Bulletin Autumn‧Winter 1979

tration and the right to practise in the United Kingdom, primarily and as I have already said for the purpose of postgraduate study. Luckily the General Medical Council (of which I myself am currently a member) is fairly flexible in its approach. This means that although it insists that there are certain basic requirements to any medical curriculum, options are still available. This is fortunate for two reasons. The first is that there is in-built flexibility in the design of medical curricula which allows medical schools to experiment and leads also to a certain degree of healthy rivalry between one and another none of whose medical curricula are precisely similar. The second reason applies particularly to overseas medical schools based on the British pattern which have to pay special attention to the health requirements of the populations w h o m their medical graduates will ultimately serve. Although, therefore, there are similarities in the diseases that occur both in the United Kingdom and Hong Kong, there are also differences to be found rather more in their prevalence perhaps than in their nature. Due regard must be taken of these differences in planning a medical curriculum. Likewise the overall patterns of disease are changing. Professor Choa in a paper which he gave at the 25th Anniversary Symposium of Chung Chi College, stated that Hong Kong ‘has now caught up with the developed countries in that people die mostly of the degenerative diseases rather than infectious diseases including tuberculosis. Consequently in the field of preventive or community medicine the emphasis is now quite different'. This brings me to remark that m y own subject—psychiatry—has grown enormously in importance in the U. K. over the last 25 years so that the number of psychiatrists now exceeds the total number of internists. It is a common observation that as a population becomes physically healthier mental disorder and social problems tend to loom larger. Quite probably the same is happening here in Hong Kong. Indeed, there is evidence that this is the case. Likewise because people today are living much longer than they used to we are seeing very much more of the diseases which are commonly associated with growing older. These include cancer—a special problem in Hong Kong—heart disease, strokes and dementia, all of which are greatly on the increase. This increase has led to the filling of hospital wards so predominantly by old people that geriatric medicine as such is almost beginning to lose its identity as a specialty as it becomes more and more the business of all physicians and surgeons or indeed of almost all doctors save perhaps obstetricians and paediatricians. Specialization and Lifelong Training I would like to make two further points about medical education in general. The first is that medicine has so grown in its various dimensions that no student, however assiduous can absorb anything approaching the totality of medical knowledge. In view of this it would appear that medical education is moving towards the identification of a core of knowledge which every student must necessarily acquire together with the opportunity to undertake various options or electives. As these should be a matter of choice, this in effect may mean earlier specialization. Although some may be opposed to this idea, its ultimate acceptance is probably inevitable. M y second point arises out of the first. This is that medical education no longer stops at the point of qualification and the granting of a medical degree. It is an on-going process which should last a lifetime. Gone is the day when a newly-qualified doctor could be let loose to practise, with no provisions made for periodic if not continuous refreshment of his skills. In medicine as in other disciplines it must not be forgott that the facts of today often turn out to be the fictions of tomorrow and that doctors must be kept aware of this, together with that of the changing pattern of diseases and of advances in their treatment and prevention. Mr. Vice-Chancellor, I think there is only one thing which now remains for me to do. This is to offer m y very best wishes to all of today's graduates, to wish them well in their future careers and endeavours and to say how much I and m y colleagues and no doubt many others also are looking forward to the day when their numbers will include those who, for the first time, are graduating in medicine with a degree from The Chinese University of Hong Kong.