LCQ18: Assisting non-locally trained doctors in practising in Hong Kong

***********************************************************************


     Following is a question by the Hon Chan Hok-fung and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (November 16):


 


Question:


 


     The Medical Registration (Amendment) Ordinance 2021 came into effect in October last year. The Government announced in April and June this year respectively the lists of a total of 50 medical qualifications recognised by the Special Registration Committee (the lists of medical qualifications) to allow non-locally trained doctors possessing recognised medical qualifications to come to Hong Kong through a “special registration” route, and take up doctors’ work in public healthcare institutions (i.e. the Hospital Authority (HA), the Department of Health, the University of Hong Kong and The Chinese University of Hong Kong). In this connection, will the Government inform this Council:


 


(1) whether it knows (i) the number of enquiries about special registration received, and (ii) the respective numbers of applications received and approved, by the aforesaid public healthcare institutions since the introduction of the lists of medical qualifications; among the applications received and approved, the number of applicants who have acquired specialist qualifications, with a breakdown by the specialty involved;


 


(2) as it is learnt that the applications for posts submitted to HA by some persons who meet the special registration conditions (i.e. being a Hong Kong permanent resident, possessing recognised medical qualifications awarded by non-local medical schools, and having acquired qualifications for medical registration in any places where such medical schools are located) have not been approved for over two months, whether it knows the relevant reasons for that, and of the criteria adopted by HA for vetting and approving applications for posts from non-locally trained doctors;


 


(3) whether it knows the average time taken by the aforesaid public healthcare institutions to handle each application, and whether they have formulated key performance indicators for handling applications; if they have, of the details and the status of meeting the indicators; and


 


(4) whether it knows if the aforesaid public healthcare institutions have plans to provide specialist training to non-locally trained doctors coming to Hong Kong, such as reserving a certain number of training places for them in each specialty; if they have, of the details; if not, the reasons for that?


 


Reply:


 


President,


 


     After the Medical Registration (Amendment) Ordinance 2021 came into effect upon gazettal on October 29, 2021, non-locally trained doctors who possess the recognised medical qualifications, subject to their fulfilment of certain criteria, may apply for special registration to practise in the public healthcare institutions (i.e. the Hospital Authority (HA), the Department of Health (DH), The University of Hong Kong (HKU) and The Chinese University of Hong Kong (CUHK)) in Hong Kong. After serving for a certain period, obtaining recognised specialist qualifications and passing the assessment, they will be granted full registration to practise in Hong Kong. For non-locally trained medical graduates who possess the recognised medical qualifications but have yet to undergo internship outside Hong Kong, subject to their fulfilment of relevant criteria, they may take the Licensing Examination of the Medical Council of Hong Kong (MCHK) in order to apply for special registration to practise in the public healthcare institutions in Hong Kong. They may also obtain full registration after meeting the requirements applicable to all special registration doctors. On the other hand, limited registration doctors, who have worked in the public healthcare institutions for at least five years, are eligible to migrate to the special registration route after obtaining recognised specialist qualifications, irrespective of whether they possess recognised medical qualifications.


 


     In November 2021, the Special Registration Committee (SRC) was established under MCHK in accordance with the amended Medical Registration Ordinance (Cap. 161) (MRO) to determine the list of recognised medical qualifications after reviewing programmes offered by non-local medical schools with quality comparable to those provided by the two medical schools in Hong Kong. The list is to be submitted to the Registrar of Medical Practitioners for promulgation. To date, the SRC has promulgated two batches with a total of 50 recognised medical qualifications.


