Global Perspectives: A SLP's Journey Working Abroad #4 (Location: Shanghai, China)
In our fourth week in our SLP’s working abroad series, we have Tiffany. She moved from the States to Shanghai, China and here she discusses the difference in cost of living from the New York City and Shanghai and gives advice to those SLPs who consider following in her footsteps.
Thank you Tiffany for sharing your experience with us!
What are your name, pronouns, and your job/professional title?
Tiffany Chen (she/her/herself), Speech Language Pathologist
Tell me about yourself. Where did you initially move from (before you worked abroad) and what graduate school did you attend? Why did you become a SLP?
I grew up partially in California, then I moved to Taiwan. I completed my Masters in CSD at NYU and received my bilingual extension from Columbia University. I pursued SLP because I was interested in languages and linguistics. I wanted to pursue a career with the clinical aspect of linguistics. At the same time, I was volunteering at a community center that supported the local people with special needs. I loved interacting with them and helping them become independent and valued in many ways. This brought me to pursue a career as an SLP.
What city and country do you currently work in, what setting do you work in (e.g., international school, clinic, university, research, etc.), and what age range do you currently work with? How long have you been working abroad?
I worked in Shanghai, China from 2019-2022. I worked in a private company, that provided gateways to work in many different settings, including international schools, clinic, day program, home health care, and opportunities to provide trainings or workshops. I worked with children from 6 months to 22 years old.
Where did you apply for this SLP international job and how was the application process?
I applied through their website online. I was directed to fill in their job application, then participated in three rounds of online/video interview. It was a fairly straightforward process speaking to staff from different departments to get a sense of what types of services were provided and explain the process/answer any questions of relocating abroad.
What did the process look like for you to move abroad (e.g., obtaining visas/work permits or sponsorships, finding a place to live, moving, SLP licensure, etc.)?
-SLP licensure:there is no official SLP licensure in China. Therefore, my CCCs were accepted.
-With Taiwanese citizenship and an ID issued by Taiwan, I did not need a work visa, a work permit, or sponsorships to work in China -I had friends that shared websites to help me look at apartment listings before the move. Once I landed in Shanghai, I first lived in a hotel for a few days. During this period, I set up a bank account and a phone number. These were needed as everything was paid electronically over phone and no cash. I also needed access to e-pay to then further sign an apartment lease and pay deposit. I worked with an agent who showed me listings until I found one suitable.
What motivated you to pursue work opportunities abroad as an SLP?
Having grown up in Taiwan, and then working with underserved first generation Chinese immigrants in Brooklyn, I then felt the impact and difference I could potentially create as a bilingual SLP. I knew China was lacking in supports in the SLP field. While I could not find enough information online, that was also evidence that there was not much established. That spurred the idea to work in China and potentially help create structure and increase awareness in communication sciences and disorders.
How does the pay rate, cost of living, and quality of life compare to living in your home country?
I think this depends city by city. For example, I was moving from New York City ( a high cost of living city) to Shanghai ( a high cost of living city in China). The pay rate from the U.S will certainly be a huge cut if you translate the amount into RMB. However, with the cost of living and rent being significantly cheaper compared to NYC, I was able to save much more than I could have in the US. As I was living in an international city, Shanghai, the quality of living was comparable to living in the US and NYC. Had I been in a different city in the US or in China, the outcome would have been different.
What specific challenges do you face working abroad as a SLP?
My challenge was specific to the context of China, where the speech language field was under-recognized and under-developed. In China, insurance did not cover speech language therapy. There were also minimal funding to support families to find services. Additionally, quality and licensed SLPs were rare unicorns in China. Even as a Taiwanese that shared cultural values similar to China, it was hard to maintain cultural sensitivity, while explaining to parents that because "other children were late talkers and were fine" that we should not base on experience assume everything is okay. There were many difficult challenges revolving around counseling and communication with families in denial and many more challenges similar or different in many ways.
What are your favorite things about working abroad as a SLP?
I appreciated the opportunity to expand my knowledge and my skillset. This not only included speech language pathology knowledge, but also other related skill set such as public speaking-speaking in front of live audience, or live streaming on the internet about speech language topics. It also included graphic designing or video-editing, to make SLP related graphic materials and educational videos. It also allowed me to get a glimpse and practice project management, when I first started my own social skill program within my job.
What are the most significant differences between practicing as a SLP in your home country versus abroad?
Flexibility and ability to think outside of the box. Whatever we learned in school or in the work field in the US may not be applicable. For example, support groups for parents who need information or support for their children and themselves. Finding a pediatrician that is up to date with evidence based practice and makes appropriate referrals for ENT, orthodontist appointments when there are breathing, sleeping, or enlarged tonsils concerns are difficult too with the lack of resources and not enough informed knowledge between parents and their community. Even recommending parents to remove enlarged tonsils can be a difficult conversation as parents are wary of surgery for young children.
How does your experience working abroad influence your perspectives on diversity and cultural sensitivity in speech-language pathology?
It was interesting a humbling to see that even if I felt like I shared the same/almost the same cultural values, being culturally sensitive and responsive was still a tremendous challenge for me in China. It made me realize that every family carries and interprets cultural values differently. Every family has a different dynamic, and the best we can do is inform them of the recommendations while respecting that if they ultimately do not follow through or pursue services, that we have done all we can. We can only respect their decision and follow up from time to time.
What advice would you give to other SLPs who are considering working abroad for the first time?
Be prepared mentally and physically. Physically it may be hard to seek medical help with language barriers or insurance, so being physically healthy might be a consideration that is less spoken of. Mentally, having an open mind to accept, listen, and remove your personal judgement is important. You will have to be prepared to search for your own friend groups and community for your support system. When there are challenges and difficulties navigating cases or finding resources, it is important to utilize all resources (e.g., facebook groups, CEUS, colleagues) because you might be on your own.
How do you handle homesickness or any potential challenges related to being far away from family and friends?
I think it was different for me because my family was in Taiwan- a 1.5 hour flight, 3 hour door to door trip. However, I also went through Covid and lockdown where I could not go home for 3 years. I also did not and could not leave Shanghai for 3 years due to imposed travel restrictions and limitations. It was a huge mental toll for me. Ultimately, the lockdowns, the continuous building/community/compound lockdown that did not cease even when city-wide lockdowns were lifted got to me. It was hard to make progress with my clients with all of the unexpected starts and stops. It was also hard to advance in my career as nothing could be carried out or seen through as businesses were struggling to reopen and stay open with staff being out due to unforeseen lockdowns. I made the choice to leave as I felt that I had no longer had control of my own time and my freedom of space.
Any other information, stories, and experiences that you would like to share?
I have lots to share, since I lived and worked in China for 3 years and especially during COVID. It maybe hard to share in text. Feel free to email me if you would like to talk about it instead.
Can SLPs contact you for more information? How can they contact you?
Yes! My email is tiffanychenslp@gmail.com.
My website is www.speechwithinreachslp.com
