Psychiatry Resident From China Makes Rewarding Transition to U.S. System

Joan Arehart-Treichel

Layan Zhang, M.D., stands in front of historic St. Elizabeths Hospital in Washington, D.C., where Civil War soldiers were once quartered, the wind whipping through her hair and a pensive look on her face.

Yes, it is far from the village in the People’s Republic of China where she was born and grew up. But here she is, a second-year psychiatry resident at the new St. Elizabeths Hospital, which is only a short walk away from the old one.

And, all things considered, she is pleased that her path in life has brought her here, she says.

Zhang is from Shanxi Province, which is in northwest China and separated on its northern flank from Inner Mongolia by the Great Wall of China. Her parents were farmers, and she recalls “walking through the fields, down a little path, I felt free and fresh.” She also has a brother and sister. “The one-child policy applies to all citizens in China,” she explains. “However, it was a bit flexible for people in the villages during the early 1980s.” She adds that her parents were warm and supportive and did not drive her to succeed academically. She is very grateful for that, she says.

Because of her father’s encouragement and her own interest, she applied to Shanxi Medical University after graduation from high school. One can go directly from high school into medical school in China, she points out. She graduated in 2003.

Training Followed at Yale’s Sister School

After medical school graduation, she attended the Xiang-Ya Medical School of Central South University to study clinical psychology. The university was founded by the Yale-China Association in 1914. It is the only sister university of Yale University in China and a leading university in the mental health field in China. She earned a master’s degree in clinical psychology in 2006.

From 2006 to 2008, she worked as a rehabilitation psychologist/psychiatrist at Beijing Bo-Ai Hospital of the China Rehabilitation Research Center, which is the largest rehabilitation facility in China.

In 2008, after her husband received his Ph.D. in molecular biochemistry from Peking University in Beijing, he was offered a research position at the University of Michigan. So Zhang and her husband moved to the United States. During the next several years, she worked hard to achieve her “American dream”—becoming a psychiatrist in the United States.

For example, she enrolled in a community college to improve her English and got involved in various community activities to learn about the local culture. She volunteered in a medical clinic as a nurse assistant and observed inpatient clinical practice to become familiar with the American medical system. She volunteered as a research assistant in the child subdivision of the University of Michigan’s Department of Psychiatry. And, during this period, she gave birth to a boy.

In 2012, she was accepted into the psychiatry residency program at St. Elizabeths Hospital. She, her husband, and their son moved to Washington, D.C. In June her husband started work as a cancer researcher at the National Institutes of Health.

Good Things Have Happened

It is now a year since Zhang started her psychiatry residency at St. Elizabeths, and she reports many positive experiences.

St. Elizabeths is the District of Columbia’s public psychiatric facility for individuals who have serious and persistent mental illness and need intensive inpatient care to support their recovery. In 2010, the hospital moved into a new state-of-the-art facility that incorporates best practices in inpatient mental health care. The new building’s therapeutic design includes bright and airy living and treatment areas, green spaces off each patient unit, and enclosed courtyards. In brief, it is a congenial environment for doing a psychiatry residency.

Zhang is pleased with the supervision she is receiving at St. Elizabeths. For instance, “James Hutchinson, M.D., is a wonderful psychiatrist and psychoanalyst,” she says. “He is my mentor and also supervising me on individual psychotherapy with a patient.”

Exposure to different types of patients has been a valuable educational experience, she notes. There are about 300 psychiatric patients in St. Elizabeths, including patients with acute and chronic conditions, forensic and civil patients, adult and geriatric patients. “Here, one can learn pretty much all of the psychopharmacology knowledge you need as a psychiatry resident,” she says.

Since she started her residency training last year, Zhang has been involved in several research projects. She began doing research with Teodor Postolache, M.D., of the University of Maryland on the “association between seasonality and evening chronotype in the Old Order Amish.” She presented her study results at the APA annual meeting in San Francisco in May and during a poster session at the recent annual meeting of the Society of Biological Psychiatry. She is working on another project involving depression screening in a primary care setting in China, which is part of a research program in global mental health initiated by psychiatrist Eliot Sorel, M.D., of George Washington University.

But Zhang has faced challenges as well.

Sometimes she is too “soft,” she admits. “Yet being pliable also helps her build good therapeutic alliances with patients,” Farooq Mohyuddin, M.D., head of the psychiatry residency program at St. Elizabeths, told her. “It is a rare combination to have a resident who is well versed in research and also has excellent clinical acumen.”

She also possesses other strengths that serve her well as a psychiatry resident, Hutchinson notes. “She is thoughtful and observant, adventurous in what she is willing to try, and passionately committed to what she is doing. She quietly and constantly tries to integrate her experiences in and out of the hospital.”

As for the future, once she completes her residency training, Zhang plans on getting specialty training to become a child and adolescent psychiatrist.

And will she, her husband, and their little boy ultimately remain in the United States or return to China? “We’re open to either,” she says. “We’ll see!” ■