Prof. Dr. Ngeow Wei Cheong
‘First of all, could you please begin by telling us a little bit about your beginnings and how you ended up as a lecturer here in UM?’
So, I was interested in medicine or dentistry. Of course, obviously because of the number of schools that were less, our options were less and I was in a way lucky to be able to get into dentistry as a second choice and admittedly a lot of people as dentists in my generation get into dentistry as a second choice. So, either that or maybe pharmacy. I think there’s 1 dental school, 3 medical schools, and 1 pharmacy at that point. So, I got into dentistry and I graduated around 1992 where I actually worked in private practice. I worked with a very famous doctor, Dr. Sim Tang Eng. He used to be the founder and president of the Malaysian Association of Aesthetic Dentistry. So, I worked for him but there was only one catch, private practice is a business. I am not too much of a businessman, I’m more into a serviceman. I’m more into a person that likes to provide service without taking care or worrying about the cost because that is the issue when it comes to cost, there are things that you can do and cannot do. I did work for about 9 months at private practice, wanted to join the government service but then the posting wasn’t that ideal. So having said that, the university knocked my door, suddenly I got a call and was asked whether I was interested to join academics and that’s how I began actually because that’s the only other option to join their service, to provide service and hopefully with less issues about the cost. I was roped in as a training tutor, it’s a contract job. We don’t get scholarships and the maximum is 3 years. By the end of 3 years, I was quite desperate. One of my mentors, Professor Leanne managed to find me a job in the UK, they have this scheme called Overseas Dentist Training Scheme, that was in the 90’s. I was lucky, they took me in, I got a job for a year and that’s where I actually trained further after my training in UM as a tutor. So, all in, I have 3 years in UM, 1 year overseas, and those were the days when I passed my fellowship exams. The exam was the only thing that they needed those days, they don’t need a Master or PhD. Of course, that would be an added advantage and that’s how I ended up with academic qualification. When I returned from training overseas, I wanted to join UM, that was in 1996, unfortunately, because I did not belong to the group of trainee lecturers I actually joined UKM. So, for those of you who are from UKM, and maybe some of the curriculum that you have seen in oral surgery, we were the ones drafting it in 1996 when the school first started. I was the first lecturer appointed then. From UKM, I moved on to UM. The reason was I wanted to study. Unfortunately UKM did not have the avenue at that point of time, they were new, whereas I wanted to carry on and study as I say, you have a master, you have an extra advantage. It’s a knowledge thing. I went to UM and they allowed me to do a part-time master, which I did and of course, that was a drag because you’re doing it part-time while working. It drags for years and years. I finished that and that was how I ended up in UM ever since the millennium until now. So I have passed 20 years in UM.
‘You specialize in Oral & Maxillofacial Surgery. What is this specialty about and how did you decide on pursuing it?’
Oral surgery right, I think everybody knows, anything to do with the mouth surgery. But then, if you look at the whole scope of Oral and Maxillofacial Surgery, some people even do craniofacial surgery, they go up until the base of the skull, or area around there. So, I started in the 90’s, so those days our training was different, our training is more fellowship, hands-on training, it's not really a big course that people follow like how we’re training our doctors now in UM or UKM or USM. So, my exposure was more on dentoalveolar trauma, a bit about orthognathic, and with some cancer work as well. So, it’s dependent on the center actually. You look at the whole Malaysia, some oral surgeons do cancer, some do not. But you will be surprised, from my experience in the US, the same actually applies. Of course, now in UM, my colleague, we do a lot of extraction, craniofacial, and also cleft. That is admittedly something that I do not do and I wasn’t trained and we have enough young people to train so it’s not a need for me to be retrained to do it. Why I chose it, long story, it all boils down to where I started when I was working in UM as a tutor because of my post it wasn’t a permanent post, it doesn’t come with a scholarship. I wasn’t eligible for that and because of that, I can’t be going overseas to do a master and a fellowship, which was the norm then. If you look at some of your consultants at KKM or even at UM, they actually have a Master in Science, in dentistry from UCL, that is actually Eastman and fellowship. So those days, I started with a fellowship, as I said just now, that was how I ended up in UM again because I wanted to do a master to make up for whatever I don’t have. So, I actually worked the other way round, in a way. So, why I actually ended up in Oral Surgery was because that training actually allows us to do only the exams in Oral Surgery. It won't allow us to do an exam in Orthodontics for example. There wasn't such a program in the past, in the 90’s, in Malaysia. And for others like Restorative, Endodontics, yeah you can, but my training in UM wasn't enough as a tutor even though I was rotated in every department and every specialty and the work in the UK is actually very hospital-based, really hospital-based oral surgery or a bit of dentistry. That's how I ended up in the oral surgery really. So, it's not by choice, it's kind of that is the best situation you can get yourself in actually. You guys are lucky, you have more choices, it's just a matter of you know, your interest, of course, finance is an issue and if you need a scholarship, years of service is an issue.
