NUS Pharmacy STEER Taiwan: Education, Culture and Practice Immersion in Pharmacy

“Like all great travellers, I have seen more than I remember and remember more than I have seen.” – Benjamin Disraeli

From 13 to 23 December 2019, 15 Pharmacy and Pharmaceutical Science undergraduates and a postgraduate student embarked on an eleven-day Study Trip for Engagement and EnRichment (STEER) programme to Taiwan, accompanied by A/Prof Paul Heng and Dr Celine Liew. The aim of the programme was to learn more about Pharmacy education and practices, healthcare as well as Taiwanese culture and heritage.

Their academic visit began in Taipei at the School of Pharmacy, National Taiwan University (NTU) where the students were introduced by NTU Pharmacy faculty to the school, NTU Hospital (NTUH) and the direct six-year PharmD programme unique to Taiwan. The NUS visitors were brought for a walking tour around the herb garden within the school campus. During the networking lunch, the NUS students had the opportunity to interact with their NTU counterparts and conducted exchanges on their respective countries’ pharmacy curriculum and cultures, which helped deepen mutual understanding and cultural appreciation.

Academic and cultural sharing session with our friends at NTU.

On the tour to the NTUH Department of Pharmacy, the group visited both the inpatient and outpatient pharmacies and learnt about pharmacy services and operations at the chemo drug clinic, anticoagulant clinic and operation room pharmacy.

One highlight of the students’ stint in Taipei was their experiential site visit to Sun Ten Pharmaceutical Company’s herb garden. A student recalls: “We embarked on this trip not having any prior knowledge of herbal medicine from our Pharmacy curriculum, so it was an eye-opening and enriching experience to learn about the medicinal value of herbs grown at the Sun Ten herbal garden. Guided by the garden keeper, Mr Chen, we learnt about the etymology and medicinal properties of several common herbs. We were also able to taste or smell some of the freshly plucked herbs. For instance, we got to try cactus leaves and ginger biscuits prepared by Mr Chen, which were delicious and invigorating!”

Our visit to Sun Ten Herb Garden in Yangmingshan. On the right, Mr Chen, our friendly guide who takes great care of the herb garden!

The NUS team visited several research laboratories at the Institute of Biopharmaceutical Sciences and Faculty of Pharmacy at National Yang-Ming University (NYMU) to gain insights into research in biopharmaceutical sciences such as using zebrafish as an animal model to study the effect of gene modification. They toured the Herbarium at National Research Institute of Chinese Medicine and learnt to appreciate the diversity and complexity of herbs Taiwanese physicians use in healing their patients. They were also introduced to traditional tools used to process herbal medicines in the past, such as a grindstone which was operated by using one’s two feet.

Students posing as TCM pharmacists in a layout of a Traditional Chinese Medicine (TCM) pharmacy clinic at the Herbarium.

For their cultural tour in Taipei, the students explored several popular areas such as Dadaocheng Wharf, Dihua Street, historical buildings at Tamsui and Tamsui Old Street, National Palace Museum, Shung Ye Museum of Formosan Aborigines and Beitou Hot Spring Museum and Thermal Valley, where they learnt more about Taiwanese heritage, Chinese and aboriginal cultures and how Taiwan developed in antiquity.

Group photograph and fun shot Dadaocheng Wharf.

From Taipei, the NUS team travelled to Taoyuan to visit Mingtai Chemical Co., Ltd., an excipient/food ingredient manufacturer and one of the major players in the global microcrystalline cellulose (MCC) market to learn more about the production of MCC, an ingredient which finds wide use in the pharmaceutical as well as food and cosmetic industries. They received a warm welcome and introduction to the company from the President, Dr Richer Chen, and staff before experiencing gowning up for the factory tour of the MCC and croscarmellose sodium production facilities.

They then headed further south to Taichung to Sun Ten Pharmaceutical Company to learn more about traditional Chinese medicine (TCM), from standardizing medicinal plants/raw herbs to finished products, their quality control and manufacturing processes. This visit provided the NUS students with some first-hand insights into TCM products in modern dosage forms which they may encounter upon graduation and working in the retail Pharmacy sector.

At Taichung, the students continued with an academic visit to China Medical University (CMU) where the study and practice of TCM is more comprehensive and popular. They met up with CMU School of Pharmacy faculty and students who accompanied them on a tour of Lifu Museum of Chinese Medicine, CMU’s herb garden and CMU Hospital’s TCM Pharmacy Department. The students were introduced to inventory management and dispensing of TCM products, which are unique to hospitals in Taiwan. They also visited two local pharmacy stores with TCM alongside with allopathic medicine dispensing. From the visit, the students gained better insights on the hospital and community pharmacy landscape in Taiwan.

While at Taichung, the students also visited Yung Shin Pharmaceutical. They met the company’s Chairman, Dr Lee Fang-Yu, who gave an inspiring welcome speech. They toured the manufacturing facilities and warehouse to learn about manufacture of pharmaceutical dosage forms and gained much insights into the various activities, from product development to market launch.

Taichung City was a memorable stop for the students as their peers from CMU introduced them to the popular Feng Chia and Yichung night markets, and they enjoyed lots of sweet treats at Miyahara Ice Cream. In addition, the bubble tea-loving students had “hands-on” training on how to prepare their own pearl milk tea at the Chun Shui Tang tearoom, where bubble tea is believed to have originated from.

To sum up their trip and stay in Taichung, the students also visited the 921 Earthquake Museum where they learnt about the catastrophic past Taiwan earthquakes and how the country deals with regular earthquakes, through measures that minimise damage and promote survival in an emergency. In addition, a day trip to visit Lukang old town area was arranged.

On the return journey to Taipei, the students were acquainted with the Hakka culture by a visit to the Taiwan Hakka Museum and introduced to tea cultivation at the Tongluo Tea Factory where they also sampled Taiwanese tea and had a traditional Hakka lunch, one commonly enjoyed by the local farmers. In the afternoon, the visit to Vigor Kobo’s pineapple cake factory provided a “hands-on” pineapple cake making session and a feast of delicacies thereafter.

From their visits to the universities, university hospitals and local pharmacy stores, the students noted that Taiwanese pharmacists may have to handle and dispense both Western and Chinese medicines. They also learnt more about the preparation and packaging process for TCM, as well as various systems the Taiwanese pharmacies have implemented to minimise dispensing errors and maximise efficiency. Robotic preparation of more toxic sterile products was also used by the NTUH Pharmacy.

From the industrial visits, the students were better able to appreciate Taiwan’s expertise in producing excipients, Chinese medicines and ethical products. These industrial visits also provided them insights of industrial practices, in product manufacture and marketing.

The opportunities to sample and learn about Taiwan’s famous beverages and food, by visits to Chun Shui Tang Tearoom, Tongluo Tea Factory and Vigor Kobo Pineapple Cake Factory, complemented the academic and industrial visits for a holistic understanding of the socio-cultural-economic environment of Taiwan.

It has been an enriching and fulfilling trip for the students and they will surely reminisce the adventures in Taiwan for a long time to come.

Homebound! We are thankful to our tour guide, Jill Wei, for her hospitality and care towards us
throughout our trip.

#PassionPridePurpose

Article by Alton Choo, Chua Qi Shan, Grace Cheong, Law Rei Yin, Shannon Lim, Tan Siew Wen, Siar Wei Ming (Pharmacy and Pharmaceutical Science students), Natalia Veronica (Postgraduate student), A/Prof Heng and Dr Celine Liew (NUS Pharmacy academic faculty)