Dr. Jingjing Hu, MD

Hematologist & Oncologist, Southern New Hampshire Health

Read our interview with Dr. Jingjing Hu about her advice on leading a balanced life as a physician, and her life priorities as an experienced doctor.

Transcript

David An (DA)

Dr. Jingjing Hu (JH)

Well, let's get started then. Thank you so much for meeting with me. I'm David An. I'm one of the co-founders of HealthPath Horizons, a Boston-based group dedicated to empowering low income students to pursue careers in healthcare. And we're looking to interview people to write up stories of people's real life journeys with entering the mmedical field. And we thought you'd be a great fit, seeing as how I previously reached out to you about being an advisor, and you've been helpful in giving us new ideas. So, do you mind if I record this conversation?

Sure.

Yeah, okay, great. So could you share just a little bit about your background with us? We're particularly interested in learning about where you're from and the environment you grew up in, because we really believe that every journey into the medical field is unique and also very valuable.

Yeah. So my name is Jingjing Hu. I'm one of the practicing oncologists working at Mass General right now. I'm a foreign graduate, so that means I hold my medical degree from a different country, other than from the U.S. I have learned quite some experience from my family, because some of them are physicians. So, when I was a child I knew I wanted to be, you know, a physician, but I didn’t know what kind of physician even into high school, when I was taking time to figure out the high school entrance exam to apply for medical school. And luckily, I was accepted into one of the pre-medical plus medical school kind of direct programs for a total of eight years. And after the pre-clinical training, we started the research and the background of my thesis was oncology. So that's kind of when I decided I was going to apply for that for my sub specialty, so that's a kind of straightforward journey for me. There’s not a lot of interesting stories about it.

Okay, I see. Yeah, thank you for that. We'll go a little bit deeper into that as well. So you said you got interested in, you know, medicine. But when did you first realize it was something that you may seriously want to do?

Probably during middle school? At that time, I saw a lot of, you know, sick people when I visited my relatives, and I also saw people getting cured and getting the help they needed. That was probably like at a really young age, but it's hard to remember exactly.

I don't remember exactly either for me. I just know it was when I was young. Now, were there any other potential, you know, careers you're considering, or did you know that medicine was what you wanted to do?

No, it was pretty clear. Just medicine, you know, and maybe some research, but mostly related to medicine.

Okay, and did you have any sort of mentors who played a significant role in shaping your interest?

No, I didn’t. I had some support, but I didn’t have any mentors. It's very different. When I was in China, we didn't have this kind of similar mentorship idea as in the U.S. We don't have mentors during high school for the medical field.

I see. So you kind of had to figure out the journey alone. Was that a hard thing to do? Did it feel confusing at times?

For me? I wasn't. I want to point out that the path to medicine is different for other countries. For a lot of schools in China or Asia, you don't have to go to undergraduate education to apply to medicine directly. So that makes things simple.

I see. So for you, because the system is set up in a way that's very clear and very systematic, there weren't many doubts about how you would get to that point. That makes sense. So then, you know, through that whole process of you becoming a doctor in China and coming to the US and practicing as a physician, and getting to where you are now, what was the hardest part about that entire journey?

Yeah, that's an interesting question. You know, you mentioned that it is difficult for as foreign graduates to get used to the US training system, and also you should have those kinds of hands-on experience. So we missed that part, especially when we were fresh new graduates from medical school. So I did have to go through some externship or observership, and then I rotated like extra years before I applied for the residential training. So that probably was a more difficult part compared to others.

I see. Was there anything that you regretted on that entire journey?

No, I think I set myself up well. And I don't think I'm a person that really regrets.

I see, okay, thank you. And then, what do you think has been the most meaningful or fulfilling part of becoming or being a doctor?

That question actually has multiple layers. You feel fulfilled after you help the patient, help society, and then also, kind of help yourself too. It's an inner peace when you feel what you are capable of doing? It's important and it's pretty rewarding. It's not like necessarily just treating the patient, but also kind of providing a lot of medical information to your own society, family friends, getting them screened, and answering a lot of medical question because it's harder for them to understand, but it's very easy for me to explain. You know, sometimes when you increase people's knowledge of the medical field, it can feel even more rewarding than treating a patient.

