cuhk address的八卦，YOUTUBE和Yahoo名人娛樂都在討論

《非主流意見》

最近係CUHK見到有preclinical醫學系二年級嘅同學抱怨無限個lectures同考試成日會考萬幾張slides裡面其中一個角落嘅minute details

首先，其實講粗口我覺得真係無乜所謂。私人生活同工作要有嘅專業形象係可以分開。不過要小心嘅係日後要確保真係私人生活同it won’t come back and bite you，呢一行好窄同好多人對粗口敏感，而你嘅事業好取決於同行對你嘅評價。

我覺得成件事有幾個好重要嘅點值得所有人反思下

1. 考試內容有無必要考d偏到無得再偏嘅details

全世界醫學院考試都有類似嘅題目，問一些上堂其中一張slide個角落嘅其中嘅minute detail。好多人話靠這些題目可以分辨邊d學生係精英中嘅精英，邊d學生值得攞distinction

我同意要有differentiating questions，但如果條題目問你AdenoCa Lung with EGFR mutation T790M應該用邊隻TKI時，呢類嘅題目又係唔係適合去分一個學生嘅能力？係咪今日無背到個mutation panel係咪代表你唔係好學生，係咪差過其他有背到張Slide嘅同學？

如果要differentiate一個學生嘅能力，我會覺得complicated clinical presentation +/- multiple comorbidity同藥物相沖etc去睇下個學生會點clinically prioritize同workup個病人，會更加能夠分辨到精英中嘅精英。

如果preclinical basic science嘅題目我倒唔覺得有幾需要分辨有背到minute details同無背到嘅同學，反而更加應該加多少少clinical relevance on basic sciences例如pharmacology, microbiology, drug interaction, disease presentation with regards to physiology etc

2. 真係唔好睇考試睇得太重

醫學唔係淨係科學，同時係充滿人性嘅一門藝術。傳統考試並唔代表d乜嘢，考得好考得差，合格嘅你就係醫生。

Don’t ever be defined by exam

你需要嘅係合格，達到醫學界對醫生知識嘅最低要求同埋擁有應對困難嘅能力。當刻你醒唔起lecture 134第48張slide嘅內容唔代表你唔識，亦唔代表你之後會醫死人，會係庸醫。考試其間有種種因素，時間嘅壓力、大腦突然mind blank、一時諗唔通等等，令你答錯呢條題目。

呢個並無咩咁大不了，如果你真心唔識嘅，就吸收呢次經驗同知識，be better next time 。如果你係識但因種種原因答錯嘅，唔緊要，下次更小心就好，無須覺得自己比別人低等。

香港學校好容易會出現一種互相比較嘅氣氛，really there is no need for such culture，相信自己嘅能力，記著，你唔需要一份筆試去定義你嘅人生。

*不過當然你仍然要合格，只係無必要去同人競爭鬥高分

當你看開d唔再區泥分數時，就算你無背到d rare minute details時，你一樣會合格會progress，呢d古怪題目唔會佔多過10-20%

我明好多時會覺得個考試唔公平，覺得個分數唔能夠充分反映你嘅努力同能力。

你絕對entitle你對考試內容不滿嘅感受，this should be acknowledged and not dismissed and framed as you are just a whining child

3. 基本重要defining features你其實真係要識

你未必需要知道concurrent chemoRT for NPC個platinum based regimen係乜嘢，但你起碼都要知個mainstream treatment係乜，chemo要be aware of neutropenic fever，RT個概念係乜嘢，呢d真心同你以後日常工作有關嘅知識

你的確可以以後睇症時up to date所有嘢，但你起碼要有個概念先知要uptodate乜嘢，如果唔係真係search到2046無都未搵到個答案。

至於whole genome sequencing其實我覺得你唔需要知得好詳細，但都可以了解下到底迎l近年醫學因為基因學嘅發展而有幾大嘅進步，癌症同autoimmune等疾病嘅治療近年咁大嘅改變，基因研究功不可沒。

