CHINA: Hong Kong helps to upgrade medical training

Prestigious overseas universities have been hovering in China hoping to forge collaborations in medical education and research. Yet so far none have set up a medical school there, despite the country's huge need to upgrade medical training. It is Hong Kong, with its international medical education standards and world-class health system, that has been quietly helping China with undergraduate training.

The Chinese University of Hong Kong (CUHK) has just accepted its first group of mainland Chinese students from Shantou University medical school in Guangdong province. The students will spend a year in Hong Kong at the CUHK medical school.

"China is looking to Hong Kong for assistance in improving standards of training [of doctors]," said Tai Fai Fok, dean of the CUHK medical school.

Vice-chancellor Joseph Sung said Shenzhen University Medical School, which opened in 2007 just across the border from Hong Kong, has also asked to cooperate with CUHK. "We are happy to share our experience with them, such as curriculum design and medical teaching methods," said Fok.

The medical faculty regularly telecasts surgical procedures and even lectures to Chinese institutions as a way of disseminating its expertise.

Hong Kong teaching hospital in Shenzhen

Meanwhile another top medical school, at Hong Kong University (HKU), will assist in conducting clinical medical training for both Hong Kong and mainland Chinese students across the border in Shenzhen.

With funding from the Shenzhen authorities and in a joint venture with them, HKU will open a new 2,000-bed public teaching hospital in Shenzhen in November to train medical professionals from both China and Hong Kong.

Although still regarded as a pilot project under China's national health care reform, it is billed as a world-class teaching, research and healthcare services institution in China. In Hong Kong it is described as HKU's second teaching hospital, although exactly how it will be managed by HKU is still unclear.

What is clear is that HKU will send medical professors to Shenzhen to teach, particularly in its areas of specialisation of organ transplants, spinal and joint surgery, cardiology and oncology.

"Over the years Hong Kong's system evolved to integrate some best practices of the Western world. The aim is to share our experience in a practical way. If this proves to be a successful example, the mainland government can use it as an example to follow," said Paul Tam, Pro Vice-chancellor of HKU and a professor of paediatric surgery.

China's plan to upgrade healthcare

It has taken a long time to get to this stage. The dilapidated state of China's hospitals and healthcare system is a sensitive issue, rarely aired in public, although there are some state-of-the-art hospitals in several bigger cities.

But China is looking to revamp its public health system under a 12-year US$130 billion initiative that began in 2009 to expand access to medical care.

"What they want to improve on is the system, including the training system," Fok told University World News. "There is no structured medical training in China. Every hospital is doing its own training in its own way without a formal accrediting system or a national standard. I'm not saying it's not good, but it's not uniform."

"They are trying to introduce a system now. They have already done the pilot, but doing things will take some time," Fok added.

Although smaller collaborations in medical education do exist with overseas institutions, China has held back from following any particular model of training. There are also cultural and political issues.

"Some foreign universities can be very patronising," said Tam, explaining China's preference for collaboration with Hong Kong. "If China decides to introduce the Hong Kong system as a model to train doctors it does not seem to them like importing foreign ideas. Hong Kong is seen as part of the [Chinese] family," Tam told University World News.

Mainland students in Hong Kong

The first students from Shantou are about to arrive in Hong Kong.

"Shantou University is sending its first-year medical students to spend the entire first year of study here. They would like their best students to get exposure in Hong Kong. They believe the Hong Kong [public health] system is on par with the rest of the world, and we use English for teaching," said Fok.

Shantou already has links with Hong Kong - it receives considerable funding from Hong Kong entrepreneur and philanthropist Li Ka-Shing, who helped set up the preclinical medical centre at the university.

Meanwhile, CUHK already has experience of mainland-trained medics: around half the postgraduate medical students at the university are from the mainland. Fok jokes that the language in the university's biomedical laboratories is now Mandarin, widely spoken on the mainland, rather than Cantonese, which is commonly used in Hong Kong.

"The Shantou medical students will be attending the same classes as the Hong Kong students," said Fok. "There is no problem in adjusting when they go back to Shantou. The university already changed their medical curriculum several years ago to make it more or less identical to ours."

Two-way traffic

The demand from China for help in upgrading medical education is very high.

"We have been approached by a number of medical universities in China, requesting us to send teachers up there or asking to send their students to us. At the most we can only accommodate a small number for a short time. We would love to take more, but we don't have the capacity," said Fok.

Shantou University wanted to send up to 30 of its first year medical students to Hong Kong, but CUHK could only accommodate 10, he noted. "Also, sending teachers up there is not easy because our teachers are so very busy. We try as much as possible, but very often we have to turn down these kinds of requests."

Hong Kong is suffering from a shortage of doctors. This has led to criticisms in Hong Kong of the HKU collaboration with Shenzhen, with many fearing that bottomless demand in China for medical training skills will deprive Hong Kong of experienced medical teachers.

But it is not just mainland students who want to learn from Hong Kong.

"The rural part of China has different disease patterns compared to the cities. We go up there to learn, not just to teach because we are not familiar - it is a two-way traffic. We also try to encourage our medical students to spend time there," Fok said.

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