When Dr. Michael Thao graduates today from a Fresno psychiatric residency program, he'll be joining a small class.
Nationwide there aren't many Hmong doctors. There are even fewer who specialize in psychiatry. Thao, 29, figures to be just the second in the U.S., joining a medical school buddy who is graduating this year from a North Carolina program.
In Fresno, with the nation's second-largest Hmong population, there are less than a dozen Hmong physicians, Thao says.
He will add to that number. Thao grew up in Michigan but has decided to stay in Fresno and plans to practice psychiatry at the VA Central California Health System. He will be the only Hmong mental-health doctor in the central San Joaquin Valley, with a Hmong population of more than 30,000. Only Minneapolis-St. Paul has more.
"I wanted to be in a large Hmong community," Thao says. "I felt like that's where I could really make a difference."
Growing up, Thao struggled with being Hmong. He was acutely aware of being different, "and of being ashamed of that," he says.
It wasn't until college that he gained "a sense of being proud of who I am and where I came from," Thao says. He has a bachelor's degree in sociology, with a subconcentration in social inequality from the University of Michigan, and earned his medical degree at the University of Minnesota.
He became interested in psychiatry while in college. "I find human behavior interesting," he says. And during his second year of medical school, an aunt committed suicide. "That did influence me," he says.
Mental illness often goes unspoken in all cultures — but it can particularly be a taboo subject in the Hmong community. When someone is deemed mentally ill, it's a reflection on their family and clan, Thao says, and he hopes to help break down stigmas that keep people from seeking help.
"It's defining mental illness that is relevant to the culture," he says. "I can't say I can teach the Hmong population better about the science (of the brain), but I am able to understand that the Hmong population may have different views or understand what it's like to have different views."
Since January, Thao has worked two days a week at the Fresno State Student Health Center. He has developed an interest in the experiences of children of Hmong refugees, whom he says can be burdened by a sense of debt to their parents for what they endured to make a better life for their children.
Thao's parents seldom spoke of hardships and traumatic experiences from their past in Laos and the Thailand refugee camp, but he knows that one of his sisters died there.
During his four-year Fresno residency through the University of California at San Francisco, Thao conducted a pilot study on the "transgenerational transmission of trauma." He wanted to know whether the relationship between children and parents improved when parents talked about past traumas.
He didn't find a clear-cut answer, Thao says. But he'll continue to look for one. "I want to be able to educate the Hmong community with my research."
Thao has also worked at the Fresno County Department of Behavioral Health. Adult division staff there will miss him, says Susan Holt, the division manager. "He's been a tremendous support to our clinical staff."
Thao's fluency in Hmong and his cultural understanding has been invaluable, she says. "He's been able to fill a gap which has long existed in our community, and he's filled it exceptionally well."
Dr. Scott Ahles, chief of psychiatry at UCSF-Fresno, says Thao's decision to stay here also helps fill an overall shortage of psychiatrists. Fresno recently lost state money to start a children's psychiatric residency because it could not recruit a child psychiatrist for the program, Ahles says.
Thao is one of four UCSF-Fresno psychiatry residents to graduate today but is the only one to stay in Fresno. Two are going to Hawaii and another is joining the Air Force. Typically, about 30% of residents trained here remain in the community after graduation.
Besides working at the VA hospital, Thao will be a UCSF-Fresno assistant clinical professor, helping to train residents where he can be an influence in helping them understand Hmong culture.
An interest in academics is one reason he chose to work at the VA, which encourages research and study, he says. Plus, he says: "I take pride in taking care of the men and women who served my country."
Fishing at Shaver Lake also played a part in his decision to stay in Fresno — that and family influences.
An aunt and uncle live in Fresno, and his parents, who cashed in retirement savings to start a poultry farm in Oklahoma, plan to move here, Thao says. "They like the weather."
UCSF-Fresno graduating class
A look at the 89 doctors graduating tonight at Saroyan Theatre from the University of California at San Francisco-Fresno residency program
Internal Medicine: 31
Pulmonary Disease/Critical Care Fellowship: 3
Infectious Disease Fellowship: 2
Gastroenterology Fellowship: 1
Interventional Cardiology Fellowship: 1
Cardiovascular Disease Fellowship: 4
Family Medicine: 10
Emergency Medicine: 10
Emergency Ultrasound Fellowship: 1
Wilderness Medicine Fellowship: 1
Surgical Critical Care Fellowship: 1
Acute Care Surgery Fellowship: 1
Minimally Invasive Surgery Fellowship: 2
Graduates staying in the area: 27
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