Speech at The Royal College of Surgeons of Edinburgh and the College of Surgeons of Hong Kong Diploma Presentation Ceremony 2006

The Royal College of Surgeons of Edinburgh and
the College of Surgeons of Hong Kong
Diploma Presentation Ceremony 2006
12 October 2006

Arthur Li Oration
Enhancing Internationalization to Raise Global Standards

Good evening ladies and gentlemen:

We who have received honorary fellowships this evening thank the College of Surgeons of Hong Kong for what is truly an honour.  I myself feel particularly privileged to be addressing you this evening, and am genuinely glad that the Arthur Li Oration is not a memorial lecture ─ at least not yet.

As this oration precedes the Quincentenary Closing Ceremony of the Royal College of Surgeons of Edinburgh by one day, many of our friends from the Royal College , as well as those from other surgical colleges, are here tonight to witness the award of diplomas of the conjoint examination. I extend my warmest welcome to all our friends from afar and congratulations to the Royal College of Surgeons of Edinburgh .  You are the custodians of a long and proud tradition of surgical excellence spanning five centuries, a record unrivalled in any other part of the world. 

Old as it must be as the College itself, surgery is NOT, as we all know, the world’s ‘oldest’ profession.  Nevertheless, the Edinburgh College received its royal prefix well before the Crowns of England and Scotland were united, making it probably the oldest extant profession in the world that has been granted royal patronage.  We have much to learn from the history of the Royal College of Surgeons of Edinburgh .  I hope there would still be somebody delivering the Arthur Li Oration 500 years from now!  None of us here could wait that long for the orator and his audience to arrive, but I would certainly feel as flattered as James IV of Scotland (1473-1513), in whose memory the College’s Quincentenary Lecture was presented yesterday.  As the Royal College ventures forth into the second half of its millennium, I wish it even greater success in the next 500 years to come.

The fact that you have come to Hong Kong for your scientific conference and the diploma-presentation ceremony means a great deal to us.  With your presence, old friendships are renewed, new friendships are struck up.  We catch up on the news on the other side of the globe; we learn more about new frontiers achieved in different surgical specialties.  All this is most satisfying, at the personal level.

But there is more to it.  A surgical college is made up of many surgeons. Gratification at the individual level adds up and is translated into collective gains for both the local college and its Edinburgh partner.  Greater interaction among the members of the two colleges can only lead to deeper collaboration in surgical training, better assessment of standards, and more conjoint development projects.

Just imagine how these benefits can be tripled or quadrupled, if bilateral interaction is extended to include other surgical associations in other places.  At this point, let me bring in the concepts of internationalization and global standards, concepts that concern all our diplomates here, and form the core of my address tonight.

In the education sector, internationalization has been the subject of much discourse over the past 20 years.  It is becoming central to the provision of higher education, particularly in this age of globalization.

Globalization itself is another frequently used term these days. In fact internationalization and globalization are sometimes used interchangeably, although they refer to rather different concepts.

Whereas globalization refers to the massive flow of knowledge, technology, assets, people, ideas and values across borders, internationalization is the way a country, a sector, or an institution proactively responds to the opportunities arising from globalization within its own system.

Whereas globalization imposes itself on nations and cultures that cross its path, internationalization emphasizes partnership among equals and participatory intervention.

Globalization is facilitated by new and powerful tools of communication such as satellite TV, computers and the Internet.  The process is fuelled by the rapid elimination of trade barriers, which has opened up societies across the globe to competition and free trade.  Globalization has a tendency to homogenize, bringing a common viewpoint and much the same set of values to different peoples around the globe.  Take for example global or supra-national corporations like MacDonalds, Microsoft or Hollywood films.  Their services and products wield enormous influence over the tastes, lifestyle and work style of millions all over the world, setting the standards of what is happiness, what is the perfect way of life and work.  Little of this is deliberate, making the process all the more insidious and potent.

Globalization has time and again caused resentment. Critics have commented how it is marked by exploitation, instability and uncertainty, how it increases inequality and advances corporate interest at the expense of the well-being of the ordinary people.  Others have described the process as being colonial, displacing indigenous cultures and blurring national identities in much the same way as imperialism forced its way upon different peoples in the 19th and 20th centuries.  We have also seen how the formation of global financial markets has allowed speculators to outwit national governments, hijack macro-economic strategies, and wreak havoc on local economies.   

Internationalization on the other hand seeks to preserve diversity by respecting cultural differences and national identities.  It encourages interaction among national groupings.  Its advocates tell us that it is only through enhanced mutual understanding and cooperation that progress for all can be achieved, in a harmonious way.

In a sense, globalization can be compared to the Nazi army that was out to conquer, and internationalization the concerted effort of the Allies to restore national sovereignty and world peace.  Or better still, it is akin to the efforts of the United Nations to advance the well-being of mankind.  Let us hope of course that internationalization can be just a little bit more fruitful than the UN.

Obviously, what I am proposing for the surgical fraternity is internationalization.  While our ultimate goal is to raise global surgical standards, we are not going to impose our standards onto any other group, nor are we going to accept standards being imposed upon us. Instead of having a surgical superpower that dictates standards for all surgeons around the world, we seek to achieve continuous improvement through friendly cooperation among the surgical colleges of different places, on the basis of mutual respect and as equal partners.

