Research Personality: Dr. Toh Teck Hock

Before I joined Sibu Hospital, I have worked in the United Kingdom, Singapore and Australia for a number of years as a paediatric trainee. Besides general paediatrics, I also work in the areas of developmental-behavioural paediatrics and community child health. I am an Adjunct Professor for SEGi University Medical School as well as the Special Olympics Asia Pacific Regional Clinical Advisor in Health Promotion®, Vice President for the National Early Childhood Intervention Council, Council Member for Sarawak State Council for Early Childhood Education and Development, National Assessor for the Baby-Friendly Hospital Initiative and Secretary of the Association for Children with Special Needs Sibu. Besides scientific papers, I have also published parent-teacher handbooks on ADHD, language development and breastfeeding, as well as children reading / colouring books, and books on Chinese literary prose/short stories. I received The Outstanding Young Malaysian Award in 2010, and Special Education Network in Asia Advocacy Award in 2018.

Can you tell us when and how did you first got involved in clinical research?

I was a Houseman working in West Cumberland Hospital, Whitehaven, United Kingdom. It was during a post-call ward round with my Consultant Surgeon, where he questioned the usefulness of doing an abdominal x-ray on patients presented to A&E with abdominal pain. I then took up the challenge to help finding an answer to this research question. I spent the following two weeks in the medical record office, reviewing case records. Thinking back, the “study” could have been done a lot better. However, I was proud because I remember I was the only Houseman then given the opportunity to present my finding in the hospital grand round; and the hospital subsequently reviewed the guideline on abdominal x rays.

How has a clinical trial change your practice and management of patient care?

There are many differences in clinical practice, and with the experience, I have certainly improved my clinical skills over the years. However, it is the knowledge and skills acquired during the training and doing of clinical research that taught me to be evidence-based, doing no harm, balancing the risk and benefits when I manage a patient. Being involved in the clinical research, I also gain the ability to appraise research finding more accurately (often that means, to “reject” the so-called “evidence”), and to apply that in general patient care. Other types of research are useful in clinical practice too. For example, good epidemiological and surveillance studies provide the clinicians solid data on current and real problems that are faced locally (hence, not just “textbook says”). Health system research and behavioural studies, although not having direct impacts on individual patients, they provide us good value in overall patients care in the hospital and clinics by improving our policies.

You were recently announced as the Top Recruiter for a paediatric study (RESPIRE). Can you share with us what it takes to ensure successful recruitment of a clinical trial?

It was a “difficult” in patient study, because of short recruitment window period, meaning to say the study team often have to recruit and perform study procedure outside of office hours, till midnights. Doing study procedures (on top of routine care provided) on these young infants have extra challenges – we often have to rethink the risks and benefits of doing study on these young infants at the bedside.
However, a good team is the crucial successful factor for this kind of study. People involved include the co-investigators, to study coordinators, research pharmacist and the CRO, as well as those in the office and colleagues who co-manage the children in the wards. I define “good” as someone who shares the common goal (i.e. to complete the study safely), committed, and passionate about doing a study.

What is your motivation behind conducting clinical trials?

It is the curiosity about “why?” and “can things be done better?” that always keep the clinicians moving forward, because we always have more patients that will come to us with the same problems. Of course, to be part of the world leading clinicians that contribute towards advanced healthcare make all of us proud.

What one word best describes your career as a clinical researcher / investigator? Why?

Colourful. No single study is the same, and no single patient is the same. There is always excitement when a study starts, comes to the closure and when the results are revealed. There is plenty of opportunities to meet a variety of people during training, presentation and scientific meetings. Coaching the juniors are always as fun as learning from the senior. That makes life as a clinician more colourful. It is not just the routine of seeing patients in the clinic and doing ward round day in day out until one retires.

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In the field of clinical research, where do you wish to see Malaysia in the next 10 years?

More clinical researchers / study teams that can conduct clinical trials that can make a significant change in patient / healthcare globally. With this, there shall be more trials conducted safely, and with quality. It requires our country laying down infrastructure, policy, environment and resources to achieve this.

What changes would you like to see being made by the policy makers to create a more conducive ecosystem for the conduct of clinical trials in Malaysia?

Better distribution of resources (human and funding). At the moment, there are hospitals / centres with little manpower (and resources), overloaded works but keen clinicians / researchers. Unfortunately, the reverse is also true, which lead to an inefficient system (and sometime wastage). The good clinicians / researchers need to be recognised and given better resources and support, not only to conduct clinical trials, but to guide the juniors. It is tomorrow’s clinicians / researchers that make a country successful.