Newsletter No. 408

8 No. 408, 4.12.2012 吳浩強教授 醫學院副院長（教育） 病理科是大眾較感陌生的，它是一門甚麼樣的醫學專科？ 病理科的主要工作，是檢查從病人抽取的血液、尿液及活細胞等樣本，分析病 因和病情，以助醫生診斷及決定療法。在先進國家和香港，醫科生畢業後，要 再接受五至六年訓練，並通過專業考試，才可成為病理醫生。病理醫生最常應 用的就是顯微鏡，約過半的檢查，都是在顯微鏡下看切片。 為何放棄當臨床醫生，而專研病理？ 是機緣巧合吧。我早年在愛丁堡大學習醫，遇上良師，取得內外全科醫學士學 位後，便朝病理專科發展。臨床醫生站在最前線，親身接觸病人，但往往要兼 顧其他事務，如家屬的情緒，我希望可以更好掌控時間運用，也樂於退居幕 後，尋根究柢，雖較靜態，不過兩者都是幫助患者解除病苦，亦各有挑戰。 最讓病理醫生頭痛的問題是甚麼？ 最怕遇上檢驗的樣本數量不夠，像是腫瘤太深，只能抽取少許組織，降低了診 斷的準確性，難免會影響療效。在這情況下，唯有加倍小心檢驗，集合多位病 理醫生的意見，始行下判斷。 當病理醫生需要甚麼條件？ 必須夠耐性夠仔細，觀察力強，確保沒有忽略任何細節，且從多角度思考，以探 究病因和預測相關病變。要是能敏銳視察顏色的變化更佳，因為切片上些微的 色調改變，實際已蘊含重要的形態結構或是功能代謝的轉變信息。 早在1996年，你一力促成了中國病理醫生培訓計劃，為何有此構思？ 我在九十年代初開始與內地病理學界交流，發覺礙於資源不足，不管是器材、 參考資料，或是病理醫生的培訓都欠系統性發展，直接影響診斷的準確度。我 開始思索如何才可協助內地病理科發展，提升水準，由此催生了中國病理醫生 培訓計劃。在申請得撥款後，我安排內地主治醫師或以上級別的醫生，來中大 接受為期三個月至一年的臨床病理診斷訓練，部分更可參與臨床工作。 這些年來在培訓內地病理醫生的發展如何？ 培訓計劃舉行了三年，共為三百多名內地病理醫生提供進修機會。計劃 結束後，我於1999年動員四十位內地主要病理學會會長和醫科大學的主 任，成立了中國病理主任聯會，並獲選為主席。聯會的宗旨，就是透過引 進相關知識、資訊和技術，繼續推動內地病理專科發展。聯會定期舉辦 學術年會，明年將達第九屆了。經過這些年來的努力，內地的病理科水準 已顯著提升，加上我亦是國際病理學會的副主席和教育委員會主席，故近 年已把重心轉往病理科發展落後的鄰近地區，例如印尼、菲律賓，最近我便去 了柬埔寨，看看如何提供協助。 公餘有甚麼興趣？ 我很喜歡世界史，想知道今天的世界為甚麼是這個樣子的。 我有一個習慣，就是每次出門，是公幹也好，旅遊也 好，要去陌生地方的話，總會翻看相關的歷史書 籍，先了解這個地方的歷史文化背景。 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.