都係果句，唔識或答錯唔緊要，從中學習睇下知識，只份卷10%嘅題目真係唔會令你唔合格。

4. 好多前輩們其實可以諗諗你覆個學生嘅objective係乜嘢

如果你只係想開心share呀叔同老娘當年都係狂背書，呢d嘢係well expected嘅時候，你想achieve d咩嘢

現實就係有學生覺得考試唔能夠全面評核佢地嘅知識同能力，呢個係一個legitimate嘅感受。當我地立即judge佢嘅心態再下埋判決覺得佢唔會survive medical career，覺得佢無做醫生嘅資格或質素，甚至叫佢quit U or transfer，你係無address過個root cause and culprit

當然你絕對有權去覺得新世代都係whining child，心態有問題，但當你睇症時都可以嘗試去從病人角度出發再adjust your approach時，點解面對師弟師妹又唔可以呢？

我唔同意單憑一個secret post就落judgement去判一個人死罪再圍鞭一輪。

的確世界唔係圍繞一個人而轉，世界亦未必會為咗一個人而改變，但如果我地真心覺得有地方值得改善，係唔應該submit to the culture or system

The world might not change for you
But if you believe a change is needed
Be that change yourself

非主流意見遇咗實有人會唔同意

最後只想同所有讀緊醫嘅同學們講
Preclinical係好悶，clinical years會好好多。唔好睇考試睇太重，the last one who passes is still a doctor

相信自己嘅能力，捱過難關後便會有另一番天地

Don’t ever be defined by exams or other people

講CUHK單嘢都講到口臭，今日想講下現代醫學急速發展，科學醫學基因學一日千里後對醫學院學生同初級醫生嘅影響

拿，頭盔，我唔係故意要同senior們作對，而係有d好重要嘅概念我覺得一路都無人address過。而醫學界仍然有股好重嘅「當年都係咁捱咁讀，點解你咁多意見」嘅風氣

的確，當年前輩們嘅非人on call生活、要去library睇文獻睇書而唔係方便地用Microsoft surface神速打筆記、開uptodate、開pubmed/medline等等。

無可否認，上個年前代嘅醫生們要增進知識要靠嘅自動波去睇論文去溫書，甚至要自己去R導師做臨床教學等等。無人否認當年環境無咁豐富，上堂無精美PowerPoint、臨床教學今時今日已經好structured，分哂history session, examination session, skills session，有像真度極高嘅假人俾你練習，呢d係上代無嘅luxuries

No one is denying this fact

但上一代都一樣無嘅係咩，大家有無諗過？

就係千千萬萬種過去20年發展出來嘅科學醫學理論同治療方法。

O&G 幾十年前都未知道preeclampsia嘅實際原因係乜，原來可以early pregnancy low dose aspirin prevent or delay onset of preeclampsia。廿年前都無HPV疫苗, 都無話原來screen HPV virology比Pap smears更有效發現子宮頸病變，廿年前無人需要知道呢d

Rheumatology幾十年都無一堆biologics, TNFa, IL inhibitor 。原來autoimmune inflammatory arthritis failed NSAID/MTX可以轉infliximab, adalimumab。psoriatic可以用secukinumab但如果有IBD/enteropathic features要小心IL-17 inhibitor，廿前年無人需要知道呢d

Immunology/ID，幾十年前HIV邊有咁多種antiretroviral？今時今日ART多到就算你de novo resistance都可以換藥換到U=U，廿年前都係得舊式治療，無人需要知種種嘅新式療法。immunology仲多咗幾十種唔同嘅complement, complement inhibitor etc etc嘅investigation

Respiratory醫ILD或pulmonary HTN幾十年前個療法來來去去都係得幾種。今時今日IPF有nintedanib，Pul HTN有成堆endothelin antagonist、PDE5 inhibitor同prostacyclin類嘅藥要知。asthma當年來來去去都係ventolin+inhaled/oral steroid，今時今日分埋IgE asthma, eosinophilic asthma，有成堆唔同嘅SABA-LABA, SAMA-LAMA, IgE monoclonal antibodies, IL-5, IL-4 and IL-13，到底eosinophil要幾多先會大機會有response，用緊steroid嘅eosinophil個cutoff係幾多。

