LCQ3: Non-locally trained doctors and medical graduates

     Following is a question by Dr the Hon David Lam and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (April 24):

Question:

     Since the Medical Registration (Amendment) Ordinance 2021 (the Amendment Ordinance) came into effect on October 29 2021, the Government has announced a total of 100 medical qualifications recognised by the Special Registration Committee. Non-locally trained doctors who possess the recognised medical qualifications, subject to their fulfilment of relevant criteria, may apply for the special registration pathway to practise in the public healthcare institutions (i.e. the Hospital Authority, Department of Health, the University of Hong Kong and The Chinese University of Hong Kong) 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 (LE) of the Medical Council of Hong Kong in order to apply for the special registration pathway to practise in the public healthcare institutions in Hong Kong. In this connection, will the Government inform this Council:

(1) of the number of doctors practising in the aforesaid healthcare institutions through the special registration pathway each year since the Amendment Ordinance came into effect, and set out in Table 1 a breakdown by source region/country (i.e. (i) the Mainland, (ii) the United Kingdom, (iii) Australia, (iv) New Zealand, (v) Canada, (vi) the United States, (vii) Singapore, (viii) South Africa and (ix) India);

Table 1

Year	(i)	(ii)	(iii)	(iv)	(v)	(vi)	(vii)	(viii)	(ix)	Total

(2) among the doctors mentioned in (1), of the number of those who possess specialist qualifications, and set out in Table 2 a breakdown by specialist qualification;

Table 2

Year	Specialty	Number of doctors	Total

(3) of the number of non-locally trained medical graduates who have directly taken and passed LE in Hong Kong without undergoing internship outside Hong Kong each year since the Amendment Ordinance came into effect; and

(4) of the number of non-locally trained medical graduates receiving specialist training in Hong Kong each year since the Amendment Ordinance came into effect, and set out in Table 3 a breakdown by specialty?

Table 3

Year	Specialty	Number of medical graduates	Total

Reply:

President,

     The Government has been addressing the shortage of doctors in the public healthcare system through a multipronged strategy, including the admission of qualified non-locally trained doctors to work in the public healthcare system. To that end, the Government amended the Medical Registration Ordinance (Cap. 161) (MRO) to introduce special registration (SR) on top of the existing limited registration (LR), so as to broaden the pathways for qualified non-locally trained doctors to practise in Hong Kong. Since the gazettal of the first batch of recognised medical qualifications for the purpose of SR in April 2022 to the fourth batch in June 2023, a total of 100 medical qualifications offered by 80 universities from nine places were recognised. In the meantime, the Hospital Authority (HA), the Department of Health (DH) and the medical schools of two universities have been jointly recruiting non-locally trained doctors under SR and LR or arranging for exchange of professionals overseas and in the Mainland since 2022 with a view to increasing the manpower of doctors in the public healthcare system. 

     The reply to the question raised by Dr the Hon David Lam is as follows:

(1) and (2) According to the information from the Medical Council of Hong Kong (MCHK), the number of applications for SR and LR in 2022-23 and 2023-24, their employment institutions, countries/places where the applicants obtained medical qualifications, and the number of applicants who have acquired specialist qualifications are set out below:

	SR			LR
	Holding recognised medical qualifications	Bridging from LR	Total
Number of applications (Note 1)
Number of applicants	63	10	73	200
Number of approved applicants	62 (Note 2)	9 (Note 3)	71	200
Number of applicants with registration effected	52 (Note 4)	9	61	210
Employing Institutions
The University of Hong Kong	3	3	6	31
The Chinese University of Hong Kong	0	6	6	50
HA	49	0	49	109
DH	0	0	0	13
Clinics exempted under section 7 of the Medical Clinics Ordinance	N.A.			7
Total	52	9	61	210
Countries/places where the medical qualifications were obtained
China (Note 5)	1	1	2	68
United Kingdom	40	4	44	64
Australia	7	0	7	11
New Zealand	0	0	0	2
Canada	1	1	2	6
United States	1	2	3	5
Singapore	0	0	0	2
South Africa	2	1	3	4
India	0	0	0	6
Others	N.A.			42 (Note 6)
Total	52	9	61	210
Specialist qualifications acquired (Note 7)
Anaesthesiology	2	0	2	1
Surgery	0	0	0	1
Gastroenterology & Hepatology	1	2	3	0
Paediatrics	0	0	0	3
Pathology	0	0	0	1
Ophthalmology	0	1	1	2
Intensive Care	0	0	0	1
Obstetrics and Gynaecology	0	0	0	1
Nephrology	0	0	0	1
Rheumatology	0	0	0	1
Public Health Medicine	0	0	0	1
Medical Oncology	0	1	1	0
Geriatric	0	1	1	0
Otorhinolaryngology	0	1	1	0
Radiology	1	2	3	0
Emergency Medicine	0	1	1	0
Total	4	9	13	13

