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InFocus

Teaching dermatology in China

David Grant reports on the development of his teaching work in other countries describing his first visit to the People’s Republic of China and the rapid growth of small animal practice there

IN 1992 Professor David Lloyd of the
RVC and I were involved in teaching
dermatology to veterinary surgeons
from all over Europe, which
continues to this day.

This has been within an organisation
called the European School for
Advanced Veterinary Studies (ESAVS), a
non-profit organisation based in
Germany.

Since its
inception,
more than
6,000 vets
have received
training in
various
disciplines
apart from dermatology.

Initially the dermatology programmes
took place in Luxembourg but for more
than 10 years they have been in Vienna at
the university veterinary school. The
format of the dermatology course has
changed very little over the years.
Mornings are given over to lectures and
afternoons to practical classes and case
evaluations in small groups.

There are three courses of two
weeks’ duration with an interval of one
year between each course, allowing for a
comprehensive range of diseases to be
studied. Between courses colleagues are
set distance-learning tasks.

Over the years we have taught
delegates from all over Europe and
further afield including Brazil, Mexico,
Guatemala, Indonesia, the USA and
Thailand. Additional lecturers from the
USA, in particular, but also the UK have
always taught the second week and
specialists in equine, exotics,
histopathology and oncology, for
example, are integrated into the course.

One of the founders and principal
driver of the ESAVS, Hans-Joachim
Koch, a veterinary practitioner and
dermatologist from Birkenfeld in
Germany, was responsible for initiating
contacts in China and since 2010 courses
have taken place there every year.

China’s economy has developed
rapidly in recent years. There is an
increasingly wealthy middle class and pet
ownership has accordingly expanded
greatly, and with it an opportunity for the
veterinary profession.

Chinese vets are now able to own
small animal practices and there are many clients who demand high standards of
care. As a result there is a tremendous
thirst for knowledge. Along with David
Lloyd, I have now taught four courses in
China totalling 20 days and this thirst for
knowledge is very evident. We have
found the Chinese vets to be very
focused and those who understand
English normally video the lectures.

This growing market for veterinary
services has not yet translated into a high
income for employed vets. In 2012 the
average salary for a young vet was
equivalent to €470 monthly with
experienced ones nearing €1,000
monthly. I am quite sure that this will
change, as the potential seems to be vast.

Already amongst the delegates the
entrepreneurial spirit is alive and well with
some of them owning three or more
practices. One of our translators has just
set up practice in her hometown where
there are few practices as yet. Her
hometown boasts 15 million inhabitants!
As I left on my most recent trip she was
busy purchasing an ultrasound machine.

Overwhelming

Our first visit was in 2010 to Guangzhou
in Guangdong province. Although I have
travelled quite extensively, nothing
prepared me for the China experience.
The sheer size of the cities is almost
overwhelming.

Guangzhou houses 12.78 million,
according to the most recent census, and
is the third largest city in China. The
Pearl River Delta Economic Zone has
more than 40 million people. The
apartment blocks reach up to the skies
and the tops can hardly be seen. The
highways are massive and there are cars
everywhere. With that comes pollution
and it is not uncommon to see people
wearing surgical masks.

Everywhere we went there was
evidence of a booming economy. The
facilities for teaching, normally the local
university or medical school, were first
class and modern. Our hotels were very
comfortable and the restaurants excellent
and always seemingly full.

I very soon had to become proficient
with chopsticks, as that was all there was
– breakfast, lunch and dinner. Some of
the restaurants were massive with dozens
of private rooms for groups of 20 or
more. Food is taken very seriously and
meals are very communal. The waiters
constantly bring every conceivable type
of food, which is served on a rotating table, allowing you to choose.

Lecturing was with consecutive translation. This
inevitably means cutting down
on the number of slides used
in comparison with lecturing
in English. The slides had
been sent to China a month
before each course and very
quickly formatted into
bilingual versions.

It was quite remarkable to
be illustrating cases of
lichenification, for example,
and see the Chinese
equivalent in subtitle form.
Having bilingual slides, which
I had not experienced before,
actually speeded things up
and made the translating
easier.

But in spite of the need
to economise on slides, it was possible to
teach at the same level as in Europe. We
had been told that the Chinese would not
interact, being somewhat shy; however,
they soon became just as interactive as we
were used to, even more so as time went
on.

After Guangzhou, the next courses
took place in Hangzhou, Shenzhen and
last year Xia Men. Each location was
spellbinding. Hangzhou is famous for its
beautiful West Lake and we experienced
the high-velocity electromagnetic train
from Shanghai airport to the centre,
travelling at 400km/hr – quite a sensation
and a contrast before the last part of the
journey, 110 miles through the Chinese
countryside on a local bus service.

In Hangzhou we had the opportunity
to visit a privately-owned small animal
practice. This was equivalent to a two-
person practice in the UK with full
operating facilities.

While there I saw a pyometra
operation performed by the practice
principal (who had received surgical
training with Hans Koch in Germany).
The operation went well, to the relief of
the owner fretting in the waiting room.

Shenzhen is the Chinese equivalent of
a new town with modern buildings everywhere and with a growing
population of 15 million in its total area,
but my favourite so far has been Xia
Men, a coastal location opposite Taiwan.

There is a small island called
Gulangyu nearby which we visited for a
day. This island has a musical tradition
(the locals call it the piano island) and we
heard a piano concert given by one of
the university professors, which was free
– and brilliantly performed. Also, the
piano museum on the island, the only
one in China, was well worth the visit.
We by-passed the ferries by paying a
small sum to travel by speedboat to the
island. Not for the faint-hearted!

As is always the case wherever you go
in the world, the friendship and
hospitality of our fellow vets was
outstanding.

I was struck by the charm of the
Chinese people – all smiles and in many
cases requesting to have their photograph
taken with the westerners.

Small animal practice in China
appears to be rapidly accelerating both in
knowledge and facilities and our
colleagues, and in many cases friends,
undoubtedly have very bright futures.
Plans are in hand for the next course in
December.

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