Hematology/oncology幾十年前都未有monoclonal antibodies，無rituximab、nivolumab、targeted therapy等等，幾十年來個發現多咗好多唔同gene mutation同targeted site，EGFR, VEGFR, CTLA-4, PD-1，PD-L1、BRAF，HER-2, you name it you got it。以前癌症病人你大多只要beware of neutropenic fever/infection，今時今日你要screen埋immune checkpoint inhibitor autoimmune hepatitis, pneumonitis, thyroditis, colitis，你要知埋有個病人用緊nivolumab時突然變黃，你要screen咩autoimmune，落咩藥，high dose steroid定點，之後仲可唔可以rechallenge。乳癌病人HER-2依加唔止用herceptin，仲有埋pertuzumab，你仲要screen埋cardiomyopathy，echo drop幾多可以接受，係唔係reversible，可唔可以rechallenge

Endocrine幾十年前糖尿病來來去去都係metformin, gliclazide, insulin今時今日T2DM有GLP-1, SGLT-2, gliptin等等，有埋continuous glucose monitoring device又有bump又有唔同林林總總嘅治療。唔止T1/T2DM，今時今日仲有埋LADA，你要知埋個autoimmune panel screen咩。骨質疏鬆當年玩來玩去都係bisphosphonate，今時今日有denusumab有teriparatide，仲有更多新藥。

Gastroenterology幾十年前IBD來來去去都係steroid/steroid sparing agent 5-ASA/aza，今時今日有TNFa blocker有a4b7 inhibitor vedolizumab。當年hepC得幾種antiviral今時今日有sofosbuvir, velpatasvir, glecaprevir等等，仲變成curative。

Neurology MS幾十年前邊有natalizumab，今時今日如果MS on natalizumab with rapid neurological decline，你要諗埋會唔會可能係JC virus reactivation。GBM以前都係只靠surgical resection，今時今日可以用avastin, temozolomide仲要screen埋MGMT hypermethylation去決定有無得用chemo

呢啲改變同發展只係佔各system嘅一小部分，只係我細小嘅腦袋突然諗到嘅小部分內容。世界不斷發展，學海無涯，我們有愈來愈多嘅知識要學，呢一點無人懷疑過。

醫生擁有比一般人更多嘅權力同地位，就自然需要更大嘅責任。

但係，值得大家反思嘅係，當個knowledge base不斷擴大嘅時候，考試仍然要期望你記埋某張slide嘅角落嘅minute details時，呢個係唔係一個合理嘅期望？

當一個basic trainee去考PACES/long case嘅時候，到底係唔係同以前一樣要知得咁深入？當深度一樣，而個base不斷widen broaden時，新世代嘅醫生應該如何應對？

而考試嘅範圍似乎未有被address過，呢點好值得我地一齊諗諗

【After Winning Majority in LegCo: Beijing's Crackdown May Trigger International Intervention】

***感謝Hong Kong Columns - Translated，將我早前撰寫『議會過半想像：以「#國際攬炒」反制「臨立會2.0」』長文（https://www.facebook.com/joshuawongchifung/photos/a.313299448762570/2887650867994069/）翻譯成英文，鼓勵國際社會關注立會選舉一旦過半的沙盤推演，在最惡劣形勢下的制衡策略。***

中文精簡版本：https://www.facebook.com/joshuawongchifung/photos/a.564294826996363/2888641404561682/

Hongkongers have experienced our revolution for over half a year. They no longer take a consequentialist view to the effectiveness of their movement as they did years ago, or waste time second-guessing the intentions and background of fellow activists. Following the defensive battles at CUHK and PolyU, November’s District Council election saw a great victory of unity. More marvellous is the union between peaceful and “valiant” protesters.

In the process of resisting tyranny, the people have realised that one cannot prioritize one strategy over another. This is also how the common goal of “35+” came into being—the hope that we will win over half of the seats in the Legislative Council (LegCo) this September, such that the political spectrum that represents the majority of Hongkongers is able to gain control of legislative decisions. The political clout of Hongkongers will increase if 35 or more seats are successfully secured on our side. It is certainly one vital step to achieve the five demands within the system.

