The provenance of this quote must be familiar to all. Dating from the Spring-Autumn Period almost 2,700 years ago, it epitomises the philosophy on what we would now call human capital development by Guan Zhong (管仲), prime minister of the State of Qi (齊).
The true essence of any university is its people – students, faculty and staff. HKUMed was the first faculty to have established a deanery portfolio in human capital back in 2013, that has since been elevated in stature to come directly under the Executive Associate Dean’s purview. Since the Vice Chancellor’s arrival in 2018, he has emphatically and persistently reminded us of the importance of recruiting the best talent and nurturing them in a supportive environment. Therefore, we have designated human capital development as our headline priority for this academic year. Let me explain further in HKUMed’s「一年之計」, otherwise known as the annual State of the Faculty Address.
When I took over the deanship almost a decade back, the top three most pressing needs were space, space and space. The last major campus extension was completed in 2002 when we moved into our main complex at 21 Sassoon Road. HKUMed also took up new space at 5 Sassoon Road in 2011 but is only one of several tenant faculties at the Hong Kong Jockey Club Building for Interdisciplinary Research. There has been no new space for us to grow since. Meanwhile, the size of the Faculty has grown by leaps and bounds. Looking at undergraduate student numbers alone, in 2002, we offered only four programmes, consisting of 303 first-year-first-degree places. For the 2022 intake, we will be admitting 295 MBBS, 210 BNurs, 35 BPharm, 20 BChinMed, 38 BBiomedSc, 20 BASc (Global Health and Development) and 15 BSc (Bioinformatics) first-year students. We have doubled both the number of programmes offered as well as our total undergraduate intake over the past 20 years, from 303 to 633 per year.
During that time, with the increase in student places came 73% more faculty members, who in turn require laboratory space, and the recruitment of postdocs and research postgraduates (RPgs). For instance, the number of RPgs, while still in short supply, has already tripled from 283 to 813. Therefore we formulated our「十年之計」at the beginning of my deanship nine years ago to develop new space. I am gratified to report to you today that we are now beginning to realise those building dreams.
First, the Faculty Administration Wing on Tang Court, eponymously named after one of my predecessors Professor Grace Tang’s family, was just commissioned this September along with extension and improvement works in the William Mong Building at 21 Sassoon Road. The Schools of Nursing and Chinese Medicine are getting ready to move into 3 Sassoon Road during the coming summer. Our research team leaders have been busily working with architects to put the finishing touches on detailed 1:50 design plans for the University Block at Grantham Hospital that is slated for completion by the end of 2024. At around the same time, the first of two new clinical training and amenities buildings, incorporating student residential places, will be ready for occupation. Finally, to coincide with our 140th anniversary in 2027, the second clinical training and amenities building will be commissioned together with the green belt development along Pokfulam Road between 3 Sassoon Road and the Ebenezer School.
With the support of Government that has been increasingly invested in innovation and technology development for Hong Kong’s future, our research footprints have spread beyond the Island to now include 5,000 sqm laboratory and other work space at the Hong Kong Science and Technology Park as well as 1,100 sqm at the Hong Kong Children’s Hospital.
Altogether, we will have expanded from 40,000 sqm to 64,000 sqm, equivalent to more than a 50% increase of net operating floor area.
Having secured our space needs in situ for the Pokfulam campus and in Hong Kong generally, at least for the medium term, we cast our sight to the other side of the Shenzhen River.
The China Dream: health care and health tech in the Greater Bay Area
This September, the University signed a memorandum of understanding to establish a second campus in Nanshan district of Shenzhen that would complement the Hong Kong campus in Pokfulam. Whereas the Hong Kong College of Medicine for Chinese preceded the University by 25 years, HKU-Shenzhen Hospital is already celebrating its tenth anniversary. HKUMed has been and will always be pioneers, opening up fresh tracks with our own footprints. Those tracks were paved with the gut, sweat and tears of our colleagues who had hand-carried scarce supplies every day they crossed the border, held their heads high when all around them deemed the project infeasible, resolved a long-running debt repayment crisis, fought off a corporate takeover bid, calmed labour unease with the introduction of modern human resources best practice, and kept faith and rallied the crew when support on the home front has been less than embracing.
