Newsletter No. 408

8 No. 408, 4.12.2012 吴浩强教授 医学院副院长(教育) 病理科是大众较感陌生的,它是一门什么样的医学专科? 病理科的主要工作,是检查从病人抽取的血液、尿液及活细胞等样本,分析病 因和病情,以助医生诊断及决定疗法。在先进国家和香港,医科生毕业后,要 再接受五至六年训练,并通过专业考试,才可成为病理医生。病理医生最常应 用的就是显微镜,约过半的检查,都是在显微镜下看切片。 为何放弃当临床医生,而专研病理? 是机缘巧合吧。我早年在爱丁堡大学习医,遇上良师,取得内外全科医学士学 位后,便朝病理专科发展。临床医生站在最前线,亲身接触病人,但往往要兼 顾其他事务,如家属的情绪,我希望可以更好掌控时间运用,也乐于退居幕 后,寻根究柢,虽较静态,不过两者都是帮助患者解除病苦,亦各有挑战。 最让病理医生头痛的问题是什么? 最怕遇上检验的样本数量不够,像是肿瘤太深,只能抽取少许组织,降低了诊 断的准确性,难免会影响疗效。在这情况下,唯有加倍小心检验,集合多位病 理医生的意见,始行下判断。 当病理医生需要什么条件? 必须够耐性够仔细,观察力强,确保没有忽略任何细节,且从多角度思考,以探 究病因和预测相关病变。要是能敏锐视察颜色的变化更佳,因为切片上些微的 色调改变,实际已蕴含重要的形态结构或是功能代谢的转变信息。 早在1996年,你一力促成了中国病理医生培训计划,为何有此构思? 我在九十年代初开始与内地病理学界交流,发觉碍于资源不足,不管是器材、 参考资料,或是病理医生的培训都欠系统性发展,直接影响诊断的准确度。我 开始思索如何才可协助内地病理科发展,提升水准,由此催生了中国病理医生 培训计划。在申请得拨款后,我安排内地主治医师或以上级别的医生,来中大 接受为期三个月至一年的临床病理诊断训练,部分更可参与临床工作。 这些年来在培训内地病理医生的发展如何? 培训计划举行了三年,共为三百多名内地病理医生提供进修机会。计划 结束后,我于1999年动员四十位内地主要病理学会会长和医科大学的主 任,成立了中国病理主任联会,并获选为主席。联会的宗旨,就是透过引 进相关知识、资讯和技术,继续推动内地病理专科发展。联会定期举办 学术年会,明年将达第九届了。经过这些年来的努力,内地的病理科水准 已显著提升,加上我亦是国际病理学会的副主席和教育委员会主席,故近 年已把重心转往病理科发展落后的邻近地区,例如印尼、菲律宾,最近我便去 了柬埔寨,看看如何提供协助。 公余有什么兴趣? 我很喜欢世界史,想知道今天的世界为什么是这个样子的。 我有一个习惯,就是每次出门,是公干也好,旅游也 好,要去陌生地方的话,总会翻看相关的历史书 籍,先了解这个地方的历史文化背景。 Photos of Prof. Ng Ho-keung in this issue are by Keith Hiro Prof. Ng Ho-keung Associate Dean (Education), Faculty of Medicine Pathology is not a medical specialty that’s commonly known to the public. What is it about? Pathology is concerned with examining blood, urine and cells samples, etc., extracted from patients to determine etiology and morphologic changes in order to facilitate diagnosis and treatment. In developed countries and Hong Kong, medical graduates have to undergo training for five to six years and pass professional examinations before they can become pathologists. Microscopes are the best partners of pathologists who spend over half of their time looking at specimens through the lens. Why did you give up being a clinical physician and study pathology? It’s just a coincidence. I was in the MB ChB programme at Edinburgh University where I met an inspiring pathologic mentor. Upon my graduation, I turned to pathology in my career. Clinical physicians work on the frontline and have face-to-face contact with patients. However, they have to handle other businesses too, including taking care of the emotions of care-givers. Being a pathologist gives me more flexibility in time management as I seek answers and solutions quietly behind the scenes. That said, both jobs aim at curing patients and they are equally challenging. What gives a pathologist the biggest headache? When the samples available are not enough for an accurate diagnosis. That’ll affect the accuracy of the prognosis. For instance, when a tumour lies deep in the body or in a critical area, only a small amount of tissues can be extracted. In this case, pathologists have to be very careful when examining and have to obtain the opinion from peers before drawing a conclusion. What does it take to be a good pathologist? Besides patience, attention to detail and being observant, a good pathologist should think from different perspectives when trying to seek the causes of diseases and predict pathological changes. It’s better if the pathologist has a sharp eye for colour changes, because the subtle discrepancies of colour in the specimens could be the result of important changes in the form and structure or in functional metabolism. What gave you the idea for launching the Summer School for Pathologists from China in 1996? I began academic exchange with pathologic circles on the mainland in the 1990s. I soon found out that due to financial or resource limitations, neither the equipment and reference materials nor systemic specialist training were adequate. This made accurate diagnoses difficult. In order to improve the overall standard of pathology in China, I obtained extra funding to set up the school. Mainland doctors of general practitioner rank or above were invited to CUHK to receive clinical diagnostic training from three months to a year. Some of them even participated in clinical diagnoses. How is pathologist training for mainland China coming along? The summer school programme was held for three years, benefitting over 300 mainland pathologists. After that, in 1999, 40 chairmen of pathology associations or departments of major institutions and myself came together to form the Association of Directors of Pathology of China. I was elected as the chairman. The aim of the association is to bring pathologic knowledge and technology to China. Academic conferences on related topics are organized from time to time and the ninth annual conference will be held next year. Throughout these years, the pathology standard of China has improved significantly. Being the vice-chairman of the International Academy of Pathology and the chairman of its education committee, I’ve switched my focus to underdeveloped neighbouring countries such as Indonesia and the Philippines in the past few years. Recently, I went to Cambodia to explore how I could lend my expertise. What do you do in your spare time? I like world history and am interested in how the past shapes the present. Thus, whenever I visit a new place, whether for business or leisure, I like to read up on its history beforehand.

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