Replies to LegCo questions

LCQ3: Training for medical graduates

Following is a question by the Hon Chan Yuen-han and a reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (October 22):

Question :

It has been reported that the Hospital Authority ("HA") has reduced the intake of graduates in Medicine due to its expenditure reduction, thus depriving the graduates of their chances to receive specialist training and placement in Hong Kong. They are thus unable to apply their expertise to serve the community and some even have to practise overseas, resulting in a waste of the public money spent on training the talents. In this connection, will the Government inform this Council:

(a) of the respective numbers of graduates in Hong Kong in each of the past five years and, among them, the percentage of those who have been employed to receive specialist training by HA;

(b) as it has been reported that quite a number of graduates in Medicine are offered to receive the Family Medicine Specialist Training of a shorter duration, of the criteria adopted by HA for allocating graduates to receive such specialist training; and

(c) of the average cost of training a graduate in Medicine, and the measures taken by the authorities to assist them in finding employment so as to avoid wasting resources?

Reply :

Madam President,

(a) The number of graduates of University Grants Committee (UGC) - funded undergraduate programmes in medicine in the past five years are set out at Annex A. After completion of internship and following registration with the Medical Council of Hong Kong, graduates of UGC-funded medicine undergraduate programmes are fully qualified for medical practice. While many may wish to seek specialist training, not all doctors would like to become specialists. Over the past five years, an average of over 80 per cent of the local medical graduates who apply for specialist training with the Hospital Authority (HA) after completion of internship are offered resident positions each year. Recognised training in certain specialties is also provided by the Department of Health (DH), amongst other institutes. On the average, DH employs about 26 doctors per year in the last five years.

(b) The decision on the number of New Residents to be admitted for specialist training is made on the basis of a number of factors, including the projected specialist requirements, the projected supply of specialists in the light of number of trainees completing training, the turnover rates, HA's plan on service development, the training capacities in HA hospitals and the applicants' suitability for specialist training.

Over the past five years, the HA has been progressively increasing the number of family medicine trainees from 68 in 1999/2000 to 98 in 2003/04. The increase in the number of intake of family medicine trainees is due to the projected increase in the need for such specialists which in turn arises from the emphasis we place on primary health care in recent years. Our policy objective is to develop a pluralistic primary care model in Hong Kong. Under this model, the Government is committed to provide more community-based, patient-centred and integrated health care services to the community. The objectives of the new model are to enhance the health of the population by promoting lifelong wellness and care, improve health outcomes through self management and care support, and make the heath care system more cost effective through rationalisation of service delivery and fostering closer collaboration with other community-based health care providers. To cater for these needs, we aim to provide training in family medicine for about 50 per cent of specialist trainee intakes in HA.

(c) The recurrent grants are allocated to the institutions by UGC in the form of block grants. The institutions have flexibility to allocate resources among individual departments or programmes to suit their development needs. According to the information provided by the institutions, the average annual student unit cost (in full-time-equivalent terms) for students in the medicine academic programme category between 1997/98 and 2001/02 is set out at Annex B. As the accounts for 2002/03 are yet to be finalised, the figure for 2002/03 is not yet available.

Registered medical practitioners may seek employment in the public sector, with private medical institutions or engage in their own private practice. In addition to placing advertisements in newspapers and recruitment notices on their homepages, DH and HA maintain close liaison with universities on job openings in the public sector. The universities organise various workshops, including interview workshops, CV writing workshop, pre-internship training block, etc, to offer advice and assistance to medical graduates in job hunting. At present, there are over 9,600 registered medical practitioners in Hong Kong, about 40 per cent of whom are working in the private sector.

To ensure that the supply of doctors are broadly in line with the longer term requirements of the population and minimise short-term fluctuations in the labour market, Government will regularly review the manpower situation for health care professionals based on careful considerations of the requirements of the population, changes and advances in medical technologies and in the context of the development of the local health care system.

Annex A

Academic year         Number of graduates
1998/99                             300
1999/2000                         313
2000/01                             328
2001/02                             345
2002/03                             322

Annex B

Academic year          Average annual student unit cost($'000)
1997/98                                         566
1998/99                                         558
1999/2000                                     609
2000/01                                         623
2001/02                                         559

Ends/Wednesday, October 22, 2003
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