Symposium 18 - Leadership and Research

Medical education in Mainland China and Hong Kong reflects distinct approaches shaped by scale, healthcare needs, and global influences. Mainland China's system, the world's largest, follows the "Healthy China 2030" blueprint, standardizing a "5+3+X" model: five-year bachelor's degrees, three-year residency, and variable specialty training (3–8 years total). Problem-based learning and integrated curricula are increasingly adopted, yet regional disparities and diverse pathways challenge uniformity. By 2019, China trained 182,900 clinical graduates annually, with 75% holding bachelor's degrees, supporting 2.8 doctors per 1,000 population. 
In contrast, Hong Kong's medical education, concentrated at the University of Hong Kong and Chinese University of Hong Kong, adopts a UK-inspired six-year MBBS program. This includes two years of pre-clinical training (basic sciences) and four years of clinical rotations, emphasizing early patient exposure and problem-based learning. Post-graduation, a one-year internship precedes licensure, with non-local graduates requiring the Hong Kong Medical Licensing Examination. Specialist training, overseen by the Hong Kong Academy of Medicine, mirrors UK postgraduate pathways, requiring 6–8 years across 53 specialties. Structured assessments and competency frameworks, akin to the UK's General Medical Council standards, ensure rigorous progression. Hong Kong's selective intake (around 500 students annually) contrasts with Mainland China's mass-scale output, prioritizing quality over quantity.
Comparatively, Mainland China focuses on workforce expansion and standardization, grappling with uneven quality, while Hong Kong's UK-modeled system emphasizes elite training and global compatibility. Collaborative Greater Bay Area initiatives bridge these systems, fostering cross-regional healthcare integration to address diverse population health needs, with Hong Kong serving as a hub for advanced training and Mainland China scaling primary care capacity.

Medical education (undergraduate education for future doctors and postgraduate training thereafter) must be fit for purpose equipping a workforce, which is capable of meeting the healthcare needs of the community they serve now and beyond. Doctors belong to a caring profession so from selection, curriculum design through to assessment, we should focus not just on imparting knowledge and skills, but also on professional behaviours and values. In contrast to the traditional approach based on subjects or organ systems, we should integrate disciplines appropriately, in teaching and training, and in assessments. Entrustable professional activities (EPAs) and capabilities in practice (CiPs) are examples of a more holistic framework which may be used to determine the readiness of trainees at different milestones. A combination use of clinical materials and simulation in training and assessing technical (e.g. diagnostic and therapeutic procedural skills) and non-technical (e.g. communication) skills should be the norm. Clinical and academic experts should work with educationalists including psychometricians in the development and quality assurance of the training programme and assessments, which will ensure fairness for trainees and reassure members of the public on patient safety.

Academic research holds immense potential to revolutionize healthcare, yet translating discoveries into real-world solutions demands strategic vision, entrepreneurial action, and vigilant stewardship of intellectual property (IP). In this presentation, Prof. Allen Chan will explore the transformative power of bridging academia with industry, drawing on his pioneering journey in developing non-invasive prenatal testing (NIPT) and multi-cancer early detection technologies alongside Prof. Dennis Lo.


As a chemical pathologist, Prof. Chan's work in cell-free DNA diagnostics redefined prenatal care, replacing invasive procedures with safe, accurate blood tests. Today, over 10 million tests are performed annually worldwide. Building on this success, his team pioneered a multi-cancer screening blood test, recognized by Time magazine as one of 2022's "Best Inventions," demonstrating how iterative innovation addresses unmet clinical needs. However, scaling these breakthroughs required entrepreneurial collaboration and rigorous IP management. Through ventures like Cirina and Insighta, Chan and Lo transformed academic insights into globally accessible tools, underpinned by robust patent portfolios. The merger of Cirina with Grail-a deal fortified by strategically prosecuted patents-led to its $8 billion acquisition by Illumina, exemplifying how IP protection enables corporate scalability and mass adoption.


Prof. Chan will outline critical strategies for translating research: fostering cross-sector partnerships, securing early-stage funding, maintaining scientific rigor during commercialization, and proactively managing IP through patent prosecution, licensing to commercial partners, and defending against infringement. He will emphasize that securing granted patents is not merely a legal formality but a cornerstone for attracting investment, negotiating mergers, and ensuring long-term commercial viability. Challenges such as navigating global patent landscapes, enforcing IP rights against infringers, and balancing exclusivity with collaborative innovation will be addressed.


Looking ahead, Prof. Chan will highlight emerging opportunities in precision oncology and AI-driven diagnostics, advocating for institutional frameworks that empower researchers to embrace entrepreneurial thinking while safeguarding their inventions. He will stress the need for academia to prioritize IP education, leveraging legal and industry expertise to avoid costly missteps.


Ultimately, this presentation underscores entrepreneurship as a catalyst for amplifying academic impact. By nurturing ecosystems that unite discovery with execution-and by treating IP not as an afterthought but as a strategic asset-healthcare systems can accelerate the delivery of transformative, life-saving innovations to patients globally. The true measure of research lies not in publication alone, but in its power to save lives.

The university hospital model represents far more than a collection of separate functions. It embodies a deeply interconnected ecosystem where the boundaries between patient care, education, research, and innovation blur into a cohesive whole. This symbiosis creates unique value impossible to replicate in standalone institutions. The true power of the university hospital model emerges from the multiplicative effects of these integrated domains: Accelerated Therapeutic Evolution: New treatments improve faster than in isolated systems Dynamic Knowledge Networks: Information flows rapidly across traditional boundaries Problem-Solving Density: Concentration of diverse expertise increases solution generation capacity Resilient Healthcare Infrastructure: Adaptability to new challenges through embedded research capabilities. This comprehensive integration creates not just incremental improvements but transformative possibilities for healthcare advancement. The university hospital stands as society's most sophisticated mechanism for simultaneously delivering today's care while creating tomorrow's medicine. 
The Hospital Clinical Research Program (PHRC) constitutes a fundamental pillar of the French health research system, representing a unique model of public investment in clinical innovation. This national initiative presents several distinctive strengths that make it an essential catalyst for medical and scientific progress like independence from the pharmaceutical industry: exploration of clinical questions without direct commercial interest, head-to-head studies without funding bias, generation of independent data on treatment efficacy and safety. The strength of the PHRC is explained by the networking of the 32 French university hospitals (CHUs) and cancer centers. The French government allocates 150 million euros per year to the PHRC through competitive calls for proposals, with an average funding level of 800,000 euros, primarily for multicenter randomized placebo-controlled clinical trials. The majority of the work is published in the best specialty journals and in top-tier journals (NEJM, Lancet, JAMA, BMJ). The PHRC is a powerful tool because all major hospitals across the national territory are networked with clinical research departments that operate in the same manner. Finally, the costs of studies (project managers, clinical research technicians, biostatistics, placebo, physician time, nursing staff, etc.) are the same for each center participating in a PHRC project, with an additional premium for the coordinating center of the study.