Interview

I took the same flight with GY and KL on my way back Hong Kong. During our casual conversation, the cardiologist questioned about the admission interview of our medical school.

"We asked mostly the usual stuff: Why do you want to study medicine, why do you choose our medical school rather than the one on the other side of the harbour, and so forth," the professor of gastroenterology explained, "In general, candidates with a good examination result would be admitted - unless they appear eccentric in the interview. For the mediocre, it really depends on how well they perform in that 10 or 15 minutes."

The answer was hardly surprising.

But my friend went on, "The annoying bit is, most of the candidates have no creativity and give very boring answers. Take my first question as an example. More than half of them would say they have a special experience when they or their family fell sick some years ago, or they are inspired by some great doctor. You know what, it is often difficult for us to stay awake throughout a long day of interview !"

I nodded. In fact, the better an applicant does in the examination, the more likely they would give a dull answer in the interview.

There is an entirely scientific explanation.

川菜

There’s actually very little to say about my stay in Chengdu – except perhaps the Sichuan food.

I shall elaborate a little.

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Dandan noodle (擔擔麵): Contrary to what you have in Hong Kong, there's very little soup in the Sichuan version. In essence it is kind of a bàn miàn (拌麵) with spicy dressing. There's no flavour of peanut butter and, in the one that I had, very little Sichuan pepper either.

Twice cooked port (回鍋肉): Honestly I could not recognize the dish when it was put on the dinning table. There were only a few slices of pork, hardly any cabbage or sweat pepper, but a lot of mushroom of all kinds. As I was told long ago: If you forget about the name and just take it as a hot dish, it is fabulous.

Steamed five cereals (五穀豐登): This is a simple but brilliant one. After repeated challenges of pepper, what is better than an assortment of potato, sweet potato, corn, taros, and yam ?

By the way, the order of dishes was in itself remarkable. Unlike Canton and western banquet, Sichuan people serve fresh fruit as the starter, and there's no clear separation between appetizer and main dish - a series of them, cold and hot, big and small, vegetable and poultry and meat, appeared to come in a seemingly random order.

Of course, food is never the focus on the dinner table - but I am no expert of liquor and would not make any comment.

Chengdu

We arrived at Chengdu late in the evening and were warmly welcome by a group of local doctors. To our surprise, they did not bring us to the hotel – we were invited to a late supper.

As expected, alcohol was a main dish of the meal.

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I shall not elaborate further about the evening. This was the first time I went to the mainland, which seemed incredulous to our chairman. During the day, he asked me no less than three times: How could that happen ?

Each time I put up a polite smile as the reply.

In reality, although I have much respect to my home country, I always find it uneasy to go to a universe where the laws of physics are different.

As Li Wenxiu (李文秀) said towards the end of the novel Swordswoman Riding West on White Horse (白馬嘯西風): Those are very very good, but they are not my cup of tea.

Or my glass of beverage ?

Cantonese

While I was pondering on the behavior of our delinquent house officers, we set off to Chengdu (成都) for a conference.

There were eight of us – including our man from Pluto. On our way to the airport, he sighed, “You know, I’m coming to the conclusion that VC is one of the worst jobs you could get. Our students often behave as if they are the boss and I am their servant.”

A few of us giggled and made an inviting grunt.

“That was the University Grant Council visit last week,” he went on to explain, “Two of the visitors were British but, you know what, our student representatives refused to speak to them in English – because they are students of the Chinese U !” (I could imagine how embarrassing the scene was.)

“Inferiority complex,” KL murmured.

“And we are still in the procedure to justify why we have to teach some of the subjects in English …” our future VC continued.

“Do they propose to use Putonghua to teach all subjects in our university ?” I suggested.

“Of course not. Most of them could speak only Cantonese.”

“In that case, shall we propose to change our name to the Cantonese University ?” I said to myself.

Theory

There is, in fact, a division in opinion on (what we should do with) our house officers' delinquent behaviour. By the law of nature, two schools of thought emerge - conforming to the traditional teaching by ancient Chinese philosophisers.

One group is the keen followers of the conventional Confucianism (actually the theory of Mencius) and believes human beings wish to do good. In other words, if the department provides a satisfactory environment and gives sufficient incentive or reward to the graduating interns, they would do their best in return.

The others are believers of Xun Zi (荀子) and concludes that conscience is not reliable. We must put up disciplinary actions in order to ensure houseman doing their job right.

Which one is right ?

I don't know. But I'm sure human behaviour has nothing to do with the amount of teaching in ethics and professional conduct in the medical curriculum.

PS. To begin with, I tend to think an increase in supply of house officer (as compared to the number of MO vacancy) would improve the performance. That's certainly a naive idea: interns who have fixed up with their future job would continue to pay no attention to things at hand, while those who could not find a job would have a low morale and use the time to secure their future.

Discipline

"What do you make out of XXX's emails ?" I asked LS.

"What do you think ?" my friend asked back.

"I suppose we are going to defer some of the poorly performed interns ?" I was rather naive.

"Well, do you know the procedure of doing so ?" She went on.

"So it is complicated ?"

"Not quite - although it could be a torture to us. You see, we first have to see them and list the event that we are not satisfied. We then give a verbal warning. After some time, if there is no improvement, we see them again and give a written warning. It needs another while and we have to review the situation again. Deferral could only be issued if things remain bad ..." She explained.

"And ... ?" I saw that she had not finished.

"And, all through the process, the intern could give explanations to their poor performance. Many a time the stories they put up are obviously excuses, but we have to accept and do away with the formal warning - because we usually have no evidence to prove that the story is fake." Check.

"Moreover, procedures take time," I began to saw her point, "It is difficult to have all these finished in a 3-month rotation - unless you start the ball rolling from their first day. In fact, if a house officer deliberately performs badly in the last week or two, there isn't even enough time to give a verbal warning !"

Checkmate.

PS. No wonder the last rotation of houseman starts on 1st April. We are treated as fools.

Intern

A recent hot topic amongst our colleagues during lunch is the quality of our house officers.

Oh, I mean the lack of quality of them.

The reason is simple: Most of the interns have already fixed up with an MO job. The last three months of internship is nothing but a pass time.

One of my friends is particularly furious (which I fully agree). He went so far to wrote two emails, one to our chairman and the other to us.

Here they are.

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Dear Chairmen,

I hope you could allow us to have more stringent disciplinary actions on our interns, particularly the last group of them who fail to execute their jobs in a professional way after securing their next jobs. While we have been accumulating tremendous tangible assets through publications, awards, grants, donations, new centers etc, we are also running the risk of losing intangible assets through tolerance to substandard practice. In the long run, this will undermine our medical school's reputation and professionalism.

XXX

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Dear all,

We set role models and develop culture for our students so that they can follow. This is how the tradition of professionalism can be perpetuated. Unfortunately, we do see a small minority of them, for various reasons, fail to practise professionally. And in most occasions, they are well aware of what they should do but they deliberately choose not to do.

If positive discipline through encouragement and acknowledgement doesn't work, I strongly support that they need to bear the consequence of what they have done. This implies deferral of internship, written warning and notification of future employers. We should also think of some forms of database or inquiry system of disciplinary / conduct problem in which their future employers, whether they are of private sector or HA, can get access with careful observation of privacy issues. Tolerance or negligence will lead to perpetuation of this malpractice and in the long run erode the creditability of our profession and our medical school.

XXX