Meet Wong Tien Yin, the Hong Kong-born Singaporean involved in China's quest to grow its academic medicine system

When renowned Singaporean ophthalmologist and scientist Wong Tien Yin agreed to take up a position at China's top Tsinghua University last year, he felt he was making, as he describes it, a major "leap of faith".

China's strict border controls and reduced air travel amid the Covid-19 pandemic meant Wong, 54, could not visit the campus in Beijing or interact in person with any of his colleagues.

Yet, the series of Zoom video interviews with Tsinghua's leadership impressed him enough that he agreed to be the founding head of Tsinghua Medicine.

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The new health care and medical sciences academy aims to train the next generation of professionals to straddle both medical care and biomedical research, equipping them with the skills to tackle evolving and emerging problems.

As a trailblazing clinician-scientist - medical doctors who devote a large portion of their time to scientific research - Wong, who wears numerous hats in Singapore, is well-placed to head the academy.

He won the prestigious President's Scholarship to study medicine at the National University of Singapore and went on to do a PhD at Johns Hopkins University in the US.

Before his appointment at Tsinghua, he was medical director of the Singapore National Eye Centre, one of the largest speciality eye hospitals in Asia. He was also executive director of the world-leading Singapore Eye Research Institute and held a senior leadership role at the Duke-NUS Medical School, where he also coordinated research strategy and execution across its academic health care system - the SingHealth Duke-NUS Academic Medical Centre - one of two in the city state.

He has stepped down from all roles in Singapore but will be a senior adviser at the SingHealth Duke-NUS Academic Medical Centre.

Wong, whose work has focused on major eye diseases such as diabetic retinopathy and age-related macular degeneration, has won several top research awards and come up with screening and disease prevention strategies using telemedicine and innovative imaging, including artificial intelligence. He was elected to the US National Academy of Medicine in 2020.

He said he made up his mind to lead the new academy after a senior Tsinghua professor recently recruited from overseas told him: "You can either watch the rapid development of China's health care system from the sidelines, or be part of it."

"So it's an opportunity to make an impact by being part of the journey," Wong said.

Wong plans to move to Beijing after the Lunar New Year with his wife Ng Hsueh Mei, a family doctor. Their two sons are currently studying medicine at Cambridge University in Britain.

The Tsinghua appointment holds extra significance for him, Wong said, as his father - John C H Wong, a prominent economist and policy researcher who was born in China - was an esteemed sinologist who spent decades studying the country's economy and development.

"He regularly watched China's rise over the past 40 years," Wong said. His father taught at the National University of Singapore for decades and helmed its research centre on East Asian studies until 1997. He died in 2018.

"I am sure he would have been very proud that I had taken up this position in Tsinghua," said Wong, whose mother is Singaporean sociologist and former People's Action Party politician Aline Wong - among Singapore's first women members of parliament when she was elected in 1984. She served in ministerial positions spanning health and education until retiring in 2001. Both Wong and his mother were born in Hong Kong.

At Tsinghua, Wong will focus on integrating China's university and health care system into an academic medicine system, which is currently not as well developed as those in the United States and Australia. This will allow the innovation and research capabilities of China's universities to be applied in a health care environment.

"These systems are not easy to set up ... and there are many pitfalls and challenges in doing this. So that is the first thing that I will do at Tsinghua," Wong said, adding that he intends to build capacity for future Chinese doctors, scientists and professors to find solutions to health care issues.

Though Tsinghua, Peking, Fudan, Shanghai Jiaotong and Zhongshan are all internationally competitive, the lack of formal links and structures between medical schools and hospitals - save for notable outliers such as the Peking Union Medical College Hospital in Beijing - has resulted in the global standing of China's health care system lagging behind others.

With research and academic development traditionally coming under the remit of the Education Minister, while the Health Ministry or National Health Commission looks after hospitals and public health, China's system of academic medicine has "never [been] fully integrated and aligned", Wong said.

"I am not here to look at a particular research problem such as ageing, disease or cancer, or technology. Rather, I hope to put in place the foundations for a structure and system, as well as build talents and an international perspective, that will allow Tsinghua to work and collaborate at the cutting edge with the international community."

Academic medicine has its roots in the earliest human civilisations, but the modern discipline's origins date back to the 1910 Flexner Report, which is often credited with transforming the nature and processes of medical education in the US and Canada.

Among other things, the book-length report called for the merger of clinical practice, research and medical education, which ultimately led to some of the more globally competitive university-hospital partnerships.

These, according to Wong, include the Duke University School of Medicine, Stanford University School of Medicine and Johns Hopkins Medicine.

"A lot of the research and development is in the university medical schools but the application to patient care is in the hospitals," he said.

"Therefore the most successful places are [those that have] one ecosystem where discoveries can be translated into clinical care quickly through clinical trials or implementation.

"I think this is what Asia needs. Very few systems and countries have done it. Singapore started the journey in academic medicine in the last 10 to 15 years but fewer systems are in place in other Asian countries, including China."

In a statement announcing his appointment, Tsinghua said that Wong's expertise and international connections would help the university take the medical education it offered to a new level.

"Professor Wong will also be developing new international networks and partnerships with top medical schools and academic health care systems in the US, Europe, Asia and Singapore," it said, adding that Wong's research had improved the understanding of the burden and risk factors of a number of eye diseases - particularly diabetic retinopathy, a leading cause of blindness in China and globally.

Wong also hopes to grow China's pool of clinician-scientists. But this will not be easy, he said, as "out of 100 doctors, you are lucky if you have three to five" who want to assume the role - rising to 10 in 100 in more mature health care systems.

China faces similar problems to societies elsewhere - such as an ageing population, rising health care costs, the increased burden of chronic disease, and patients' rising expectations - but needs to devise its own academic medicine model, Wong said.

The country's growing middle class of some 600 million people wants better diagnoses and care, and sometimes require more tests and scans and the use of robotics, new drugs and precision medicine during that treatment, he said. They are essentially looking for a better health care and patient experience.

"China understands the challenges that are looming in health care," Wong said. "[The authorities want] their best in their universities with the physicians in the hospitals to tackle the problems."

When China's leaders "are determined to do something they generally put all their energies behind it", he said. "Rhey are very resourceful and agile at looking at solutions, they are not wedded to a single approach."

Long-term planning and a willingness to adapt will help, Wong suggested, as "health care, in particular, is not a frivolous short-term journey, it's a long-term goal".

This article originally appeared on the South China Morning Post (SCMP).

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