‘In 2015, you were a visiting professor at the University of San Francisco in the United States. Do enlighten us about your working experience there.’
In university we have a break, called sabbatical, it means you don’t have to go back to university, you can go elsewhere, you can go to another center, You may spend that break, it may be between 5 months or 9 months depending on your years of service and you actually commit to something say I want to spend the time writing a book so, at the end of the 9 months, you’re supposed to produce that book because that’s the contract. So I chose instead to get posted to UCSF, the reason being the person in there, there’s a professor there by the name of Tommy. He’s an expert in nerve injuries in the US. When I did my PhD., between 2007 and 2010, I actually spent 3 years in Sheffield to learn about nerve injuries, the healing mechanism and things like that. When I was working before that in UM, I did cause, unfortunately we do, or we did get referrals of patients with nerve injuries, things like lingual nerve injury, and I was kind of lost, because nobody in Malaysia actually treats them or are interested in treating them. So, that’s how I ended up in the UK and the US. I was there hoping to see some cases that they do because when I was in Sheffield I knew how they do the surgery but then in the US I actually wanted to see how much difference, but essentially they are the same. A lot of things we do in dentistry is universal, it’s just the level of care, maybe my level of care is a higher standard than yours. Maybe we can spend more time talking to the patient, they cannot or the other way round. So those are the things that make the difference because skill-wise it is very individual, of course, the training program will provide you with that. So, I spent the 6 months there, observing what they do, learning from their way of work. The UK and Malaysia are very similar because we adopted the British system. The US is basically all insurance-based, so you’ll be surprised how people come in, they have to get insurance approval before they get an operation done. You’ll be surprised how small is the waiting area before the operation, how small is the operation theatre, if you have been to one, compared to some of the one we have in Malaysia. Once you’ve seen those things you will realize that we are quite luxurious in a way. Why are they small and not big because it’s just a matter of cutting costs, covering the cost because everything in the US is insurance. The government will not provide treatment like what we have done in KKM. If you have an accident, you come in to get yourself fixed, maybe about RM2000? Whereas the actual price for the whole treatment is about RM20000. Imagine how much the government is caring for the population here. It’s a good experience. Of course, I stayed near the hospital, the dental school and hospital are actually on the hillslope overseeing the bay and you can see the golden gate every day, the beach. So that’s the fun part of it, besides going to the hospital, you get to see the city of San Francisco. I did spend a lot of time with them, seeing how they do their implants. For me, it's to learn, come back, and then teach or pass on what I have learned, what’s their philosophy, how they do things, why they do certain things. Yeah, we know we can read, we know we can Youtube, we know we can Zoom, but it's not the same experience as we are there. You can talk to them straight, you know in the face, you can question them and debate, that kind of thing.
‘You have been working actively in Malaysia for about 30 years. What is the most fulfilling part of being an Oral & Maxillofacial surgeon?’
