LCQ7: Non-locally trained medical practitioners
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Question:
Since the 2011-2012 financial year, the Hospital Authority (HA) has employed non-locally trained medical practitioners who have been approved by The Medical Council of Hong Kong for limited registration. Persons employed as Service Residents under limited registration must possess qualifications comparable to the Intermediate Examinations of the constituent Colleges of the Hong Kong Academy of Medicine (HKAM) (Qualification One), while persons employed as Associate Consultants under limited registration must be certified or registered as a specialist in relevant specialty in the country of practising medicine or possess equivalent qualifications, and the certification or registration system of the specialist status concerned must be nationally or officially recognised in the country of practising medicine (Qualification Two). In this connection, will the Government inform this Council:
(1) whether it knows, among the non-locally trained medical practitioners employed by HA in each of the past five financial years, the respective numbers of those with Qualification One and those with Qualification Two;
(2) whether it knows, in each of the past five financial years, the number of non-locally trained medical practitioners employed by HA who received training offered by HKAM (broken down by specialty);
(3) whether it knows HKAM's considerations in determining the number of training places; the number of specialist training places offered by HKAM to locally trained medical practitioners in each of the past five financial years, and whether HKAM reduced the number of such places as a result of provision of training for non-locally trained medical practitioners;
(4) whether it knows, among the non-locally trained medical practitioners who sought employment with HA in each year since the 2011-2012 financial year, the number of those who did not possess Qualification One or Qualification Two; and
(5) as it has been reported that the constituent Colleges of HKAM will no longer require non-locally trained medical practitioners who receive their training to possess Qualification One, whether it knows if HA will correspondingly adjust the conditions for employment as medical practitioners under limited registration; if HA will, how HA ensures that the quality of public healthcare services will not deteriorate?
Reply:
President,
My reply to the question raised by the Hon Alice Mak is as follows:
(1) Under the Limited Registration Scheme of the Hospital Authority (HA), applicants for the position of Service Resident under limited registration must possess qualifications comparable to the Intermediate Examinations of the constituent Colleges of the Hong Kong Academy of Medicine (HKAM) (Qualification One), while applicants for the position of Associate Consultant under limited registration must be certified or registered as a specialist or equivalent in relevant specialty in the country of practising medicine, and the certification or registration system of the specialist status must be a nationally or officially recognised system (Qualification Two).
The respective numbers of Service Residents and Associate Consultants employed by the HA under limited registration in the past five years are tabulated below:
| 2015 | 2016 | 2017 | 2018 | 2019 | |
| Service Resident | 10 | 12 | 12 | 9 | 18 |
| Associate Consultant | 0 | 0 | 0 | 1 | 4 |
(2) As at December 31, 2019, the HA employed 22 non-locally trained doctors under limited registration to serve in departments with manpower shortage, including anaesthesia, accident and emergency, cardiothoracic surgery, family medicine, medicine, neurosurgery, paediatrics, pathology, radiology and surgery.
As regards the provision of specialist training for non-locally trained doctors working in Hong Kong, the HA has been discussing with various stakeholders, including the HKAM and the Medical Council of Hong Kong (MCHK), to allow those doctors recruited with limited registration to continue their specialist training in Hong Kong. Currently, a number of colleges under HKAM have admitted these doctors to continue their specialist training in Hong Kong.
(3) With the increasing number of local medical graduates, about 420 of them who have completed internship with full registration by the MCHK are available for employment by the HA each year since 2018-19. Correspondingly, the HA has increased the number of Resident Trainee posts in order to recruit all qualified local medical graduates and provide them with specialist training. This also enables the HA to fill the existing vacancies and supports the implementation of new service programmes for the year. In other words, the HA did not reduce the number of specialist training places for local medical graduates to make places for training non-locally trained doctors.
The numbers of Resident Trainee posts for recruitment in the past five financial years are tabulated below:
| 2014-15 | 2015-16 | 2016-17 | 2017-18 | 2018-19 | |
| Total | 326 | 432 | 393 | 382 | 477 |
(4) Every year, the HA receives a certain number of applications from non-locally trained doctors under the Limited Registration Scheme. However, not all of these applicants were employed for most of them did not meet the qualification requirements while some declined the appointment offer due to personal reasons. Take, for example, the financial year 2018-19, in which 154 applications were received under the scheme. Among those applicants, 30 were assessed to be eligible (including attaining Qualification One or Qualification Two) and considered suitable for appointment after interview by relevant clinical departments. Of the remaining 124 applicants, 118 were assessed to be ineligible and six withdrew their applications for personal reasons.
(5) Regarding the provision of specialist training for non-locally trained doctors, a number of colleges of the HKAM currently admit these doctors for continuation of their specialist training in Hong Kong. The HKAM and its relevant colleges are discussing and working out the implementation details. Upon finalisation of the details, the HA will update the recruitment requirements for doctors with limited registration accordingly, and submit relevant applications to the MCHK for approval.
As for the standard of doctors with limited registration, the HA has set up a Task Force on Limited Registration Scheme for vetting the qualifications and eligibility of applicants to ensure that the doctors to be appointed have attained the required medical standard. Members of the Task Force comprise the Deans of the two Faculties of Medicine, the President of the HKAM, representatives of the HA Board and the Chief Executive of the HA. The selection process includes scrutinising the applicants’ specialist qualifications by the relevant colleges of the HKAM, and examining the applicants’ qualifications and clinical experience by the Co-ordinating Committees of respective specialties and user departments of the HA. Upon completion of the final interview, the HA will submit relevant applications to the MCHK for approval.
Ends/Wednesday, January 15, 2020
Issued at HKT 12:57
Issued at HKT 12:57
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