Stella Pak-Ngor Ho – An Autobiography of a Doctor from the Sun Yatsen Medical School

 

I was born in Hong Kong in 1924 and this short account explains how I came to graduate from the Sun Yatsen University Medical College in 1949 and ended up as a British qualified anaesthetist and settling down in the UK.

 

Why did I want to be a doctor?

 

When I was a young teenager I was once very ill with appendicitis, which was cured by an appendicectomy.  During my recovery, I was inspired by the private nurse who cared for me.  She recounted to me her experience as military nurse in China explaining that in the field hospital she nursed the sick and wounded soldiers back to health.  She felt great pleasure in seeing them getting well and returning safely home.  Money cannot not buy this sort of pleasure and happiness; thus, I decided one day to help people in this way and I hoped it would bring meaning to my life.

Another influence was my medically qualified relatives.  My two elder brothers at that time were studying medicine at the Hong Kong University (HKU) and two of my cousins and a sister in-law practiced as doctors in Hong Kong.  I knew that studying medicine would not be easy, but I was determined to challenge myself and at school I studied hard to get into university.

 

I passed the school-leaving exam of Hong Kong (香港中学畢黹会考文憑) when I was 15 and the following year, during my matriculation studies for the HKU, World War II broke out in Hong Kong on 8 December 19410. At the time, I was studying under English speaking teachers in the Anglo-French convent school in Hong Kong and prior to that I was at the Italian convent school. We were not taught Chinese in either school, and I only learned basic Mandarin through a private teacher.  This was later to prove a great handicap in my medical studies in China, but an aid to my studying in England.

 

A few months after the surrender of Hong Kong, we heard a radio broadcast from China inviting overseas students to go to China for free university education with all expenses paid.  Not long afterwards, a brother, sister and I joined a group, which left Hong Kong and went to free-China to find safety and to continue our studies.  It was a journey of over 40 days, which first took us northwest to Guilin (桂林) through Japanese occupied territory and no-man’s land.  We then headed east to Pingshi (坪石) in Guangdong, where I entered the premedical school of the Sun Yatsen University (国立中山大学先修班農医組).  This first year of study from 1942-43 was a tremendous struggle for me, because the courses were taught in Mandarin Chinese with very little English.  Thus, I had to quickly learn to read, write and speak Mandarin Chinese, which meant staying up late every night to study.  Without the help of my school friends it would have been impossible.  However, at the end of the year, I passed my exams and was admitted to the Sun Yatsen University Medical College in Lechang (樂昌) as a first year student in 1943-442.  As its curriculum used German, Latin and Mandarin Chinese, I had to learn yet more foreign languages.

 

At the end of the first academic year, the Japanese neared the city and everyone had to be evacuated.  I arranged to meet my brother and sister in Guilin and with difficulty I spent weeks travelling there by foot and car.  To my disappointment, my family had left for Guiyang (貴陽) city, but when and where we would meet I had no idea!  Our plan was to leave our contact details at the British Council offices.  I headed northwest to Guiyang by train and stopped in Dushan (獨山) to change train. It needed an overnight stay, so I went to the British Council to inquire about room vacancies and just by chance another brother was there waiting for his luggage to arrive and incredibly he heard my voice and managed to find me.  It was just like striking gold, I was so happy that I cried with joy and together we travelled to Guiyang.

 

At Guiyang, I had to join the medical college (国立貴陽医学院) as a first year medical student again, because its curriculum was different.  Unlike Sun Yatsen University, it taught in English rather than German.  Thus, I built up a good basis for medicine in English, which became an advantage when I pursued my studies abroad.  After our first year exams, the Japanese threatened Guiyang - they were only 50 miles away and the whole medical college had to march on foot northwards to the war time capital of free-China – Chongqing (重慶).

In Chongqing, I joined the Shanghai medical college (国立上海医学院), which also sought sanctuary there a few years earlier.  Like Guiyang University, they taught in English, but additionally followed the syllabus of the medical schools in London.  All their professors and senior doctors were from Beijing Union Medical College Hospital (北京協和医学院医院) I studied there from 1944-45 until the end of the war in 1946., then In the,in Autumn 194of the same year7 I followed the Guiyang Medical College back to Guiyang and the following year, I returned to the Sun Yatsen Medical College in Canton as a third year medical student. After completing 5 years of medicine,   I passed my final exams in May 1949 leaving just an internship in clinical training as the After 6 years of medicinesixth year of the degree, which I completed in 1950, I undertook an internship in clinical training at the Guangdong municipal hospital (廣州市立医院) in Canton, where English was the main language for all specialties.  After completing my internship, I received my degree (医学士) from the university in May I graduated in the Class of 1949 with a degree (医学士),, which was equivalent to the MBBS (Bachelor of Medicine and Bachelor of Surgery) qualification at Hong Kong University. 

 

My first job in 1950 was working as an honorary resident doctor in gynaecology and obstetrics at the Sun Yatsen University Medical College Hospital  (中山大学医学院婦產科義務助教), where I returned to using the German and Chinese languages again.

 

In the summer of 1951, it was eventually time for me to return home to Hong Kong, but my medical qualification was not recognised in Hong Kongthere for private practise.  Nevertheless, as a refugee medical doctor, I was able to work for the government medical department (香港医務处) provided vacancies were available.