While University Central has not planned for HKUMed to be amongst the first group of faculties venturing into Shenzhen, we plough on readying ourselves for a full-fledged northern medical campus that is now more than three years in the making and counting. Some worry that much time has been lost and opportunities forgone; I nevertheless remain confident that there is a bright future ahead. The 14th Five-year Plan envisions health innovation and technology as a national strategic cornerstone for the Greater Bay Area. Shenzhen is arguably becoming more dynamic than Silicon Valley for digital technology companies, and has invested very substantially in health care infrastructure and training. Hong Kong retains its leading edge as Asia’s medical hub. All the ingredients for integrated success are ripe for harvest. Our job is to ensure the fruits are picked in good time. As the Director of the Central People’s Government Liaison Office said in August: 「不進則退，慢進也是退」, whereas the Deputy Director of the Hong Kong and Macao Affairs Office summed it up more parochially as「蘇州過後無艇搭」.
Reassuringly, I am pleased to report that we are well on our way to renewing our collaborative agreement with the Shenzhen municipal government in operating the HKU-Shenzhen Hospital. Vice President Professor Peng Gong is leading that effort on the University’s behalf. And by 2027, on the 140th anniversary of HKUMed, a new clinical block of 1,000 additional beds and a research block equivalent in floor area to the Laboratory Block at 21 Sassoon Road will be completed at the Hospital. This enhanced capacity for clinical service delivery and evolution towards a truly research-led academic health science complex is a milestone to which we all look forward.
終身之計，莫如樹人 (A lifelong mission of nurturing people)
Having sketched out various huge efforts at upgrading the built infrastructure on both sides of the border, let me now turn to the crux of 管子’s lifelong mission or「終身之計」, which is of course「莫如樹人」or human capital development. As I said at the beginning, echoing my repeated emphases back in the 2013, 2015, 2017 and most recently 2019 State of the Faculty Addresses, human capital is at the heart of what we do and who we are. But precisely how should a school expand, enhance and enrich its human capital?
Research metrics, prizes and awards are often ready proxies for quality. By these measures, we have completed the year in spades. Topping the list are Professors Guan Yi (Public Health), Malik Peiris (Public Health) and Yuen Kwok-yung (Microbiology). The first two became laureates of the 2021 John Dirks Canada Gairdner Global Health Award “for significantly contributing to understanding the origins and options for control of newly emerging infectious disease outbreaks in Asia, notably zoonotic influenza and severe acute respiratory syndrome (SARS).” The last two were awarded the 2021 Future Science Prize in Life Sciences “for their discoveries of SARS-CoV-1 as the causative agent for the global SARS outbreak in 2003 and its zoonotic origin, with impact on combating Covid-19 and emerging infectious diseases.”
Dr Maria Zhu Huachen (Public Health) won the 16th National Young Woman Scientist Award (中國青年女科學家獎) for her work in emerging infectious diseases, especially steering the establishment of the Shantou University-HKU Joint Virology Laboratory with her mentor Guan Yi.
Professor Chen Honglin (Microbiology) led his team to win a Gold Award with Congratulations of the Jury at the 2021 Inventions Geneva Evaluation Days for their work on an intranasal influenza virus-backboned COVID vaccine that will hopefully become a useful next-generation option as we transition from pandemic to endemic.
Professor Jin Dong-yan (Biomedical Sciences), Dr Vincent Lui (Surgery) and Professor Leo Poon (Public Health) won three out of the four health-related Theme-based Research Scheme projects awarded by the Research Grants Council this year.
Of course our colleagues continue to make important contributions to the ongoing pandemic control effort, locally, nationally and globally. One yardstick, amongst many others, would be the number of citations already accrued of our COVID-19 related papers. HKUMed has produced 16 papers that have already attracted at least 1,000 citations each, with the top paper alone having been cited 14,000 times to date.1
On the topic of citations, four days ago, Clarivate Analytics announced that a record 17 colleagues attained the coveted “Highly Cited Researcher” or HCR status. HCR is determined by production of multiple highly cited papers that rank in the top 1% by citations for field and year in Web of Science. HKUMed’s proportion made up more than half of the University’s total 31 researchers so honoured. This has lifted HKU to being included amongst the top 50 schools worldwide in terms of number of researchers judged as HCR.
You will find a full list of notable achievements during the past academic year at the end of the printed Address.
