Connected Conversations | Chien-Li Holmes-Liew

Chien-Li Holmes-Liew is not only a well-regarded clinical titleholder, helping to shape the new Bachelor of Medical Studies degree at the University of Adelaide, but also one of South Australia’s leading lung transplant physicians at CALHN. Recently recognised for her exceptional contributions to the University of Adelaide community as a titleholder at the 2021 University Awards for Outstanding Achievement, she has gone above and beyond to ensure she leaves a positive impact on the people in her life. After many years climbing the career ladder and becoming one of the best in her field, Chien-Li now strives to contribute to building a better world for future generations, which includes her six-year-old daughter, Olivia.

Chien-Li Holmes-Liew

Please tell us a little bit about yourself.

My name is Chien-Li Holmes-Liew and I am a Respiratory, Sleep and Lung Transplant Physician at Central Adelaide Local Health Network (CALHN) and professor in medicine at the University of Adelaide. I completed medical school at the University of Adelaide and was awarded the Dean’s Medal at graduation in 1999. I trained in lung transplantation in Toronto and Sydney and before later returning to Adelaide’s Royal Adelaide Hospital as a Physician and Head of Thoracic Medicine Training and Education. I am one of only two senior lung transplant physicians in South Australia, and have a very heavy patient load, dealing constantly with some of the most complicated groups of patients who are preparing for or have received lung transplants.

I have been a clinical titleholder at the University of Adelaide for over 10 years as I greatly valued the education I gained. I feel gratitude and appreciation towards the University of Adelaide and have a strong ongoing wish to contribute to the University and the broader community as much as I can. With my skillset, I achieve this by providing patient-centred input at an early stage in the medical curriculum and helping students to better understand our health care systems. I was previously Clinical Practice Coordinator for Year 3 medical students. This was a key part of their learning in which they are immersed in the hospital setting and meet real patients, and I was subsequently appointed the Domain Lead in Clinical Practice for the new Bachelor of Medical Studies curriculum. I hope to build upon and enrich education by providing a more in-depth focus on areas such as Indigenous health, health management systems, patient-focused care, interprofessional learning, and general practice, in addition to the many excellent aspects which already exist.

I am incredibly grateful for the support I have received from mentors within the University of Adelaide throughout my career, and I have, in turn, prioritised supporting the people around me. Some of my greatest accomplishments have been having a key role in helping shape the training of the next generation of doctors into compassionate, ethical, patient-focused practitioners, leading by example and demonstrating that compassionate, inclusive, and responsible leadership is the way forward.

My greatest accomplishment is raising a daughter who is curious, empathetic, hilarious, and excited about her future. I am proud of having bounced back from multiple challenges while maintaining my own values and integrity and of demonstrating that it is possible to succeed in my field as an Asian female, wife of a busy clinical academic, and mother of a young child.

What has been your journey to get where you are today?

My path has been shaped and inspired by incredible people around me — clinicians, academics, mentors, patients, family, friends, and my leadership coach, Dr Tabitha Healey from Small Moments, Big Lives. As my career has developed, it has been a windy road and I have realised and accumulated different skills and focused on new areas which have brought fulfilment and enjoyment at the same time. Throughout my entire career as a doctor, I have loved the patient interactions and have always gone above and beyond to manage individual patients and patient groups, seeing a large number of the most complex patients with highest needs and developing systems for groups of patients to receive best care.

I previously was a proceduralist (performed bronchoscopies and pleural procedures on patients) but, when I injured my hands after the birth of my daughter, I had to give that up. Although devastating at the time, in retrospect, this gave me time to focus on other areas such as education and training of junior medical staff and helped me to create a better balance between family life and clinical work. I realised I could use my experience and patient-focused approach to help teach students right from the beginning of their careers to use their skills to be the best possible doctors, teachers, and researchers for our community, and this is when I became even more involved with the University of Adelaide. With each step, I have realised I could contribute more and more, in varied enough ways so that my current working days are a hectic — but highly rewarding — mix of patient care, systems development, teaching, research activities and meetings, emails, and document writing!

Along my path, I have experienced a great many challenges, particularly based on gender and race — ranging from overt prejudice to assumptions, expectations, and stereotypes. These have, at times, caused me to feel somewhat demoralised and re-examine my entire path and approach, but I have learnt that, for me, the best way to improve these aspects of our society are to always continue to act with integrity, lead by example, educate, and work actively to create a culture of inclusivity, diversity and support, reinforce promotion and recognition by merit, and always reach my hand back to help the next person up.

A major strength of the University of Adelaide is living by this. All around me, I have seen talent, energy, and integrity recognised and rewarded, and support extended to those who need it. The culture set by Professor Benjamin Kile, Professor Corinna Van Den Heuvel and Dr Martin Bruening from the Faculty of Health and Medical Sciences has been exceptional. As a titleholder, it has instilled in me a wish to contribute as much as possible and I always feel proud to be a part of this university. Many institutions speak a lot about diversity and modern leadership, but the University of Adelaide actually puts these words into action and recognises the strength and merits of this approach. I am also honoured to have just received the 2021 University Award for Outstanding Achievement in the category of Connected and Enriched Community: Exceptional contributions by a Titleholder. This sums up many things which are important to me, and which I have worked towards.  

Chien-Li Holmes-Liew

What are you working on now?

At the University of Adelaide, I am working on developing and building on the clinical aspects of the Bachelor of Medical Studies curriculum to make it as current, relevant, innovative, and inspiring as possible, giving students the foundational knowledge and learning capacity to set them in good stead for the rest of their working lives. I am very excited to have the opportunity to contribute to this incredible project and have been privileged to work with many exceptional people while in this role. It takes many talented people to develop a robust, future-proof, and dynamic curriculum!

