is a totally separate department in China), a position she has held for three years—the hospital’s youngest director ever at the time.

For each of them, the excitement of the program turns on the opportunity to do research and to think deeply about “the way a treatment works in each individual case,” says Zhao. While there are many dynamic research enterprises in China, large hospitals and high clinical volume mean ultrasound physicians are frequently compelled to work by rote in order to ensure that patients receive proper attention. So large is this volume, physicians, who often perform the scans themselves, can develop repetitive use injuries like tennis elbow.

CAUSTP is an opportunity to break out of the routine and compare notes with their Western counterparts. For Liu, this means better appreciating the intersection between traditional Chinese medicine (a rich collection of remedies that go far beyond acupuncture) and Western-style approaches to health and healing, particularly echocardiography.

“What they learn is how to raise larger questions based on what they observe,” says Jimmy of the program’s philosophy of treating the connection between theory and practice, not as a trickle down system, but as a two way street.