ENT Masterclass® China was a landmark event that brought an international training resource to Beijing. Profs Shusheng Gong and Shahed Quraishi discuss the organisation of this event, the training pathway in China, and the setup of a typical ENT academic department.
Prof Shusheng Gong.
Prof Shusheng Gong
Can you summarise the structure of a typical academic ENT department in China? How does this model differ from the ENT department at the Friendship Hospital, Capital Medical University?
In China, the academic ENT department can be part of general hospital or specialised hospital. Also the size and structure varies according to different situations. For example, in a middle-sized general hospital, of 70 ENT beds, the structure would be: 8-10 professors or associate professors (full time, usually 15-20 years after qualifying as doctors). They are clinical professors but can also apply for the research fund and are part of the faculty in the local medical school.
The hospitals pay for the majority of the salary; 4-6 attending doctors (after completing residency and chief residency training, doing clinical work and clinical research); 10-15 residents in different years of the programme (after medical school, they enter a five-year residency programme); 1-2 research fellows (fulltime, supported by research fund); 4-6 visiting doctors (three months, six months or one year, only doing clinical work); 4-6 clinical technicians (audiologists, voice therapists).
For ENT in specialised hospitals, there will always be a research institution, and most of the staff in the institution will be researchers’ and scientists. The ENT department at the Friendship Hospital (general hospital) is trying to combine these two models. Other than the clinical staff, we have our laboratory and principal investigator (PI) for basic research. The residents and attending doctors have training facilities for both clinical and research projects.
What is the approximate number of ENT trainees in China and could you tell us about the ENT specialty training system and continuing medical education in China?
We don’t have a nationwide number for the ENT trainees because of the regional diversity in policy. Take the Beijing area for example: we have a five-year residency programme with almost 50 trainees for each year and fellowship for one to two years in some hospitals. Regarding continuing medical education in China, the most common form is the credit system, which is actually popular in all medical specialties. Each ENT doctor needs to complete 25 credits every year by attending the projects of continuing medical education approved by the national Ministry of Health; this could be academic conferences, technique trainings, or workshops. Also there are some online continuing medical education courses, mandatory for every doctor, like infectious diseases.
After finishing training in ENT from the Friendship Hospital, where will these postgraduate ENT doctors find employment?
Nowadays, these postgraduates could have been employed before entering the training programme. So except for the doctors who need to return to their original hospital, the remaining candidates can apply for ENT positions in academic, public sector, private practice or military hospitals. There will be a certain degree of difference for each admission based on the bidirectional choices. For example, an academic ENT department will always choose the doctors good at both clinic and research, and teaching skills can be another consideration. Of course, academic or public sector will also be the first choice for the young doctors.
How did you get to know ENT Masterclass®? What opportunities do you see to promote your cooperation with this Europe-based training platform?
I initially heard about ENT Masterclass® from ENT and Audiology News, but not in detail. During the conference of APSCI 2015 in Beijing, Prof Dan Jiang from London gave us a complete introduction to ENT Masterclass® and expressed willingness to work together. We were very interested and both of us desired to build such cooperation. In our view, it would be a perfect chance to introduce western medical training programmes to Chinese ENT doctors and build a platform of communication. Thanks to the recommendation of Prof Dan Jiang and the confidence of Prof M Shahed Quraishi, the joint project is developing very nicely.
What was the feedback from the delegates on the 1st ENT Masterclass® China?
The debut of ENT Masterclass® China received nationwide attention from practitioners at different levels, who were postgraduates, residents or specialists. All the delegates appreciated the free training platform and enjoyed the all-inclusive academic content. For next year we have some considerations: what level of ENT surgeons would benefit most from the masterclass? Would they prefer a special series of topics? In order to attract more delegates, simultaneous English / Chinese translation would be arranged for next year. Anyhow, a well-begun project is half the work done, and the 2nd ENT Masterclass® China is on its way (17-18 June 2017). The organisational processes and academic content will continue to improve as well.
Have any other such available ENT educational platforms been used or considered appropriate for the Chinese ENT workforce?
The most attractive ENT educational platforms are series of academic conferences held by the Chinese ORL Society, including the national conference of ORL&HN and academic conference for young doctors yearly in turn. In addition, annual symposiums for each sub-specialty are also welcome. The ENT Masterclass® China has brought forth new ideas to the training of the Chinese ENT workforce. We still have a lot of work to do and hopefully it will bring ENT practitioners worldwide closer.
Prof M Shahed Quraishi.
Prof M Shahed Quraishi
As the chairman and founder of ENT Masterclass® when and how did you get the idea to initiate this programme, and offering all the courses for free?
