The biggest public doctors union yesterday urged the Hospital Authority to promote all the medics who had acquired specialist qualifications to senior posts to stop a brain drain. But the authority said doing so would stretch its finances as more than 700 doctors had the qualifications. But it pledged to shorten the promotion path for them to less than six years. The Public Doctors' Association threatened industrial action if the authority failed to address a manpower shortage with a package of improvement measures by March 18. At present, 777 doctors from different specialities have attained specialist qualifications but remain at the junior medical officer or resident doctor grade - the lowest in the system. It takes a doctor at least six years after graduation to take a specialist position, such as surgeon, physician or paediatrician. Hospital Authority chief executive Dr Leung Pak-yin yesterday said that a wholesale promotion would be financially impractical. Instead, the authority would consider introducing a policy that ensured doctors promotion to senior medical officer or associate consultant position five or six years after receiving the specialist qualification. Leung hopes to enforce the policy in the next two to three years. 'It is an important policy with a long-term commitment, we cannot just make a one-off move,' Leung said. 'We have to look carefully into our financial situation before coming up with a final package.' A medical officer earns up to HK$102,959 a month, but his monthly salary will increase to between HK$108,227 and HK$124,684 if he is promoted to the associate consultant grade. More than 200 doctors attended a forum held by the Public Doctors' Association last night to express their grievances over heavy workloads and poor career prospects. The doctors were from all public hospitals in Hong Kong and practised in different specialties. Dr Peter Pang Ka-hung, a senior medical officer who specialises in neurosurgery at Kwong Wah Hospital in Yau Ma Tei, said he had taken to using sleeping pills to get to sleep during the past 13 years. He is on call 10 to 15 nights every month 'Doctors always ask patients to take a rest. But they are the ones who needed rest the most,' he said. Tuen Mun Hospital medical officer Dr Yuen Mang-ho said: 'The workload is so heavy that I no longer feel like a doctor. I feel more like a slave.' Association president Dr Loletta So Kit-ying called on the authority to set standard work hours for doctors. So said the authority should also compensate doctors with extra pay or time off for overtime work. However, Leung said stipulating standard working hours was a complex issue which needed careful consideration. Five per cent of Hospital Authority doctors have quit in the financial year ending this month, with many heading to the private sector. The departures mean heavier workloads for those who remain. Poor promotion prospects have been a main factor leading to a high turnover of doctors. At Tuen Mun Hospital, the major acute-care hospital in the western New Territories, 25 per cent of junior doctors at its internal medicine department have quit since January last year. Doctors of internal medicine complained that they were not getting promoted even after they attained specialist qualifications and had worked for the authority for more than 15 years. Meanwhile, the Hong Kong College of Physicians warned that the severe manpower shortage at public internal medicine departments was putting patients at risk. The top training body for specialists in internal medicine gave its 'strong support' to doctors who expressed dissatisfaction over heavy workloads and career prospects. In a letter to all college fellows and trainees on Monday, college president Dr Patrick Li Chung-ki said: 'Doctors in medical departments of public hospitals have become severely stretched beyond their limits. Due to overcrowding in medical wards, premature patient discharge is commonplace making unplanned readmissions a high risk. Further risks are incurred because contact time with both in- and out-patients has, inevitably, been compromised.' The college urged the Hospital Authority to review the manpower allocation in all departments, reduce doctors' workloads by providing clerical support, and promote doctors who have acquired specialist accreditation to senior posts. In the next few weeks the college would modify its examinations 'as a priority to reduce the hardship to our trainees in the light of their heavy workload'. Internal affairs At public hospitals, internal medicine accounts for 40 per cent of discharges and of clinical attendance: 30%
