Newsletter No. 260

Magical Partnerships An Interview with Prof. Fok Tai-fai, Dean of Medicine The word 'synergy' has its roots in the Greek word 'sunerg' and 'sunergos' which means respectively 'co-operation' and 'working together' . A full dictionary definition is 'the interaction of two or more agents or forces so that their combined effect is greater than the sum of their individual effects'. Organizations seek synergy. So do doctors. But it takes the right leader to make it happen as the line between synergy and chaos is a fine one. Redefining the Boundaries of Medical Research Prof. Fok Tai-fai, dean of the Faculty of Medicine and a well-known paediatrician in his own right, is a specialist in the art of alliance. Since he took over the reins of the faculty in mid-2004, it has made strides towards multi- disciplinarity in both research and teaching. 'Traditionally, medical research was department- based. This tended to thin out resources, equipment and talent. Integrative research, on the other hand, involves the partnering of experts from different departments who are engaged in same-area research — be it cancer, DNA or stem cell. The result is something greater than the sum of the parts,' he explains. The New Institute of Health Sciences The latest r ewa rd for the faculty's efforts at integrative research came in the form of a timely donation of HK$60 million from the Li Ka Shing Foundation to set up the Li Ka Shing Institute of Health Sciences. The new institute, to be headed by Prof. Fok and Prof. Dennis Lo, associate dean (research), will be an enactment of his statement that 'scientists pooling their knowledge generate more ideas than scientists working in isolation'. Its research w i ll be devoted to areas related to the health of individuals, w i th particular emphases on sickness prevention, clinical sciences and regenerative medicine. Its research foci w i ll include early detection of severe diseases such as cancers, genetic diseases, common urban health problems and infectious diseases, innovative therapeutics, and disease prevention through understanding of genetic susceptibility. The institute w i ll also seek multi-disciplinary collaboration w i th private and public partners on research projects related to personal health and health education. The institute w i ll be housed within a new 12-storey building at the Prince of Wales Hospital. The building, wh i ch w i l l also be named after Dr. L i Ka-shing, is scheduled for completion in late 2006. Apart from research facilities, it w i l l have facilities for teaching and other academic activities. Prof. Fok h i gh ly appreciates the foundation's generosity and public spiritedness. He says. ' The Li Ka Shing Foundation has always been greatly supportive of healthcare and education in Hong Kong and mainland China. In fact Dr. L i told us himself that nothing is as important as medicine and education. We're very pleased to collaborate with them.' The new institute is by no means the first time the foundation's philanthropy has benefited the CUHK Faculty of Medicine. Two specialist clinics at the Prince of Wales Hospital were built with their support in 1984 and 1997. And in 2001, the faculty joined forces with Shantou University, a key ongoing project of the foundation, to establish the Joint Shantou International Eye Centre. Perfecting the Curriculum In 2001-2, the faculty introduced a system-based undergraduate curriculum in response to worldwide trends in the medical profession. Based on the synergistic integration of know l edge f r om different medical disciplines, the five-year curriculum stresses practical skills and clinical relevance, and favours a learner-centred, problem-based approach, as opposed to didactic teaching, in the methods of course delivery. In the four years since its introduction, the faculty has been continuously striving to consolidate it and make it sustainable. Quoting Deng Xiaoping, Prof. Fok says, 'We are still crossing the river by feeling for stones. The o ld curriculum had had a history of over a hundred years. Change was necessary. But there are still kinks to iron out in the new one and adjustments to be made. The students have no problem w i th it as they have never known the old curriculum. However many teachers who have experienced the old one may need to be more receptive to this novel mode of thinking.' The government has been seriously talking about reverting to a four-year undergraduate curriculum. Prof. Fok is supportive of the reversion which w i ll entail, for most departments in the medical faculty, a shift to a six- year curriculum, and, for the Nethersole School of Nursing and the School of Pharmacy, that to a five-year curriculum. He believes that w i t h extended studies, students w i ll enjoy more clinical exposure and practice. They w i ll also have a chance to improve their bedside manners and when a doctor has the right manners, he says, the healing is half done. Reaffirming the Value of Teaching Members of the medical faculty often wear three hats —teacher, doctor and researcher. While it is true that the three can be mutually enhancing, it is also true that medical professors often end up with a lot on their plate. Helping them strike a balance, therefore, is a test of good leadership. 'In research universities in general, there is a perception that teaching is less important than research and clinical service,' oberves Prof. Fok. 'The "publish or perish" culture is a culprit. The other reason is the urgency of clinical service. Doctors are committed to their patients. Therefore it is considered acceptable for a professor to rush off to a patient in the middle of class, but not the other way round.' The faculty has done much to recognize teaching contributions. A teaching portfolio documenting a staff member's involvement in pedagogical activities, such as classroom teaching, cu r r i cu l um development and admission interviews, is now under trial online. There have also been faculty-wide curriculum retreats and discussions on how to improve teaching evaluation exercises. Prof. Fok says that the University administration may want to consider being more demonstrative, through staff promotion and substantiation policies, of the weight it places on teaching. It may also w i sh to consider appointing staff to different tracks such as a clinical service track or a teaching track, to raise proficiency and effectiveness in both environments. Comparing Hong Kong to North America, he says, 'Over there, medical professors enjoy protected time for research. For instance, it may be stated in their contracts that 30 per cent of their time is reserved for research. But here, we are expected to give 100 per cent to everything and this adds up to 300 per cent. When one gives all to all areas, quality is sacrificed along w i th personal and family life.' Juggling Three Roles Prof. Fok finds his job 'challenging yet enjoyable'. Though he wou ld still welcome more time for family, Mrs. Fok, he says, is a very understanding person and his son is a grown-up having his own career. But having come such a long way, he must have made his share of sacrifice and, in some ways, an established doctor may feel the system's demands just as keenly as someone younger. Sure, young doctors have to work hard looking after patients and doing night calls. They also have to study for multiple postgraduate examinations in order to attain specialist qualifications. Those in academia need to do both research and teaching, and this may continue un t il retirement. A n d due to the lack of time, most doctors, notes Prof. Fok, do not engage i n physical exercise. This could have adverse effects on their health, effects which only rear their heads w i th age. The toll on family is just as great. 'Many colleagues, including myself, did not spend enough time with their children when they were young, and regret it only when it is too late, that is, after their children have grown up.' His advice to young doctors is that health and family, especially young children, should always come first, no matter how busy their schedules. An Empathetic Leader Prof. Fok may respond to email in a timely manner but, as a man who values more personal exchange, it is definitely not his favourite means of communication. 'Email is so impersonal,' he remarks. 'I don't like memos either. They may save time but they are counterproductive. The phone at least allows one to hear the voice. Face to face is best.' Guiding his leadership is a policy of transparency as he believes it is the only way to w i n his colleagues' trust. His preferences may have something to do w i t h his training as a paediatrician. Paediatricians are, on the whole, more patient, gentle and accommodating than other doctors, he says, and they tend not to lose their temper even when dealing w i th very difficult patients. Numbers alone do not ensure quality. It is only when strategically juxtaposed that knowledge, experience, people and faculties become greater than themselves. With the wisdom and instinct of a doctor. Prof. Fok knows that, like a human body, true synergy in an organization requires the combined healthy action of every organ of a particular system. PieraChen 3 No. 260 19th May 2005