ENT Masterclass® evolved as a natural outcome of the limited training funds for ENT residents in the UK. After finishing my training in 2003, I found that many senior colleagues shared this view, and a consensus evolved to ‘give back’ to our specialty. With this mandate in hand, I began setting up a core group of senior ENT surgeons from Nottingham (Pat Bradley, Nick Jones, Anshul Sama and Kevin Gibbin), Middlesborough (Liam Flood) and London (Tony Narula, Shak Saeed, Ricard Simo and Hesham Saleh). The result was the inaugural three-day ENT Masterclass® course at Doncaster Royal Infirmary in January 2005. We had resolved to keep this educational platform ‘free at the point of delivery’. The feedback from both the faculty and delegates has been overwhelmingly positive and we now have over 150 senior professors and consultants from four continents in our faculty who pay their own travel and subsistence, some coming from as far away as New York and Sydney.
What gave you the idea to bring ENT Masterclass® into China?
In 2014 we undertook our first international ventures at Sydney, Delhi and Mumbai. The enthusiasm, feedback and good will that was generated confirmed our strategy to engage with colleagues in other continents while maintaining the principles of free training. China, representing one-fifth of the world’s population and an ENT fraternity running into tens of thousands, was a natural venue for further expansion. India and Australia confirmed that free training and education have no boundaries and there were enough ‘good people’ in faculty who would volunteer their time and resources to bring this educational platform to the doorstep of trainees all over the world.
Prof Dan Jiang from London, who is a senior faculty member, offered to take this up and discussed the plan with Prof Shusheng Gong and Prof Liangfa Liu from Friendship Hospital, during one of his visits to Beijing in 2015. An agreement was reached soon after.
Members of the ENT Masterclass China team with Prof Shusheng Gong (Sitting front, fourth from left).
Why did you choose Beijing Friendship Hospital as your partner in China and how do you evaluate the 1st ENT Masterclass® China in May 2016?
While China is a huge country, one should not forget that Beijing alone has a population more than the Australian continent. Beijing Friendship Hospital was chosen due to its position as one of the centres of excellence in China with a very eminent ENT team led by its departmental chairman and cochlear implant surgeon, Prof Shusheng Gong. Over the course of 12 months, Prof Gong and his colleague Prof Liu, put together one of the best international ENT Masterclasses® to date. Over 500 delegates registered, from Central Asia to Inner Mongolia.
The academic content was very well laid out, covering topics from dysphagia to dizziness, rhinitis to rhinoplasties and parotids to parathyroids. It was reassuring to see Prof Zhiquiang Gao, President of the Chinese ORL Society, and other senior office bearers in the faculty along with colleagues from all over the world engaging with the receptive delegates. The attention to detail, both academic and social, was testimony to the successful team from Beijing Friendship Hospital.
The President and faculty at Beijing Friendship Hospital.
Where do you think the ENT Masterclass® fits into the ENT education system for China?
As for trainees anywhere in the world, the ENT Masterclass® platform has provided an opportunity to share international practices, delivered by a high-powered faculty. An annual event providing free state of the art lectures from ‘different clinical cultures’ would appear to fit nicely into the training curriculum of trainees as well as surgeons in the ENT education system of China as it has in other international venues.
Do you plan further ENT Masterclasses® in other regions of China? Will there be further associations with the Beijing Friendship Hospital next year and in the future? And finally, are there any other training opportunities for Chinese ENT H&N doctors?
Although it is tempting to move to other regions of this vast country, almost a sub-continent, the casualty is going to be the stability that comes with keeping it in a fixed venue. With limited resources and volunteers, experience from other ENT Masterclasses® has shown that moving sites adds to expenses and can become a recurring logistic challenge. The Friendship Hospital team has put together a great group and it would be their choice to engage other colleagues and perhaps consider having regional satellite sessions to follow each masterclass. We are in the process of setting up a Chinese language ENT Masterclass® website and will possibly translate articles from the Journal of ENT Masterclass for the local trainees in Mandarin.
The ENT Masterclass® China has opened new vistas for training, but it should not be confined to these meetings. In January 2017, ENT Masterclass® along with ENT and Audiology News, has sponsored two travelling scholarships for Ms Jiao Xia and Ms Jing Xie, senior trainees from Beijing, for a two-week visit to the UK. With further goodwill and planning, we could work out possible avenues for fellowship places for each other’s trainees.
Delegates and faculty at the 1st ENT Masterclass China, 27-29 May 2016.
Interviewed by Jiao Xia and Jing Xie.