Intended for healthcare professionals

Rapid response to:

News Extra [these Stories Appear Only On The Web]

Fear of SARS thwarts medical education in Toronto

BMJ 2003; 326 doi: (Published 12 April 2003) Cite this as: BMJ 2003;326:784

Rapid Response:

SARS and Medical Education in Hong Kong

SARS and Medical Education in Hong Kong


I read with interest the News Extra piece on SARS in Canada (1) and
would like to respond with our local experience.

It was not fear of SARS but SARS itself that initially thwarted
Medical Education in Hong Kong. The first indication that there was a
problem was when our Dean, Professor Sydney Chung at 14:50 (local time) on
12th March 2003, announced that a number of staff and medical students had
been taken ill with high fever, myalgia, chills and vigors. Astutely
Professor Chung declared an immediate closure of all medical wards to
medical students at the Prince of Wales Hospital (PWH), the main teaching
hospital of the Chinese University of Hong Kong. Later that day the Dean
sent a second email (at 19:41). The seriousness of the situation was
becoming apparent and all undergraduate teaching at PWH was suspended and
the hospital, including library and study rooms were placed ‘out of
bounds’. Two days later, on the 14th of March, Professor Chung announced
the complete cessation of all clinical teaching at all hospitals within
our cluster. On the 16th of March the Dean made the very prescient
observation that ‘a long and difficult battle is ahead of us, there will
be a lot of rumours circulating around, both by word of mouth and by the
mass media’. What was initially atypical pneumonia had now become Severe
Acute Respiratory Syndrome, SARS. On the 18th of March there were 100
patients, including 46 staff and 16 medical students admitted to PWH. At
this stage with a still developing medical crisis the Dean had to take a
fine line between reassuring the students that the examinations would be
still be arranged but also for class representatives to keep a close eye
on all their classmates to ensure no student with symptoms was overlooked.
The evolving story of SARS has been reported in detail (2) but life,
including Medical Education had to return to some degree of function.
This was and is truly a case for a paradigm shift.

Professor Chung, tireless in the face of this unprecedented crisis
continued to keep all faculty and students informed of plans and progress.
On the 26 of March a meeting of the Executive Committee agreed that
everything should be done to facilitate the interns taking up their posts
and that the final examinations should be held with the minimum of
disturbance. It was felt that clinical teaching and clinical examinations
involving real patients was not realistic for several months. As such the
Heads of Department had to restructure their programs. The final MBChB
would be postponed but only for two weeks and the examination would
comprise the traditional written essays and MCQs but incorporate OSCE’s
without patients instead of the clinicals.

The return to teaching was delayed for one week due to a complete
closure of all educational establishments ordered by the Government of the
Hong Kong Special Administrative Region (HKSAR). Finally on the 7th of
April lectures and tutorials started again but with everyone wearing
masks. OSCE stations have been designed and submitted and meanwhile the
Faculty Intranet has really come of age. Staff have posted a continuous
stream of teaching material on the ‘net’ and some enterprising staff are
using ‘chat rooms’ to engage in real-time exchange with students.

It is not possible to minimize the reality of the ‘fear of SARS’ in
staff, students and public. However, under the astute and inspiring
leadership of Dean Sydney Chung, the Medical Faculty at the Chinese
University of Hong Kong has not only embraced this fear but, indeed SARS
itself and is determined not to be thwarted. As the Dean has said, ‘It is
precisely at the time of such a major medical crisis that educating the
next generation of doctors becomes so important’. Today yet more new
cases, and deaths, are being reported worldwide. The war is being waged
on many fronts and whilst considerable successes are being announced e.g.
the cracking of the genetic code for the virus, the duration of this
conflict is still uncertain. What is certain is that Medical Education
must not suffer at this time.


Andrew Burd

Chief of Division of Plastic & Reconstructive Surgery

Department of Surgery,
The Chinese University of Hong Kong,
Prince of Wales Hospital,
Hong Kong



1) Clark J. Fear of SARS thwarts medical education in Toronto. BMJ
2003;326:784 (12th April 2003).

(2) Lee N, Hui D, Wu A, Chan P, Cameron P, Joynt G, Ahuja A, et al.
A major outbreak of severe acute respiratory syndrome in Hong Kong. The
New England Journal of Medicine, published at on 7th April

Competing interests:  
None declared

Competing interests: No competing interests

17 April 2003
Andrew Burd
Chief of Plastic Surgery
Chinese University of Hong Kong