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China Revisited
A physician scientist introduces geriatrics to China in a hospital with long ties to Hopkins

Seng Leng, shown here in front of Bayview’s Care Center, will build a subspecialty of geriatrics at Peking Union Medical College Hospital.

China’s population is graying fast. In 20 years, experts say, the number of older adults in China will exceed the total population of the United States today.

So Peking Union Medical College Hospital, in the heart of bustling downtown Beijing, is building a huge inpatient/outpatient facility exclusively for seniors.

It will have all the latest in medical technology and a broad range of services, for PUMCH is considered the best of the best, the Johns Hopkins of China, some say. The institution was in fact modeled on Hopkins’ School of Medicine, and Hopkins men and women helped to get it off the ground in the early 1900s.

One thing the new senior care center will not have, however, is a cadre of physicians with expertise in geriatric medicine, because in China, there is no subspecialty of geriatrics.

All that is about to change, thanks to geriatrician Sean Leng. With a $1 million, four-year grant from the China Medical Board of New York, Leng, an assistant professor in the Division of Geriatric Medicine and Gerontology, is building a full-blown subspecialty in geriatrics at PUMCH. His ambitious plan addresses a pressing need in China, and fittingly, it returns Johns Hopkins to the very setting in which it played such a key role nearly 90 years ago.

This month, Leng will travel to Beijing to identify and recruit a couple of exceptional internists in PUMCH’s Department of Medicine. They will train in geriatric medicine at Hopkins for six months starting in January before returning to PUMCH to teach others how to best deliver clinical care to the elderly.

Midway into the grant, Leng and faculty on the project’s advisory committee will visit the Beijing hospital to do on-site consultations and assess needs in building a multidisciplinary geriatric team.

Finally, Leng, himself an investigator who studies the frailty syndrome in the elderly, will add a research component. “That will be the biggest goal, because it is the only way to advance medical care,” he says. “There is already some aging research being done in different subspecialties at PUMCH, and I believe that once the connections are made, it will really take off.”

Leng’s program dovetails nicely with the mission of Geriatric Medicine and Gerontology, says division director Linda Fried. “It will be a model for a larger initiative, an institute of geriatric education in which we hope to ‘train the trainers’ from many countries as well as the U.S.,” she explains.

Born in China in 1963, Leng was sent along with his family to the countryside in 1968 during the Cultural Revolution to work on the land. In 1977, China gave the first national exam for entrance into medical school. Two years later, Leng took it and gained admission to the medical college in his province, Jiangxi Province. After graduating, he joined PUMCH, where he practiced in allergy and clinical immunology.

In the United States, Leng obtained a Ph.D. in molecular virology and immunology at Texas A&M, followed by a postdoctoral fellowship at Yale. Then, inspired by his late father’s Alzheimer’s disease, Leng changed course in midstream: He did a residency in internal medicine in New York and a two-year clinical and research fellowship in geriatric medicine here.

Though Leng’s work has taken him all over the United States, he still retains connections in Chinese academic medicine circles. In fact, it was a PUMCH colleague who introduced Leng to Jerry Lazarus, Bayview’s director of dermatology.

Lazarus had spent several years in China as a health care consultant under the auspices of the China Medical Board. He became Leng’s entrée to the CMB. A foundation that supports health care initiatives and medical research in the Far East, the CMB has long ties to Hopkins. (It is currently funding a JHU School of Nursing Ph.D. program at PUMCH, the first of its kind in China.)

Other medical centers in China, Leng says, had approached him about starting up a geriatrics subspecialty, but he held out for the prestigious PUMCH. He expects the senior care center there will have great influence throughout China, in part because it will accommodate mostly retired officials of the Chinese central government, the senior leaders of the 1970s and 80s.

“I want to build a program that will lead the way in China. If we can get this thing to work, Hopkins will leave its footsteps in China’s senior care for years to come.”

—Anne Bennett Swingle

Peking Union Medical College

The China Medical Board, a division of the Rockefeller Foundation, established Peking Union Medical College in 1917 with the aim of bringing Western medicine to China. It modeled the school on the medical education program at Johns Hopkins. Two of the leading lights of American medicine, William Welch and Simon Flexner, a School of Medicine graduate and director of the Rockefeller Institute, were instrumental in planning the institution.

In the early years, Hopkins-trained physicians practiced at PUMC. Anna Wolfe, later director of nursing at Hopkins Hospital, established it as a degree-granting nursing school and almost single-handedly transformed nursing into a profession and respectable career for Chinese women.

PUMC Hospital fell on hard times during the war years, and in 1951 it was nationalized by the People’s Republic of China. By the mid-1970s, though, it began to enjoy a renaissance. Today it is considered China’s top academic medical center.



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