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John Carney

A tough examination that all overseas-trained nurses must pass in order to practise their profession in the city is behind the serious nurse shortage, a Filipino medical worker says.
Dr Esperanza Velvez-Ciriaco, who is trained as a doctor and works in Hong Kong as a school nurse, points to the mandatory licensing exam as the reason why more Filipino and other overseas nurses cannot find jobs in local hospitals.
She said it was very hard for a nurse who had been trained overseas to pass the exam, conducted by the Nursing Council of Hong Kong.  
'Most foreign nurses, not only Filipino nurses, who have taken Hong Kong's Licensing Examination  will tell you that it is extremely difficult to pass,' said Velvez-Ciriaco, who works as a nurse at  the Hong Kong International School.   
The council rejects the claim, saying past exam papers and revision courses are available to help applicants prepare. It also says the training it conducts is suitable for the city.
The Hospital Authority has 20,000 nurses. It wants to recruit at least 1,300 nurses in this financial year, but expects fewer than 1,200 positions will be filled.
All nurses, whether they are trained locally or overseas, must obtain the council's Practising Certificate  before they can practise in the city. Nursing qualifications that are recognised in their home countries do not suffice.
The certificate is obtained by passing the licensing exam, which qualifies the applicant as a registered or enrolled nurse. The exam comprises written and practical components. It can be done in English. After this, applicants undergo interviews to assess their suitability, experience, knowledge and skills, before getting the green light.
'The major hindrance now is the exam requirements from the Nursing Council of Hong Kong, which many of my peers from Australia, the UK and the US also find extremely difficult,' Velvez-Ciriaco said.
'Even Hong Kong Chinese nurses who have trained in universities overseas and return to work here find it hard to pass the exam. A nurse I know who has 12 years' experience in the ICU (intensive care unit) from a foreign country has tried a number of times to pass the local licensing examination and failed.'
She also said the application process for a nursing licensing exam was 'long and tedious'.
It takes about five months to process an application. A council spokeswoman, Daisy Lo, attributed the time required to the amount of references and supporting evidence that had to be gathered. 
Lo denied that the exam put overseas nurses at a disadvantage.
'We do not compare other countries' nursing exams with our own,' she said. 'The training syllabus we use is suitable for Hong Kong and a mark of 50 per cent correct answers or over is a pass.'
She said past test papers could be viewed on the council's website. 
It would be hard to find someone in the city working as a nurse at any of the hospitals, let alone an international school, with credentials similar to Velvez-Ciriaco's.
She graduated with a Doctor of Medicine from the College of Medicine at Our Lady of Fatima University in the Philippines in 1986, then finished a postgraduate internship programme in 1987 at Veterans Memorial Medical Centre.  
She practised in Manila before joining her husband in Hong Kong. She worked for nine years at South Island School,  an English Schools Foundation  secondary school, before moving on to the Hong Kong International School, where she has served for three years. 
Filipino nurses in the city work in schools or private hospitals, such as the Matilda International Hospital  at The Peak. 
It made more sense to apply for work as a school nurse at the international schools rather than the hospitals, Velvez-Ciriaco said.
'To be able to work in a local hospital, I would be required to take the licensing examination,' she said. 
'Registration with the nursing council by far has been the biggest barrier for [the] foreign-trained nurses I know.' 
She said that if exams were to be a basic requirement, then the format should be different. International registration exams in the US and Canada, for example, used 'multiple choice and were not based on pages and pages of writing what you've memorised from textbooks'. 
The licensing exam 'should be given a smaller percentage in considering the success of an applicant', she said. 'It is the clinical skills that are more important than gauging the result of a written examination.
'Another option would be for the Hong Kong government to lower the licensing examination fees for both nurses and doctors so that is more affordable for applicants seeking employment here in Hong Kong.'
The licensing exam fee is HK$715 in an application to be a registered nurse and HK$765 to qualify as an enrolled nurse.
Put to the test
The Nursing Council holds a licensing exam for nurses trained outside Hong Kong
The pass mark is: 50



Lack of overseas nurses blamed on tough exam