 

At the time, most Hong Kong doctors went abroad to get internationally recognised postgraduate qualifications in order to get the best jobs.  Thus, it was a long climb for me to get international recognition, but it started in 1951 when I was employed for 6 months as a house paediatrician (小兒科住院医師) at Queen Mary Hospital, which was a university teaching hospital.  Whilst my qualification was not recognised, I had more than sufficient work experience to undertake this role.  It was a high-ranking post and was recognised as a qualifying prerequisite for the Diploma in Child Health (DCH) exams in London (準考倫敦小兒專科試文憑).  I worked and studied medicine and paediatrics by myself in my spare time to improve my knowledge of the subject in order to prepare myself for exams to become a British registered doctor.  I worked extra hard and as a result everyone liked me.

 

After a while, I was promoted to an Assistant Medical Officer of Hong Kong, which was a post to relieve any doctor from any specialty in the government service. After a short time, an opening appeared in the anaesthetics department of Queen Mary Hospital and so I began a part-time post in anaesthetics and midwifery, which gave me training and experience in both specialties. After 6 months I became a full-time anaesthetist and was able to take on major cases.  In a couple of years I was promoted to a full-time Medical Officer in anaesthetics.  However, my big break came when I was allowed to take unpaid study leave and head to London and study for the diploma in anaesthetics.

 

In 1956, I took the slow-boat to London, which took almost six weeks and was like a holiday as I visited many beautiful cities.  I studied anaesthetics at the post-graduate medical school of London University in Hammersmith Hospital in London.  After three months I found work as a full-time Senior House Officer (SHO) in anaesthetics at Memorial hospital, Woolwich, London.  My promotion as a registrar in anaesthetics happened at Lewisham Hospital (London) in 1957 and six months later in 1958, I passed my diploma in Anaesthetics in 1958 with the Royal College of Surgeons in London (倫敦皇家外科医学院麻醉科文憑).

 

At Lewisham Hospital, I needed to work very hard not only for my diploma, but also to pass the exams for the Scottish Triple qualification.  The triple qualification, which is was recognised by the UK’s General Medical Council and was therefore my path to becoming a registered British doctor. It involved taking exams for three different Scottish examining boards and led to me becoming a Licentiate of the Royal College of Physicians (LRCP Edinburgh), a Licentiate of the Royal College of Surgeons (LRCS Edinburgh), and a Licentiate of the Royal Faculty of Physicians and Surgeons (LRFP&S Glasgow). 

 

 The full-time anaesthetic Registrar post at Lewisham was more demanding than any other post in medicine, because of the wide knowledge of medicine needed to do the job.  This was because our patients were referrals from anywhere and everywhere in the hospital and we needed sufficient knowledge and experience of all those medicals specialities before we could do our job.  For example, a diabetic patient with cardiac trouble complicated with foot gangrene and requiring a simple below-knee amputation needs knowledge of four specialties.  Thus, anaesthetists need to be able to handle any complex and special cases, which is why many doctors avoid a career in anaesthetics.  It also explains why today’s Intensive Care Units are run largely by anaesthetists, it is because they are the only ones with the depth and breath of medical knowledge and experience to keep critically traumatised patients alive.

 

At the same time as studying for and passing the Scottish Triple qualifications, I also passed the examination for the London LMSSA qualification (Licentiate in Medicine and Surgery of the Society of Apothecaries, 倫敦葯劑師会医生執照).  This was also recognised by the UK’s General Medical Council, which.  This meant that I qualified as a medical doctor three times: once in Scotland, once in London, and once in China.

 

After passing all my exams in the UK, I returned to my post in Hong Kong as Medical Officer in anaesthetics in 1960.  Very soon, I left the post as government Medical Officer, because of unequal pay.  At that time in Hong Kong, female doctors in the government medical service only earned 75% of a man’s pay.  This unequal pay was sex discrimination!  When my protestations fell on deaf ears, I left to join a London missionary hospital – the Nethersole Hospital in Hong Kong with equal pay as head of its anaesthetics department (1960-62). 

 

I came back to London to get married in 1962 and have been here ever since. From 1966-69, I stopped working as an anaesthetist in order to train in clinical dentistry and facial maxillary at a London dental school.  My plan was to have more quality time with my family and baby son in a profession without night and weekend shifts. However, in 1970, I was offered a full-time locum registrar post in an anaesthetics department.  I found a good housekeeper and a live-in child nanny, thus I decided to return to anaesthetics.  Shortly afterwards, the May Day Hospital in Croydon, Surrey offered me my first locum consultant anaesthetist post and I dropped dentistry for good without regret as my domestic problems had been solved.  All over London, I steadily worked my way up the anaesthetics ladder and I retired in 1989.

 

So what was it like being a Chinese female doctor working in England in the 1950s through to my retirement?  Well, you might not be surprised to hear that there were very few foreign doctors, during this time, but you will be shocked to hear that I was the only foreign doctor in the anaesthetics departments of more than 10 London hospitals for most of my career.  Indeed, it was only shortly before my retirement that I worked with another foreign anaesthetist.  There were also very few women in anaesthetics in the top position of consultant.

 

As a foreign doctor, one needed to be better qualified and have significant experience beyond the requirements of the post being applied for.  On the plus side, I have seen excellent foreign doctors get jobs promised to less qualified local doctors, which shows how highly the standard of medicine was valued in the UK at that time.  It is different now.

 

Looking back, I think it was definitely worth my while to work hard whilst I was young and able to enjoy the fruits of my success, and I heartily recommend this to all the young alumni leaving university and starting their careers.  My advice is don’t give up!  Where there is a will, there is a way (有志者事境成).

 

Stella Pak-Ngor Ho (中山醫歐洲校友會何柏娥)