Meet Dr Hao Wang
Dr Hao Wang from Beijing Children’s Hospital, China finished her international observership in the Department of Paediatric Respiratory at GOSH.
Dr Hao Wang from the Department of Paediatric Respiratory at Beijing Children’s Hospital, China has nearly 10-year clinic experience since she graduated from her master’s degree in 2012. In March 2019, she successfully finished her one-year international observership in the Department of Paediatric Respiratory at Great Ormond Street Hospital for Children (GOSH), London. Today, she is sharing her observership experience at GOSH.
Why did you choose GOSH for an international observership?
Hao: I came to GOSH because I'm very interested in studying children's bronchiectasis, primary ciliary dyspraxia, cystic fibrosis and rare diseases of the respiratory system in children. GOSH is a world-class hospital and is the international partner with Beijing Children’s Hospital. My tutor Prof Christopher O’Callaghan from the Dept of Paediatric Respiratory at GOSH and UCL Great Ormond Street Institute of Child Health (UCL GOS ICH) is the world-leading expert in studying cilium. He has been invited to our department in Beijing for research sharing many times, so we are very familiar with him. Previously, we also had a colleague who studied bronchoscopy with Chris' team at GOSH.
GOSH also does lung transplants, which is very appealing to me personally, because a lot of complicated respiratory diseases have no cure, so our only treatment option is a lung transplant. In China, this kind of procedure started relatively late, and is better for adults, being seldom carried out for children patients. I wanted to study lung transplantation for children.
I decided, therefore, to participate in the international observership program at GOSH, and the idea of studying with Prof Chris was also supported by the director of my department in China. In March 2018, I left from Beijing and started my one-year observership in London.
What was your main job responsibility? Was it in line with your expectations?
Hao: My plan was to do more basic research work in the laboratory on the diagnosis of primary ciliary dyskinesia and respiratory ciliated epithelium. GOSH and UCL GOS ICH are closely linked, so I was able to conduct research work in the laboratory and participate in college lectures and multidisciplinary meetings, including discussing and studying the latest complex real cases of children with respiratory diseases at GOSH. This was a special experience, half-school and half-hospital.
What did you learn during the observership?
Hao: I learned the most from the multi-disciplinary meetings. Every Wednesday morning, doctors, nurses, therapists and PhD students in the respiratory department come together for a multi-disciplinary discussion. A typical meeting will involve 10 cases, and last from one to one and a half hours. Particularly complex cases may even be discussed several times. Both clinical and research cases are involved, which enabled me to learn a lot. There was also a regular imaging meeting on Wednesday afternoon, where a multi-disciplinary team of 10 to 20 people meet to review images and discuss cases. The cases are normally new outpatient and inpatient cases in the hospital, but also include very rare and complex cases sent from other hospitals. We discussed the next examination and treatment plan together, and the best way to communicate these plans with the parents.
In addition to my major, I am very happy that I was able to work with colleagues from different countries and international teams, which is truly a breakthrough for me.
Were there any differences in healthcare between China and UK?
Hao: Throughout the year, I experienced many differences. In terms of multi-disciplinary meetings, we also have a weekly meeting with the imaging department in China, but it is still limited to our own respiratory department. However, the multi-disciplinary meetings at GOSH cover a wider range of specialties, which is very good. The pathologists are also be invited, and this lets the pathologists and radiologists work together to make a comprehensive evaluation for the treatment plan.
I also felt that there was a difference in the attitudes towards complex and severe patients in the UK, which is more positive. Because GOSH is a specialist tertiary and quaternary hospital, the cases we picked up and discussed were very difficult and often the hardest ones. If these patients were in China, the Chinese parents may choose not to continue treatment for a variety of reasons. However, the parents and doctors in the UK never give up easily.
The treatment here is not just medication but also takes time to focus on patients’ mental health, considering the patient’s wellbeing as a whole. Mental recovery and quality of life are also considered as part of the treatment. Moreover, there's also funding going into the projects that specifically study the patient’s quality of life, which support the clinical practices. For example, designing software and interactive games to enable the child to better cooperate with the breathing therapy machine and receive breathing therapy.
I think this is because of the differences between Chinese and Western cultures, actual situations, and healthcare systems. Because China has the largest population in the world, the proportion of patients and doctors is out of balance, so Chinese doctors are left to grapple first with the critical problems that their expertise can solve. However, in the UK, the NHS has a triage mechanism, able to allocate medical resources reasonably. In addition, the British population is relatively small compared with China, so the British doctors can spend more time on each patient. British society also shows high respect and provides comprehensive care for people with physical defects.
Furthermore, the nurses work very hard, and doctors will also take on some of the nursing work in China. Everyone's work rhythm is very tense, while in the UK, the proportion of nurses and doctors are relatively higher. The consultants always have a personal assistant to help them with admin work. I think this is the difference and gap, but I believe that along with the deeper medical reform and more international exchange, China's medical situation will gradually improve.
What are your plans when you return to China?
Hao: When I am back in China, in addition to normal clinic work, I will continue with the diagnosis and research of primary culinary movement disorders. This is a congenital disease that often has symptoms in childhood and some children have been mistreated as asthma or bronchitis for many years, so there is room for improvement in China.
Did you like living in London?
Hao: I really love London. International tolerance in London is very strong, so it was easy to adapt. The relatively slow pace of life here makes people pay more attention and enjoy life more. During the year, I also spent my spare time participating in many meaningful charity activities related to GOSH, which was very interesting.
Would you recommend the programme?
Hao: I highly recommend the international observership programme of GOSH, and I hope my peers have the opportunity to come here. GOSH is one of the best children’s hospitals in Europe and you are able to focus on very complex and rare cases when here, which is a challenging but also allows you to grow as a doctor.