That's interesting. Okay, so, like, that’s something that's, you know, almost as interesting as just treating the patient themselves, right? It’s maybe like teaching not only the patient, but also like teaching the general public.

And then you could have the screening, and then you give proactive messages about what people can do to prevent certain diseases, instead of, like, waiting for them to get a sick and go to the hospital, especially in rural areas of China or other countries. It doesn’t need to be big; you are already in a small circle of people. You may not be able to affect a whole big circle. You just are starting to look at the surroundings and how you can help them, push them to do the mammogram screening, for example, doing a colonoscopy screening. So I think that's also important. So that’s kind of like, not only just treating your own patient in the hospital, but making the circle bigger with a greater and greater effect to the people. Even healthy people. It’s preventive medicine.

Okay, yeah, that's really cool. Actually, I don't think I've ever heard a doctor really be very vocal about the full circle, right?

It’s a different perspective. I always think of good medicine meaning not only treating sick people, but also preventing healthy people from getting sick, through detection or prevention. And I'm sure there's a lot of people who have already done this, but they haven't realized how much they've affected the people around them. They may already be doing this; for example, going to people in China, who have no sense of screening for colon cancer, and telling them to screen. They listen to you and do it. And then, hey, they end up having colon cancer, but it was detected early. They don't have to be dying from it. And that’s a real example; I don't even remember how many dozens of people I’ve told to do that. They actually survived early colon cancer and lived very happily.

Wow, that's awesome. So it's also very rewarding to motivate someone to go get screened and discover that you might have saved their life just by doing that. That's cool. So, you also talked about another big part of being a doctor is being very involved with the community, and being involved with those around you and those you know. And I want to ask a question, which is, because you're very involved in these various kinds of community circles, do you think that we need more diverse circles to be represented in medicine? Is there a need for greater diversity or representation in medicine? Not only as in, you know, different ethnicities in the U.S., but also maybe we need some more international representation from foreign graduates?

We need similarly higher representation from different ethnic groups and international branches. For example, African Americans are always underrepresented in clinical trials, in access to the medical field, in their inclusion of treatment. So I don't really think it’s even a question—there is definitely an unmet need.

Got it. And what sort of issues do we see in healthcare that come from that unmet need?

Well, to break down a few different factors, there is less awareness and access to insurance which impacts the cost, as well as unequal quality of medical treatment when comparing the non-immigrants who have lived here for multiple generations to new immigrants. It is still very difficult for them to access a medical field. And that’s talking about patients, you know, but there’s also the issue of health awareness. Some immigrants may not understand what we think are the basics of health awareness. Or they may not have the time to learn. So the awareness is definitely not as complete as non-immigrants, and same with low-income people having less awareness compared to the high-income individuals because they just didn't build great habits or didn’t have the opportunity to learn more. And then some people also may have some cultural background that makes them hesitant to share personal details.

I see, yeah, I think that's a good point. I haven't really thought about the fact that a lot of people might, especially if they're poor or they're immigrants, not be very knowledgeable about all the insurance options available to them, and they have this sense that they wouldn't be able to afford medical care.

Okay, now, I just want to ask you a couple questions about your specific life to kind of give people an idea of your lifestyle, your thoughts, and your background. So you mentioned that in your childhood, you kind of already knew you wanted to be a doctor, right? Because your relatives were doctors, and you were able to get exposed to medicine that way, but you didn't know what specialty you wanted to do. So what made you want to choose to be a hematologist oncologist?

