By Grace Chua

DR VICTOR Dzau, a key figure behind Singapore's latest medical institution, is quick to acknowledge that the disadvantage and illness suffered by his forebears helped to shape his outlook on medicine.

He is a passionate advocate of making a difference in terms of health outcomes, both in one's own backyard and in the poorest corners of the globe.

Dr Dzau, 62, now a United States citizen, was born in Shanghai, and his family moved to Hong Kong when he was a toddler after the communists took over the mainland in 1949.

'All my grandparents died of tuberculosis, and my family of five lived in a single room, sleeping on cots...I guess that has had some influence on the way I look at things,' he said recently.

Dr Dzau, an eminent cardiovascular researcher and the head of Duke University's medical school in North Carolina, was in Singapore for the official opening late last month of the Duke-NUS Graduate Medical School at Outram.

The school, Singapore's first graduate medical school, is the result of a historic tie-up between Duke and the National University of Singapore. It was established in 2005 and had its first intake of students at an interim campus in 2007.

The school will produce about 50 doctors a year, but will also be engaged in cutting edge medical research.

Dr Dzau, believes the school's students are among the region's best and brightest - and it will produce high calibre clinician-scientists equipped to make scientific breakthroughs.

The Duke-NUS students have taken many paths to attend the school. They have, for example, graduated with arts degrees or spent years as research assistants in neuroscience labs. At least one, a former electrical engineer, is a parent.

Such winding, atypical career paths are well known to Dr Dzau. His own daughter, 30, is a physician in training after completing medical school at Duke.

'My daughter had a master's in psychology, never wanted to go into medicine. Then later on, she's taking care of autistic kids and working with Planned Parenthood, and says she wants to go into medicine to help people,' he said.

Dr Dzau, who became Duke's chancellor for health affairs in 2004, studied biology at Montreal's McGill University, stayed on for a medical degree, then did postgraduate training at Harvard Medical School. He admires the US medical education system, where medical schools take students with other degrees including non-science disciplines.

'When I grew up in Hong Kong, you went straight to medical school. I really subscribe to the US education system because it allows people to make choices without pressure to decide, which makes people that much more committed.'

Recruiting committed talent, Dr Dzau believes, is the key to innovation.

Students at Duke-NUS meet stringent admission requirements, including academic tests, leadership, community service experience or research experience.

International students make up just under 40 per cent of each cohort, while the rest are Singaporeans.

Duke-NUS, Dr Dzau pointed out, is not trying to compete with the Yong Loo Lin School of Medicine at NUS, which is an undergraduate programme. Instead, he said, it will add diversity to the medical education landscape here.

It can serve as a conduit for Asia-US cultural and social exchange. He said given the 'cultural and geographic differences between here and there, you're going to have people come up with really creative ideas that Duke US may not even have thought of, and vice versa'.

Already, Duke-NUS research efforts are bearing some fruit.

For example, its researchers last week published a paper in the journal PLoS Genetics, on new ways of classifying stomach cancers by the tumours' signalling pathways.

That could enable doctors to target treatments more effectively to specific tumour types, in a form of personalised medicine.

Besides its cancer biology programme, Duke-NUS is taking strides in its four other signature programmes: neuroscience, metabolic disorders, emerging infectious diseases and health services research.

These research areas were chosen in consultation with Singapore's health policymakers for their potential relevance to the region, Dr Dzau explained.

For example, cognitive decline, such as Alzheimer's disease, is a growing problem in an ageing society. The neuroscience programme studies the biology of cognitive decline, while the health services research programme will look at better ways to deliver care to afflicted patients.

Such social aspects of medical care - particularly ways to get health care to those in Third World countries - are a priority for Dr Dzau, the son of a businessman father and maths teacher mother.

To this end, he teamed up with Harvard medical anthropologist Paul Farmer to help create a Division of Social Medicine and Health Inequalities at Brigham and Women's Hospital in Boston, where he chaired the department of medicine between 1996 and 2004.

At Duke, he also launched the Global Health Institute in 2006 to tackle health disparities around the world. It leads projects in fields such as sanitation, mental health and prenatal care in nations as far-flung as Haiti, Thailand and Tanzania.

'Already there are many students who are interested in health services research and the Global Health Institute.'

He hopes to find ways to allow Duke-NUS students to take part in its projects.

One issue is funding for these projects, which were once met with scepticism from university funding boards in the US, a nation struggling with its own domestic health-care issues.

'We don't define global as international. If you do it in your own back yard, that would be global health as well.'

Indeed, the institute has projects in Duke's home base of North Carolina, and in inner-city Boston neighbourhoods.

Sending local students on such projects would need support from Singapore.

'The Singapore Government, Singapore education, universities and citizens can all come together and say 'That's really exciting, we're doing the right thing for people who are under-served.'

'And young people are driving the conversation. They want to do something. It'll be hard for leadership and government not to listen to young people who want to do these things.'

This article was first published in The Straits Times.