Notwithstanding these impressive statistics and reputational accolades, I keep revisiting a few questions that go to the very heart of our raison d’être. Would assembling an ever larger contingent of people with high h-indices who have already garnered international recognition be a sufficient, or even desirable, aim for a medical school? Or perhaps we could more single-mindedly coach and cajole our own towards the same research metrics-driven goals? If still not entirely satisfactory, what else is missing from the definition of rich human capital?
Let me relate a couple of stories I witnessed in the past month alone. I was visiting a colleague who was recently hospitalised on his birthday. Given COVID restrictions, there was no family visitation allowed. Just as I was leaving, a former medical student who is now almost ready to exit her specialist training came into the room with a takeout dinner from the hospital cafeteria, given that hospital meals were hardly appetising. I commended her for her thoughtfulness, and quietly alerted her that it was the patient’s birthday. She beamed back and showed me a chocolate bar she had in her whitecoat pocket, signalling that was going to be the “birthday cake” after dinner. That was what a caring doctor should look like. That was empathy. That was the art of medicine which our medical humanities programme aims to inculcate. And that was immeasurable by impact factor analysis.
Another former colleague recently spent down much of her already dwindling political capital, against all odds internal and external, to push through a complete ban of all non-traditional tobacco products, including both electronic cigarettes and heat-not-burn devices. Why would a politician in today’s environment, risk her personal stakes over a piece of legislation, even if implemented with the desired effect, that would not allow her to win political plaudits? To underscore the science underpinning her new legislative fiat, another junior academic colleague effectively rendered his two children orphans for a month to rush through round after round of new analyses and simulations that culminated in an 80-page supplementary appendix. This herculean effort led to timely acceptance of the paper in a high profile journal that was disseminated in the lay media, which in turn directly and positively influenced the final session of the bill’s committee proceedings. The law finally passed third reading last month in the Legislative Council. That was an affirmation of「上醫治國」. That was lifesaving impact of hundreds of thousands of tobacco-related deaths averted in the decades to come. And that was immeasurable by research metrics.
On recognising impact by unsung heroes, there were a few most worthy of honourable mention that is two decades overdue. They had absolutely enabled the headline success of our own professors who have been recognised by the Gairdner and Future Science awards for discovering the SARS coronavirus back in 2003. At the risk of being invidious and non-exhaustive, they include our longtime HKUMed colleagues Dr Chan Kwok-hung (Microbiology), Professors John Nicholls (Pathology) and Leo Poon (Public Health), Drs Wilina Lim at the Department of Health and Dominic Tsang (Medic 1984) at the Hospital Authority who anchored the first response in the public sector, and individual clinicians looking after the very earliest patients at Kwong Wah Hospital such as Dr Wilson Yee who was the attending physician, Dr Ko Kai-ming (Medic 1975) who carried out the first open lung biopsy despite grave personal risks, Dr Elaine Gwi who arranged for the sample to be shared, and Professor John Chan (Medic 1981) who provided corroborating evidence by electron microscopy.
During the course of this academic year, we will be bidding farewell to two distinguished colleagues. Professor Paul Tam, former acting Vice Chancellor, interim Provost, Pro Vice-Chancellor and Vice President (Research) and Associate Dean (Research) will be retiring from HKU and joining the Macau University of Science and Technology, working alongside its President Professor Joseph Lee who was HKU’s Pro Vice-Chancellor for staffing, or in today’s nomenclature academic development. I am glad though that he will be continuing his research at the University, not least in the Theme-based Research Scheme programme headed by Dr Vincent Lui, his protégé. Without Paul, there would have been no TRS, full stop.
Professor Keiji Fukuda, Director of the School of Public Health, who was first introduced to Hong Kong during the 1997 avian influenza outbreak as part of the US CDC delegation will be retiring to Atlanta, home of the CDC, completing the full circle of the past quarter century. Keiji has long been a personal friend and global health collaborator, through SARS, MERS, the 2009 swine flu pandemic and of course the ongoing COVID-19 pandemic. I still remember well the many conversations I and others had had with Keiji, persuading him to come to HKUMed. These took several years spanning different continents, from Geneva to Atlanta to Doha, before two important women would support his move – Holly his dear dear wife and Dr Margaret Chan, former Director-General of the World Health Organization and his former boss. I thank them both for having supported Keiji and HKU throughout these years of his service to the University and wish him and Holly well.