So I always wanted something fun and challenging, you know, like I enjoy trying to solve problems, especially anything challenging or unknown. There's a lot of new medicines and new technologies coming into the field. It’s always changing. I think that makes me really driven to understand the mechanisms behind them. In this 21st century, we have kind of a new understanding of humans. So that actually was kind of my interest. And I knew I didn’t want to be a surgeon, so I would instead be some other doctor. And then a major point is that I want to be in something diagnostic where I can solve problems. Secondly, when I was getting into my graduation thesis, I ended up learning more about cancer related projects, which kind of furthered my interest. And I also did a couple of rotations in hema-onc when I was a medical resident and found that I actually like it.

During that process, I did have some doubts and began thinking: Am I going to survive this? Am I going to feel like I will be the right person in this field? But I remember I got a lot of feedback from my mentors at the time, like program directors, established oncologists, and they felt that I could be a really good oncologist. So I think that's how I made my decision.

I see, so you got some positive feedback from those kind of short term temporary mentors, and that was important to you choosing to be a hema-oncologist. Okay, how would you advise aspiring students—students that really want to go into medicine, but aren't really sure what exactly job they want to do—you know, choose? And not just choose to be a physician, but also maybe they want to be, you know, a nurse, PA, NP, or something similar.

It’s always useful to do some, you know, shadowing to dip one’s toes into the environment, and not necessarily in hospitals, but also in nursing homes, health centers, community centers, and more. It’s always a good thing to see what you might like and see how your personality matches the job environment. And no matter where in which country, no matter if it's a big hospital or a small hospital, I think my universal suggestion is to then sit down and think, “Is this a very exciting experience that I want to do more, and do I think I'm the right kind of person?” It's good to always test the waters first, like when you have time during summer break or spring break. And yeah, I watched a lot of documentaries, too. TV show documentaries. Also documentary books, like medical history books, anything like that. It might inspire you to learn more.

Okay, so generally like any sort of exposure or anything you can learn. So now, of course, there's my understanding of the medical system and the different specialties and the jobs that assist the doctors. But could you maybe explain, in your own words, just generally what different specialties exist, and what are some of the other jobs that play a major part in supporting physicians in healthcare?

Right so first there’s now a lot of intermixing within the healthcare industry from institutions, small clinics, and large hospitals. But overall I feel that the supporting field for medicine is actually bigger than the medicine itself. For example, medical devices and then even computer software for transcribing notes, medical imaging, and patient data storage. All these are related.

Another major thing is the jobs that support physicians, like nurses and physician assistants. These roles are very heavily relied on in medicine, especially for building the patient relationship. I also want to say that jobs without patient contact are more important a lot of the time too.

Honestly, it's hard to spell out everything there is. Now, if you ask me, like, if I had to do something other than being a doctor, I would be interested in research, like clinical trials, as a research coordinator. Another one, and I couldn't name a lot, because it's so random, is to be involved with pharmaceutical companies in drug development and drug testing. And all these are related, and some of them are very directly engaged with patients, like clinical trials. Pharmaceutical companies also have multiple people, like physicians and nurses, who are actually hired to follow patients throughout trials.

Okay, now just for you, specifically, what is your daily lifestyle like? How much free time do you get and what do you enjoy doing in it?

I cannot speak for full time jobs since my job is not. Every week I do have certain days for clinical duties. And my typical clinical day, if I do work that day, is I start at about eight o'clock. I meet with patients, give them a diagnosis, make a training plan, view all their tests, and often give chemotherapy.

How does your day differ between clinical days and non-clinical days?

Personally, I have to set up some time to be with my family, and also I do involve myself with the Mass General Brigham Global Advisory, so I have some international cooperation.

So, the amount of free time you get, or the amount of time you get to do things that aren't clinical; how does that differ between different medical specialties?

Oh, that's a great question. I think I can speak for the whole day on that. You know, there are those kinds of specialties where you have to be in the hospital, like doing surgery for example, and that makes it very hard to get away from the hospital. My job is more clinic-based. The hospital setting is maybe 5% for me, like when I take consultations in the hospital. So hospital-based doctors, like surgeons and obstetricians/gynecologists, are in the hospital so much that going part time is much harder or even impossible for them. But it’s possible for me. So I feel like this is what I want about my lifestyle, in order to give myself some family time as well. It's what I want.