The possibility of realizing legislative majority

Technically it is not unrealistic to win a majority even under the current undemocratic system. Back in the 2016 LegCo election, we already won 30 seats. In addition to the District Council (First) functional constituency seat that is already in the pocket of the pan-democrats, as long as the candidates in Kowloon East and New Territories West do not start infighting again, we could safely secure 33 seats based on the number of pan-dem votes in 2016.

The other 3 seats required to achieve a majority depend on democrats’ breakthrough among the functional constituencies by dispersing the resources of the Liaison Office. They also count on whether the turnout this September could exceed 71.2% — that of last year’s District Council elections. Some of the factors that could affect the turnout include: will the epidemic persist into the summer? Will there be potential violent repression of protests in the 2 weeks preceding the election? Will Hong Kong-US relations be affected by the downturn of the global economy?

Therefore, the ambition of “35+” is to be prioritised by the resistance as both a means and an end. I have already expressed my support for an intra-party primary at the coordination meeting. In the meantime, it is pleasing to see the ongoing debates reaching a consensus of maximising the seats among geographical constituencies in the upcoming election.

Whilst enthusiastic coordination, we should also assess the post-election landscape and gauge Beijing’s reactions: if we do not reach 35 seats, Hong Kong will be subject to tighter control and more severe repression by China; but if the democratic parties successfully form a majority in LegCo, CCP’s fears of a “constitutional crisis” would become imminent. Hence, the key questions are how the Pan-Democrats should deal with the volatile political situation in Hong Kong and how they are going to meet Beijing’s charge head-on.

Watching out for Beijing’s dismissal of LegCo after reaching majority

To take back control of LegCo such that it faithfully reflects the majority’s principles and needs is the definition of a healthy democracy. Recently, however, DAB’s Tam Yiu-chung has warned that the plan of the Pan-Dems to “usurp power” in the LegCo would only lead to Beijing’s forceful disqualification of certain members or the interpretation of the Basic Law. This proves that winning a majority in LegCo is not only a popular conception but also a realistic challenge that would get on the nerves of Beijing. Could Beijing accept a President James To in LegCo? These unknown variables must be addressed upon achieving a majority.

While there is no telltale sign as to Beijing’s exact strategy, we are already familiar with the way CCP manipulated the Basic Law in the past 4 years. Having experienced three waves of disqualifications in LegCo, twice kicked out of LegCo with my team, and thrice locked up in jail, I have no false hopes of an easy compromise from Beijing: they would not let Pan-Dems control LegCo for half a year and wait (as is the proper procedure) until after having negatived the Budget to dissolve the legislature, and thereby giving them an easy victory in the re-elections. The greater the Pan-Dems threaten Beijing’s rule in Hong Kong, the more likely that it will trigger Beijing’s repression.

Since the disqualification and arrest of lawmakers have already become “normalised”, one can even imagine the police stepping into the LegCo building to force Pan-Dems into voting. Neither is it beyond our imagination to expect the CCP to kick out all 70 lawmakers in a fit of rage and replace them with a provisional LegCo “2.0” [HKCT note: The first was from 25 Jan 1997 to 30 Jun 1998]. To depend on a majority that could lead to a chapter of a “new testament” for One Country, Two Systems is perhaps what many elites long for, but they are overly optimistic:for a ticket to the promised land will not be available at the Chief Executive election campaign a year and a half later.

Admittedly, the Pan-Dems cannot unilaterally initiate “Laam-chaau” [HKCT note: mostly translated into “scorched-earth” mentality or “mutual destruction”; some even translated into “If I burn, you burn with us”]. The most they can do is to force a standstill of the government, and not for long the LegCo will have been eliminated from the equation to make the wheels turn again. It all leaves the plan of “Negativing the motion → Dissolving LegCo → Re-election after re-election → the stepping down of Carrie Lam” merely as overly positive speculation, probably resulting from their overestimate of CCP's capacity for rational calculation. The Pan-Dems must guard their frontlines and recognise what the biggest threat from Hong Kong to China could be. In this case, should LegCo sessions be disrupted or suspended, the Pan-Dems would have to be well prepared to surmount the expected obstacles and prevent the disqualification crisis 4 years ago—a Catch-22 indeed.