The job is not fun. I tell my patients one thing, I don’t want to see them. Because if they’re coming to see me, they will get operated upon or something is not right with them. So, I keep telling my patients, if I have a choice, even though I’m trained, I don’t want to operate unless I have no choice and if I have a choice, I would try and choose a more conservative treatment. I know people who like to cut, do big things like a free flap, big surgery, and stuff like that but at the end of the day the most fulfilling thing is learning about yourself. When you train at a young age, you think you are Superman, maybe right, in a way you think you can do a lot of things. We can, as technology allows us to do. Over time, you will be humbled by it. Some of the things we do, we fail. Things didn’t work out the way we wanted. Complication happens. You tell yourself and you tell others and you question people and said, I followed my books, I followed my training and then why? The thing that I find most you know, happy is when patients feel good, they feel comfortable. I know that they will be in pain after that, they will get swelling, I know maybe they can’t chew, maybe they lost part of the jaw but the interaction with them is where they appreciate. It doesn’t matter if they don’t give you gifts, we do get gifts. It’s never the issue, the issue is when you see from their expression, from their eyes, they are happy. Because even if things go wrong, they think you have done the best for them. I think that is the most important thing as a healthcare worker. It’s not about ourselves actually, it’s about them. How we try to help them solve their problem, or minimize their agony, if there is any.
‘You have successfully published 176 research papers till date. What is the biggest challenge you face in research and what do you foresee about the prospects of research in dentistry?’
Oh, that’s a tough question, isn’t it? The problem with academics is there’s always this word called publish or perish. I started my publishing very early because my mentor, the ex-dean of UM, Dato Hashim got me off then. My first paper was something that I do in the blind, I would say blind because I honestly don’t know where to start, what to do, or things like that. But when you get a task to do, you have to figure it out. So, it’s a bit like problem-based learning. You figure out how to do it, you look at other people doing it, we don’t have YouTube those days, we don’t have webinars and things like that to teach you so we depend on whatever people have done instead. That’s how I got started and the good thing is, fortunately, I was quite a good writer. In secondary school, I wrote quite a lot of work in Malay, published it in newspapers and magazines. I took it as a training because where else can you get training? If you can get training by sending it to somebody and they publish it, that means your writing is not too bad. So, the same rule applies when it comes to dentistry, academics. My teacher always says, when you publish something, your idea and argument will get closer to the expert because when you send something for publication, it will be reviewed, it will be read by somebody who is an expert. If the expert thinks that it’s good, he will recommend publication. If he thinks it’s bad, sorry you’ll get rejection. I do get, I still get now. Of course, if you ask if the publication is getting tougher and tougher. I started early, so I was fortunate. It's just a bit like people who want to start their clinic now compared to a person who wants to start their clinic 20 years ago. Having said that, every generation has the competition, the challenge. Different times have different perspective things to be thrown onto you so I think we should not fear it. If I’m born now, I would tackle it in a different way. Now, I can actually write a paper sitting in the room here, for example, without going anywhere because I can get the resource, information from the Internet. Back in those days, we had to run to the library, find the thing in hardcopy and sometimes the library did not have it, we had to get it from another library. It costs you a lot of money just to get the printed records or documents sent to you and those take ages. It can take you a month or two to finish up a paper because you’re doing it halfway and then you say ah I have to wait for this to come in so that I can add on information and stuff like that. So those were the challenges in the past. With digital things, I have managed to finish one paper in one day. That’s how quick you can do it, yeah. But it’s not the norm, I would say. I believe there’s always a lot of things to learn because the interesting thing is we always thought we know everything. We always think that we are in the modern scientific era but if you start digging up the history of healthcare, especially dentistry, you will realize a lot of medical care started about 100 years ago, the real thing that we do on patients, the invasive thing. I know you learned about GV black, which was 150 years back. If you look at oral surgery and more recent stuff, certain things can only do with what, general anesthesia. Those days we started with ether and stuff like that, local anesthesia, and if you learn you’ll realize your LA was only invented around the 1960’s. Some of your painkillers were only invented 20 years ago. Of course, you can say Panadol, Aspirin. So, how much knowledge have we moved into dentistry? Actually, in digital and in the material we have moved very fast. In oral surgery, in some other pockets like dental anatomy, oral anatomy we are still a bit behind. There’s still a lot of gaps. If I were to ask you a question in return. What is the root length size of all the population in Malaysia, including all the Kadazans, Ibans, Bajau orang Asli? I don’t think anybody has the answer. I’m still collecting those data because that is what I do, not as a researcher but do on a patient if I want to treat them, do an extraction, do a root canal, or surgery. I know where to cut, what is the length, the size, what is the limit, and things like that because my data is on the people that are around me. There’s a lot of questions that need to be answered and the room is there. Of course, if you’re doing something else like digital, something else like material, we are not that strong because our resources, the company, the lab all cost a lot of money, and a lot of them are dependent on the manufacturer which unfortunately if you look at Malaysia, we are good at making gloves. But then, we don’t make anything else. We don’t make composite, we don’t make dental instruments. If your friend comes back from Pakistan or India, they actually bring their own instruments back because they were required to buy and they were made in those countries. We don’t, so we are not strong in this area, we are strong in certain areas. It depends on us, which direction we want to go. As far as research, it’s just 100 years. There’s a lot of room for us to learn. I don’t think it’s a problem, just a matter whether you can catch it or not.
