Medical education in Hong Kong
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Modern medical education in Hong Kong started with the founding of the Hong Kong College of Medicine for Chinese (Chinese: 香港華人西醫書院) in 1887. Currently, six institutes of higher education are engaged in the training of medical practitioners in Hong Kong.
Contents
History
The Hong Kong College of Medicine for Chinese (Chinese: 香港華人西醫書院) was founded in 1887 by the London Missionary Society, with its first graduate (in 1892) being Sun Yat-sen. Sun later led the 1911 Xinhai Revolution, which changed China from an empire to a republic. The Hong Kong College of Medicine for Chinese was the forerunner of the School of Medicine of the University of Hong Kong, which started in 1911.
Medical and Healthcare Education Institutes
The intakes of various healthcare related Bachelor's programs in Hong Kong are limited.
Hong Kong has only two comprehensive medical faculties, the Li Ka Shing Faculty of Medicine, University of Hong Kong and the Faculty of Medicine, Chinese University of Hong Kong, and they are also the sole two institutes offering pharmacy and six-year medical programmes. Other healthcare discipline programmes are dispersed among some other universities which do not host a medical faculty.
Various postgraduate courses in different fields of healthcare or biomedical sciences are also provided by those institutes.
Internship
To be registered as medical practitioners, medical graduates must successfully undertake and complete at least one year of supervised practice, generally known as an internship, with satisfactory performance. The internship is undertaken in hospital positions accredited for this purpose.
During this year interns (house officers) are rotated to four specialties (medicine and surgery plus two of obstetrics and gynaecology, paediatrics, orthopaedics and traumatology, emergency medicine, psychiatry or ophthalmology). Each of them lasts three months. There is no work hour limit in Hong Kong and interns are expected to work 80–100 hours per week.
Foreign Medical Graduates
Before the handover in 1997, medical degrees from HKU and CUHK are eligible for full registration with the General Medical Council in the United Kingdom. However, this reciprocality has been abolished and UK/ Commonwealth medical graduates have to take the Licentiate Examination held biannually by the Medical Council of Hong Kong to obtain registration.
The examination has a low pass rate of around 5-10% in the past 10 years. Many have criticized the exam to be excessively difficult, far superseding standards in the UK. The Medical Council has responded that the examination is set at the same level as the final MB examination of the HKU MBBS/ CUHK MBChB, with questions taken from the same question bank.
Residency
Hong Kong does not employ the US concept of residency. After successful completion of their internship year, medical graduates are eligible for full registration and can practise in the private sector as general practitioners. However, virtually all house officers enter specialist training under the Hospital Authority and 'general practitioners' are being phased out in the medical community gradually.
Specialist training
Specialist training is only offered at hospitals under the Hospital Authority of Hong Kong. A trainee has to undergo one year of pre-registration internship and at least six years of supervised specialist training and pass in the exit examination or assessment held by Hong Kong Academy of Medicine. Passing the exit examination or assessment is a prerequisite to Fellowship of the Academy. The examinations are all conjoint with the British and Australian royal colleges, e.g. Royal College of Physicians, Australian and New Zealand College of Anaesthetists. For example, a Hong Kong trained general surgeon in Hong Kong will be eligible for FCSHK, FHKAM (General Surgery), FRCS (General Surgery) and FRCS (Edinburgh) while a radiologist will expect to obtain FHKCR, FHKAM (Radiology) and FRCR at the end of their fellowship training. The FHKAM examination focuses on local pathology and also incorporates other components, e.g. logbook evaluation, literature appraisal, teaching, research and annual viva voce that are not included by the Royal College examinations. The pass rate of the FHKAM is similar to that of the Royal College exams, viz. 20-60% depending on specialty.
Unlike foreign countries, after obtaining specialist qualification, the specialist is not promoted to a 'Consultant' or 'Attending Physician' as would be expected in the UK or USA within the Hong Kong Hospital Authority. They will remain 'Medical Officers'. Promotion to a further post, e.g. Associate Consultant/ Senior Medical Officer often depends on availability of posts, e.g. whether the senior has left for private practice rather than the competence of the specialist. This has generated an exodus of specialists from the HA to the private sector, and the HA has responded by pledging to promote all specialists to Associate Consultants within 5 years of obtaining specialist qualification. However, this is not a permanent policy and is subject to the government budget. Before the new policy, it is not unusual to see public doctors remaining as 'Medical Officers' more than 10 years after obtaining their specialist qualifications. (1)
Family medicine is recognized as a major specialty in Hong Kong. Specialists in family medicine have undertaken at least six years of accredited training, and earned internationally renowned postgraduate medical qualifications as well as Fellowship of The Hong Kong Academy of Medicine just as their counterparts in hospital medicine or other medical fields.
Continuing medical education
Continuing medical education for specialists
A registered practitioner who wishes to have his/her name included in the Specialist Register of the Medical Council of Hong Kong is required to satisfy the continuing medical education (CME) requirements as stipulated by the Medical Registration Ordinance (Cap 161).
The objective of the CME is to
- maintain, develop or increase the knowledge, skills and competencies relevant to the practice of specialists that may change over the years;
- enhance professional performance to enable the delivery of quality professional care and safe standard of practice to the patients, and public that specialists serve, and;
- ensure that specialists will remain competent throughout their professional career.
The Hong Kong Academy of Medicine requires each specialist to attain a minimum CME requirement of 90 points in a 3-year cycle. A point is equivalent to 1 hour of participation in CME activities. To encourage active learning elements and a balanced mix of different activities, the Academy limits the passive CME points (i.e. points obtained through attending lectures or talks) to 75 points maximum per cycle. Each college of the Academy may recommend additional requirements.[17]
Continuing medical education for non-specialists
The Medical Council of Hong Kong has also implemented a CME programme for practising doctors who are not taking CME for specialists. Enrolment to the programme is on a voluntary basis. The purpose of the programme is to encourage practising doctors to keep themselves up-to-date on current developments in medical practice so as to maintain a high professional standard.
Practising doctors who have accumulated the required minimum credit points per year, i.e. 30 credit points, will be awarded a certificate to certify that they have achieved a satisfactory level of CME activity during a particular period. Such a certificate can be displayed inside the doctor's office. In addition, those practising doctors who have accumulated the required minimum credit points during a three-year cycle, i.e. 90 credit points, will be allowed to use the title "CME certified" on their visiting cards.[18]
Graduate Entry Medicine
The two medical schools in Hong Kong do not offer such programs and postgraduates have to undergo the same program as high school graduates. Despite that, postgraduates are increasing in number in local medical schools, now amounting to one fourth of the entire student population.
Career structure in the Hospital Authority
| Rank | HA General Pay Scale Point |
|---|---|
| Intern | 16 |
| Resident | 30-44B |
| Resident Specialist | |
| Associate Consultant | 45-49 |
| Consultant | 50-53A |
See also
References
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