Success at succession
The retirement of senior leaders reminds us of the vital importance of ongoing leadership renewal. It is a perennial goal of any successful organisation, not least in a university faculty. Sometimes it feels Sisyphean, especially when there is disequilibrium between attrition and availability. The 2019 social unrest and its aftermath coupled with COVID-19, against a longrunning background of the peculiarities of the local medical labour market have together made for a less than optimistic pool of appropriately qualified and interested leadership candidates in many fields.
Despite these odds, I am delighted to have welcomed during the past year Professors Wing Leung and Chris Leung who respectively lead Paediatrics and Ophthalmology. Wing has enjoyed a distinguished career at the world-renown St Jude’s Children’s Hospital in Memphis, Tennessee and the National University of Singapore before joining HKUMed. Chris comes to us from across the Lion Rock and is without doubt a leading clinician cum translational visual scientist in Asia. We will soon welcome a brilliant radiologist who formerly headed a major US department at the University of Pittsburgh Medical Center. He was chosen as a recipient of the highly selective government Global STEM professorship. I am sure he will be taking our Department of Diagnostic Radiology to new heights. Closer to home, I have recently appointed four younger colleagues to the headships of Microbiology, Obstetrics and Gynaecology, Orthopaedics and Traumatology, and Psychiatry. They are a new generation of HKUMed leaders who will bring fresh thinking and youthful energy to the many challenges and tasks ahead.
Leading by listening
The original Silicon Valley firm, Hewlett-Packard, pioneered the management principle of “managing by walking around”. Taking a leaf out of its books, I sat down with all 200 assistant and associate professors, in groups of a dozen or so during the month of September. Importantly I listened to and heard them out on a whole range of topics, ranging from career prospects to the academic and general environment to personal aspirations. And last month in October, I continued my annual tradition of holding town hall meetings with students from each of our undergraduate and research postgraduate programmes. Together we resolved quick and easy issues on the spot, like captioning and uploading of archived e-learning videos or provision of additional microwave ovens; as well as acted as mutual sounding boards on deeper and more complex areas of interest such as reforming the MBBS clinical curriculum or the impact of the future Chinese Medicine Hospital on teaching and learning.
These sessions have been very useful in grounding my colleagues and I in the everyday realities of our stakeholders, whom we serve in addition to lead.
Meritocracy and equality of opportunity
So far I have talked about buildings and professors, but scarcely mentioned the very subjects in whose name we serve. We are not a technical research institute but a school. As such we must always remember that students are at the heart of our being. It is at least as important to recruit students than faculty. Therefore, we expend much deliberate energy in thinking about whom and how we admit.
In the East, the Confucian moral ideal of well-educated rulers has always found syntonic echo with the Platonic concept of the philosopher king in the Athenian states. Since the end of World War II, this age-old emphasis on intelligence and ability as traits that societies should value has resulted in the rise of the meritocracy, in much of the developed world. One can understand it, at least in part, as a default by exclusion after experientially rejecting feudal aristocracy or collectivisation.
Being at the intersection of the East and the West and per se an exemplar of Milton Friedman’s free market economy par excellence and very much a product of and beneficiary of globalisation, Hong Kong, like most other cosmopolitan, urbane and smart metropolises has come to represent the pinnacle expression of meritocracy.
This has percolated through every facet of society, including university admissions. On the surface of it, meritocracy is a system that intends to give each new generation an equal chance to rise to the top by dint of their natural abilities and through hard work. Who could argue with that? But when educated professional elites pass on their connections, money, work ethic and ambitions to their children, while offsprings of the working class lack most of these “heritable” traits, the gap endowed by the meritocratic advantage grows into an unbridgeable chasm and becomes entrenched intergenerationally.
When this apparently “fair” hierarchy hardens, like it has in Hong Kong as elsewhere over the decades, two problems inevitably emerge. First, the system is cruel because it justifies why some people fail. “Perhaps they should have worked harder and aimed higher”, so the saying too often goes. This leads to resentment and shame. Second, even for the winners in this system, there is a constant hum of anxiety that one is never good enough. Nowhere is this more true than in the preparation for university entrance examinations and interviews. The dystopian tutorial school and extracurricular activities merry-go-round suffered by every pupil is one such manifestation. Therefore many mainland teachers and parents breathed a quiet sigh of relief when the national government intervened recently, although finance types might have grumbled about the way it was executed.