Note 1: Refers to the number of applicants and approved applicants in 2022-23 and 2023-24, excluding application for renewal. 
Note 2: The remaining one application has been approved in April 2024.
Note 3: The remaining one application is being processed.
Note 4: The SR of eight of the remaining individuals took effect after March 31, 2024. The SR of another one individual was terminated in January 2024, and one other individual passed the Licensing Examination of the MCHK in February 2024 and obtained full registration.
Note 5: Includes Mainland China, Macau and Taiwan region.
Note 6: The countries/places that those 42 doctors under LR concern countries/places are concerned with are the Czech Republic (2 people), the Philippines (10 people), Sri Lanka (1 person), Ireland (8 people), France (1 person), Italy (1 person), the Netherlands (1 person), Argentina (1 person), Malaysia (6 people), Thailand (1 person), Saudi Arabia (1 person), Russia (2 people), Japan (1 person), Turkey (1 person), Poland (1 person), Germany (1 person), Myanmar (1 person), Indonesia (1 person) and Pakistan (1 person).
Note 7: Refers to the number of specialists whose names are included in the Specialist Register of the MCHK as at March 31, 2024, by specialties.

(3) According to the information from the MCHK, since the enactment of the Medical Registration (Amendment) Ordinance 2021, there is as yet no non-locally trained medical graduate, who is a Hong Kong permanent resident holding a recognised medical qualification but has not participated in internship elsewhere, to directly take part in the local Licensing Examination under section 7A(1)(b)(ii) of the MRO.

(4) According to the information from the Hong Kong Academy of Medicine (HKAM), the numbers of non-locally trained doctors admitted by Academy Colleges under the HKAM for specialist training from 2021 to 2023 are as follows:

Year	Specialty	Full Registration		LR		SR
		Employed by HA	Not employed by HA	Employed by HA	Not employed by HA	Employed by HA	Not employed by HA
2021 (Note 8)	Anaesthesiology	0	0	1	0	N.A.
	Community Medicine	0	0	0	1
	Dental Surgery	0	3	0	0
	Emergency Medicine	4	0	1	0
	Family Medicine	8	0	0	0
	Obstetrics and Gynaecology	0	2	0	0
	Orthopaedic	1	0	0	0
	Otorhinolaryngology	0	0	1	0
	Paediatrics	1	0	1	0
	Internal Medicine	11	0	1	0
	Radiology	1	0	0	0
	Sub-total	26	5	5	1	N.A.
2022 (Note 9)	Anaesthesiology	0	0	1	0	0	0
	Community Medicine	0	0	0	2	0	0
	Emergency Medicine	1	0	0	0	0	0
	Family Medicine	6	0	0	0	0	0
	Orthopaedic	4	0	0	0	0	0
	Paediatrics	1	0	1	0	0	0
	Internal Medicine	0	0	3	0	0	0
	Radiology	2	0	0	0	0	0
	Surgery	5	0	0	0	0	0
	Sub-total	19	0	5	2	0	0
2023	Anaesthesiology	0	0	2	0	2	0
	Community Medicine	0	1	0	1	0	0
	Dental Surgery	0	4	0	0	0	0
	Emergency Medicine	3	0	4	0	0	0
	Family Medicine	14	1	1	0	0	0
	Obstetrics and Gynaecology	3	0	1	0	1	0
	Ophthalmology	0	0	2	0	0	0
	Orthopaedic	1	0	0	0	0	0
	Otorhinolaryngology	0	0	1	0	0	0
	Paediatrics	1	0	1	0	0	0
	Pathology	0	0	0	1	0	0
	Internal Medicine	9	0	3	0	3	0
	Psychiatry	0	0	1	0	0	0
	Radiology	1	0	2	0	0	0
	Surgery	2	0	0	0	0	0
	Sub-total	34	6	18	2	6	0
Total		79	11	28	5	6	0

Note 8: The College of Ophthalmologists of Hong Kong, the Hong Kong College of Pathologists, the Hong Kong College of Psychiatrists and the College of Surgeons of Hong Kong did not admit non-locally trained doctors in 2021. 
Note 9: The College of Dental Surgeons of Hong Kong, the College of Ophthalmologists of Hong Kong, the Hong Kong College of Otorhinolaryngologists, the Hong Kong College of Pathologists, the Hong Kong College of Obstetricians and Gynaecologists, and the Hong Kong College of Psychiatrists did not admit non-locally trained doctors in 2022. 

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