Productive tension from global intervention: Using Laam-chaau against the CCP

What aggravates the CCP the most is the potential threat to Hong Kong’s unique status as the one and only “separate customs territory”. Any miscalculation will compromise its role as the Chinese economy’s “white gloves”. Imagine if CCP were to disqualify all 70 elected lawmakers and convene a meeting north of the Shenzhen River to pass a resolution to Hong Kong’s affairs (much like the Provisional Legislative Council “1.0" in 1997), how great will the shock be in a world with an effective Hong Kong Human Rights and Democracy Act? However hard it is to predict the future one thing is certain: With the US presidential election just around the corner, blows to the separation of powers would not be tolerated, and the West would necessarily effect countermeasures against the Hong Kong government.

Beijing has been relying upon Hong Kong to navigate the international community for decades. While clamping down on the political freedom of the cosmopolitan city, Beijing desires to maintain the financial centre’s economic freedom. Hence, we started lobbying for the Hong Kong Human Rights and Democracy Act four years ago, and today we are determined to promote “Laam-chaau” on an international scale.

The will of the voters must be reflected in an election. If a “35+” legislature were to be dismissed and replaced, such flagrant violation of democracy would assuredly cause a greater backlash than the infamous extradition bill. Knowing what the reality ahead of us could be, we have to combine our election and international strategies to oppose the placement of a 35+ LegCo with an “Emergency Legislative Council 2.0”, to advance an international “Laam-chaau” to Hong Kong’s status as “separate customs territory”. Only then will we stand a chance to resist the regime and to realise the five demands.

Adjusting our mindset: Overcoming the “constitutional crisis” to reach a resolution

Upon the realization of the “35+” LegCo, it is expected that the CCP will launch a devastating counterattack. The Pan-Dems should not expect LegCo to run normally; neither can the lawmakers realise their governing blueprints they have for Hong Kong. Rather, candidates will be able to compete against one another with visions of a liberated Hong Kong through popular vote. Bringing this point up has nothing to do with undermining the common goal of reaching a majority in LegCo, but rather channels the battle of LegCo to positive use upon the rule of law’s death and a “constitutional crisis” ahead. Knowing that Hongkongers have nothing to fall back on, all Pan-Dems should not miss the only way to the realization of “35+”.

Thus, be they partisans, nonpartisans, incumbent politicians, amateur politicians, or the civil society as a whole – if we stay in the political discourse of 2016 and continue to perpetuate old stereotypes, that is to deal with the divisions on the pan-democratic camp by favouring the most “local” faction; to consider only resource allocation and self-aggrandizement as the purpose of a LegCo campaign; to ignore how potential lawmakers are fitted to what specific roles; to turn a blind eye to the journey of resistance since last summer (extending indefinitely into the future)—They would lead as astray and cost us lose a precious opportunity for change by winning a 35+ majority.

The extent to which the pan-democrats can stay united in light of the political atmosphere since last summer is another problem that our side must to address. Before the watershed moment of 12th June 2019, many democratic delegates were trapped in the mentality of needing to “preserve people’s livelihood”, “be content of what we have accomplished”, and other strategies that favours stability. As the government refuses to heed to the five demands, whether the democrats, especially those in the functional constituencies, have the political will to go all-in is the real difficult question that confronts us in the upcoming LegCo election.

All in all, if “35+” cannot be realised, it is unsurprising to see LegCo being more heavily suppressed in the next 4 years; even if "35+" is achieved, it is questionable whether the pan-democrats are able to weather multiple attacks, verbal or physical, from the regime (judging from its power in the last four years) and utilise the international Laam-chaau strategy against the displacement of LegCo. Adhering to the motto of “we fight on, each in his own way”, I can only hope that Hongkongers in elections, street confrontations and international front can reconcile with each other, so that we may collectively compel the government to yield to our demands in the next six months. It is only by reaching a resolution before a real constitutional crisis that we can combat the institutional violence of the regime and not be devoured by it.

https://hkcolumn.blogspot.com/2020/04/joshua-wong-after-winning-majority-in.html?fbclid=IwAR216gf53pG_j9JOpDfr2GItvjLfrFSekKTPzoEs3-s9KBqvPEwz865P8vw

