The Hong Kong College of Anaesthesiologists

My sincere thanks to the support of all fellows and members of the college, as well as all council members, for me to have this opportunity to be President of the Hong Kong College of Anaesthesiologists. The “mission” of the college, written in the college webpage, is to ensure the quality of our specialists through training, examination, certification, continuing medical education, accreditation and other related activities. Since founded in 1989, the college has been a leader in patient safety, quality improvement and medical education. We should all be deservedly proud of those achievements. However, we are facing major changes in our society especially in the last few years. Those changes are imposing major challenges to our systems. On the other hand, insecurity could bring about a sense of urgency which may drive changes and improvements. “It was the best of time, it was the worst of time,….it was the spring of hope, it was the winter of despair.” I think we should reflect on those words of Charles Dickens in The Tales of Two Cities and see how we can make this the best of our time and our spring of hope.

Dr Hing-yu SO
President
2021

Prof. Lo Chung-mau, Prof. Gilberto Leung, Prof.  Prof. Lau Chak Sing, Prof. Gavin Joynt, Dr. Theresa Li, Dr. Meredith Craigie, Dr. Rodney Mitchell, Prof. Davy Cheng, Presidents and representatives of our sister colleges, honourable guests, fellows and members, new graduates, ladies and gentlemen,

Welcome to the 35^th Congregation of the Hong Kong College of Anaesthesiologists. May I, on behalf of the College, commence by congratulating all our new fellows. I passed my final examination in anaesthesia in 1989, the year when this College was established; and then the final examination in intensive care in 1992, when our Academy was established. After more than 30 years, I can still remember how stressful that experience had been. Of course I took the Australian examinations, but I believe that the magnitude of trauma would be similar. Based on my personal experience, I fully understand what all of you have gone through to receive your fellowship today. May I again congratulate you on your achievement. But I guess few of us can achieve this solely on our own. Most likely you would have received supports from your family, friends, supervisors and peers. May I ask all our new fellows to stand up and wave to them as a token of appreciation.

You may sit down now. When I talked about the magnitude of trauma, I was not joking. It is evidence-based. I believe Prof. C.S. Lau would attest to that. I have listened to Prof. Lau’s oration not long ago when he presented the results of a number of research studies on local medical students and trainees indicating a rate of burnout which cannot be ignored. Training and examination has been identified as a major stressor and Prof. Lau urged all trainers to be kind to our trainees. Trainers adopting a positive and encouraging attitude is certainly important. And I would take this opportunity to inform you that our Wellness Workgroup, under the leadership of Dr. Albert Chan, has secured a research grant from the Medical Protection Society on trials of positive psychology. But I would also like to complete that picture. The Book of Rite 《礼记·檀弓上》mentioned the teaching of Zeng-Zi before his death: A superior man loves another on grounds of virtue; a usual man’s love of another is seen in his indulgence of him. “君子之爱人也以德，细人之爱人也以姑息。” Our trainers obviously want to make sure that their trainees achieve required competency and that can be stressful to themselves as well. I have been involved in many training programs and courses for trainers and I heard consistently that trainers find it difficult to train their young trainees. I would say that both our trainers and trainees are victims of circumstances. Despite the requirement of modern frameworks of postgraduate training, our specialists are not receiving training in modern medical education regularly. My hypothesis is that, until we take measures to modernise our training and assessment, this phenomenon of burnout will not improve. It is likely to get even worse because we are facing rapid development in medical knowledge and skills. And that is only one of the reasons why postgraduate medical education must evolve continuously. We are lucky that we do have a core group in our Boards of Education and Examinations who already started some changes. I have reported those in our Annual General Meeting in August. Those are necessary but insufficient. Modernisation of postgraduate medical education demands a fundamental paradigm shift which requires support from various stakeholders. I understand that Prof. Gilberto Leung & Prof. Phillip Lee are very supportive and the Academy is planning to host a strategic planning retreat on postgraduate medical education early next year! It also requires support from the Government and the Hospital Authority for necessary resources. For example, we have been talking about the addition manpower required for effective implementation of workplace based assessment for some time. I would take this opportunity to seek the kind support of Prof. Lo and Dr. Li. But even more important, we need the participation of all our fellows and trainees, especially young fellows like your good self.

Talking about engaging young fellows in medical education and other College activities, may I introduce you to our newly established Young Fellows Committee. Thanks to the kind efforts of Dr. Vivian Lau and Dr. Patrick Wong, who have successfully engaged members from different hospitals and established the Young Fellows Committee earlier this year. In the past, when we urge young fellows to participate, it could be difficult for you to get connected. Those of us on the stage could be too intimidating. Now, I believe you can find someone in the Young Fellows Committee not too far away. They will act as a bridge between young fellows and the various Boards and Committees of the College so that your voice can be more easily heard and it would be easier for you to participate in their activities. Another important mission of the Young Fellows Committee is help nurture future leaders of our profession. We started by inviting them to recommend distinguished young fellows through the Council to the Academy. The Young Fellows Committee adopted the seven roles mentioned in CanMEDS as their selection criteria. In other words, young fellows should be considered distinguished not only because of their personal effectiveness as a clinicians, but also their contribution to mutuality of clinical teams and sustained development of our profession. Based on their recommendation, the Council has nominated Dr. Wesley Chu of QEH and Dr. Patrick Wong of QMH to the Academy. I think that is a good beginning. And we must follow-up with mechanisms to nurture our young leaders.

As part of our efforts to refine the governance structure of the college, we invite boards and committees to present their plans to the Council so that we can provide advices. We started with the Young Fellows Committee. When we advised them on the need to guide their actions and plans using visions and missions, I realize that as a college we are not doing that ourselves. I must confess that the actions and plans I reported in the AGM are reactive. Unless we take proactive actions and plan for the future, we will continue to be reactive. With the kind support of the Council, the college will be holding a planning retreat on 8^th Jan 2023. Dr. PP Chen has kindly taken  up the chair of the Organising Committee. It will be an opportunity for all of you, young and the not so young fellows, as well as trainees, to contribute to our future. The organising committee will engage those interested to come to the retreat, and consultations in various formats will also be organised to collect feedbacks and ideas.

The theme of our ASM this year is “Exploring the Unknown”. There are many unknowns in our future which can represent risks or opportunities. To exploit the opportunities, we must work together proactively to co-construct the future we envisage. May I finish with this line inspired by my old school song: “Old fellows young fellows winning glory, we ourselves must write the story. Keep this challenge still before ye. No matter what is your age, collaborate, and contribute to your college!”

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