Resources to alleviate specialist shortage urgently needed

June 25, 2021 06:00
Photo: Reuters

It is known that Hong Kong patients have been suffering from long waiting time for specialist treatments. The government must seek a solution to ease the plight of the patients. The recently proposed regulatory amendments to introduce non-locally trained doctors into the system can help but it is only a mitigation measure. To effectively address the shortage of doctors, it requires the coordination of multiple stakeholders.

At present, public hospitals in Hong Kong are facing a high turnover of doctors. Taking consultants as an example, the turnover rate was as high as 10% in 2018-2019, and it was 7.7% and 7% respectively in the following two years. Currently, it takes 12 years to train a specialist. Besides, the experience of specialists, especially senior specialists, is precious. Even if the two medical schools in Hong Kong increase the number of locally-trained doctors right now, there will not be an immediate effect on the replenishment of the lost expertise. Amidst the global competition for medical talents, Hong Kong must try every possible means to attract medical professionals to serve the community.

The exemption of licensing examination is a welcome step. However, it is not a sufficiently strong incentive to attract non-locally trained doctors to Hong Kong if their promotion or professional training prospects are restrained. Even for those attracted by the exemption, there is the possibility of losing them again. Therefore, in addition to the proposed amendments to attract non-locally trained doctors, the Hong Kong Government must also come up with talent retention measures.

Our Hong Kong Foundation recently released a report entitled “Fit to Practise: Reviving the Role of Non-locally Trained Doctors to Strengthen Hong Kong’s Workforce for a Better Tomorrow – An Insider’s Perspective into Optimising Doctor Supply and Uplifting the Patient Care Experience". The Foundation suggests that Hong Kong should increase its investment in specialist training. In the current system, non-Hong Kong trained doctors coming to work in Hong Kong without a licensing examination can only serve as associate consultants, which limits their career prospects. The Government should fully utilise the attracted talents by allowing them to enjoy equal promotion opportunities as their local peers. Different specialties should increase the number of consultant and associate consultant posts to create promotion opportunities for capable doctors. This will strengthen the motivation of the capable ones and the overall medical care standards can therefore be enhanced.

Currently, young, non-locally trained doctors have been facing difficulties in receiving specialist training in Hong Kong. This constitutes an obstacle to their career development in the city. While ensuring the training opportunities for local medical students on one hand, the Hospital Authority should also offer integrated contracts to non-locally trained doctors on the other, so that they can continue their specialist training in Hong Kong. The Government should empower the Hong Kong Academy of Medicine to mandate training quotas under the Academy Colleges to provide specialist training to non-locally trained doctors, with a priority given to Hong Kong permanent residents. In addition, the list of recognised non-local specialist qualifications and other Academy College entry requirements should be clearly organised, made publicly accessible and centralised by the Hong Kong Academy of Medicine so that non-locally trained doctors can self-assess the degree of recognition of their qualifications. In case they do not meet the prescribed requirements, they may also seek training for self-improvement accordingly.

In the meantime, the Government should consider setting up an independent specialist accreditation body, with members including international experts, that will be specifically responsible for the recognition and accreditation of specialist training courses and the determination of qualifications for inclusion in Hong Kong’s Specialist Register. Alternatively, the Government can consider empowering the Education and Accreditation Committee under the Medical Council of Hong Kong to take the role.

There are complaints about non-locally trained doctors facing career disadvantages in terms of training opportunities and career progression due to bias or human factors. To address these issues, Hong Kong could consider the British example. In the UK, international medical students and local medical students both receive the same training opportunities allotted in accordance with the ability of the applicants.

In conclusion, Hong Kong patients’ waiting for more than a year to receive medical care is far from ideal. Timely treatment is vital for alleviating the suffering of patients. However, due to the shortage of doctor supply, the medical conditions of patients may deteriorate while they are queuing up for delayed treatments. In the face of an ageing population, the Hong Kong Government must face the shortage of doctors squarely. Allocation of additional resources for specialists and reforms in the medical care system are long overdue.

-- Contact us at [email protected]

Managing Editor at Our Hong Kong Foundation.