The face of medicine in Hong Kong is increasingly a female one, as women make up a growing proportion of medical school graduates and doctors' rolls. Their needs for more flexible employment and family-friendly work conditions are posing challenges for the medical profession and Hospital Authority. The authority is in the process of projecting its staffing needs for the next decade. It employs 5,100 public sector doctors and may be facing the loss of as much as 6.8 per cent of them through resignations, retirements and other reasons - the highest level in five years. Women made up 28.4 per cent of all Hong Kong doctors last year, up from 22 per cent in 2000 and 16 per cent in 1982, according to a government survey. Many of them will work less than their male counterparts due to maternity leave and part-time work arrangements they will need to look after their families. This means Hong Kong needs to think about training even more doctors to maintain the productivity of the workforce. At public hospitals, there is one female doctor for every two male doctors. Women may become the majority if the current trend of student intake continues at the city's two medical schools. At the University of Hong Kong's medical faculty, the women-to-men ratio among new medical students rose gradually from 1:7 in the 1960s to 1:3 in 1990, reaching 1:1 in 2000. In the past 10 years, women have made up between 39 per cent and 50 per cent (this year) of all new students. At Chinese University's medical faculty, the ratio rose from about 1:4 in the early 1980s to 1:2 in the 1990s, and to more than half, for the first time, in 2000. Female students have been in the majority for most of the past decade. This year, 57 per cent of its 166 medical students are women. Professor Raymond Liang Hin-suen, president of the Hong Kong Academy of Medicine, says the government must review its future needs for doctors taking into account the growing number of women entering the profession. The academy is the body responsible for specialist training. 'Female doctors have more family obligations, especially when they have children. They may want to practise part-time, which will have an impact on manpower. 'I have had female colleagues who had to struggle between work and family,' Liang said. 'In the UK, flexible employment for female doctors is quite common.' Dr Ching Wai-kuen, the Hospital Authority's chief manager (doctors grade), said the rising female-to-male ratio would be a key factor in determining projections for future hiring needs. 'We have not quantified this in the past, but definitely we have to do so in the next round of manpower projections. Women doctors need maternity leave when they are pregnant and some may want to turn to part-time employment. 'As a result, their effective work time will be less than their male colleagues,' Ching said. The authority has to hire at least 400 doctors a year to offset the loss of doctors and support new services. 'If there are more and more women doctors in the new recruitment, we may need more than a headcount of 400,' Ching said. Public Doctors' Association president Dr Loletta So Kit-ying, a specialist in respiratory medicine, said some of her female colleagues' requests to switch from full-time to part-time employment had been turned down. The reason given is the shortage of doctors in Hong Kong's public hospitals. The Hospital Authority projects that the turnover of doctors will jump from 4.4 per cent in the 2009-10 financial year to 6.8 per cent this financial year, a five-year high. So said: 'The current rigid policy [on work arrangements] is actually causing a brain drain. Some female doctors who cannot switch to part-time end up quitting the job.' Female doctors also want more stable working hours once they had children to look after, she said. Shifts and extended duty calls currently can last for over 30 hours. She said the authority should consider a new system so doctors who took on more work were paid more. 'Doctors who choose to work less to give more time to their families would then receive lower pay. It would be fair to all,' So said. At present, the authority gives out a flat HK$3,500 monthly honorarium for all doctors who have to take on extra duties. So said she would raise these issues - including a more caring policy towards pregnant doctors - with the authority's new chief executive, Dr Leung Pak-yin. Many clinical departments currently spare doctors from long shifts during the first three months of pregnancy. But after that three-month grace period, pregnant doctors also have to take on night shifts and work continuously for 24 to 30 hours. The Hospital Authority's Ching said hospitals had been given the authority to decide on part-time employment arrangements for the past three years. The number of part-time doctors increased from 97 in 2007 to 123 this year. 'We understand that some small departments may not be able to offer part-time positions to their staff because it may affect the level of public services,' Ching said. 'We are open about this issue, and would like to talk to the unions and frontline staff about it. 'For pregnant doctors, we cannot promise any special arrangement at this stage because manpower is very tight, but we will be looking into this,' he added. Chinese University's dean of medicine, Professor Fok Tai-fai, said the medical school always selected students based on ability, not gender. 'Many girls now have very good academic results, and they perform well in interviews,' Fok said. 'That's why we have more and more female students - gender is never our consideration.' Some female doctors have set up partnerships so they can cover for each other's private practices, according to Hong Kong Medical Association president Dr Choi Kin. Some female doctors had given up the idea of having a child after they had spent years on specialist training, Choi said. 'They spend years in training, achieving their specialist's qualifications in their mid- or late 30s, and then they realise it is already too late to have a child.' Historic shift The number of female physicians in Hong Kong is growing steadily Of the 166 medical students in Chinese University's faculty of medicine this year, women account for: 57%