Entry bar for doctors must be seen to be fair

PUBLISHED : Monday, 28 November, 2011, 12:00am
UPDATED : Monday, 28 November, 2011, 12:00am


When I was in the US for specialist training in the 1970s, my competency in the practice of medicine was always suspect because I graduated from a medical school in the East. Such prejudice was widespread but understandable, given that I went to a country with rightful claims to be the most advanced in science, technology and medicine, while Hong Kong was then a third-world city. The validation of my competence came with passing exams.

I was tested on my basic knowledge in medicine and in English proficiency before I was even allowed to be trained as an intern, even though I had already gone through internship in Hong Kong. I had to pass another exam after internship to qualify for a medical licence. After years of training in pathology, I took and passed another exam to be a certified specialist.

I tolerated the hardship because this was the career path I had chosen, and I found consolation in knowing that all 'foreign medical graduates' were given the same treatment, without exception and exemption.

Many foreign medical graduates, especially those from other Western countries, protested vociferously. But the American licensing authority has stuck to its non-discriminatory policy over the years, and has never exempted any foreign graduates based on their country of origin, or the prestige of their medical school.

Not only is the decision politically correct, it has also proven to be wise. Doctors from all over the world continue to flock to the US for training and to pursue a medical career, knowing their future success is based on meritocracy. Many from developing countries have made invaluable contributions to the US health care system.

Examinations, imperfect as they are in assessing competency, are in general fair and square. Knowledgeable and qualified candidates have nothing to fear.

Yet the Hospital Authority is ready to give (limited) medical licences to selective 'foreign medical graduates' so they can practise in public hospitals without having to take an exam. The reason given was that an exam acts as a deterrent for many qualified doctors to apply to work here.

By picking candidates based on their paper credentials and not by a more objective method such as test scores, will the authority be inclined to admit only those doctors from world-renowned schools, and exclude those from less prestigious ones, especially those from the mainland?

The problem with this approach is that it is non-transparent, whimsical, and easily perceived to be discriminatory or having a hidden agenda. It will only invite criticism, and possibly lawsuits.

Dr Feng Chi-shun is a Hong Kong pathologist