Educating the next generation of doctors

11 January 2019

Dr Forshing Lui (Croucher Fellowship 1982) is exploring the generation gap in medical education. In his contributions to the book Mind the Gap, Dr Lui discussed how students today learn differently from previous generations due in large part to their relationship with technology.

As a Professor of Clinical Neurology and the Chairman of Clinical Sciences at California Northstate University, Dr Lui is constantly faced with the challenge of teaching new generations of medical students. Physicians who are millennials (commonly defined as those born between the mid 1980s and mid 1990s) grew up on an area of readily available information via the internet and tend to value technology. They are also generally more confident and less willing to sacrifice work-life balance in exchange for career progress.

In contrast, older physicians are less trusting of new technologies and tend to be more career-focused. These generational differences are important for professors to consider when designing their coursework for medical students. “As a professor, I teach my students and learn from them at the same time,” Dr Lui said.

From Hong Kong to the USA

Dr Forshing Lui (Croucher Fellowship 1982)

Dr Lui has not always resided in California. He was born in China and grew up in Hong Kong, where he attended the University of Hong Kong Medical School. When he completed his degree, Dr Lui was interested in pursuing neurology. However, there were fewer than 10 neurologists in all of Hong Kong at the time, making it difficult to find mentors to train in this area.

In 1982, Dr Lui was awarded the Croucher Fellowship, which enabled him to travel to Newcastle upon Tyne in England and pursue training in neurology. He spent more than a decade practicing neurology and internal medicine in Hong Kong before immigrating to the United States, where he was among the first neurologists to get Board Certified in vascular neurology.

Dr Lui spent much of his career working at Kaiser Permanente, an integrated American healthcare organisation, while also volunteering as a professor at UC Davis. “Teaching medical students has always been one of my passions,” Dr Lui said. In 2015, he retired from Kaiser and joined the faculty at California Northstate University in order to teach and mentor students full-time.

The Barriers to Stroke Management

Though he practices general clinical neurology, which encompasses all neurological conditions, Dr Lui is particularly interested in strokes. He noted that the research on strokes tends to lag behind the research on heart attacks. While muscle cells in the heart can survive longer with their oxygen supply cut off, brain cells start to degenerate very quickly.

As a result, reopening the arteries following a stroke has even greater urgency. “A lot of the research right now is focused on expanding that treatment window for strokes,” Lui explained.

Strokes are the #5 leading cause of death in the United States. They are usually treated with a clot buster called tPA (Tissue Plasminogen Activator), which dissolves clots and allows blood to flow more readily to areas of the brain near the stroke.

However, tPA becomes less effective if it is administered more than four and a half hours intravenously after the stroke. At these later stages, tPA can lead to more brain haemorrhaging and other serious complications. As a result, early detection is critical. Newer treatment strategies will include direct attack of the clots by an intra-arterial catheter or utilising newer imaging techniques to defining areas of the brain that may still respond to revascularisation. These new techniques allow many stroke patients to respond to therapy even up to 24 hours since the onset.

According to Lui, public education about recognising the signs of a stroke and knowing the appropriate response could save countless lives. These warning include sudden numbness, confusion, vision problems, loss of balance or coordination, trouble walking, and severe headaches, according to the National Stroke Association.

People experiencing these symptoms should be managed at a hospital emergency department immediately to increase their odds of recovery. “You need to act quickly to minimise brain damage, Time is Brain.” Dr Lui said.

Dr Forshing Lui earned his medical degree from the University of Hong Kong Medical School in 1978 as the top graduate in his class and recipient of the John Anderson Memorial Gold Medal Award. He practiced clinical Internal Medicine and Neurology in Hong Kong until he immigrated to the US in 1995. He completed another Neurology residency at UC Davis and became Board certified in both Neurology and Vascular Neurology (Stroke). He then became a Senior Physician and Chief of Neurology at Kaiser Sacramento and Roseville Medical Center. He also served as a volunteer Associate Professor of Internal Medicine, and later Neurology, at UC Davis. Currently, Dr. Lui is a Professor of Clinical Neurology, Neurosciences Course Director, and Chairman of Clinical Sciences at California Northstate University.

To view Dr Lui’s Croucher profile, please click here