Although Macao’s first hospital – the now-defunct Saint Raphael – opened its doors as far back as 1569, the city has always depended on doctors trained elsewhere to deliver Western-style medical care. That dynamic is beginning to shift. In June, Macao celebrated a historic milestone: the inaugural graduation of students from its first and only medical school.
The Macau University of Science and Technology (MUST) Faculty of Medicine launched its six-year Bachelor of Medicine and Bachelor of Surgery (MBBS) programme in 2019. This opened doors to an internationally influenced and recognised medical education for locals, as well as regional and overseas students who meet strict entry criteria. Taught in English, the degree’s curriculum is designed to mirror those of renowned medical schools in Hong Kong, Europe and the US.
Thirty-seven MUST students received their MBBS on 10 June, at MUST’s main campus in Taipa. Macao-born student representative Sophie Ian Pui Si described the Class of 2025 as “pioneers who helped to build this medical programme from the ground up” in her speech at the ceremony.
Macao magazine spoke with three of these new graduates about their studies and ambitions going forward. Li Yan Wa and Mason Iao Kai Hei were born and raised in Macao, while Elmira Victória Coutinho joined the course as an international student from Cabo Verde, a Portuguese-speaking country in West Africa. Each now aged 24, the trio share a common goal: to improve people’s lives and contribute meaningfully to the future of healthcare.
A momentous day in medicine
Graduation day was an emotional, reflective occasion. Coutinho recalls waiting to be called to the stage, her mind cycling through everything she’d experienced in the past six years. When she finally received her degree, she felt her father’s pride emanating from the audience. “Then, when I stepped down, I started crying immediately, but it was a happy cry,” she says.
For Li, the achievement is taking some time to sink in: “I know I’ve graduated, but everything that comes with it, I’m still loading,” she says.
Sitting in the office of their vice-dean, Dr Nivritti Gajanan Patil, the three share what first drew them to medicine. Iao recalls being a sickly child who spent a lot of time with his family doctor, whose kindness inspired him to follow in the GP’s footsteps. Li, meanwhile, has always just been fascinated by the mysterious complexity of the human body. Coutinho says she didn’t have a defining reason for becoming a doctor – but she always knew she wanted to do something that helped people.
The road to becoming a doctor
Getting into MUST’s MBBS programme was the first hurdle Macao’s aspiring doctors faced in their medical journeys. Of 120 shortlisted applicants, each with top-notch academic results, just over a third were admitted. They were selected based on a series of interviews assessing their motivations to study medicine, leadership skills, capacity to cope with stressful, emotionally-charged situations, and linguistic ability. While lessons are conducted in English, Chinese language skills are also considered very important; students should either be competent in Chinese beforehand or be willing to learn it during the course.
The next big obstacle was unexpected: the Covid-19 pandemic. It meant some of the medical students’ theory classes happened remotely during 2020. Each student was assigned a tutor for support in matters inside and outside the classroom to help them through the challenging period.
By their second year, the cohort was back to face-to-face classes and getting ready to start clinical clerkships. These hands-on experiences would prove transformative, shifting their learning from theory to real-life application and deepening their understanding of the human condition.
Coutinho vividly remembers witnessing a patient pass away for the first time, and observing how her tutor broke the news to their family. “He managed to make them feel calm and comforted, which made me feel this profession is very, very noble,” Coutinho recalls. “Watching him made me feel very proud of the choice I made [to study medicine].”
The students encountered hundreds of patients during their training, many of whom impacted them deeply. Li recalls taking a terminally ill man’s patient history, a task made all the more difficult by the fact he was suffering from throat cancer and could not speak. His calmness in the face of death was moving, she says, and she admired how the man maintained his passion for football even while in hospice care. “He watched a lot of Liverpool FC and just seemed like a great person,” she reflects.
Iao, meanwhile, speaks of an “awkward” encounter that turned out to be a useful lesson in interpersonal communication. A patient’s wife had misunderstood her sick husband’s radiology report, and thought his attending doctor was exaggerating his progress. “I ended up spending two hours explaining the report to her so she’d be willing to speak to the doctor again,” he recalls.
Internships in Portugal and the GBA
The sixth and final year of the MBBS programme takes the form of a full-year internship utilising Macao’s close ties with the Chinese mainland and Portuguese-speaking countries. Li and Iao’s internships took place at the First Affiliated Hospital of Sun Yat-sen University in Guangzhou, Guangdong Province, while Coutinho completed hers at Santa Maria Hospital in Lisbon, Portugal.
Coutinho’s time in Lisbon proved particularly life-changing. During her obstetrics rotation at a peripheral hospital, she had the opportunity to assist with a number of births and even successfully delivered three babies herself. She describes working at the smaller hospital as her time in Portugal’s high point, because its size meant everyone in the obstetrics and gynaecology ward was familiar with her. The team supported Coutinho’s special interest in their field. In fact, her tutor was so confident in Coutinho’s ability with birthing mothers that she handed her the reins quite early on – selecting easy cases so as not to overwhelm the keen trainee.
“I was quite nervous holding a newborn baby for the first time, but it felt so good,” Coutinho recounts, noting that the experience inspired her to pursue obstetrics as a speciality.
Closer to home, MUST has forged partnerships with a number of hospitals in the Guangdong-Hong Kong-Macao Greater Bay Area (GBA). These include Macao’s own University Hospital, the University of Hong Kong-Shenzhen Hospital in Shenzhen, the Fifth Affiliated Hospital of Sun Yat-sen University in Zhuhai, the Zhuhai People’s Hospital and the First Affiliated Hospital of Sun Yat-sen University in Guangzhou, where Li and Iao’s internships took place.
According to Patil, the Guangdong Province hospitals have embraced MUST’s medical students with open arms. He says they consider it a “privilege to welcome Macao interns to the motherland.” Patil also notes that the size of mainland hospitals gives students exposure to a patient volume and diversity that’s hard to find in Macao, or even in Hong Kong.
Shaping tomorrow’s health sector
MUST’s Faculty of Medicine not only deepens professional ties between Macao and the mainland, but plays an important role in Macao’s broader economic diversification strategy. As Patil puts it, a medical school is “an absolutely important area for innovation” with a remit beyond training doctors. “These institutions can guide the government about public health issues and conduct important research,” he notes.
Patil is optimistic that the Class of 2025 has what it takes to become Macao’s “future leaders” in healthcare. He believes the MBBS programme’s small size, which enables highly personalised training, and focus on real-world competency means these homegrown doctors have a lot to offer.
The timing is pertinent, with the government having identified ‘big health’ as one of Macao’s key emerging sectors. Last September, the city marked a major step forward in this direction with the opening of the Macao Union Hospital – a large-scale facility that added 852 beds and 26 operating theatres to Macao’s healthcare system. Designed to serve the local population as well as attract medical tourists from the Greater Bay Area and Southeast Asia, the hospital is expected to generate employment opportunities in the health sector, including potential positions for some of MUST’s new graduates.
Looking ahead, Iao and Li are intent on earning their doctor’s licences in Macao – a process involving a qualification exam, completing a government-organised internship, and then passing a final licensing exam. Iao also hopes to gain overseas experience, and plans to apply for a UK licence in the future. Coutinho, meanwhile, wants to return to Portugal to specialise in obstetrics.
Wherever their careers take them, the three graduates agree that empathy and compassion are at the heart of good medicine. As Coutinho puts it, quoting Swiss psychologist Carl Jung: “Know all the theories, master all the techniques, but as you touch a human soul, be just another human soul.”
