Plan for medical schools to boost intake by a third

PUBLISHED : Monday, 11 April, 2011, 12:00am
UPDATED : Monday, 11 April, 2011, 12:00am


The government wants the city's two medical schools to accept substantially more students to address a severe staff shortage at public hospitals. The plan calls for the institutions to raise the number of first-year admissions from the present total of 320 to about 420, starting next year.

The Food and Health Bureau said it expected a 'substantial increase in demand for health care practitioners in the future'.

'The final student number targets for individual disciplines will be worked out taking into account many factors, including the capacity of the institutions, institutions' assessment of manpower needs and competing demand for student places and resources,' a bureau spokesman said.

The exact number of medical students will be based on the government's manpower projection and approved by the University Grants Committee, which will come up with a final figure in the fourth quarter of the year.

The government has been repeatedly criticised for lack of long-term manpower planning and secrecy surrounding how it works out staffing needs. Amid intense debate over staff shortages at public hospitals and threats by public doctors to take industrial action, health officials believe one solution is to train more doctors.

The Hospital Authority admits it does not have manpower projections for planning purposes. It says hospitals have different doctor-patient ratios based on their own needs.

Some leaders in the medical profession have warned that comprehensive, long-term manpower planning must be done before taxpayers are asked to train more doctors.

'The government has never told us how it decides on the number of medical students every year. No one knows the rationale behind it. Members of the public can't take part in the discussion at all,' Medical Council member Dr Ho Pak-leung said.

Intakes of medical students have fluctuated over the past decade - from 340 in 2001 to 280 in 2003, then down to 250 in 2006 and up again to the present 320.

The two deans of medicine agreed on the need to train more medical students to meet growing demand.

University of Hong Kong dean of medicine Professor Lee Sum-ping said many places around the world were facing shortages of medical professionals. Training more students was a 'rational and positive step forward', he said. 'The evolution of any supply-demand equilibrium is never going to be static and we should be prepared to adjust this balance in a continuous and dynamic way.'

Lee's counterpart at Chinese University, Professor Fok Tai-fai, believed Hong Kong needed more doctors to meet the growing demand of an ageing population.

The ratio of doctors to population in Hong Kong is one of the lowest among developed cities. Government figures show there were 1.8 doctors per 1,000 people in Hong Kong in 2009, compared with 2.2 in Singapore and 2.3 in South Korea.

Many European countries have three to six doctors per 1,000 people. Britain has 2.7 and the United States 3.1. The figure is even higher in Italy (6.2) and Finland (4.5).

Concerns have been raised that adding an extra 100 medical students could mean the universities would have to dig into the budgets of other courses. Medicine is always the most costly course.

According to the UGC, the average annual cost of training a medical student has reached HK$647,000, which is 3.6 times the average of HK$180,000 for humanities courses. It costs more than HK$3 million to train a doctor.

But medical legislator Dr Leung Ka-lau warned against a sudden increase in medical students. 'If we continue to produce 320 doctors per year at the current speed, there will be about 2,000 doctors in the coming eight years. I doubt if the authority can hire them all, even taking into account the normal wastage in both the public and private sector.'

He urged the authority to allocate 10 per cent of its workload to contracted doctors from the private sector so it could be more flexible in adjusting its staffing levels.

Medical Association president Dr Choi Kin said the doctor shortage at public hospitals did not mean the city was short of doctors. 'Many public doctors left public hospitals because of poor working conditions,' he said. 'There are still many doctors in the private market. There is an imbalance between the two sectors.'

Yeoh Eng-kiong, professor of public health at Chinese University, said manpower planning was always complex. 'Good manpower planning needs to look beyond the demand in the public sector. It should look at the system as a whole, the service delivery models and the health care financing situation.'

Big swings

Intakes of medical students dropped from 340 in 2001 to 250 in 2006 and then rose again to the present: 320