Ultimately though, one still needs to address the root reason – university admissions. That was why since 2013, HKUMed is the first and only school, to have explicitly set a reserved quota of at least three-quarters of available places for graduates of the local high school diploma system. It was not because of local favouritism but a recognition that the DSE2 is the only system that is truly open to all and that empirically other routes of entry are dominated by applicants from more advantaged families.
We have upheld this self-imposed, equity-driven 75% JUPAS3 floor quota in our MBBS4 admissions ever since. However, given the JUPAS mechanism, one cannot predict how many of these offers are eventually “matched” by the system, after incorporating candidate choice. Indeed from 2018, a number of candidates who were offered a place did not choose our programme because we would not compromise on assessment standards nor coddle. As such, the remaining places were subsequently offered to degree holders, IB5 and GCE A-level6 candidates, in order to fulfil the government mandated manpower-planned quota.
Fundamentally, demographics have been a major headwind. Hong Kong’s overall eligible JUPAS candidate pool has shrunk by some 40% in the past decade. In parallel, the total number of manpower-planned medical undergraduate places has increased by more than one-quarter. Therefore, medical programmes have become considerably less selective; to be precise, it is more than twice as easy to gain a place into medical school in 2021 compared to the beginning of the “3+3+4” era in 2012/13.
During the past decade between the two local medical schools, fewer than two-thirds of first-year intakes have been from the JUPAS pool. In other words, whether the split is 50% vs 70% HKU vs CUHK like in the past few years, or 70% vs 50% like in earlier periods, there are only so many JUPAS candidates who are deemed qualified for medical studies by both schools overall. The introduction of the Medical Registration (Amendment) Bill 2021, which opens the door for those who graduate from 100 pre-approved non-local medical schools to practise medicine in Hong Kong without the need to sit local licensing examinations, is likely to pose further uncertainty to admissions uptake at the two local medical schools in future. The competition for the same pool of candidates will shift from essentially between two schools to 102 schools. Furthermore, the government manpower-planned quota will increase from the current 530 to 590 for the 2022-5 intakes, thus making the medical programmes even less selective than currently. These two fundamental policy changes will almost certainly impact medical student admissions from next year onwards, likely further reducing the proportion admitted through the JUPAS route.
Having made the diagnosis, what is the solution?
Should we lower admission standards that would inevitably lead to higher failure rates? We have witnessed a disproportionate number of students who came in just above the admission threshold struggle through the first- and second-year summative examinations, as well as fall victim to maintaining mental and emotional wellness. Or perhaps we could lower the normative standards in our largely self-regulated curriculum, although that would be shirking our dual responsibility as a guarantor of quality doctors for the future.
On another front, we could preferentially admit less qualified applicants on grounds of redressing intergenerational disadvantages, and then provide extra remedial help to get them through the curriculum. How would one operationalise this though – by using the JUPAS route as a proxy to mark out the unfairly disadvantaged? If so, would this be consistent with government policy dating from the first SAR Administration that proactively encouraged a diversity of school types, for instance by introducing the Direct Subsidy Scheme (DSS) that has now accumulated 24 newly established and 35 government-aided/private independent schools which have switched over to the DSS. Most of these schools, in addition to the international schools, offer in whole or in part non-DSE programmes of study thus their students apply through the non-JUPAS route.
Besides, any deliberately biased admission policy, however well intentioned and justified, has been tried for half a century in the US. “Affirmative action” purports to correct a legacy of discrimination against applicants of colour. It has indeed broadened opportunity generally but has largely failed in its mission. Over the past 20 years, the proportion of African-American students admitted to the top 100 most selective American campuses has fallen by 60%, according to the non-profit Education Trust.7 In part, the policy has failed because its legal basis had been shaky from the outset, as reflected by the extreme heterogeneity of views expressed through six different judicial opinions in a 5:4 Supreme Court vote in the landmark case Regents of University of California v. Bakke in 1978. The US Supreme Court may soon hear another case – Students for Fair Admissions, Inc. v. President and Fellows of Harvard College. It is a lawsuit about discrimination against Asian-American applicants in Harvard’s student admissions process. Many have come to believe this case could be the final coda of affirmative action in university admissions in America.