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【學系．大格鬥】第一回：三大環球商業學(GBUS) | 學生、老鬼同場交流 | JUPAS面試內幕
https://youtu.be/1N4Gr13caxk

【考前必看】7科5**榜眼的DSE一天：如何盡用時間，計劃Study Leave時間表？
https://youtu.be/gqy4bwV66xs

【考前衝刺】DSE LS 通識：有咩係大家一定要溫？ | 答題技巧以外的溫習方法 - 拆字、推論、例子
https://youtu.be/oxy5vFjTO64

【中大生活 CUHK Vlog】疫情下的中大一日遊：深入中大探險各處，停課後猶如空城？
https://youtu.be/lfIIWl5npBY

Royalty Free Music by Bensound (https://www.bensound.com/)

#jupas #cumed #hkumed

我都開通左Patreon了！我懇請大家訂閱我嘅Patreon，等我有資源同大家分享更多更高質嘅片！Stay Tune！

?支持我的Patreon：https://patreon.com/ffclassroom

?下面有主題目錄，直接跳轉?

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我地創作者團隊不斷製作左各式各樣嘅影片、文章 (由讀書、DSE到大學生活都有)，都放左上Flowsophic了！? 另外知道在場有好多中四中五嘅同學，上面有由狀元、神科學生創作嘅DSE筆記同模擬試卷，一定幫到你係屋企都可以有效學習！

?Instagram帳號: https://www.instagram.com/flowsophic
?文章專欄：https://flowsophic.com/

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大家成日笑三大Science係水泡科，但係有無了解過實際有咩要讀? 仲聽講出路好狹窄，第時人工好難高得去邊? 今次邀請左UST IRE + CU BME (BioMed)嘅3位同學，同大家分享呢兩科嘅內幕資訊，同大家拆開Medic嘅神秘面紗！仲同大家分享面試Interview嘅絕密內容！

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鳴謝今次贊助場地的ST Music!
?Instagram帳號: https://www.instagram.com/stmusichk
?Website網站: http://www.stmusic.com.hk/
?Address地址: 觀塘工業中心第四期三樓E室

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追蹤我的動態！

?Instagram帳號: https://www.instagram.com/ffclassroom
?Website網站: https://ffclassroom.com
?合作請洽: freezyflameff@gmail.com

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0:38 IRE有咩Major可以選擇?
1:07 IRE同Science有咩分別?
2:40 IRE同Biomed多唔多人轉入去?
3:56 IRE有無安排Exchange?
4:23 Biomed會讀咩範疇的知識?
5:17 兩科讀書競爭大唔大?
6:00 IRE收生比例係點?
6:26 UST Science的新收生模式!
7:00 每個UST Science都要讀的課程
7:20 CU Biomed真係能Trans入Medic?
10:01 抱咩心態讀IRE?
10:58 DSEr入IRE要點準備?
11:31 兩科Science讀書量有幾多?
12:21 科大的Honours Course係咩黎?
13:35 中大Biomed求生指南!
14:46 中大BMED與科大IRE畢業後的出路
17:37 Science科的入學面試係點?
20:33 讀Science會玩咩活動?
22:39 Biomed都要做Intern?
22:58 可以由Asso上番IRE?


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?更多影片?

【學系．大格鬥】第一回：三大環球商業學(GBUS) | 學生、老鬼同場交流 | JUPAS面試內幕
https://youtu.be/1N4Gr13caxk

【考前必看】7科5**榜眼的DSE一天：如何盡用時間，計劃Study Leave時間表？
https://youtu.be/gqy4bwV66xs

【學系．大格鬥】第二回：港大、中大醫學士(MBBS/MbChB) | Year 2至5學生同場交流 | JUPAS面試內幕
https://youtu.be/W90lb1jlons

【中大生活 CUHK Vlog】疫情下的中大一日遊：深入中大探險各處，停課後猶如空城？
https://youtu.be/lfIIWl5npBY

Royalty Free Music by Bensound (https://www.bensound.com/)

#jupas #cumed #hkumed