Arriving in Baltimore on the passenger shoip "Rhein" on 3 August 1886 at the age of 19, he emigrated to the United States to pursue his medical education.
Hoch returned to America with his new bride on the "Veendam" passenger ship, arriving in New York City on 12 November 1894.
In Queens, New York City, on 3 July 1921 Susan married Lawrence S. Kubie (1896–1973), who would go on to become a noted psychiatrist and psychoanalyst.
On 1 July 1905, Hoch began a new position at the Bloomingdale Hospital in White Plains, New York as its first assistant physician and special clinician.
[5] In 1908 he spent time in Zurich at the Burgholzli Mental Hospital with its director, Eugen Bleuler, and second-in-command Carl Gustav Jung where he deepened his knowledge of psychoanalysis, was trained in the use of the word association experiment, and became familiar with a new disease concept – schizophrenia – which Bleuler had first proposed in a publication that year.
After four years at Bloomingdale, in July 1909 he was offered the directorship of the New York State Psychiatric Institute, following Dr. Adolf Meyer (psychiatrist) who was moving to the Johns Hopkins University.
In 6 March 1913, Hoch introduced Eugen Bleuler's disease concept of schizophrenia to elite American alienists and neurologists for the first time during a meeting of the New York Psychiatrical Society.