You know, you can definitely look at the other specialties like, for example, anesthesiologists. Their job is this set time period—the hospital needs them from five to five, for instance. So during these times they cannot leave the OR, okay, so it's less flexible. My job is more flexible compared to them. But in another way, when anesthesiologists finish their duty, they don’t have a lot of paperwork following them when they go home. But I still have some notes. I have some phone calls. So even on the days when I'm not technically working, I need some time to “work.” I may be calling the patient to explain and listen to them about their condition. So my relationship with patients may be very different from anesthesiologists, who don't usually form long-term relationships with patients.

Yeah, so you already mentioned there were a couple different things that go into your decision of how you work as a doctor and maybe what kind of doctor you work as, right? So what are the factors that go into choosing to pursue a specific path in healthcare and how do you balance research, clinical practice, family life, etc.?

It is a very tough question, especially for me, as a female physician. You probably have heard that there is a high burnout rate, and there was a grave loss of physicians from the COVID pandemic, because people were not able to balance their life. And that's something I learned from my experiences. You have to set your boundaries so you know what is most important. Like, I was doing clinical research at one point, clinical trial investigations. So I was the Principal Investigator. But it'll take a lot out of your time. A lot of your personal time goes to grants and papers, meetings after meetings, and after a certain point, I gave up the clinical research investigator job because I didn’t think it was the most important thing in my life. I think quitting made me more focused on my patient care.

To learn these things, it’s important to talk to your peers, your mentors, support groups, etc. We also need a support group as a physician, because when you're nearing the middle portion of your life with balancing family, work and everything else it’s a challenging process. You learn how to balance it better each day, but finding a good support group and trustworthy friends is still very important. Sometimes, I have to accept that there's limitations to what I can do. Sometimes I just cannot handle everything, right? That's okay. I can just focus on the things that are most important to me.

I think that's actually one of the first times I've ever heard someone stress the importance of having a support network as a doctor. A lot of the time it's the doctors telling patients, “you need to have some support network.” But it's also important on the other end.

Yeah, because in healthcare, no matter what job you have, it's going to be tough, right?

So what sort of lifestyle would be compatible with a career in healthcare? And what sort of lifestyle maybe isn't as compatible?

Could you please specify the question? Are you asking outside of medical jobs, what other jobs are compatible?

Like, what sort of lifestyle, right? So, you know, maybe those who really want to do research, or those who really want to be involved in family life. Is that compatible with certain careers in healthcare? Or maybe, is it not compatible?

The question is more like, you know, to what degree of compatibility? Is hiring a nanny to take care of your kids okay versus you driving your kids to school? Do you want to miss your kids’ sports games? So it's like the small things plus certain big things you can either give up or keep. It’s especially tough for female physicians who have higher rates of part time work, lower pay, etc.

Now, that’s just talking about my lifestyle choices. I did see some of my colleagues focus on medicine completely early on. But they later discovered they actually were not able to live the life they would like, and so they worked to change their subspecialty to something totally different. I have seen multiple people do that. I think they are still happy now, but I feel like they could probably have benefited from having a support group for physicians. At Mass General, we do have a support group of female physicians who are trying to coordinate this.

It’s important to know that it’s not shameful to ask for help. In the first few years of medicine, you probably feel like you can do everything. But then after 10 years, 20 years, things come up and new challenges arise.

Thank you for that. My last question is, what is something about your life or your lifestyle that most people would be surprised about?

Of course, I’m an oncologist who treats cancer patients, but I'm also a relative of cancer patients myself. So it’s not like I have a desensitized view to cancer, as an oncologist. When we’re on the other side of our medical job, we are still anxious, just like every patient.

So that is also kind of important, since we can better understand the patient's needs or how the patient is feeling. It’s very helpful to put ourselves, as doctors, in our patient’s shoes.

Okay, that’s all the questions I have for you. Thank you so much for agreeing to this interview and for giving us some of your time. I really appreciate it!

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