At CALHN, I am working on developing a Centre for Advanced Heart and Lung Disease. I helped develop and manage the South Australian Lung Transplant Service, the world’s first lung transplant satellite centre, which has provided equitable access to lung transplantation for South Australians for over 20 years. With new innovations and technologies, we wish to expand this model to further improve access to advanced medical care.

On a day-to-day level, I like the individual patient interactions — dealing with vulnerable patients and actively working towards a better outcome, in partnership with them. I also love looking for new educational, such as giving the developer of a new program or author of an innovative paper a forum to link in with others who may help them to advance their ideas or benefit from their knowledge. I really want to demonstrate that the way forward is to have a broad, innovative, positive vision, and inclusive leadership, recognising and supporting the talents and roles of those around us.

From a research point of view, my main interests are in the management of immunocompromised patients and those with chronic lung disease. I am the principal investigator for lung transplant and bronchiectasis trials at the Royal Adelaide Hospital. We are excited to have advanced the field with the first patient to successfully receive adoptive T-cell immunotherapy for cytomegalovirus (CMV) following lung transplantation, and we are now involved in a multi-centre trial including other solid organ and bone marrow transplant recipients. This is a good example of investigator-led laboratory-based research with high patient-focused relevance.

In my personal life, I am determined to create and model a sense of wellbeing, safety, and comfort for those around me. I am a strong supporter of the development of the Wellbeing Centre at Scotch College and of the wellbeing projects run through the South Australian Health and Medical Research Institute (SAHMRI). It’s critical that learning to look after ourselves and our community starts early, as the next generation deals with additional pressures and expectations.

What do you love most about working with the University of Adelaide?

I love the people. I know that is a cliché but, in this case, it’s true. In my numerous projects, I have worked with some of the most compassionate, thoughtful, and brilliant people I have ever met, and I have some excellent mentors and role models within the University. The culture created by the faculty’s Executive Dean, Deans and Heads of Schools, and the leadership team has been very inspiring. It’s a true demonstration of how much a team can achieve when there is an environment in which they can thrive and make a positive impact. I love the opportunity to be creative, to engage people or groups ‘outside the square’ to contribute towards a common goal, and to interact with people who I know have the best interests of the students and the community at heart. I really enjoy working in a hospital setting and integrating my clinical work with the University. The camaraderie, pace and network, and the opportunities for growth and development in education and research are very positive.

What inspired you to pursue a career in health?

I have always been a compassionate person with a deep wish to help those who are vulnerable. Together with an inquisitive mind and an enjoyment of science and complex problem-solving, at the time when I had to decide, around three decades ago, medicine seemed to be a field which suited my personality, and had the most diverse opportunity to follow specific interests.

What opportunities do you see for the future?

COVID-19 has forced almost everyone to do things differently, to re-examine priorities and both work and teaching practices, to accept change and deal with the even more unpredictable world we now live in. This has been difficult and stressful in many ways but, when looking at the positive aspects, there have been real advances in how we learn, how we use technology, understanding the aspects of our work or teaching lives, and also some reinforcement and reassurance that the ways of teaching previously have been best. From this, the way forward would be to use what we have learnt and maintain any improvements to build on the previous models. For example, I think some face-to-face lectures are still necessary but topics can be carefully chosen to be those of best value in that environment; simulation training has gone from strength-to-strength, teams and groups need to use technology to stay connected (the loss of ‘bumping into each other in the office space’ has led to reduced quality of work life); and rural and frail patients can benefit from more input by telehealth.

I developed the Thoracic Medicine Training and Education program at the Royal Adelaide Hospital by looking at the day-to-day opportunities to engage students and junior staff, and I think there is a lot to be gained by continuing this approach. My plan for the new curriculum is to see the medical course and postgraduate teaching as a continuum to enable students to have a high-level understanding of the workings of the health systems and develop an ability and level of comfort to advocate for patients from a very early stage.

Chien-Li Holmes Liew with her daughter, Olivia

Have you ever had a life-changing experience?

When I met my husband, and when our daughter was born. My husband has inspired and supported me continuously, and I have always looked to him as a shining light of integrity, thoughtfulness, and balance (people will probably puke when they read this). When our daughter was born six years ago, I made the decision to re-examine all priorities and actively use my time at work to contribute where my best skills were. It became even more important to me to make a real difference and try to, in any small way possible, do whatever I could to make the world a better place. I used to work a huge number of overtime hours before my daughter was born and, when I first lay eyes on her, I made a pact with myself. So many mothers feel guilty about being at work and away from their children, then guilty about being at home and away from their jobs. Guilt is an unproductive emotion, and I decided that I would concentrate fully on my work and give this my full attention when there, and do the same for my family when not at work. Of course, as I am on-call every second day, this is not always 100 per cent possible, but it was a good starting point! Over time, we have integrated our child with work as much as possible. Prior to COVID, she came to the hospital with me a lot. She has heard me on the phone so many times that, the other day, when a friend answered the phone breathlessly after rushing, she asked whether they needed oxygen.

What’s something most people don’t know about you?

I have quite severe prosopagnosia — I can’t remember faces very well! I think I might have accidentally offended quite a few people.

What are your top café/restaurant recommendations around Adelaide?

  • Shōbōsho – the fire-roasted leek is amazing
  • Stem – the broccoli hummus is the must-try dish

What kind of difference would you like to make in the world?

The legacy I would like to leave is to have had a positive impact on many people on an individual basis — family, friends, patients, and colleagues. I would also like to know that I have used my position to advance the care of heart-lung disease for patient groups, to find a space for new innovations, to shape the next generation of doctors with the best education possible, and to give a voice to people who would not otherwise have been easily heard in today’s society.

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