A difficult doctors' exam is set to become even harder for overseas-trained practitioners. The Hong Kong Medical Council said yesterday that from September, the licentiate entry exam for all doctors who qualify outside Hong Kong, including those from Britain and Commonwealth countries, will double the number of multiple-choice questions to 240. The questions measure a candidates' knowledge of medical fields such as surgery, psychiatry and paediatrics. Medical Council secretary Rupert Cheung Ming-bor said the change aimed to make the test more comprehensive following local doctors' concern that it was easier than tests set at the two local medical schools. Mr Cheung said low pass rates were due to the poor standard of overseas candidates, especially from the mainland. Pass rates of more than 35 per cent were only gained when more US and Taiwan students sat the exams. A former member of the licentiate examination board, Dr David Anderson, yesterday criticised the existing exam as so difficult it kept many overseas-qualified doctors out. 'A five per cent pass rate is ridiculously low. A lot of people think this is the fault of the candidates but some of the questions are so bad that nobody can answer them correctly,' Dr Anderson said. He said everyone wanted an exam which could genuinely weed out bad doctors but he feared a lot of extra exam questions would not do that. Dr Anderson suggested local students should sit the same exam to compare standards. Hong Kong-qualified doctors are exempt from the three-part exam, as long as they have passed final exams at the University of Hong Kong or Chinese University of Hong Kong. Parts of the licentiate exams cover the use of medical English and clinical examinations. In January, 260 foreign-trained doctors, many from China, sat the exam. Only 13 passed Part One, which tests basic medical knowledge. In 1994 only 10, or five per cent, of 197 candidates passed. Hong Kong Medical Association vice-president Dr So Kai-ming said many felt the exam was easier than local medical tests.