So, like all vexed problems, there are no easy answers. But one thing is for certain: reducing this complex social problem by executive fiat that is thinly veiled real politik would be wrong and unfair for all.
HKUMed will continue offering 75% of our total quota to JUPAS candidates. We will also reflect more deeply what undergraduate medical education by 2050 should become, thus how we go about it in a better way that is fit for purpose and with student wellbeing at its centre. We will not carve out an elitist subprogramme and pre-label a small minority of high school leavers as destined to become medical leaders. Because in effect, that would condemn the majority of medical students to belonging to a future working class of doctors subsumed from the outset of their medical journey simply because they score a couple of points lower on their DSE examinations. Hong Kong already suffers from extreme inequalities, we must not add to it. A university education is supposed to bring intergenerational mobility, not restrict opportunities based on birth and breeding. President Xi Jinping’s clarion call for “common prosperity” should be our guide to resolving this conundrum.
University admissions is a symptom, not a cause. As the father of modern pathology and social progressive Rudolf Virchow, whose birth bicentenary we just celebrated last month, once said:
Medicine as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution; the politician, the practical anthropologist, must find the means for their actual solution.
New opportunities for a new era
Three important new developments will fundamentally change the future health and health care landscape of Hong Kong. They are the establishment of the Hong Kong Genome Institute, the development of the Hong Kong Academy of Nursing and its constituent colleges coupled with recently reformed nursing career pathways at the Hospital Authority, and the soon-to-be commissioned Chinese Medicine Hospital. In response, we are strategically rolling out complementary human capital training opportunities. Respectively, we will be launching a refreshed bachelor’s in bioinformatics next September to produce the necessary analytic minds who will go on to decode the peta bytes of multi-omics data coming out from the Hong Kong Genome Institute. We have also admitted our first intake of BNurs students on the advanced leadership track, that is targeted at those who aspire to become specialist nurse consultants or even articulate into a double degree programme with MBBS. Based on the success in the most recent Research Assessment Exercise in which our School of Chinese Medicine was ranked top out of the three local schools for the first time, we are redoubling our efforts in preparing the next generation of clinician-scientists in Chinese medicine under the leadership of the incoming Director.
Building dreams, realising possibilities
Finally, please allow me the opportunity to give thanks. HKUMed has for the first time in our 135-year history been recognised as one of the top 20 medical schools in the world, according to the latest authoritative Times Higher Education ranking. This would not have been possible without the collective dedication and hard work of our students, alumni, faculty colleagues, researchers, teachers, professional and administrative staff, and indeed all those who have come before us. Your alma mater owes each and every one of you a heartfelt “thank you”. Today's HKUMed has been able to aim a little higher and reached a little further because we stand on the shoulders of giants who have blazed the way – from Sun Yat-sen to the latest laureates of “China's Nobel” the Future Science Prize.
This Congregation marks the official start of our 135th anniversary celebrations. They will be bookended by this and the next Congregation in the summer of 2022. I will be hosting four Dean’s 135th Anniversary Lectures by national and global luminaries throughout the year. We will also be commissioning a series of permanent art exhibits to celebrate our most important achievements, for each School and Department. Publicly displayed succession rolls honouring all current and former emeritus and chair professors, heads of departments, faculty board chairmen and deans will be installed in prominent locations around campus. We will organise heritage walking tours of the Sun Yat-sen Historical Trail and the Sassoon Road campus for alumni and members of the public to learn more about our history and works. The HKU Medical Alumni Association will be organising a football tournament and our Student Wellness Team will be hosting “HKUMed Games” and e-sporting events. COVID-19 has taught us how to work virtually, so we will also celebrate through an enhanced social media presence. There will of course be the obligatory HKUMed-branded mementoes and paraphernalia for you to purchase as gifts.
First in Hong Kong and amongst the top 3 in Asia and top 20 in the world on our 135th birthday. Bravi friends and colleagues – well done! With our rich heritage and present achievements, we must strive onwards and upwards ever more, ultimately for our patients, our communities and humanity.
2020-21 Honour Roll
Professional Recognition and Honours/Awards (Teams)
Professional Recognition and Honours/Awards (Individuals)
Major Research Support