Reflections on My 6-Month Clinical Attachment in Pediatric and Adolescent Gynaecology at Children’s Hospital, Zhejiang University School of Medicine

I am an Obstetrician and Gynaecologist from Malaysia currently pursuing my subspecialty training in Reproductive Medicine, with special interest in Pediatric and Adolescent Gynaecology (PAG). My journey so far has taken me across diverse healthcare settings, from completing two years of assisted reproductive medicine and PAG training in Malaysia, followed by a 6-month clinical attachment at Birmingham Women’s and Children’s NHS Foundation Trust in the UK, to now completing the final part of my training at Children’s Hospital, Zhejiang University School of Medicine (ZCH) in China. Each phase has enriched my understanding of this evolving field, but my experience at ZCH has been especially formative.

A Diverse Clinical Exposure: From Endocrinology to Surgery

One of the most striking aspects of my time at ZCH was the sheer breadth of clinical cases. The department caters to a wide spectrum of pediatric and adolescent gynaecological conditions, offering me first hand exposure to everything from common presentations such as vaginal infections, menstrual disorders and precocious puberty to rare and complex endocrine disorders like congenital adrenal hyperplasia and Mc Cune Albright’s syndrome.

I also had the privilege of observing and assisting in surgical procedures, ranging from minimally invasive diagnostic laparoscopies to advanced reconstructive surgeries for Müllerian anomalies. A particular highlight was the opportunity to join robotic-assisted surgeries for ovarian cysts in children and adolescents, an area of growing importance in pediatric minimally invasive surgery. The precision and innovation of these procedures were remarkable, and I was grateful to witness the skill and coordination of a high-performing surgical team.

Collaborative Case Management Through MDTs

The hospital’s multidisciplinary team (MDT) approach was a cornerstone of care, especially for challenging and rare cases. I regularly attended MDT meetings involving pediatric gynaecologists, endocrinologists, radiologists, urologists, psychologists, and geneticists. These sessions provided rich learning experiences in clinical reasoning and decision-making, particularly in the management of Disorders of Sex Development (DSD).

The DSD MDT, in particular, emphasized the importance of nuanced and sensitive communication, family counselling, and long-term follow-up, reinforcing the ethical and psychosocial dimensions of PAG practice.

Continuous Learning and Academic Rigor

The department held frequent CME sessions, which included case discussions, journal clubs, and topic reviews. These sessions encouraged critical thinking and deepened my understanding of evidence-based practices in PAG. I appreciated the culture of open dialogue, where junior staff were encouraged to question, present, and contribute meaningfully to academic discourse.

Additionally, I was honoured to participate in the Asia Oceania Society for Pediatric and Adolescent Gynecology (AOSPAG) webinar hosted by the ZCH team, which brought together regional experts in the field. It was an excellent platform for knowledge exchange and a testament to the hospital’s leadership and influence in the arena of PAG. The event was a resounding success and proudly showcased the dedication, expertise, and collaborative spirit of our team.

A Personal and Cultural Homecoming

As a Chinese immigrant, returning to China, even in a professional capacity, was a deeply personal experience. Living and working in Hangzhou, immersed in the language, traditions, and rhythms of daily life, felt like a homecoming of sorts. The warmth and camaraderie of my colleagues made my transition seamless and my stay joyful.

From sharing meals during festival seasons to informal language exchanges and local excursions, the cultural integration added another layer of meaning to my clinical journey. It reminded me of my roots and deepened my appreciation for the Chinese medical community’s commitment to excellence and compassion.

This six-month attachment at Children’s Hospital, Zhejiang University School of Medicine has significantly enriched my clinical acumen, broadened my academic horizons, and reconnected me with my cultural heritage. I leave with a profound sense of gratitude for the privilege to learn in such a dynamic environment.

I would like to express my heartfelt gratitude to Dr. Sun Liying and her team for warmly embracing me as part of their team. Professor Sun is truly an inspiring figure, her journey of single-handedly establishing the Pediatric and Adolescent Gynaecology (PAG) unit at ZCH 25 years ago, and nurturing it into what is now an internationally recognised training centre, is nothing short of remarkable. Her unwavering positivity, resilience, and vision have deeply inspired me and left a lasting impression.

My sincere thanks also go to the President of ZCH, Professor Dr. Fu Junfen, Dr. Sun Liying, and the entire PAG team for their guidance, support, and generosity throughout my attachment. I am equally grateful to the International Affairs Department, especially Ms. Zhang Ling and Ms. Sun Xiaoying, for their outstanding coordination and kindness, which made my stay not only smooth but truly memorable.