• Wed
  • Dec 24, 2014
  • Updated: 10:44am
NewsHong Kong

Chronic shortage of doctors in Hong Kong will not be resolved for years, report warns

University report warns that even with rising number of medical graduates in Hong Kong, city faces staffing shortage for years to come

PUBLISHED : Wednesday, 06 August, 2014, 11:46pm
UPDATED : Thursday, 07 August, 2014, 10:05am

The medical watchdog is under growing pressure to relax stringent licensing rules for overseas doctors after a government-commissioned study concluded that a chronic shortage of doctors "would not be resolved in the medium term", the South China Morning Post has learned.

The study, carried out by University of Hong Kong researchers for the Food and Health Bureau, has not yet been released to the public. It is intended to assess demand for health professionals in the next 15 to 20 years so the government can draw up a strategy.

"Even with the increase in the number of medical graduates starting from 2015, there will still be a scarcity of doctors amid the increasing demand [for] medical services," an official with access to the report cited it as saying.

Public hospitals have struggled for years to fill vacancies as doctors are lured to lucrative jobs in the private sector.

The Hospital Authority has about 250 vacancies for doctors and an annual staff turnover of more than 5 per cent. But the Medical Association, the doctors' union, has long opposed lowering licensing requirements for overseas doctors.

Ninety per cent of patients use public hospitals, but they employ just 40 per cent of doctors.

Efforts to meet the shortfall have included adding places on medical courses at the two universities that train doctors, the University of Hong Kong and Chinese University. Some 320 graduates will join the workforce next year, rising to 420 by 2018.

But the authority believes it will need 18,000 extra beds and 6,200 more doctors by 2041, when the government expects the city's population to have grown to 8.5 million.

The findings come as the Medical Council considers easing licensing requirements for foreign doctors who want to work in the city, an idea that has sparked conflict with the Medical Association.

Council chairman Professor Joseph Lau Wan-yee told the Post that the council last month passed a resolution to exempt overseas doctors with specialist qualifications in fields including paediatrics and obstetrics from a clinical examination that forms part of the licensing exam.

It is also considering exempting experienced foreign doctors from a mandatory 12-month internship at local hospitals.

"We are now seeking legal advice on this matter since it may require legislative amendments," Lau said of the internship rule.

Foreign doctors would still take a multiple choice test on their professional knowledge and an English language exam before being licensed.

The Medical Association proposed reducing the internship to six months - provided the doctor agreed to work for three years in a public hospital. However, the council's legal advisers have cast doubt on that idea. Lau said the council had agreed to put the issue on hold for four months to seek further legal advice.

Patients' Rights Association spokesman Tim Pang Hung-cheong said he welcomed the idea of more overseas doctors. But medical sector lawmaker Dr Leung Ka-lau argued importing doctors would not solve the imbalance in manpower between the public and private sectors.

About 100 overseas doctors sit the council's licensing examination every six months, of whom about half pass.

The Hospital Authority offers a one-year "limited registration" for overseas doctors on short-term contracts, who are exempted from the full licensing exam. But since the contract lasts only a year, it has proved unattractive, with just six doctors signing up by November last year.



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May I ask the medical association, in what ways are doctors from the likes of Britain, North America, Aus/NZ or Singapore inferior to those trained in HK? For example, if ou want to become a qualified doctor in US or Canada, you must first hold a bachelor degree in life science or a related subject and then pass the MCAT before you can be admitted into medical school.
Can the medical association please inform the public as to whether there is any special training that local doctors receive which make them standout vis-a-vis overseas trained doctors? Otherwise it is just pure protectionism.
I can understand private Doctor's motive in protecting their turf principally for financial interest. That is fine. You go make your millions. But the public health system is a different matter. Once you turned private, you should have no say in the public system. You are no longer a golf amateur who play for passion of the game. You have turned pro to play for money. From a patient's point of view, your ethics have changed. Your medical passion is less pure.
Doctors in public hospitals will never make as much as you and will never own nice sports cars or yachts. They are more concerned about saving lives in the pure sense rather than how much will I earn for saving lives. Please don't try to influence the public health system in a negative way. We are talking about people's lives, ordinary people's lives. These are people who cannot afford your private medical fees.
If there is a lack of doctors, why don't the medical association and doctors' union consider recognizing graduates from certain overseas universities like what is happening in Singapore, rather than putting more than well-qualified doctors through these tough examinations.
Graduates from well-known universities with good training overseas will benefit patients in Hong Kong in the long run. After all, Hong Kong is a cosmopolitan city with people from different countries living in this city. We have to be more open-minded rather than putting the lives of patients at risk just because we want to protect own doctors.
Well said. The medical licensing system is yet another example of HK's totally wrong-headed regulatory regimes, which are designed to protect special interest groups rather than serve the public interest. If enough people in HK understood how they are really governed, there would be a revolution tomorrow. At least more people are now being awakened, but I for one am losing patience.
Indeed. A foreign doctor of my acquaintance who at the time was teaching medical students at ChineseU told me that he was shocked by the mindset of his students. His assessment was that the students had no thought of how to become good doctors and uphold the Hippocratic Oath. They we're only interested in knowing what they had to know to pass their exams. Perhaps the HK system is to blame rather than the students. Either way it was a disturbing insight from an insider.
Apparently, entering the medical program at HKU or Chinese U is considered by top scoring students as trophy. I am sure many turn out to be fine Doctors. I know many who devoted their life to public medicines who put making it rich low on priority list. These Doctors endure long hours and are on-call all the time. Sticking around in the chaotic public health care system in Hong Kong is a higher calling. Doctors who chose to turn private should give up messing around in the public health system. Let public hospitals hire Doctors they need so that they can serve the Hong Kong public who cannot afford private medicine.
Chronic shortage of almost everything else in HK ; shortage of housing , shortage of education places, shortage of hospital beds.
Interest groups artificially induce this shortage to protect themselves.
What we are not short of is millionaires and many 20% of households are considered poor.
What we are not short of are mainland tourist.
What we are not short of are too many interest groups.
Do not expect anything to change at all unless people start to die in public hospitals.
This is a classic case of a squeeze put on by a narrow vested interest group (some doctors in the private sector) on the general population.
As most HK 'business' people know a good squeeze is just as addictive as crack. There is not way one should release it.
There is no shortage of potential solutions though:
-The language requirement should be totally separated from the qualification requirement. Language requirement is up to the actual employer based on the circumstances of the job.
-HK should adopt a modern unbiased qualification requirement instead of pretending that all UK/Australian/Canadian/European doctors are suspicious (a classic smell of protectionism).
-Language requirements in public hospitals should be up to the position: radiologist/anaesthetists/surgeons can go with English - no reason to ask for Cantonese or Mandarin (another classic smell of protectionism).
-The private sector shouldn't be protected. We keep being told that HK is Asia world city and open, so just walk the walk.
-If necessary put a requirement for new registered doctors to work in the public sector for a few years.
-The private sector doctors should have no say on the public sector recruitments. They made their choice, let them stick to it.
None of this will happen, especially not in the present difficult political situation where all support is needed. Expect more of the same.
The HK income tax is among the lowest in the world, the proportion of HK workers paying income tax is low, hence the 'cheap' public service. Wealthy USA doesn't even provide medical services for all its citizens, so what are you complaining about?
Exactly. And why do we put up with it?



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