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Training Taiwan's Elite Health Care Leaders

By Mary Beth Regan

One recent February night, on the eve of Chinese New Year, Bloomberg School associate professor Leiyu Shi gathered with faculty to welcome 30 visiting scholars, the elite of the Taiwanese health care system, to the United States. The celebratory dinner, at the Blue Sea Grill downtown, was the culmination of more than two years of planning by the Bloomberg School, the Education Development Corporation (EDC) and the Taiwanese government.

As guests dined on lobster, sea bass and steak, a group of well-wishers arrived at Shi's table with a toast: "Happy New Year!"

For Shi, DrPH, a native of mainland China and program architect, it was a sweet moment.

The exchange, called the Taiwan Cohort Program, jointly sponsored by the School and EDC, will allow students to pursue a DrPH in health care management and leadership through both onsite and distance learning. The Taiwanese students will travel to Baltimore twice yearly, conducting much of their research and 128 hours of coursework at home. While the School has had three previous distance MPH programs with Taiwan, this is the first doctoral program.

Shi and the School faculty and students know they are under the microscope. Supporters laud the effort as the wave of the future: allowing high-ranking health professionals to pursue advanced degrees and leadership training without having to leave their jobs.

The School's Ellen MacKenzie, chair of the Department of Health Policy and Management, Shi, and professor Laura Morlock are committed to the concept and see it as a model for educating health officials worldwide. "This is not the traditional doctoral immersion program where someone comes for two, three or five years," says MacKenzie. "But I think we can show the world it works." Says Thomas Chiou, MHA, PhD, chief executive officer of EDC: "We hope to build a model for the rest of the world."

Taiwan was the first country to initiate such a program with the Bloomberg School, says Morlock, PhD, in part because of its close ties with the School. When Health Minister Sheng-Mou Hou, MD, PhD, MPH, was appointed to the country's top health post in February 2005, he became the fourth health minister to have graduated from the Bloomberg School. He joked: "A Hopkins degree may be a prerequisite for the job."

Morlock says the genesis for the exchange was a Taiwanese official's attempt to model his health care administration on a military structure. "His vision was to create a cohort of health care leaders, like he had in the military, who would become agents for social change throughout the country," she says.

Unlike the United States, Taiwan has reached nearly universal health care coverage, with 99 percent of its 23 million citizens covered. That wasn't always the case. In 1995, only 58 percent of the population was insured, says Morlock, but through legislative changes that greatly expanded the definition of an "insurable unit," Taiwan upped its coverage to roughly 90 percent of the population. Officials then worked to cover the remaining 10 percent through community-based programs.

Taiwanese leaders in the first cohort of students, like Chin-Liang Liu, MD, chair of neurosurgery at the Taipei Municipal Yang-Ming Hospital, say they are eager for Western-style training in leadership, management and research. Liu was recently appointed to a committee tasked with revamping the city's hospital system amid allegations that corruption had drained billions of dollars from an employee retirement fund. "I am an expert in my field of neurosurgery," Liu says. "But I want to sharpen my management skills."

Others are interested in research methods. Shao-Yi Cheng, MD, MS, attending physician at the National Taiwan University Hospital, is focusing on women's health and aging issues. Specifically, she is looking at isoflavone, a naturally occurring estrogen found in plants, and its impact on menopause. "Hopkins is known for its strength of research," she says. "I want to focus on biostatistics because that is very important for my research."

MacKenzie is pragmatic about the future of the exchange. "It may be harder than we think," she says. "It's not a one-way street, though. We are teaching these students, but we are learning from them as well."