For his elective, Neil Stone went to Hong Kong; the province was handed back from British rule to China in 1997. He contrasts the east meets west atmosphere with the communist capital, Beijing

I did my elective in obstetrics and gynaecology at Hong Kong University, in the Hong Kong Special Administrative Region (SAR) of the People's Republic of China. Academically, the elective was excellent. Queen Mary Hospital is a first class facility, beautifully located on a hill on Hong Kong Island, overlooking the western shore. The hospital is modern and well equipped, clean, and well maintained.

All teaching was in English, despite the fact that in some cases the students and also doctors had fairly poor spoken English, and as soon as the teaching session was over doctors and students alike would revert to their mother tongue of Cantonese. The language barrier did cause difficulties in outpatient clinics, as taking a history was virtually impossible. Nevertheless, I did have ample opportunity to examine patients and managed to learn a few basic phrases of Cantonese, but it is undoubtedly a difficult language to pick up.

Hong Kong was an enormously interesting city, and after teaching each day I took the opportunity to explore the city. From the congested, neon lit mayhem of Kowloon, to the sophisticated shopping avenues of Hong Kong Island. The great cliché--east meets west--was surely invented for Hong Kong. In many areas you could be nowhere else but China, but at the same time there are parts of the city as cosmopolitan, advanced, and hi tech as New York.

A word of warning, though. Despite the fact that I was officially in China (Hong Kong returned to Chinese control in 1997), it did not feel like it. The atmosphere, as far as a visitor like me could tell, was resolutely westernised. However, when discussing the hand over with local students it quickly became apparent that there is a great deal of nervousness about gradual yet important changes that were occurring in Hong Kong. Days before my arrival there had been a huge demonstration against an anti-subversion law recently imposed by Beijing, which Hong Kongers fear will curb their much prized civil liberties denied to the population on the mainland. Most of the students I spoke to agreed that they should be a part of the mainland, without necessarily sharing the ideology of the government that now controls their city. Press freedoms are being curtailed, and many Hong Kongers attribute the current economic downturn to the hand over, which stands in stark contrast to the phenomenal growth of the economy on the mainland.

In terms of health care in Hong Kong, medical staff informed me that little had changed since the hand over. The territory has maintained its system in which most primary care is in the private sector and hospital services are mostly publicly run, with only nominal fees charged--the case with Queen Mary Hospital. China's controversial policy of having only one child is not to be introduced to Hong Kong, and health care as a whole seems set to remain independent for now.

During my elective, the system appeared to me to be efficient and effective. In this respect, it is mainland China which is itself evolving and the previously rigidly centralised and entirely government funded healthcare system now resembles that of Hong Kong. Newly affluent Chinese can now afford to pay to see a doctor of their choice. Government run hospitals are now being asked to fund some of there own costs, and many hospitals now charge small fees for services, in a similar fashion to Hong Kong. The exchange of ideas between China in Hong Kong is clearly not one way traffic.

After my elective in Hong Kong ended, I decided I wanted to experience the real communist People's Republic of China and visit Beijing, the city from where Hong Kong is now run.

With a language barrier as formidable as the Great Wall, and temperatures that plummeted to ­10ºC, I realised it would not be an easy trip. Tiananmen Square, famously adorned with a giant portrait of Chairman Mao Zedong, was naturally my first port of call. The square itself is the largest in the world, and can accommodate up to a million people. On each side of this concrete wilderness are two gargantuan buildings. On one side stands the mammoth Great Hall of the People, where the Chinese government sits. In the heart of the square lies Chairman Mao's mausoleum. The square is awe inspiring, and decidedly intimidating. The bloody events of 1989 were in my mind, contributing to my slight discomfort at being there. The square exuded size and power, and the sense of history is almost palpable.

In stark contrast, the Forbidden City of the emperors of China lies directly behind Tiananmen. It is an ancient imperial jewel in the heart of socialist Beijing, a magnificently preserved piece of old Peking. Peppered with magnificent palaces, it provides a fascinating insight into the almost mythical lives of the emperors. And of course no trip to Beijing would be complete without a visit to the Great Wall of China. Justifiably famous, it snakes quite beautifully along the hills and off into the distance. The structure itself is impressively tall, wide, and seemingly impenetrable.

Beijing is the heart of the last great communist country in the world, but it is itself going through extraordinary changes, as is the whole of China. There is now a McDonalds restaurant in Tiananmen Square, and Kentucky Fried Chicken is easily the most popular place to eat for young people. Neon signs are springing up, as are gleaming shopping malls. As Hong Kong feels the squeeze of being run by the Chinese communist party, it struck me as ironic that Beijing looks more and more like Hong Kong. China is reaping the economic rewards of its open door policy, which involves massive Westernisation and the encouragement of foreign investment. This change is welcomed, at least by the young people I spoke to in Beijing; it is obvious that they are proud of China's modernisation and economic boom. However, it sits uncomfortably with the ongoing suppression of dissident and the absolute control of the media by the government. China is at a crossroads. It is a superpower waiting to explode on to the world scene while the all powerful communist party maintains its grip on the country and now on Hong Kong as well. Meanwhile, Chairman Mao's portrait suspiciously eyes the fast food chains and internet cafes cropping up all over his socialist city.

Hong Kong symbolises the evolution of China. Although people in Hong Kong feel that their freedoms are slipping away from them, China itself is adopting more and more the capitalist ways formerly associated with Hong Kong. This merging of two fundamentally opposing ideologies appears to have resulted in an uneasy fusion.

I can strongly recommend Hong Kong as an elective destination. With the pace of change taking place in the territory, any visit to Hong Kong is guaranteed to be unique.