Our faculty won a grant for cooperation with Taipei Medical University (TMU) in Taiwan under the Erasmus+ International Credit Mobility Program. The aim of cooperation is mainly teaching, exchanges of teachers and students. The cooperation was planned for the three years, ending in July 2023.
Unfortunately, the cooperation was severely affected by the covid-19 pandemic from the beginning. Especially on the Taiwanese side, there were strict measures that made planned visits and exchange stays of students completely impossible. Distance learning, which takes place on both sides in a hybrid form, was not possible either, i.e. it is not possible without at least short-term in person participation in classes.
In the period of 2021-2022, five online conferences took place, resulting in an agreement on mutual cooperation in the field of pediatrics and neuro-otology. Unfortunately, it was not possible to exchange students due to a lack of interest on both sides. Undoubtedly, this is due to concerns on longer stay (2 months required) in a distant foreign country with existing health and safety risks.
However, we managed to organize mutual visits of academics only in 2023, literally just before the end of the program. It's a shame because Taipei Medical University has a lot to offer. It is a modern university founded in 1960, with a total of 11 faculties and about 6,000 students in a year group. At present, TMU has five large hospitals affiliated. TMU is among the ten best-rated universities in Taiwan, according to an independent assessment.
Colleagues from Taiwan in Prague
Between 30 March and 6 April 2023, our faculty hosted Associate Professor Hsun-Hua Lee, Head of the Neurological Clinic of Taipei Medical University, and Dr. Che-Hsuan Lin, Head of ENT Clinic, Taipei Medical University. Both colleagues are interested in the issue of dizziness and balance disorders from the point of view of their specializations. They had the opportunity to familiarize themselves with the operation of the Vestibular Laboratory and consultation room for the treatment of vertigo at the ENT and Neurological Clinics of the Motol Hospital. They presented lectures on benign positional vertigo in neurological degenerative diseases and a series of case reports of patients with down-beating nystagmus. Program of the visit also included a joint lunch with the dean and staff of the dean's office, a tour of the university hospital and social events. Taiwanese colleagues particularly appreciated the guided tour of Carolinum. It was a very pleasant and fruitful visit not only due to the extraordinary interest of both colleagues in neuro-otological issues, but also thanks to their very friendly and positive approach, which I would describe as exemplary.
Dr. Rudolf Černý at TMU
I visited the Neurological Clinic of TMU for 4 days in April 2023. During my stay, I presented a paper on residual MRI findings after surgery for vestibular schwannomas at a seminar of the Neurological Clinic. As an invited speaker at the 4th International Congress of Taiwan Neurological Society I presented a paper on the nociceptive flexion reflex in patients with chronic pain. I also got acquainted with the operation of the Neuro-otology clinic and laboratory. A number of meetings with TMU representatives and the Taiwan Neurological Society took place.
How it works at TMU Neurological Clinic
It is necessary to emphasize the truly extraordinary hospitality of all Taiwanese colleagues and especially the ubiquitous positive atmosphere. It made my stay very pleasant. It also undoubtedly represents an important element for preventing stress from overworking. The workload of TMU colleagues is truly extraordinary by our standards.
In a typical working day, one doctor examines several dozen patients, roughly from 50 to 100 or even more. I witnessed that 139 patients were booked into the neuro-otology surgery for one day. The consultation time was from two to ten minutes per one patient ( I measured it on stopwatch) which sounds unbelievable. But the workflow is perfectly organized. The doctor does not write anything at all, he has two nurses at hand. One takes care of the patient (brings him in and escorts from the consulting room, etc.). The other nurse sits at the computer, presents the results to the doctor for his evaluation, then records the results of the consultation and organizes any subsequent examinations recommended by the examining physician. However, the doctor completes this at the time when next patient is already entering the room. It is not uncommon for a doctor to treat several patients at the same time. For example, the doctor performs tests for positional nystagmus of which it takes a few minutes to get the results - the nurse stays with the patient for that time. And then the doctor returns to check on the patient. In this way, the whole process is accelerated in a major way. However, the burden on doctors is still enormous. The technical equipment, diagnostic and treatment procedures at TMU are fully comparable to ours. A number of TMU colleagues also practice the methods of traditional Chinese medicine, especially acupuncture. However, these are only complementary methods in university hospitals.
What next ?
Both visits resulted into an agreement on further cooperation in the field of neuro-otology. In particular, we will try to develop a joint online optional subject of diagnosis and treatment of vertigo. We also plan a joint online consultation of interesting patients (anonymously) and joint research projects in the field of video head impulse test analysis and down-beating nystagmus. A visit of Professor Lébl from the Pediatric Clinic of Motol Hospital to the Pediatric Clinic of Taipei Medical University is planned for June 2023. We all hope that we will be able to obtain financial support for the next period – our faculty submitted a grant application through the Rectorate of the Charles University in January 2023.
MUDr. Rudolf Černý, CSc.