This, in fact, is what members of the College of Surgeons of Hong Kong have been trying to do since its inception, well before internationalization or globalization becomes the buzz word.  At the personal level, members of the College have striven to broaden their horizons and update their skills by visiting surgical centres of excellence overseas, or by exchanging experience and collaborating with their peers worldwide.  They find role models in people like the Mayo brothers, the famous 19th century US surgeons who made some 90 trips to Europe in the course of twenty years to observe how surgery was performed there.  In those days, there were no jumbo jets!  Today the Mayo Clinic in turn attracts surgeons from around the world to study there.

At the institutional level, the Hong Kong College has worked closely with the British, Australasian and other surgical associations to maintain standards for postgraduate training; it has organized conjoint fellowship examinations; it has co-hosted scientific meetings to promote state-of-the-art surgical expertise and continuing medical education.  It has contributed its share towards enhancing surgical standards across the world.

Speaking from experience, I cannot think of a more delightful group of people to work with than my fellow members at the Hong Kong College .  As individuals, all of us are strong characters, each with even stronger convictions of our own on diverse subjects.  People say: never argue with surgeons, for they have ‘inside’ information.  You can well imagine what will happen if people with inside information argue among themselves! People also say: to obtain a man’s opinion of you, make him mad.  Apparently surgeons are very keen to know what other surgeons think of them.  That’s why we have a process called ‘peer review’.  That is also why we have been seen to be driving each other mad all the time.  In short, it is most laudable that a bunch of haughty individuals like ourselves could have risen above our personal prejudices and come together to form a body, a college dedicated to the development of the surgical profession.  Those who are familiar with the history of the local college will certainly agree that we have come a long way since the days when the college was still known as the Hong Kong Surgical Society.  We won’t forget all the difficulties that we have surmounted to achieve what we have achieved.  We treasure the spirit of solidarity and collegiality that we enjoy today.  We are determined to make greater contributions to the discipline of surgery, for the good of the profession and all the patients entrusted to our care.

That the Hong Kong College has been able to go from strength to strength also owes much to the internationalization efforts of our friends from Edinburgh .  By this I mean they have been most zealous in reaching out to make friends with surgeons of other countries and regions, and to contribute their expertise and experience for the development of the surgical profession in various places, including Hong Kong .  In helping others to improve, they obtain useful feedback and pick up new information, which in turn helps them explore new grounds and develop new surgical skills.  This process of reaching out to understand others and drawing inspiration from a wide variety of surgical cultures exemplifies the true spirit of internationalization.  Our Edinburgh friends have never forced upon us any Edinburgh model of surgical excellence.  They are here to share with us what they cherish in their tradition and to find out what we have to offer in a collective effort to raise global standards.  We are true friends to each other.  I think I speak for the Hong Kong College when I say how deeply grateful we are to our Edinburgh partners for all the help they have rendered us over the years.

Ladies and gentlemen, many of you seated here have just received your diplomas from the Royal College of Surgeons of Edinburgh and the Hong Kong College .  The diplomas are no ordinary pieces of paper.  They are official documents testifying to the standard you have achieved as a surgeon.  It gives you the credentials that are globally recognized, admitting you into a prestigious surgical fellowship, enabling you to practise as professionals at the international level.

The Scottish historian and writer Thomas Carlyle (1795-1881) was once talking to a young friend, and asked him what his aim in life was.  The young man replied that he had none.  “Get one, then, and get it quick,” said Carlyle, sharply.  “Make something your specialty.  Life is a very uncertain affair.  Knowing a little about five hundred things won’t do us much good.  We must be able to do something well, so that our work would be needed and valuable.”  This is a most relevant quote for tonight, and I take this opportunity to congratulate all the diplomates here for having set an aim in life and made surgery your specialty.  It is an honourable calling you have chosen and you have proved that you can do it well.  Your work will bring much good to society and your services will be highly valued by your patients.  You should be proud of yourselves.

As a professor emeritus of surgery, I know how tough surgical training is and how hard one has to work continuously in order to maintain standards and upgrade professional skills and knowledge.  All surgeons also work very long hours under great pressure.  Yours is a profession that gives a lot of job satisfaction but at the same time requires a lot of sacrifice: sacrifice of your own, and sacrifice of your family.  You couldn’t have come this far without the support of your family members, especially your spouse, if you have one.  While I share the joy you feel right now, I would also urge you to, when you return home this evening, reiterate your deep affection for your better half and your true appreciation of their support, which you will continue to need for many many years.  Surgeons’ spouses are a very special lot.  Time and again they are long suffering by the nature of our work and the requirements of our duties.  But I always tend to believe there is a higher purpose behind this long suffering: that we may love them more and appreciate them even more.  This is purely my conjecture, after many years as a surgeon.   

Dear diplomates, I have to declare my interest in expecting you to love your spouses.  I need more children for my schools.  From yesterday’s Policy Address, you know I have done the difficult part.  Now it is up to you to do the pleasurable part!  I also have other high expectations of you.  I look forward to your staunch support for the College of Surgeons of Hong Kong in the years ahead, in particular its efforts to enhance internationalization.  Come help perpetuate its fine tradition of reaching out to other countries and regions.  Try always to look beyond our shores.  Cultivate an international outlook.  Keep yourselves updated of what is happening in the world of surgery.  Contribute what you can to the development of your profession.  Be a proud member of the surgical fraternity worldwide.  Whether surgery in Hong Kong is world-class depends ultimately on you, and I wish you the very best in your future endeavours.

Thank you.