“My family and friends were surprised at first. Several of my friends thought I was crazy wanting to study medicine at this age,” Toh Hong Keng, a retired Malaysian executive, said over a coffee in Hong Kong, where he has been living for decades.
This July, at 70, Toh became one of the world’s oldest students to graduate from medical school.
“It wasn’t always easy,” said the freshly minted medical graduate of the Southwestern University PHINMA in Cebu, Philippines. “At 65 to 70 years old, my memory, eyesight, hearing and body are not as good as when I was younger.”
Toh spent most of his life working in tech sales. But, for him, retirement didn’t bring long lunches and games of golf. Instead, each day for five years, he immersed himself in anatomy textbooks, aided by flashcards, reading glasses and large mugs of coffee.
Even for someone with multiple degrees, the material wasn’t easy. He was held back a year after failing a pediatrics exam in his third year. And in his final year, he was required to complete a one-year placement at private and public hospitals, with some shifts lasting a grueling 30 hours.
“Actually, why do I have to do this? Maybe I should give up,” Toh recalled saying to himself many times during those years.
His family constantly checked on him, helping to dispel many waves of doubt. And his classmates, many decades younger than him, would remind him that giving up would be a waste.
But Toh said one word became his mantra, keeping him going.
“Sayang” — a phrase in the Tagalog language meaning it would be a shame not to see it through. “Sir Toh,” his classmates would affectionately tell him, “If you give up now, it will be sayang.”
During five years of intensive study, Toh never asked for any special consideration and had “a very strong resolve” to persevere, said Dr Marvi Dulnuan-Niog, dean of the medical school. “Mr Toh is already an accomplished businessman and professional, yet he is still very open to new things. He was very passionate and persevering.”
Too old?
Toh said he never had grand ambitions as a child to become a doctor. The idea came up when he met two young Indian medical students during a vacation in the central Asian country of Kyrgyzstan in 2018.
That encounter over lunch sparked an idea that he might one day be able to pursue a medical degree.
“The only reason why I decided to study medicine was because I wanted something useful to do,” he said. “I’ve done different courses. I’ve done economics, I’ve done chemistry, I’ve done electronic engineering – but I don’t want to do that again.”
To Toh, medicine meant taking an entirely different direction.
“If I can’t be a practicing doctor, at least I can look after myself somewhat,” he said.
After signing off from his last day in the corporate world in 2019, Toh spent weeks studying for entrance exams and applied to nearly a dozen universities across Asia.
But he struggled to find a program without an age limit on applicants. Most were capped from 35 to 40.
Feeling a little dejected, he got in touch with his family’s former domestic worker whose daughter recently graduated from medical school in the Philippines.
After a few more exams and interviews, Toh eventually landed an offer at Southwestern University in Cebu. A week later, in 2019 he packed his bags, found a small apartment on the island and started his medical school journey.
He completed his first year in Cebu, which included a course with clinical labs and hands-on learning. But when the coronavirus pandemic hit in 2020, he moved backed to Hong Kong and took all of his lectures online.
The average age of first-year medical students in the United States is 24, and most students are 28 years old when they graduate, according to data from the American Medical Association. It can take at least 10 years more to become a fully licensed and practicing physician with residency experience.
Dr Atomic Leow Chuan Tse obtained his medical degree in 2015 from the University of Medicine and Pharmacy in Romania when he was 66, according to Singapore’s Book of Records. The following year, he passed a licensing exam which allows him to practice medicine in Europe.
While its unclear whether Toh is the oldest person to ever complete a medical degree, there are many examples of doctors still practicing well into their later years.
That includes Dr Howard Tucker of Cleveland, Ohio, who was born on 10 July 1922. He was recognized in 2021 by Guinness World Records as the oldest practicing doctor. Dr. Tucker just celebrated his 102 birthday and is still teaching neurology.
‘A better life’
A self-described provincial kid, Toh grew up on his family’s rubber plantation in Malaysia. As a teen, he and his siblings would wake up at 4 a.m. to tap rubber from the trees before heading to school.
“In those days we didn’t have much idea about what our dreams are. We just hoped that we can have a better life.”
He worked hard on the farm and even harder on his studies, which landed him an offer to study chemistry and control engineering at the University of Bradford in Britain between 1974 and 1978. He supported himself working part time as a waiter, mainly taking shifts during summer breaks.
He moved to London to do a master’s degree. To cover his student loans, he worked as a garbage collector alongside his studies. He didn’t mind the stench or grueling hours, as Toh said: “It paid good money.”
Armed with an unshakeable work ethic, he had no problems landing a job back home in Malaysia and jetting around Asia on different stints before settling in Hong Kong, where he and his wife raised three children.
But even after five years of intense study, Toh is not convinced he’ll take the extra steps needed to become a practicing doctor. That would require a year-long internship and more study for a medical board exam.
Instead, he plans to work as a consultant for a friend’s company dealing with allergy and immunology diagnostics in Hong Kong.
Toh’s years of study may be over, but they’ve inspired another challenge — to create a scholarship fund for medical students who struggle to pay for degrees as foreign students.
According to the Association of American Medical Colleges, the average tuition fee per year costs around $60,000 for in-state students at public medical schools and $95,000 for out-of-state students in the US. Private medical schools have an average tuition and fees cost upwards of $70,000. As for international students, the figures are much higher.
Tuition fees were nowhere as high in the Philippines. It cost about $4,000 to 5,000 per year at Southwestern University for Toh, which he said was still very expensive for prospective students from developing countries across Asia.
But for anyone with enough energy to follow Toh’s path, he has this advice: “If you have a dream to be a medical doctor, you can still do it at any age.”
“Studying medicine is intensive and extensive, but it’s not that hard, it’s just hard work.”