I AM writing with reference to the article 'Brightest doctors victims of 'unfair' system' (South China Morning Post, November 7) by Allison Wiseman. I am not writing to criticise or praise the proposed new amendment of the Medical Registration Ordinance. I am merely trying to dispel the belief among the general public, and sometimes even within the medical profession, that merely passing the examination for a higher qualification equals recognition as a specialist in a particular medical field. Reading the long list of letters following a doctor's name is sometimes confusing. In Hong Kong, this list usually reads 'MB,BS' or equivalent, which equates a bachelor degree of medicine and surgery granted by a university. It is then followed in some cases by a higher qualification. The latter is the subject matter in question. Until recently, Hong Kong doctors could only obtain their higher qualifications by sitting examinations set by relevant overseas learned colleges. In the local scenario, they are usually UK or, less so, Australian colleges. The most prevalent higher qualifications in Hong Kong are MRCP, FRCS and MRCOG, pertaining to the Royal College of Physicians, Surgeons and Obstetricians-Gynaecologists respectively (incidentally all UK qualifications). In the UK, medical graduates, after going through internship, have to look for a job in a public hospital, where they receive basic training from holders of the above qualifications, are generally understood to have attained a certain standard, and are then thought to be suitable for higher training. This would likely then enable the holder to obtain a job as a registrar. They generally have to stay a registrar for several years until the time comes when they successfully obtain a senior registrar post, from which time the clock ticks for higher training. Different colleges specify different minimal durations for basic training (the period before higher qualification is obtained) and higher training (as a senior registrar) before specialist recognition is granted. In general, the shorter the basic training, the longer the higher training and vice versa. For the college of physicians, they are 18 months and three years respectively. For the college of radiologists, they are four years and one year respectively. In a nutshell, it is a long hard road becoming a specialist, and one which is probably to the patients' benefit. It does not mean just passing the examination. The brightest doctors, who get their higher qualifications early, probably reflect: 1. their aptitude in passing examinations, and 2. the briefness of the duration of the basic training for the speciality they pick. NORMAN AU Sai Kung
