Shanghai’s Lung Hospital Attracts 300 Foreign Doctors for training in 3 Years, Oldest Over 80
For Jean Smith, the head of thoracic surgery at the Manatee Memorial Hospital in Bradenton, Florida, life in Shanghai, China, is a stark contrast to the spacious living he’s used to back home. In a hotel room barely 20 square meters, Smith, his surgical assistant, and a nurse spend their evenings discussing the day’s learnings, reminiscent of their student days.
The 47-year-old Smith is a diligent learner. Every day, he observes 5 to 8 surgeries of various types at the Shanghai Pulmonary Hospital, an affiliate of Tongji University. His goal is to learn the technique of single-port thoracoscopy and how to assess the feasibility and necessity of surgical procedures for lung ground-glass nodules.
“Only the Shanghai Pulmonary Hospital offers the best chance for me to learn these techniques in a short time,” Smith said. He and his team covered all their expenses for the two-week trip, including airfare, hotel stays, and meals.
According to China Youth Daily, over the past three years, nearly 300 surgeons from countries like the United States, Germany, the Netherlands, Russia, Spain, and Israel have flocked to the Shanghai Pulmonary Hospital to participate in short-term single-port thoracoscopy training programs or longer, multi-month thoracic surgery courses. The oldest “student” among them is an 80-year-old Israeli thoracic surgeon.
Why Shanghai Pulmonary Hospital?
Tiago González, a surgeon from Spain, was the first to recognize the hospital’s potential. During an academic conference in 2013, he was amazed by the Shanghai Pulmonary Hospital. “I tell my colleagues in the thoracic surgery world that Shanghai is modern and trendy, and this hospital is the best place to learn surgical techniques in the shortest time possible,” González said.
Dr. Jiang Gening, the head of thoracic surgery at the Shanghai Pulmonary Hospital, told China Youth Daily that the hospital performed about 10,000 surgeries last year, with approximately 7,000 being lung cancer surgeries. Of these, 80% were early-stage lung cancer cases, which can be treated with single-port thoracoscopy. The 5-year survival rate for early-stage lung cancer patients after this minimally invasive procedure is over 90%.
A 2016 article in the Chinese Journal of Oncology reported that China had approximately 3.586 million new cancer cases in 2012, with lung cancer being the most common, accounting for about 378,000 cases. Lung cancer is also the leading cause of cancer death, with about 569,000 deaths annually.
Single-port thoracoscopy is a minimally invasive technique that can significantly improve early lung cancer survival rates, making it a key offering at the Shanghai Pulmonary Hospital.
Firas Abu Aak, a 34-year-old surgeon from Israel, is currently a long-term trainee at the hospital, with a nine-month learning period during which he covers all his own expenses. He has already become the first single-port lobectomy surgeon in the Jerusalem area, thanks to his initial two-week training at the Shanghai Pulmonary Hospital in 2014.
Abu Aak considers the Shanghai Pulmonary Hospital to have the largest and most standardized and safe thoracic surgery department in the world, with the most experienced surgeons globally. For comparison, the hospitals he works at in Israel, the Assuta Medical Center and the Shaare Zedek Medical Center, perform only 2 to 4 small to medium-sized surgeries per week, totaling 20 to 40 lobectomies per year. In contrast, the Shanghai Pulmonary Hospital performs 20 to 40 lobectomies daily, allowing Abu Aak to observe at least 4 surgeries a day.
At the end of his nine-month stay, Abu Aak expects to be the youngest and most experienced thoracic surgeon in the Jerusalem area.
Impressed by Chinese Surgeons
Initially, many foreign surgeons arrive with a degree of arrogance. However, after just a couple of days in the operating room, they usually become eager learners.
“Their perception of Chinese doctors changes from ‘Oh, Chinese doctors…’ to ‘Oh! Chinese doctors!,’” said Dr. Zhu Yuming, the deputy director of the thoracic surgery department at the Shanghai Pulmonary Hospital. One of the most surprising aspects for foreign surgeons is the diagnostic and surgical skills of Chinese doctors, even those who have been practicing for only about 10 years.
Each morning, Dr. Smith attends a one-hour handover session where Chinese surgeons discuss cases of lung ground-glass nodules, deciding whether to operate, how to operate, and post-surgery care. “I can already perform single-port thoracoscopy, but I’m more interested in the diagnostic process and surgical planning for lung ground-glass nodules,” Smith said, noting that his 22-year career in the U.S. and 10 years of surgical experience have not exposed him to such advanced techniques.
During a surgery at the Shanghai Pulmonary Hospital, a top German thoracic surgeon, who is the head of the country’s leading thoracic department, praised a small detail during lymph node dissection. “Your lymph node dissection is perfect. No one, not even in Germany, can achieve this level of precision,” he said in front of multiple foreign doctors.
Direct and Honest Feedback
A culture of lively discussion and debate has emerged in the hospital’s thoracic surgery department, largely thanks to the influence of foreign doctors.
“Foreign doctors don’t worry about face-saving; they will challenge your diagnosis or walk out of the surgery if they think it’s not up to par, regardless of your rank,” Zhu Yuming said. The hospital’s surgeons have not only adapted to this environment but also embraced it. “Medicine is a science, and more discussions are always beneficial.”
González, who was the first to perform a single-port thoracoscopy, now proudly introduces himself as a surgeon from the Shanghai Pulmonary Hospital. In 2013, he came to teach the technique to the hospital’s doctors. Within a year, even the hospital’s attending physicians had mastered it. González realized the potential and suggested starting a training program, which has since become a global hub for learning this technique.
Pablo Gamés, the head of thoracic surgery at the Hospital 12 de Octubre in Madrid, Spain, pays close attention to the “hand movements” and decision-making skills of Chinese surgeons. “I’ve seen Chinese surgeons quickly adapt to unexpected situations, such as bleeding, and choose the most effective method on the spot. I’ve never seen so many techniques for handling such issues,” he said.
One Russian thoracic surgeon, who initially dismissed lung ground-glass nodules as common tuberculosis in Russia, was impressed by the accuracy of the Chinese doctors. After two weeks, he began using WeChat, a popular messaging app, to stay in touch with the hospital and attend academic conferences whenever invited. He found the amount of knowledge and skills he could learn in China overwhelming.
The surge in foreign doctors visiting the Shanghai Pulmonary Hospital for training underscores the hospital’s advancements in medical technology and its commitment to international medical exchange and cooperation, offering new hope and high-quality care to patients worldwide.