My practicum site is at the Department of Orthopaedics & Traumatology of Tseung Kwan O Hospital. I have been working in this hospital for 10 years now, since my graduation from HKU medical school. Currently I am serving as an associate consultant for my department and one of the challenge faced by us was long waiting time for our specialist outpatient clinic. This is a universal problem in the public health care system in Hong Kong, various ways to tackle the issue had be proposed and implemented, including adding ad hoc new case clinics to shortening the waiting time and incentivize doctors to discharge non-operative cases from the clinic, but the problem had not improved much.

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This not only affects the ability of the system to provide prompt appropriate patient care, but also put a lot of stress on the staff and the system itself. I was curious about the underlying cause of this problem so I initiated a practicum to reveal the various contributing factors to long waiting time my SOPC,and through a root cause analysis, to propose some strategies on how to intervene and improve the situation.

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As a practicing orthopaedic surgeon, the practicum had provided me with a unique opportunity to pull myself back a bit and look at the service that my department provided in broader sense, involving stakeholders that are at different levels of the healthcare system.

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I set out to look into the interface between primary and secondary medical services, and examine perceptions and utilisation of patients with orthopaedic complains. I also tried to obtain information on patient’s health-seeking and doctor’s practicing behaviour.

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Frontline medical staff has always been playing a very passive role in terms of general policy change and healthcare reform, waiting for administrators and policy-makers to act based on statistics and feedbacks. However, it is often difficult to initiate policy changes from a top-down manner when there are a large numbers of stakeholders with variation in practices, but through cooperation and collaborations, incremental changes through innovative strategies by stakeholders at the frontline may actually show the top administrators the way for policy changes.

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Personally I think a self-initial practicum is a great opportunity for part-time study to practice their knowledge from MPH at real life situation that is close to their professions. It will be even better if students can receive suggestions/advice/support from the faculty to continue refine their projects even after they have graduated.