Meet Dr Weihua Zhang

Dr Weihua Zhang, Associate Chief Doctor at Xianyang Rainbow Children’s Hospital in China, has been working in the paediatric field for over 20 years. After graduating from Chongqing Medical University with a PhD in cardiovascular science in 2015, he transferred from general paediatrics to paediatric intensive care, looking for more challenges. In November 2019, Dr Weihua Zhang started his one-month observership journey in the Paediatric Intensive Care Unit (PICU) at Great Ormond Street Hospital for Children (GOSH).

Why did you choose GOSH for an international observership?

The paediatric intensive care field is a challenging specialty which involves considering complex factors during the treatment process, making it comparatively highly pressured. The experience of participating in the Asia-Europe Paediatric Summit stimulated my enthusiasm and curiosity to go abroad to study and explore the differences in paediatric intensive care between China and other countries.

Therefore, I was constantly looking for overseas observership opportunities. With the support of my hospital and the British Embassy, I was lucky enough to learn about the International Observership Programme at GOSH and decide to participate in the programme in December 2019.

What was your main responsibility? What did you learn during the observership?

The observership was as great as I expected. My supervisor was Dr Joe Brierly, Consultant in Paediatric and Neonatal Intensive Care at GOSH. My main work was conducted in the PICU. The unit has very a clear timetable, efficiently arranging daily and weekly clinical work and academic studies. Different from China, the shift is divided into two parts at GOSH’s PICU. In the first part doctors lead the hand-over meeting and provide an update on the patients’ status. The second part is when the nurses visit the wards and update the patients’ clinical matters.

After the shift, the unit organises various exchange activities for staff to discuss and learn from the clinical cases. We could participate in the review-meeting and learn how the team here handled real cases. Moreover, we received a range of training courses related to cardiopulmonary resuscitation (CPR) and arrhythmia. GOSH would also invite guest speakers from other counties to deliver trainings and lectures. For instance, our PICU unit invited experts from Boston to present their latest research progress in extracorporeal membrane oxygenation (ECMO).

Were there any differences you noticed between China and UK?

Doctors often have to manage not just one individual patient, but the patient’s whole family. What doctors need to consider is not only the patient’s treatment plan but as importantly how to efficiently communicate with the patient’s family members, especially in the PICU. The patient-doctor relationship can become very tense when life-threatening or life-limiting moments appear. As a doctor, I am always eager to communicate honestly and directly with parents and tell them the truth. That way they can better understand their children's future and quality of life, and we can work on a plan together.

In GOSH, I noticed that the parents’ degree of participation is very high during the whole treatment process. When the patient’s disease is no longer responsive to curative treatment, Palliative Care is a very significant transition service which gives the parents a chance to accept the hard facts.  As the largest Specialist Paediatric Palliative Care (SPPC) team in the UK, the multi-disciplinary SPPC team at GOSH work closely with the family and provide personalised care based on each patient and family’s need. Personally, I think that our hospitals in China need to further explore and develop this area.

Furthermore, EPIC online patient management system is very advanced. Every patient has a unique patient number and account. Via the EPIC system, the clinical team can efficiently access each patient’s most up-to-date data all together including all the test results, medical records and consultation notes in one place. This system highly improves the convenience of information acquisition and the work efficiency of medical staff.

In terms of internal communication within the clinical teams, perhaps because of the eastern and western cultural differences, I found that the shift style at GOSH is quite diverse, with a more relaxed style and more respect for individuality. The colleagues here are easy-going and humorous, and they can express their real thoughts and discuss their opinions in a practical and direct way during the shift meetings. While in China, the doctors are more likely to not directly express their thoughts. The meetings are always organised in a formal and serious atmosphere, with one person speaking while others are listening. I feel this might not be conducive to exchanging and learning from each other.

Did you like living in London?

I love the life in London very much and the pace here is relatively slow. People are very polite and gentle. The place I lived in is near the famous Hyde Park; the environment and atmosphere there make people feel relaxed and delighted and inspire people’s thinking. Moreover, I was touched by people's sense of respect for their work, no matter what occupation such as sanitation workers, the staff distributing newspapers and the fundraisers at the underground station. People in the UK are also very focused on their own things in the underground, and most of them are quietly reading and listening to their own music.

What are your plans when you return to China?

Every journey while studying will bring different feelings and changes. For me, the observation and study at GOSH is an unforgettable experience and memory. After I return to China, I will share my thoughts and feelings from the observation widely in my hospital and make some feasible improvement plans based on the situation of my hospital, so as to apply the learnings into daily work.

I also strongly encourage paediatric peers to come to hospitals in different countries for observation, which will help them broaden their horizons. It is very important to seize the opportunity to communicate with and learn from excellent international paediatric peers.