‘What characteristics do you think is required for a student to pursue Oral Maxillofacial Surgery?’
It’s actually about the person, whether you are patient enough to do it. Patient means that you don’t rush through things, you have the passion, means that you really believe and love doing it. Oral surgery unfortunately is not a fun specialty. You close your clinic at 5pm, you actually go on-call after 5pm. And that will go on for the rest of your life, which is what I have done. Of course, when I first started I didn’t know about this because like I said, when you’re young you want to do everything. You think you can do everything, you do not mind doing anything, which is a good thing. Over time, we see, we hear stories about overseas dentists killing themselves, surgeons killing themselves, it’s all stress-related. So, the most important characteristic actually, is somebody who is resistant to stress, in a way somebody who is not too bothered by certain things unfortunately like you learn to dissociate ourselves from our patients. You don’t get too emotionally attached and things like that. Because in oral surgery, patients die. They die from trauma, they die from accidents, they die from cancer. Sometimes, they die from general anesthesia accidents. So they do die, and those are things that emotionally drain us. Most of us will face this somewhere in our careers. So, if somebody has the character that can take all this, and yet survive that, that person will be a good choice. So anybody in the future who wants to join this program must know who you are. Because we have people who drop out of the training program, who fail the training program. Not only in Malaysia, anywhere in the world. You have to judge yourself.
‘Last but not least, what advice would you give to the current batch of dental students who aspire and look up to you?’
Don’t need to look up to me. We always want somebody to look up to. Personally, if you notice, I don’t promote myself because I don’t think I should be the one you look up to. The first rule is to love yourself. Look up to yourself, your family around you, people who support you, because they are the real people who know you the best. Whoever you think you look up to, you only see half of the story. If I were to post on social media, I won’t post about my failure, I won’t post about my patient who died, I won’t post about negative things. We’re all human, after all, we are not perfect. We may have issues with our friends, our colleagues, our family and yet if you look at social media, wah this person is great, etc. That is how we sell ourselves. And of course some of you, like my university, we have mentor-mentee, but half of the time we only meet them once every semester. Often, sometimes I give them the choice to ask for advice from somebody they’re comfortable with because the person you get may not be the person you’re comfortable to tell your problem. Or some issues may be religion based so I may not be able to help them for example. So, just go around, there’s a lot of people who love you next to you. And you should start with them before looking up to people like me. What I've been trying to do all the years, it’s just to raise the level of dentistry in the country. I mean things like you say why I write so many papers. One, it’s the requirement. Two, if you don’t do it, somebody has to do it. But you can’t wait for the next guy and say, come on do it. So, you have to lead. That’s our duty, that’s our role as the senior people. So, you can look it up on the spirit that you want to achieve this. I think that type of looking up is good. But don’t be too bogged down and dragged into it because we do look up at singers or drama stars. And then suddenly some of them get bad news and then you’ll get very disappointed with them. But after all to me, my answer is very simple. They’re human, they make mistakes. It’s just we perceive them as perfect. They never ask for it but they have to keep up to their role because that’s the marketing point of their job. I don’t need to market, so that’s fine. To me it’s easy. Look up to all the people who give you positive energy. That’s the simplest advice I would give. I would advise any student who wants to be successful, to first love yourself, look up to yourself and the people around you because they are truly people who understand you. They know your down days, they know how you feel, they know your fears, they know you’re not strong in certain things.