The Big Interview – Associate Professor May Ng

To say Associate Professor May Ng is a busy person is an understatement. The Consultant Paediatrician and Consultant Paediatric Endocrinologist, who is based in Southport and Ormskirk NHS Trust, has a deep passion for children and helping them live their best lives with diabetes. 

The mother-of-three is also an accomplished author and has even found the time to write a book about the journey she experienced from a parent’s perspective when her eldest son was diagnosed with non-verbal autism and she is due to release another book entitled ‘Me and My Hormones’.

Here, she discusses what motivates her, her love for learning and why she decided to specialise as a paediatrician in the first place.

Can you give us an overview into your journey into medicine and paediatrics?

I grew up in Malaysia, as an ethnic minority Chinese and have always wanted to become a doctor from as young as five years old. I would have been the first in the family and generations before to become a doctor.

I remember vividly looking after my grandmother who passed away from pancreatic cancer which really had an impact on my vocation. At the tender age of 13, I won the Association of South East Asian Nations (ASEAN) full scholarship and had to leave my family home to study in a neighbouring country Singapore.

From there, I was awarded a full medical scholarship to read medicine in Sydney University, Australia. I was awarded the Paediatric Prize at university and always had a natural affinity towards working with children.

How has your journey into paediatric endocrinology impacted your approach with dealing with patients?

My initial specialty chosen when I graduated was in paediatric oncology but it took a heavy toll on my emotional well-being as I became very involved in the lives of children with cancer and their families.

After two years, I made a decision to specialise instead in paediatric endocrinology and diabetes, and later won a coveted grant by the Medical Research Council to run my own national trial studying neonatal endocrinopathies.

The journey gave me an insight into how healthcare professionals have the unique ability to support and improve the lives of children and families living with health conditions.

My approach has always been to work collaboratively with the individual and their families. A whole-person approach should be adopted, and to invest time to get to know my patient as a person, what his/her hobbies are and what are their hopes for the future are.

Having been a training advisor for the Royal College of Paediatrics for almost seven years, I often teach trainees to be more aware of and recognise our own behaviours, the language we use and how our verbal and non-verbal actions can have an impact during a consultation.

You recently achieved your fifth degree, an MBA after having achieved an MBBS with Honours, an MSc, an LLM and a PHD. How have you managed all this while doing your day job?

I have always had a personal philosophy in life, and that is ‘be brave to venture and learn’. That is based on one of my all-time favourite quotes by Lucius Seneca, who once said: “It is not because things are difficult that we dare not venture. It is because we dare not venture that they are difficult.”

I genuinely enjoy learning and believe that we are never too old to learn something new.

After my first MBBS degree, I won a grant to study for an MSc in Endocrinology and Diabetes. Soon after, I was fortunate to be able to do my PhD as part of the Medical Research Council grant awarded.

When I became a consultant, I was active in medicolegal work and the Dean of the School of Law at University of Liverpool convinced me to pursue a Master in Laws degree that would give me the confidence I needed when I attend court as I would have better knowledge of the law.

Several years into being a consultant, I was encouraged to take up medical management leadership roles, and in wanting to learn more about finance and healthcare management, something that is not taught in medical school, I decided to study for an MBA in Healthcare and Finance.

The Francis report in 2013 warned of a gulf between clinicians and management that needs to be closed and urged for greater involvement of clinicians in leadership management roles.

There is clear evidence that clinically qualified managers improve performance. I was the first clinician in the UK to gain an MBA through the HFMA Academy and BPP University, and I would strongly encourage the support for clinicians in leadership roles to gain the skills and knowledge in healthcare finance and management.

You are Chair of the Association of the Children’s Diabetes Clinicians (ACDC), Chair of the National Institute Health Research Clinical Research Network (NIHR CRN)/ Diabetes Research Steering Group (DRSG) for Children and you have many other international roles in the European Society of Paediatric Endocrinology (ESPE) and International Society of Pediatric and Adolescent Diabetes (ISPAD). What interested you about these roles?

The knowledge and belief that I can make a useful contribution when I am elected to these voluntary roles has been a personal driving force for me to try my best to make a difference in improving the care of children and families.

The ACDC has been crucial in producing a compendium of national diabetes guidelines for healthcare professionals and patients to freely access on the website, as well as ensuring continued professional developments through our conferences and webinars.

I have also been part of the NICE Diabetes Committee for guidelines and am deeply impressed by the amount of work that goes into producing these documents.

My role as Chair of the Diabetes Research Steering Group for children with diabetes is important to ensure that research priorities discussed nationally are also focused on children and young people.

My roles in the international arena have been important in global collaborations and sharing of best practice. For example, I have been proud to be part of an international initiative to develop a global e-learning platform for diabetes and endocrinology healthcare professionals made freely accessible and translated to five languages, English, French, Spanish, Swahili, Chinese for resource-limited areas and are now used in 136 countries.

Do you think the landscape for treating people, particularly children with diabetes, has changed permanently and if so, why?