 


     In consultation with the MCHK, the HA, the DH, the HKU and the CUHK, the consolidated reply to the question raised by the Hon CHAN Hok-fung is as follows:


 


(1) During the five months since the promulgation of the second batch of recognised medical qualifications by the SRC on June 8, 2022 up till early November 2022, the MCHK and the four public healthcare institutions mentioned above have received a total of over 80 enquiries relating to special registration. To date, the MCHK has received 11 applications for special registration (including applications from non-locally trained doctors selected for full-time employment in public healthcare institutions and those from limited registration doctors currently employed by the public healthcare institutions), seven of which have been approved. All the applicants concerned possess specialist qualifications. Details are tabulated as follows:


 













Specialty Number of Applications Received Number of Applications Approved
Gastroenterology and Hepatology 3 1
Radiology 2 1
Anaesthesiology 1 1
Emergency Medicine 1 1
Geriatric Medicine 1 1
Ophthalmology 1 1
Otorhinolaryngology 1 0
Surgery 1 1
Total 11 7


 


(2) On receipt of job applications from non-locally trained doctors who intend to practise in Hong Kong through the special registration or limited registration pathway, apart from assessing whether the applicant fulfils the prescribed criteria for special registration or limited registration, the HA also assesses the applicant’s qualification, clinical experience, etc. 


 


     The entry requirements for Service Residents under special registration are that the applicant must be a Hong Kong Permanent Resident, holds a recognised medical qualification and is registered under the law of a qualifying place as a medical practitioner in that place. As for the position of Associate Consultant under special registration, the applicant (i) must hold a recognised medical qualification and is registered under the law of a qualifying place as a medical practitioner in that place; (ii) has been awarded a Fellowship by the Hong Kong Academy of Medicine (HKAM) for relevant specialty, or has been certified by the HKAM to have completed relevant specialist training and obtained the qualification comparable to that required of a Fellow in the relevant specialty by the HKAM; and (iii) has been certified by the HKAM to have satisfied the continuing medical education requirements for the relevant specialty. As for Service Residents under limited registration, the entry requirements are that the applicant should (i) possess full registration with an approved medical authority outside Hong Kong and have attained a qualification comparable to the intermediate or pre-intermediate specialist examinations of constituent Colleges under the HKAM; (ii) possess relevant clinical experience as post-internship registered medical practitioner and have enrolled in specialist training programme recognised by constituent Colleges under the HKAM; (iii) attain proficiency in English; and (iv) attain proficiency in Cantonese (except for Anaesthesia, Pathology and Radiology). The entry requirements for Associate Consultant under limited registration are that the applicant should (i) possess full registration with an approved medical authority outside Hong Kong; (ii) possess officially recognised specialist qualification in the place of practising medicine; (iii) attain proficiency in English; and (iv) attain proficiency in Cantonese (except for Anaesthesia, Pathology and Radiology).


 


     Since April 2019, the HA has expanded the scope of limited registration recruitment to all specialties at the rank of Service Resident, and started to recruit non-locally trained specialists at the rank of Associate Consultant in specialties with significant shortage of specialists (including Anaesthesia, Anatomical Pathology, Cardiothoracic Surgery, Otorhinolaryngology, Obstetrics and Gynaecology, Ophthalmology, Radiology, Nuclear Medicine, Neurosurgery, Oncology, Emergency Medicine, Intensive Care Medicine, Medicine, Paediatrics and Surgery). 


 


(3) Generally speaking, the MCHK and the above-mentioned public healthcare institutions will process applications for special registration in a timely manner. The time required for individual applications may be affected by various factors, such as the examination of supporting documents, interview arrangements, applicants’ plan for return and practice in Hong Kong, etc., and hence no generalisation could be made. Relevant institutions have not set a particular key performance indicator for the application processing time.


 


(4) The HA and the DH are the major specialist training providers in Hong Kong. Since the implementation of the amended MRO, the Health Bureau has all along been keeping close liaison with the HKAM, the HA and the DH in order to facilitate the arrangement for non-locally trained doctors under limited registration and special registration to receive specialist training in Hong Kong. Currently, nearly all constituent Colleges under the HKAM are prepared to accept non-locally trained doctors to receive specialist training in Hong Kong.