In my experience, the landscape in the last two decades when it comes to treating children with diabetes, has changed dramatically. There is increasing awareness of diabetes as a major public health issue and therefore increase in research into prevention, complications, education and diabetes technology.

While we have yet to reach a cure, new treatment and technological advances like insulin analogues, pumps, CGM, Libre and looping have changed the landscape of diabetes management.

However, it is important to be aware that optimal diabetes management requires access to treatment and technology, patient education and support of mental health and well-being. Sadly, in many countries, affordability of basic access to insulin is still prevalent.

You have debated in Parliament in 2019 to end the postcode lottery for access to diabetes technology and you were invited to the Prime Minister’s reception in 10 Downing Street for recognition of your work. What do you think is the greatest challenge for people and in particular, children with diabetes at present?

I was very fortunate to be invited to Westminster to speak and later to meet the Prime Minister. Perhaps the greatest challenge in the UK, in my opinion, is to reduce the worsening variations in care that we are continually seeing each year.

The recent National Paediatric Diabetes Audit reported that inequalities in health outcomes, the use of technologies and levels of psychological distress in children with diabetes living in the most deprived areas and of non-white ethnicity were faring worse.

For example, the gap between pump usage amongst children living in the most and least deprived areas has widened with time from 2014 to 2019. We should be looking at why this is happening and how we should be reducing variations in care.

You are the clinical lead of a multi-award-winning diabetes team who has delivered improvements in HbA1c outcomes for more than 10 years running. How have you achieved this?

Our unit’s HbA1c improved to a median HbA1c of 62mmol/mol (7.8%) in 2019 having continuously fallen from 77mmol/mol (9.2%) since 2008.

Over a decade ago, I started out as a sole consultant leading the children’s diabetes service with only a community nurse based outside the Trust.

Over the years, we have successfully ensured business cases were approved for adequate staffing and resources to deliver a high quality service, while supporting the education and competencies of everyone in team.

I am immensely proud of our diabetes team who are like a second family to me and we’re proud to have won several national awards such as the Northwest Excellence in Health NHS Parliamentary Awards 2020, University of Liverpool Alumni Award 2019, the HSJ Diabetes Initiative Finalist 2019 and the Diabetes UK Mary Mackinnon Award 2018.

In addition, we were finalists in the Diabetes Quality in Care (QiC) Team of the Year category and I also made the finals of the Asian Women of Achievement Award UK in 2016.

In 2015, we picked up a QiC award, were Highly Commended in the British Medical Journal Diabetes Team of the Year category and reached the final of the HSJ Clinical Leader of the Year.

I am also the founder of our Diabetes Endocrine Charitable fund which was formed 10 years ago and has raised over £25,000 for resources in education and training families and children with diabetes, as well as for our nurses and allied health professionals to attend conferences to maintain their skills and education.

It has also allowed us to hold regular evening teaching sessions and weekend family fun days for families with diabetes to get together for peer support.

You have led on many international guidelines and published more than 120 peer-reviewed publications, book chapters, e-modules. You are also a book author of best-selling “A Journey With Brendan” and a recently launched “Me and My Hormone” book, which of these has had the biggest impact?

It’s difficult to say which publication had the biggest impact as my research portfolio has been fairly wide ranging from neonatal endocrinology, thyroid disorders, growth and paediatric diabetes. Each I believe deserve its own merits.

My first book “A Journey With Brendan” took more than 10 years to complete as it detailed my journey as a paediatrician and mother to my autistic son.

It was a labour of love and contains much of my personal journey and challenges. At one time in my life, I had three children under five years of age. When my oldest son was given a diagnosis of non-verbal autism, my second son was born deaf with congenital sensorineural deafness and my daughter was born premature and had to spend two months in hospital.

Both my sons were non-verbal until they were much older and I had to learn sign language, PECS and Makaton to communicate with them.

I am always a mother first, and over the years I’ve had to make decisions in my career where my family had to take precedence.

My second son, Darren who was born deaf and went to a special school until the age of seven, amazed me last year when he was on BBC news for scoring the highest possible MENSA score!

The idea for “Me and My Hormones” came about more than two decades ago when as a paediatric endocrinologist looking after patients, I was not able to source a clear, concise and easy-to-read book which explains all about hormones and things that could go wrong from birth to adulthood.

Many of my students, colleagues, patients and families that I have encountered over the years wanted to have access to a less medically jargoned, bite-sized source for understanding all hormone conditions. I became convinced that this book was needed. I am grateful that Cambridge Publishing decided to publish it.

What do you do in your spare time?

I take Muffin our dog walking or we go visiting hospitals or hospices. Muffin is a Pets As Therapy accredited dog and I have been his accredited trainer now for the last three years.

He is trained to help settle my son Brendan who has autism and high support needs. I also enjoy reading a book each week. We do a lot of family activities too such as playing board games, watching films, cycling and swimming.

As a family we tend to do fundraising activities such as raising autism awareness or deaf awareness. Last year we have raised more than £3,000 for National Autism Society as a family.

To find out more about Associate Professor May Ng, click here:

The Big Interview – Associate Professor May Ng